ArticleJournal of general internal medicine2020
A Quasi-Experimental Analysis of Lethal Means Assessment and Risk for Subsequent Suicide Attempts and Deaths.
Article in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
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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
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Actionable Steps for Preventing Firearm Suicides among Adolescents and Young Adults.North Carolina medical journal · 2023Pooled it
- Circumstances Preceding Firearm Suicide Deaths in a Large Sample of Hispanic/Latino Adults: Findings From a Content Analysis.AJPM focus · 2026Article
- Personal Circumstances Preceding Firearm Suicide Death Among Black Adults in the United States.Journal of racial and ethnic health disparities · 2025Article
- Evaluating the Effect of Routine Lethal Means Counseling in the Emergency Department on Suicide Mortality Among Mental Health Patients.AJPM focus · 2025Article
- Deliberate dietary adjustments may not mitigate the progression of glaucoma: A two-sample Mendelian randomization study.Medicine · 2025Article
- Mental and Physical Health-Related Risk Factors Among Females Who Died by Firearm Suicide.JAMA network open · 2025Article
- Suicide Prevention and Telehealth in Children's Hospital Emergency Departments.Pediatric emergency care · 2025Article
- Suicide Screening, Risk Assessment, and Lethal Means Counseling During Zero Suicide Implementation.Psychiatric services (Washington, D.C.) · 2024Article
- Reducing Firearm Access for Suicide Prevention: Implementation Evaluation of the Web-Based "Lock to Live" Decision Aid in Routine Health Care Encounters.JMIR medical informatics · 2024Article
- Pathogenic Factor Analysis of Shoulder Periarthritis and Design of Virtual Reality Exercise Intervention System.Applied bionics and biomechanics · 2024Article
- A study exploring the causal relationship between glaucoma and anxiety disorders.Frontiers in medicine · 2024Article
- The implementation of a zero-suicide framework in a child and youth mental health service in Australia: processes and learnings.Frontiers in psychiatry · 2024Article
- Mendelian randomization analysis reveals a causal relationship between preterm birth and myopia risk.Frontiers in pediatrics · 2024Article
- Causal relationship between ulcerative colitis and male infertility: A two-sample Mendelian randomization study.PloS one · 2024Article
- Critical gaps in understanding firearm suicide in Hispanic communities: demographics, mental health, and access to care.Health affairs scholar · 2023Article
- Older adults and planning for firearm safety: A qualitative study of healthcare providers.Journal of the American Geriatrics Society · 2023Article
- Practices, knowledge, and concerns for out-of-home firearm storage among those with access to firearms: results from a survey in two states.Injury epidemiology · 2023Article
- Integration of extreme risk protection orders into the clinical workflow: Qualitative comparison of clinician perspectives.PloS one · 2023Article
- Employee attitudes toward suicide prevention and Counseling on Access to Lethal Means: initial findings from an academic medical center implementing the Zero Suicide framework.Frontiers in public health · 2023Article
- Patient and Clinician Perspectives of a Standardized Question About Firearm Access to Support Suicide Prevention: A Qualitative Study.JAMA health forum · 2022Article
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 at 3 institutions in 1 country.
Funding
Abstract
backgroundCounseling on access to lethal means is highly recommended for patients with suicide risk, but there are no formal evaluations of its impact in real-world settings.
objectiveEvaluate whether lethal means assessment reduces the likelihood of suicide attempt and death outcomes.
designQuasi-experimental design using an instrumental variable to overcome confounding due to unmeasured patient characteristics that could influence provider decisions to deliver lethal means assessment.
settingKaiser Permanente Colorado, an integrated health system serving over 600,000 members, with comprehensive capture of all electronic health records, medical claims, and death information.
participantsAdult patients who endorsed suicide ideation on the Patient Health Questionnaire-9 (PHQ-9) depression screener administered in behavioral health and primary care settings from 2010 to 2016.
interventionsProvider documentation of lethal means assessment in the text of clinical notes, collected using a validated Natural Language Processing program. MEASUREMENTS: Main outcome was ICD-9 or ICD-10 codes for self-inflicted injury or suicide death within 180 days of index PHQ-9 event.
resultsWe found 33% of patients with suicide ideation reported on the PHQ-9 received lethal means assessment in the 30 days following identification. Lethal means assessment reduced the risk of a suicide attempt or death within 180 days from 3.3 to 0.83% (p = .034, 95% CI = .069-.9). LIMITATIONS: Unmeasured suicide prevention practices that co-occur with lethal means assessment may contribute to the effects observed.
conclusionsClinicians should expand the use of counseling on access to lethal means, along with co-occurring suicide prevention practices, to all patients who report suicide ideation.
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What OpenQuestion holds
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.