ArticleHealth services research2020
Relative accuracy of social and medical determinants of suicide in electronic health records.
Article in Health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Suicide Risk and Protective Factors Among Medicaid-Enrolled Black Youth With a Mental Health Diagnosis.JAMA network open · 2026Article
- Predicting suicide death among veterans after psychiatric hospitalization using transformer based models with social determinants and NLP.Scientific reports · 2025Article
- Barriers and Solutions to Efficient Health Care AI Implementation.JAMA network open · 2025Article
- Scoping review of military veterans involved in the criminal legal system and their health and healthcare: 5-year update and map to the Veterans-Sequential Intercept Model.Health & justice · 2024Article
- High dimensional predictions of suicide risk in 4.2 million US Veterans using ensemble transfer learning.Scientific reports · 2024Article
- Realizing the potential of social determinants data in EHR systems: A scoping review of approaches for screening, linkage, extraction, analysis, and interventions.Journal of clinical and translational science · 2024Article
- How legal problems are conceptualized and measured in healthcare settings: a systematic review.Health & justice · 2023Article
- Comparing mental and physical health of U.S. veterans by VA healthcare use: implications for generalizability of research in the VA electronic health records.BMC health services research · 2022Article
- Hospitalizations for COVID-19 Among US People Experiencing Incarceration or Homelessness.JAMA network open · 2022Article
- Relative accuracy of social and medical determinants of suicide in electronic health records.Health services research · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectiveThis paper compares the accuracy of predicting suicide from Social Determinants of Health (SDoH) or history of illness. POPULATION STUDIED: 5 313 965 Veterans who at least had two primary care visits between 2008 and 2016. STUDY
designThe dependent variable was suicide or intentional self-injury. The independent variables were 10 495 International Classification of Disease (ICD) Version 9 codes, age, and gender. The ICD codes included 40 V-codes used for measuring SDoH, such as family disruption, family history of substance abuse, lack of education, legal impediments, social isolation, unemployment, and homelessness. The sample was randomly divided into training (90 percent) and validation (10 percent) sets. Area under the receiver operating characteristic (AROC) was used to measure accuracy of predictions in the validation set. PRINCIPAL
findingsSeparate analyses were done for inpatient and outpatient codes; the results were similar. In the hospitalized group, the mean age was 67.2 years, and 92.1 percent were male. The mean number of medical diagnostic codes during the study period was 37; and 12.9 percent had at least one SDoH V-code. At least one episode of suicide or intentional self-injury occurred in 1.89 percent of cases. SDoH V-codes, on average, elevated the risk of suicide or intentional self-injury by 24-fold (ranging from 4- to 86-fold). An index of 40 SDoH codes predicted suicide or intentional self-injury with an AROC of 0.64. An index of 10 445 medical diagnoses, without SDoH V-codes, had AROC of 0.77. The combined SDoH and medical diagnoses codes also had AROC of 0.77.
conclusionIn predicting suicide or intentional self-harm, SDoH V-codes add negligible information beyond what is already available in medical diagnosis codes. IMPLICATIONS FOR PRACTICE: Policies that affect SDoH (eg, housing policies, resilience training) may not have an impact on suicide rates, if they do not change the underlying medical causes of SDoH.
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