ArticlePediatric emergency care2025
Accuracy of ICD-10 Codes for Suicidal Ideation and Action in Pediatric Emergency Department Encounters.
Article in Pediatric emergency care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Suicidality-Related Emergency Department Visits Among US Children and Adolescents, 2016-2022.JAACAP open · 2026Article
- Youth visiting the emergency department after a suicide attempt, suicidal ideation or non-suicidal self-injury: trends, repeat visits and costs.BJPsych open · 2026Article
- Identifying Undiagnosed High-Risk Suicidality Cases by Matching Patients With a Similar Comorbidity Burden: Retrospective Observational Study.JMIR formative research · 2026Observational
- Suicidal thoughts and behaviours in pre-adolescent children: a population-based study in Olmsted County, Minnesota.BMJ open · 2026Article
- COVID-19 and risk of self-harm, suicidal ideation, and poisoning in children and adolescents.Annals of medicine · 2025Article
- Screening and Risk Algorithms for Detecting Pediatric Suicide Risk in the Emergency Department.JAMA network open · 2025Article
- Identifying undiagnosed high-risk suicidality cases through comorbidity-adjusted risk modeling.medRxiv : the preprint server for health sciences · 2025Article
- Retrospective studies in emergency medicine: A practical guide to study design, bias, confounding, and interpretation.Turkish journal of emergency medicineReview
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Abstract
objectivesAccording to the ideation-to-action framework of suicidality, suicidal ideation and suicidal action arise via distinct trajectories. Studying suicidality under this framework requires accurate identification of both ideation and action. We sought to assess the accuracy of International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes for suicidal ideation and action in emergency department encounters.
methodsAccuracy of ICD-10-CM coding for suicidality was assessed through chart review of clinical notes for 205 emergency department encounters among patients 6-18 years old at a large academic pediatric hospital between June 1, 2016 and June 1, 2022. Physician notes were reviewed for documentation of past or present suicidal ideation, suicidal action, or both. The study cohort consisted of 103 randomly selected "cases," or encounters assigned at least 1 ICD-10-CM code for suicidality, and 102 propensity-matched "noncases" lacking ICD-10-CM codes. Accuracy of ICD-10-CM codes was assessed using sensitivity, specificity, positive predictive value, and negative predictive value.
resultsAgainst a gold standard chart review, the positive predictive value for ICD-10-CM suicidality codes was 86.9% (95% confidence interval [CI]: 84.5%-89.3%), and the negative predictive value was 76.2% (95% CI: 73.2%-79.2%). Nearly half of encounters involving suicidality were not captured by ICD-10-CM coding (sensitivity = 53.4%; 95% CI: 49.9%-56.9%). Sensitivity was higher for ideation-present (82.4%, 95% CI: 77.7%-87.1%) than for action-present (33.7%, 95% CI: 27.9%-39.5%) or action-past (20.4%, 95% CI: 15.5%-25.3%).
conclusionsMany cases of suicidality may be missed by relying on only ICD-10-CM codes. Accuracy of ICD-10-CM codes is high for suicidal ideation but low for action. To scale the ideation-to-action model for use in large populations, better data sources are needed to identify cases of suicidal action.
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