Start with a free account for 3 free CME credits. Already a subscriber? Sign in.

PECARN Pie: Computerized Adaptive Suicide Screening

Jacqueline Grupp-Phelan, MD, MPH, Jason Woods, MD, and Julia Magana, MD
00:00
14:02

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

Jason and Julia, co-chairs of dissemination for PECARN, discuss mental health screening and the use of a novel, digital suicide screening tool in the acute setting with  Dr. Jackie Grupp Phelan, Chief of Pediatric Emergency Medicine UCSF Benioff Children’s Hospitals Vice Chair, Department of Emergency Medicine as well as Professor of pediatrics in emergency medicine at University of California San Francisco and co-PI of the ED-STARS study group through PECARN.

  • Pediatric emergency departments have seen increases in a) visits for mental health crises and b) patients “boarding” in ED for longer periods of time.

  • Current tools for suicide screening have limited sensitivity at 60% and therefore, Dr. Grupp-Phelan and her team developed a tool to predict the likelihood of a suicide attempt.  The study can be found here

  • The screen is adaptive, meaning it’s contingent on the question that came before it.

  • The first study enrolled 6,000 teens and followed more than 2,000 of them to derive the tool in the 13 PECARN emergency departments that were screened in. 

    • Initially, 100 questions were asked to all of these kids on a tablet.

    • These questions derived the adaptive screening tool: CASSY.

  • The next study validated the tool in 14 sites and another 4,000 kids were enrolled, half of whom completed the validation study.

    • With this process, the screen was able to be between 8-12 questions, depending on how symptomatic the teen is and takes about 1 ½ minutes to complete.

  • The sensitivity of this screen is 80% and the specificity is above 70%.

    • Additionally, this tool gives a patient specific liklihood of a suicide attempt at 3 months to give the clinician, in particular, a better sense of risk.

  • The tool is highly flexible

    • For example, if one works in a site with many mental health resources, the tool can be increased to a higher sensitivity.

  • The hope is that the CASSY can be used in all pediatric emergency medicine departments, and it can also be used in pediatric clinics or even in school settings.

    • After the youth completes the screen, the care team gets a risk level assignment and depending on the score, the disposition of the patient can be determined.

  • The algorithms are open access. The study team has partnered with Adaptive Testing Technologies to develop the platform interface.

    • If you are interested in using it in your practice setting, email ycohen@adaptivetestingtechnologies.com.

To join the conversation, you need to subscribe.

Sign up today for full access to all episodes and to join the conversation.

To download files, you need to subscribe.

Sign up today for full access to all episodes.
Hippo Peds RAP October 2021 Written Summary 183 KB - PDF

To earn CME for this chapter, you need to subscribe.

Sign up today for full access to all episodes and earn CME.

0.25 Free AMA PRA Category 1 Credits™ certified by Hippo Education or 0.25 Free AAP credits certified by AAP (2021)

  1. Complete Quiz
  2. Complete Evaluation
  3. Print Certificate

3.25 AMA PRA Category 1 Credits™ certified by Hippo Education or 3.25 AAP credits certified by AAP (2021)

  1. Complete Quiz
  2. Complete Evaluation
  3. Print Certificate