Department of Population Health Sciences, Weill Cornell Medicine, USA.
Artificial Intelligence Institute, University of South Carolina, USA.
AMIA Jt Summits Transl Sci Proc. 2021 May 17;2021:364-373. eCollection 2021.
Suicide is the 10 leading cause of death in the US and the 2 leading cause of death among teenagers. Clinical and psychosocial factors contribute to suicide risk (SRFs), although documentation and self-expression of such factors in EHRs and social networks vary. This study investigates the degree of variance across EHRs and social networks. We performed subjective analysis of SRFs, such as self-harm, bullying, impulsivity, family violence/discord, using >13.8 Million clinical notes on 123,703 patients with mental health conditions. We clustered clinical notes using semantic embeddings under a set of SRFs. Likewise, we clustered 2180 suicidal users on r/SuicideWatch (~30,000 posts) and performed comparative analysis. Top-3 SRFs documented in EHRs were depressive feelings (24.3%), psychological disorders (21.1%), drug abuse (18.2%). In r/SuicideWatch, gun-ownership (17.3%), self-harm (14.6%), bullying (13.2%) were Top-3 SRFs. Mentions of Family violence, racial discrimination, and other important SRFs contributing to suicide risk were missing from both platforms.
自杀是美国的第 10 大主要死因,也是青少年的第 2 大主要死因。临床和社会心理因素导致自杀风险 (SRFs),尽管电子健康记录 (EHRs) 和社交网络中对此类因素的记录和自我表达存在差异。本研究调查了 EHRs 和社交网络之间的差异程度。我们使用 123,703 名患有精神健康状况的患者的超过 1380 万份临床记录,对自杀风险因素(如自残、欺凌、冲动、家庭暴力/不和)进行了主观分析。我们使用语义嵌入在一组自杀风险因素下对临床记录进行聚类。同样,我们对 r/SuicideWatch 上的 2180 名自杀用户(约 30,000 个帖子)进行了聚类,并进行了比较分析。在 EHR 中记录的前 3 个自杀风险因素是抑郁感 (24.3%)、心理障碍 (21.1%)、药物滥用 (18.2%)。在 r/SuicideWatch 上,枪支拥有 (17.3%)、自残 (14.6%)、欺凌 (13.2%) 是前 3 个自杀风险因素。两个平台都没有提到家庭暴力、种族歧视和其他导致自杀风险的重要自杀风险因素。