Gariepy Genevieve, Zahan Rifat, Osgood Nathaniel D, Yeoh Benjamin, Graham Eva, Orpana Heather
Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada.
Department of Computer Science, University of Saskatchewan, Saskatoon, SK, Canada.
JMIR Public Health Surveill. 2024 Dec 2;10:e63195. doi: 10.2196/63195.
Suicide remains a public health priority worldwide with over 700,000 deaths annually, ranking as a leading cause of death among young adults. Traditional research methodologies have often fallen short in capturing the multifaceted nature of suicide, focusing on isolated risk factors rather than the complex interplay of individual, social, and environmental influences. Recognizing these limitations, there is a growing recognition of the value of dynamic simulation modeling to inform suicide prevention planning.
This systematic review aims to provide a comprehensive overview of existing dynamic models of population-level suicide and suicide-related behaviors, and to summarize their methodologies, applications, and outcomes.
Eight databases were searched, including MEDLINE, Embase, PsycINFO, Scopus, Compendex, ACM Digital Library, IEEE Xplore, and medRxiv, from inception to July 2023. We developed a search strategy in consultation with a research librarian. Two reviewers independently conducted the title and abstract and full-text screenings including studies using dynamic modeling methods (eg, System Dynamics and agent-based modeling) for suicide or suicide-related behaviors at the population level, and excluding studies on microbiology, bioinformatics, pharmacology, nondynamic modeling methods, and nonprimary modeling reports (eg, editorials and reviews). Reviewers extracted the data using a standardized form and assessed the quality of reporting using the STRESS (Strengthening the Reporting of Empirical Simulation Studies) guidelines. A narrative synthesis was conducted for the included studies.
The search identified 1574 studies, with 22 studies meeting the inclusion criteria, including 15 System Dynamics models, 6 agent-based models, and 1 microsimulation model. The studies primarily targeted populations in Australia and the United States, with some focusing on hypothetical scenarios. The models addressed various interventions ranging from specific clinical and health service interventions, such as mental health service capacity increases, to broader social determinants, including employment programs and reduction in access to means of suicide. The studies demonstrated the utility of dynamic models in identifying the synergistic effects of combined interventions and understanding the temporal dynamics of intervention impacts.
Dynamic modeling of suicide and suicide-related behaviors, though still an emerging area, is expanding rapidly, adapting to a range of questions, settings, and contexts. While the quality of reporting was overall adequate, some studies lacked detailed reporting on model transparency and reproducibility. This review highlights the potential of dynamic modeling as a tool to support decision-making and to further our understanding of the complex dynamics of suicide and its related behaviors.
PROSPERO CRD42022346617; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=346617.
自杀仍是全球公共卫生领域的重点问题，每年有超过70万人死亡，是年轻人的主要死因之一。传统研究方法往往难以全面捕捉自杀的多面性，侧重于孤立的风险因素，而非个人、社会和环境影响的复杂相互作用。认识到这些局限性后，动态模拟建模在为自杀预防规划提供信息方面的价值得到了越来越多的认可。
本系统评价旨在全面概述现有的人群层面自杀及自杀相关行为的动态模型，并总结其方法、应用和结果。
检索了8个数据库，包括MEDLINE、Embase、PsycINFO、Scopus、Compendex、ACM数字图书馆、IEEE Xplore和medRxiv，检索时间从建库至2023年7月。我们与一位研究馆员协商制定了检索策略。两名评审员独立进行标题和摘要筛选以及全文筛选，纳入在人群层面使用动态建模方法（如系统动力学和基于主体的建模）研究自杀或自杀相关行为的研究，排除微生物学、生物信息学、药理学、非动态建模方法以及非主要建模报告（如社论和综述）。评审员使用标准化表格提取数据，并根据STRESS（加强实证模拟研究报告）指南评估报告质量。对纳入的研究进行了叙述性综合分析。
检索共识别出1574项研究，其中22项研究符合纳入标准，包括15个系统动力学模型、6个基于主体的模型和1个微观模拟模型。这些研究主要针对澳大利亚和美国的人群，部分研究关注假设情景。这些模型涉及各种干预措施，从特定的临床和卫生服务干预（如增加心理健康服务能力）到更广泛的社会决定因素，包括就业项目和减少自杀手段的可及性。这些研究证明了动态模型在识别联合干预的协同效应以及理解干预影响的时间动态方面的实用性。
自杀及自杀相关行为的动态建模虽然仍是一个新兴领域，但正在迅速发展，适用于一系列问题、环境和背景。虽然报告质量总体上是足够的，但一些研究缺乏关于模型透明度和可重复性的详细报告。本综述强调了动态建模作为一种支持决策以及加深我们对自杀及其相关行为复杂动态理解的工具的潜力。
PROSPERO CRD42022346617；https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=346617
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