Department of Criminology and Sociology, Middlesex University, London, UK.
Department of Psychiatry, University Medical Centre Utrecht, Utrecht, The Netherlands.
Sci Rep. 2022 Jan 10;12(1):461. doi: 10.1038/s41598-021-04266-9.
Oxford Mental Illness and Violence (OxMIV) addresses the need in mental health services for a scalable, transparent and valid tool to predict violent behaviour in patients with severe mental illness. However, external validations are lacking. Therefore, we have used a Dutch sample of general psychiatric patients with schizophrenia spectrum disorders (N = 637) to evaluate the performance of OxMIV in predicting interpersonal violence over 3 years. The predictors and outcome were measured with standardized instruments and multiple sources of information. Patients were mostly male (n = 493, 77%) and, on average, 27 (SD = 7) years old. The outcome rate was 9% (n = 59). Discrimination, as measured by the area under the curve, was moderate at 0.67 (95% confidence interval 0.61-0.73). Calibration-in-the-large was adequate, with a ratio between predicted and observed events of 1.2 and a Brier score of 0.09. At the individual level, risks were systematically underestimated in the original model, which was remedied by recalibrating the intercept and slope of the model. Probability scores generated by the recalibrated model can be used as an adjunct to clinical decision-making in Dutch mental health services.
牛津精神疾病与暴力研究（OxMIV）旨在为精神卫生服务提供一种可扩展、透明且有效的工具，以预测患有严重精神疾病的患者的暴力行为。然而，目前还缺乏外部验证。因此，我们使用了荷兰精神科普通患者的样本，这些患者患有精神分裂症谱系障碍（N=637），以评估 OxMIV 在预测人际暴力方面的 3 年表现。预测因素和结果均采用标准化工具和多种信息来源进行测量。患者主要为男性（n=493，77%），平均年龄为 27 岁（标准差=7 岁）。结果发生率为 9%（n=59）。曲线下面积（AUC）的判别力适中，为 0.67（95%置信区间 0.61-0.73）。大样本校准结果良好，预测事件与观察事件的比例为 1.2，Brier 评分为 0.09。在个体层面，原始模型对风险的系统低估通过重新校准模型的截距和斜率得到了纠正。重新校准后的模型生成的概率评分可作为荷兰精神卫生服务机构临床决策的辅助工具。
