Vanderbilt University Medical Center, Nashville, TN, Department of Biomedical Informatics.
AMIA Annu Symp Proc. 2023 Apr 29;2022:644-652. eCollection 2022.
Suicide is a significant and rising threat to public health. In the United States, 47,500 people died from suicide in 2019, a 10-year increase of 30%. Many researchers are interested in studying the risk factors associated with suicidal ideation and suicide attempt to help inform clinical screening, intervention, and prevention efforts. Many suicide risk factor analyses draw from clinical subdomains and quantify risk factors independently. While traditional modeling approaches might assume independence between risk factors, current suicide research suggests that the development of suicidal intent is a complex, multifactorial process. Thus, it may be beneficial to how suicide risk-factors interact with one another. In this study, we used network analysis to generate visual suicidality risk relationship diagrams. We extract medical concepts from free-text clinical notes and generate cooccurrence-based risk networks for suicidal ideation and suicide attempt. In addition, we generate a network of risk factors for suicidal ideation which evolves into a suicide attempt. Our networks were able to replicate existing risk factor findings and provide additional insight into the degree to which risk factors behave as independent morbidities or as interacting comorbidities with other risk factors. These results highlight potential avenues for risk factor analyses of complex outcomes using network analysis.
自杀是对公共健康的重大且日益严重的威胁。在美国,2019 年有 47500 人死于自杀,这是 10 年来增长了 30%。许多研究人员有兴趣研究与自杀意念和自杀未遂相关的风险因素,以帮助为临床筛查、干预和预防工作提供信息。许多自杀风险因素分析从临床子领域中提取,并独立量化风险因素。虽然传统的建模方法可能假设风险因素之间相互独立,但当前的自杀研究表明,自杀意图的发展是一个复杂的、多因素的过程。因此,了解自杀风险因素之间如何相互作用可能会有所帮助。在这项研究中,我们使用网络分析生成可视化的自杀风险关系图。我们从自由文本临床记录中提取医学概念,并为自杀意念和自杀未遂生成基于共现的风险网络。此外,我们生成了一个自杀意念的风险因素网络,该网络演变成自杀未遂。我们的网络能够复制现有的风险因素发现,并提供更多关于风险因素是作为独立的病态还是作为与其他风险因素相互作用的共病存在的程度的见解。这些结果突出了使用网络分析对复杂结果进行风险因素分析的潜在途径。