Clinician Decision Support Tool for Suicide Prevention

Overseen By Amy Ahn, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Massachusetts General Hospital

Disqualifiers: Cognitive impairment, Intellectual disability, Dementia, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6 months

4000 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to improve how doctors predict and prevent suicide attempts in patients visiting the emergency department for mental health issues. It tests whether providing a risk score to doctors can help them make better decisions, potentially lowering suicide attempts over six months. The trial includes two groups: one where doctors receive risk information from the Clinician Decision Support Tool and another where they do not. Individuals visiting the emergency department with a psychiatric concern and aged 18 or older might be a good fit.

As an unphased study, this trial offers an opportunity to contribute to important research that could enhance emergency care for mental health patients.

Do I need to stop taking my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that the Clinician Decision Support Tool is safe for use in suicide prevention?

Research has shown that a Clinician Decision Support Tool for suicide prevention is safe to use. In one study, researchers tested this tool to determine if it helped healthcare providers check for suicide risk more often during in-person visits. This study found no major safety issues.

Another study examined outcomes such as self-harm and hospital visits. The results indicated that using the tool did not increase these events, suggesting it is safe and does not cause harm.

Overall, evidence suggests that the Clinician Decision Support Tool is safe and aids clinicians in making better decisions to prevent suicide. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Clinician Decision Support Tool for suicide prevention because it offers a novel approach by enhancing the decision-making process for clinicians. Unlike standard care, which often relies on clinician experience and judgment alone, this tool provides data-driven insights to help identify at-risk patients more effectively. This support tool leverages advanced algorithms to analyze patient data, aiming to improve early detection and intervention strategies. Ultimately, the hope is that this can lead to better outcomes by tailoring prevention efforts more precisely to individual patients' needs.

What evidence suggests that the Clinician Decision Support Tool is effective for suicide prevention?

Research has shown that a Clinician Decision Support Tool, which participants in this trial may experience, can help reduce suicide attempts. One study found that this tool led to more in-person follow-ups for checking suicide risk, aiding in early risk identification and management. Another study demonstrated that using these tools during regular doctor visits reduced suicide attempts by 25% within 90 days. These tools provide doctors with crucial information about a patient's risk, enhancing decision-making. Machine learning in these tools has also predicted suicide risk more accurately than many traditional methods. ^{1 2 3 6 7}

Are You a Good Fit for This Trial?

This trial is for patients who come to the emergency department with psychiatric concerns. It's not specified, but typically participants would need to be mentally capable of consent and not have conditions that exclude them from study participation.

Inclusion Criteria

Presentation to emergency psychiatry service

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants' clinicians are provided with or without the Clinician Decision Support Tool to evaluate its effect on preventing suicide attempts

6 months

Follow-up

Participants are monitored for suicide attempts using self-report surveys and electronic health records

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Clinician Decision Support Tool

Trial Overview The trial tests if giving clinicians a tool that predicts suicide risk helps lower patient suicide attempts over six months. Clinicians get a 'risk score' for some patients, which may change how they decide on care.

How Is the Trial Designed?

Group I: Experimental Experimental Treatment 1 Intervention

Patient's clinician is given Clinician Decision Support Tool

Group II: Control Active Control 1 Intervention

Patient's clinician is not given Clinician Decision Support Tool (care as usual)

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials

3,066

Recruited

13,430,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11699529/

Risk Model–Guided Clinical Decision Support for Suicide ... This randomized clinical trial tests whether interruptive clinical decision support (CDS) prompted more frequent in-person suicide risk ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S2773065424000981

Randomized Pilot of a Clinical Decision Support Tool to ... The primary outcome was the completion of the Columbia Suicide Severity Rating Scale (CSSRS) in the 14 days following a primary care visit. The CSSRS is an EHR- ...

3. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2828654

Risk Model–Guided Clinical Decision Support for Suicide ... In this randomized clinical trial of 561 participants with 596 clinician encounters, interruptive CDS was significantly more effective at prompting in-person ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12005173/

Effectiveness of Integrating Suicide Care in Primary Care Implementation of population-based SC concurrent with a substance use program resulted in a 25% reduction in the suicide attempt rate in the 90 days after ...

5. bmcpsychiatry.biomedcentral.com bmcpsychiatry.biomedcentral.com/counter/pdf/10.1186/s12888-024-05659-6.pdf?utm_source=consensus

Developing a clinical decision support system software ... In suicide research, it has been shown that machine learning-based suicide risk predictions out- perform all widely researched theories of ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10956300/

Developing a clinical decision support system software ... These models will predict key adverse outcomes including self-harm repetition, suicide, premature death, and lack of post-discharge care.

7. mental.jmir.org mental.jmir.org/2019/5/e9766/

Database Analysis for Clinical Decision Support The aim of this study was to describe the data mining module of a Web-based CDSS and to identify suicide repetition risk in a sample of suicide attempters.