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WASHINGTON – Using machine learning and data from 2,466 Apache tribal members, researchers developed a formula for predicting suicide attempts among youths aged 15-24 years with a “pretty high” level of accuracy, Emily E. Haroz, PhD, said at the annual conference of the American Association of Suicidology.
The area under the receiver operating characteristic curve for the best performing predictive model was 0.806, said Dr. Haroz, a psychiatric epidemiologist at Johns Hopkins University in Baltimore. This compared with an area under the curve of 0.57 for prediction based solely on prior attempts, which is a “very low” predictive score, Dr. Haroz noted. The area under the curve is a performance measure used widely to make predictions.
Previously, colleagues of Dr. Haroz from the Johns Hopkins Center for American Indian Health reported that implementation of the Celebrating Life surveillance system in 2007 strongly linked with a dramatic reduction in suicide deaths on the Apache reservation during 2007-2012, compared with 2001-2006. Overall, Apache suicide deaths fell from 40/100,000 during the earlier period to 25/100,000 after the Celebrating Life program began, a 38% relative reduction (Am J Public Health. 2016. Dec; 106[12]:183-9). Among youths aged 15-24 years old, the suicide death rate dropped from 129/100,000 to 99/100,000, a 23% relative decrease.
“We don’t really know much about how to predict suicide risk,” Dr. Haroz noted, and most of what’s known has been based on retrospective data from hospital-based surveillance. Improved prediction models can help case managers more quickly identify and focus on people who are at highest risk, she added.
Other researchers from the Johns Hopkins Center for American Indian Health described a new intervention program they have developed in collaboration with the Apache tribal leaders that uses tribal elders to teach tribal culture, values, and beliefs to students 11-15 years old. Begun in 2015, “we see this as upstream suicide prevention,” said Victoria O’Keefe, PhD, a clinical psychologist with the Johns Hopkins program. “What is unique about the program is that the elders go into the classrooms,” for 45- to 60-minute sessions done monthly.
Questionnaires completed by participating students at the start of the program highlighted how ubiquitous suicide remains in the Apache community. A quarter of the students said they had a family member who had attempted suicide, more than a third knew a friend who had attempted suicide, and 15% reported losing a friend, sibling, or parent to suicide. In addition, roughly half of the students said that they knew an adult who was important in their life with a substance abuse problem, that they had no strong sense of belonging to an ethnic culture, and that they had not spent time learning about their culture, Dr. O’Keefe said.
Initial data from questionnaires completed at the end of the elders program showed high levels of enjoyment among the students and high levels of retention of some information. For example, after the elders’ program, 96% could identify their clan, and 96% could say what is sacred about the Apache land, she noted. Further data analysis is in progress, Dr. O’Keefe said, and she and her associates are adapting the elders program for use by other Native communities.
Dr. Haroz, Dr. O’Keefe, Ms. Goklish, and Dr. Cwik had no disclosures.
WASHINGTON – Using machine learning and data from 2,466 Apache tribal members, researchers developed a formula for predicting suicide attempts among youths aged 15-24 years with a “pretty high” level of accuracy, Emily E. Haroz, PhD, said at the annual conference of the American Association of Suicidology.
The area under the receiver operating characteristic curve for the best performing predictive model was 0.806, said Dr. Haroz, a psychiatric epidemiologist at Johns Hopkins University in Baltimore. This compared with an area under the curve of 0.57 for prediction based solely on prior attempts, which is a “very low” predictive score, Dr. Haroz noted. The area under the curve is a performance measure used widely to make predictions.
Previously, colleagues of Dr. Haroz from the Johns Hopkins Center for American Indian Health reported that implementation of the Celebrating Life surveillance system in 2007 strongly linked with a dramatic reduction in suicide deaths on the Apache reservation during 2007-2012, compared with 2001-2006. Overall, Apache suicide deaths fell from 40/100,000 during the earlier period to 25/100,000 after the Celebrating Life program began, a 38% relative reduction (Am J Public Health. 2016. Dec; 106[12]:183-9). Among youths aged 15-24 years old, the suicide death rate dropped from 129/100,000 to 99/100,000, a 23% relative decrease.
“We don’t really know much about how to predict suicide risk,” Dr. Haroz noted, and most of what’s known has been based on retrospective data from hospital-based surveillance. Improved prediction models can help case managers more quickly identify and focus on people who are at highest risk, she added.
