SynthesisPloS one2017
Instruments for the assessment of suicide risk: A systematic review evaluating the certainty of the evidence.
Synthesis in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 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
88 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Association of resting-state EEG with suicidality in depressed patients: a systematic review.BMC psychiatry · 2025Pooled it
- Actionable Steps for Preventing Firearm Suicides among Adolescents and Young Adults.North Carolina medical journal · 2023Pooled it
- Tools to Detect Risk of Death by Suicide: A Systematic Review and Meta-Analysis.The Journal of clinical psychiatry · 2022Pooled it
- Hospital presenting suicidal ideation: A systematic review.Clinical psychology & psychotherapy · 2022Pooled it
- Shared understanding of resilient practices in the context of inpatient suicide prevention: a narrative synthesis.BMC health services research · 2022Pooled it
- Increased C-reactive protein concentration and suicidal behavior in people with psychiatric disorders: A systematic review and meta-analysis.Acta psychiatrica Scandinavica · 2021Pooled it
- Are we Using the Right Evidence to Inform Suicide Prevention in Low- and Middle-Income Countries? An Umbrella Review.Archives of suicide research : official journal of the International Academy for Suicide ResearchPooled it
- Using Machine Learning to Predict Suicide Attempts in Military Personnel.Psychiatry research · 2020Trial
- Suicide Risk Screening: A New Method to Identify At-Risk Students from General College Populations.Behavioral sciences (Basel, Switzerland) · 2026Article
- Predicting Mental Health Risk from Early-Life Adversity: A Population-Based Study of Canadian Adults: Prédiction du risque pour la santé mentale liée à l'adversité en début de vie : Étude fondée sur une population d'adultes canadiens.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2026Article
- The course and remission of suicidality from ages 11 to 29: findings from a Dutch population-based longitudinal cohort study.BMC pediatrics · 2026Article
- Development and validation of the SuPr-10 questionnaire for suicidality assessment in primary care patients with depressive symptoms.Scientific reports · 2026Article
- Cultural Considerations in Suicide Risk Assessment with Immigrant and Refugee Populations in Canada.Transcultural psychiatry · 2026Review
- Anxiety is associated with increased risk of suicidality in Parkinson's disease.Journal of Parkinson's disease · 2026Article
- Characterizing suicidal intent among suicidal adolescents: a systematic review.Child and adolescent psychiatry and mental health · 2026Review
- Using the theory of positive disintegration's 'dynamisms' to gauge retrospective suicide lived experience.Frontiers in psychology · 2026Article
- The development and evaluation of the Patient-Controlled Admission Fidelity Checklist.Frontiers in psychiatry · 2026Article
- The assessment of suicidality in psychiatric trials: a protocol for a scoping review.Systematic reviews · 2025Article
- Clinical characteristics and suicidal ideation as predictors of suicide: prospective study of 1000 referrals to general adult psychiatry.BJPsych bulletin · 2025Article
- Predictive Validity and Cutoff Scores of the Revised Suicide Crisis Inventory in Korean Adults: A One-Year Follow-Up Study.Psychiatry investigation · 2025Article
28 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
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInstruments have been developed to facilitate suicide risk assessment. We aimed to evaluate the evidence for these instruments including assessment of risk of bias and diagnostic accuracy for suicide and suicide attempt.
methodsPubMed (NLM), PsycInfo, Embase, Cinahl and the Cochrane Library databases were searched until December 2014. We assessed risk of bias with QUADAS-2. The average sensitivity and specificity of each instrument was estimated and the certainty of the evidence was assessed with GRADE. We considered instruments with a sensitivity > 80% and a specificity > 50% to have sufficient diagnostic accuracy.
resultsThirty-five relevant studies were identified but 14 were considered to have high risk of bias, leaving 21 studies evaluating altogether 15 risk assessment instruments. We could carry out meta-analyses for five instruments. For the outcome suicide attempt SAD PERSONS Scale had a sensitivity of 15% (95% CI 8-24) and specificity of 97% (96-98), and the Manchester Self-Harm Rule (MSHR) a sensitivity of 97% (97-97) and a specificity of 20% (20-21). ReACT, which is a modification of MSHR, had a similar low specificity, as did the Sodersjukhuset Self Harm Rule. For the outcome suicide, the Beck Hopelessness Scale had a sensitivity of 89% (78-95) and specificity of 42% (40-43).
conclusionsMost suicide risk assessment instruments were supported by too few studies to allow for evaluation of accuracy. Among those that could be evaluated, none fulfilled requirements for sufficient diagnostic accuracy.
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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.