SynthesisBMJ (Clinical research ed.)2012
Use of risk assessment instruments to predict violence and antisocial behaviour in 73 samples involving 24 827 people: systematic review and meta-analysis.
Synthesis in BMJ (Clinical research ed.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 93 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
93 citing papers in PubMed, 7 syntheses or guidelines pooled it, 521 citations in OpenAlex.
- Pooled it
- Violence risk assessment instruments in forensic psychiatric populations: a systematic review and meta-analysis.The lancet. Psychiatry · 2023Pooled it
- Pooled it
- Use of risk assessment instruments to predict violence in forensic psychiatric hospitals: a systematic review and meta-analysis.European psychiatry : the journal of the Association of European Psychiatrists · 2018Pooled it
- Patient outcomes following discharge from secure psychiatric hospitals: systematic review and meta-analysis.The British journal of psychiatry : the journal of mental science · 2016Pooled it
- Violence risk assessment in psychiatric patients in China: A systematic review.The Australian and New Zealand journal of psychiatry · 2016Pooled it
- Pooled it
- A randomized controlled trial of moral reconation therapy to reduce risk for criminal recidivism among justice-involved adults in mental health residential treatment.Journal of consulting and clinical psychology · 2022Trial
- Judgments of predictability, preventability and causation of mental health homicides in England 2010 - 2023.Medicine, science, and the law · 2026Article
- Improving risk assessment in forensic mental health: Temporal validation and clinical refinement of the FoVOx risk tool.European psychiatry : the journal of the Association of European Psychiatrists · 2026Article
- Neuroscience informed risk assessment and management in forensic mental healthcare: a qualitative analysis of ethical and legal challenges and practice-oriented recommendations.Frontiers in psychology · 2026Article
- A review of progress in violence risk assessment methods.Forensic sciences research · 2025Review
- Low cholesterol and risk of violence in forensic inpatients with schizophrenia, personality disorder or dual diagnosis: same or different?European psychiatry : the journal of the Association of European Psychiatrists · 2025Article
- Dangerousness Index in Forensic Psychiatric Examination: A Tool for Aiding Medical Decision Regarding the Risk of Antisocial Acts.Diagnostics (Basel, Switzerland) · 2025Article
- Hierarchical machine learning model integrating clinical history and nursing observations for predicting violent behavior in hospitalized schizophrenia patients.Frontiers in psychiatry · 2025Article
- Discriminative and predictive validity of risk assessment measures for women incarcerated for serious violent offences in Australia.Psychiatry, psychology, and law : an interdisciplinary journal of the Australian and New Zealand Association of Psychiatry, Psychology and Law · 2024Article
- Article
- Out of their minds? Externalist challenges for using AI in forensic psychiatry.Frontiers in psychiatry · 2023Review
- Patterns of risk-Using machine learning and structural neuroimaging to identify pedophilic offenders.Frontiers in psychiatry · 2023Article
- Evidence-based sentencing and scientific evidence.Frontiers in psychology · 2023Review
33 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 3 countries.
Funding
Abstract
objectiveTo investigate the predictive validity of tools commonly used to assess the risk of violence, sexual, and criminal behaviour.
designSystematic review and tabular meta-analysis of replication studies following PRISMA guidelines. DATA SOURCES: PsycINFO, Embase, Medline, and United States Criminal Justice Reference Service Abstracts. REVIEW
methodsWe included replication studies from 1 January 1995 to 1 January 2011 if they provided contingency data for the offending outcome that the tools were designed to predict. We calculated the diagnostic odds ratio, sensitivity, specificity, area under the curve, positive predictive value, negative predictive value, the number needed to detain to prevent one offence, as well as a novel performance indicator-the number safely discharged. We investigated potential sources of heterogeneity using metaregression and subgroup analyses.
resultsRisk assessments were conducted on 73 samples comprising 24,847 participants from 13 countries, of whom 5879 (23.7%) offended over an average of 49.6 months. When used to predict violent offending, risk assessment tools produced low to moderate positive predictive values (median 41%, interquartile range 27-60%) and higher negative predictive values (91%, 81-95%), and a corresponding median number needed to detain of 2 (2-4) and number safely discharged of 10 (4-18). Instruments designed to predict violent offending performed better than those aimed at predicting sexual or general crime.
conclusionsAlthough risk assessment tools are widely used in clinical and criminal justice settings, their predictive accuracy varies depending on how they are used. They seem to identify low risk individuals with high levels of accuracy, but their use as sole determinants of detention, sentencing, and release is not supported by the current evidence. Further research is needed to examine their contribution to treatment and management.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.