Other researchers from the Johns Hopkins Center for American Indian Health described a new intervention program they have developed in collaboration with the Apache tribal leaders that uses tribal elders to teach tribal culture, values, and beliefs to students 11-15 years old. Begun in 2015, “we see this as upstream suicide prevention,” said Victoria O’Keefe, PhD, a clinical psychologist with the Johns Hopkins program. “What is unique about the program is that the elders go into the classrooms,” for 45- to 60-minute sessions done monthly.
Questionnaires completed by participating students at the start of the program highlighted how ubiquitous suicide remains in the Apache community. A quarter of the students said they had a family member who had attempted suicide, more than a third knew a friend who had attempted suicide, and 15% reported losing a friend, sibling, or parent to suicide. In addition, roughly half of the students said that they knew an adult who was important in their life with a substance abuse problem, that they had no strong sense of belonging to an ethnic culture, and that they had not spent time learning about their culture, Dr. O’Keefe said.
Initial data from questionnaires completed at the end of the elders program showed high levels of enjoyment among the students and high levels of retention of some information. For example, after the elders’ program, 96% could identify their clan, and 96% could say what is sacred about the Apache land, she noted. Further data analysis is in progress, Dr. O’Keefe said, and she and her associates are adapting the elders program for use by other Native communities.
Dr. Haroz, Dr. O’Keefe, Ms. Goklish, and Dr. Cwik had no disclosures.
WASHINGTON – Using machine learning and data from 2,466 Apache tribal members, researchers developed a formula for predicting suicide attempts among youths aged 15-24 years with a “pretty high” level of accuracy, Emily E. Haroz, PhD, said at the annual conference of the American Association of Suicidology.
The area under the receiver operating characteristic curve for the best performing predictive model was 0.806, said Dr. Haroz, a psychiatric epidemiologist at Johns Hopkins University in Baltimore. This compared with an area under the curve of 0.57 for prediction based solely on prior attempts, which is a “very low” predictive score, Dr. Haroz noted. The area under the curve is a performance measure used widely to make predictions.
Previously, colleagues of Dr. Haroz from the Johns Hopkins Center for American Indian Health reported that implementation of the Celebrating Life surveillance system in 2007 strongly linked with a dramatic reduction in suicide deaths on the Apache reservation during 2007-2012, compared with 2001-2006. Overall, Apache suicide deaths fell from 40/100,000 during the earlier period to 25/100,000 after the Celebrating Life program began, a 38% relative reduction (Am J Public Health. 2016. Dec; 106[12]:183-9). Among youths aged 15-24 years old, the suicide death rate dropped from 129/100,000 to 99/100,000, a 23% relative decrease.
“We don’t really know much about how to predict suicide risk,” Dr. Haroz noted, and most of what’s known has been based on retrospective data from hospital-based surveillance. Improved prediction models can help case managers more quickly identify and focus on people who are at highest risk, she added.
Other researchers from the Johns Hopkins Center for American Indian Health described a new intervention program they have developed in collaboration with the Apache tribal leaders that uses tribal elders to teach tribal culture, values, and beliefs to students 11-15 years old. Begun in 2015, “we see this as upstream suicide prevention,” said Victoria O’Keefe, PhD, a clinical psychologist with the Johns Hopkins program. “What is unique about the program is that the elders go into the classrooms,” for 45- to 60-minute sessions done monthly.
Questionnaires completed by participating students at the start of the program highlighted how ubiquitous suicide remains in the Apache community. A quarter of the students said they had a family member who had attempted suicide, more than a third knew a friend who had attempted suicide, and 15% reported losing a friend, sibling, or parent to suicide. In addition, roughly half of the students said that they knew an adult who was important in their life with a substance abuse problem, that they had no strong sense of belonging to an ethnic culture, and that they had not spent time learning about their culture, Dr. O’Keefe said.
Initial data from questionnaires completed at the end of the elders program showed high levels of enjoyment among the students and high levels of retention of some information. For example, after the elders’ program, 96% could identify their clan, and 96% could say what is sacred about the Apache land, she noted. Further data analysis is in progress, Dr. O’Keefe said, and she and her associates are adapting the elders program for use by other Native communities.
Dr. Haroz, Dr. O’Keefe, Ms. Goklish, and Dr. Cwik had no disclosures.
Key clinical point: The machine-learning process used data collected through the prospective surveillance program on suicide ideation, nonsuicidal self-injury, suicide attempts, binge substance use, and suicide deaths.
Major finding: The new formula produced an area under the receiver operating characteristic curve of 0.806 for predicting youth suicide attempts.
Study details: Development of the prediction formula used data from 2,466 members of the Apache tribe.
Disclosures: Dr. Haroz, Dr. O’Keefe, Ms. Goklish, and Dr. Cwik had no disclosures.