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Computerized Adaptive Test for Suicide Risk Shows Predictive Accuracy 1 Year Out
Scores on the Computerized Adaptive Test Suicide Scale (CAT-SS) were strongly associated with future suicide-related outcomes in US veterans over 12 months, according to study results published in PLoS One.
“Although results, in terms of such associations, were similar at 6- and 12-months, the strength of associations increased with repeated CAT-SS assessment,” researchers wrote. “These findings highlight the utility of the CAT-SS for both initial identification and continued monitoring of risk.”
Developed by Adaptive Testing Technologies, the CAT-SS is an adaptive measure that spans 111 items to measure suicide risk severity on a 100-point scale. To validate the tool, researchers had 305 patients seeking care at a Veterans Administration medical center complete the CAT-SS, as well as the Columbia-Suicide Severity Rating Scale and the Structured Clinical Interview for DSM-5 Disorders Research Version, at baseline and again at 6- and 12-month appointments.
Screening for Suicidal Ideation in the Emergency Department
At 6 and 12 months, baseline CAT-SS scores showed predictive accuracy for all suicide outcomes: active ideation with plan and intent; attempt; interrupted, aborted or self -interrupted attempt, or preparatory acts or behaviors; and all outcomes combined, researchers reported.
For every 10-point change on the CAT-SS, the likelihood of suicide-related outcomes increased 50% to 77%, analysis showed. Furthermore, the predictive accuracy of the CAT-SS for future suicide-related thoughts and behaviors outperformed the clinical gold standard of a suicide attempt in the past year.
On average, the CAT-SS measured a patient’s suicide risk severity using just 10 items, which took less than 2 minutes to complete.
“[A]dditional work is required to evaluate where the CAT-SS could be implemented in clinical settings. Efforts aimed at exploring this are warranted,” researchers wrote. “Nonetheless, findings from this study suggest that if implemented in the electronic medical record, the CAT-SS would be expected to rapidly facilitate precise and personalized screening and assessment of suicide risk severity.”
References
Researchers from the veteran's health administration, academia, and adaptive testing technologies validate the Computerized Adaptive Test Suicide Scale (CAT-SS) for US military veterans. News release. Adaptive Testing Technologies. January 25, 2022. Accessed February 11, 2022.
