Evidence map›Paper›PMID 33000061›Full record

ArticleJournal of the American College of Emergency Physicians open2020

An investigation of clinical decisionmaking: identifying important factors in treatment planning for suicidal patients in the emergency department.

Anne C Knorr, Brooke A Ammerman, Sean A LaFleur, Debdipto Misra, Mathrawala A Dhruv, Bipin Karunakaran, Robert J Strony

Open access · goldAbstract read
In one paragraph

Article in Journal of the American College of Emergency Physicians open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 27% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Anne C KnorrDepartment of Emergency Medicine Geisinger Medical Center Danville Pennsylvania USA.
Brooke A AmmermanDepartment of Psychology University of Notre Dame Notre Dame Indiana USA.
Sean A LaFleurDepartment of Emergency Medicine Geisinger Medical Center Danville Pennsylvania USA.
Debdipto MisraGeisinger System Services UDA Data Management Danville Pennsylvania USA.
Mathrawala A DhruvGeisinger System Services UDA Data Management Danville Pennsylvania USA.
Bipin KarunakaranGeisinger System Services UDA Data Management Danville Pennsylvania USA.
Robert J StronyDepartment of Emergency Medicine Geisinger Medical Center Danville Pennsylvania USA.
Data Management Services (United States) · USGeisinger Medical Center · USUniversity of Notre Dame · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveWe sought to evaluate the influence of several well-documented, readily available risk factors that may influence a psychiatric consultant's decision to admit an emergency department (ED) patient reporting suicidal ideation for psychiatric hospitalization.

methodsWe conducted a retrospective study of adult patients presenting to six affiliated EDs within Pennsylvania from January 2015 to June 2017. We identified 533 patients reporting current active suicidal ideation and receiving a complete psychiatric consultation. Socio-demographic characteristics, psychiatric presentation and history, and disposition were collected. Decision tree analysis was conducted with disposition as the outcome.

resultsFour of 27 variables emerged as most influential to decisionmaking, including psychiatric consultant determination of current suicide risk, patient age, current depressive disorder diagnosis, and patient history of physical violence. Likelihood of admission versus discharge ranged from 97% to 58%, depending on the variables considered. Post hoc analysis indicated that current suicide plan, access to means, lack of social support, and suicide attempt history were significantly associated with psychiatric consultant determination of moderate-to-high suicide risk, with small-to-medium effect sizes emerging.

conclusionsOnly a handful of variables drive disposition decisions for ED patients reporting current active suicidal ideation, with both high and low fidelity decisions made. Patient suicide risk, determined by considering empirically supported risk factors for suicide attempt and death, contributes the greatest influence on a psychiatric consultant's decision to admit. In line with American College of Emergency Physicians (ACEP) recommendations, this study accentuates the importance of using clinical judgment and adjunct measures to determine patient disposition within this population.

Identifiers

PMID33000061
PMCPMC7493507
OpenAlexW3031195565

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.