Validity of the classification of emergency service requests related to suicidal behavior
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Abstract
Objective. Validate the Emergency Coordination Center (ECC) classification for the detection of suicidal behavior requests.
Method. A descriptive, cross-sectional study of requests to the ECC of Málaga (Spain) during 2013 and 2014 was conducted. To classify the requests, the authors considered the ECC categorization when answering the call and the clinical assessment of the healthcare professional when attending the person who had made the call at the scene, which was considered the reference standard. To analyze the validity of the ECC classification system, sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were calculated.
Results. The total number of requests for medical assistance analyzed was 112,599. The validity indicators of the classification system for suicidal behavior were sensitivity = 44.78%, specificity = 99.34%, PPV = 46.91% and NPV = 99.28%.
Discussion and conclusion. The ECC classification system has a lower capacity to detect the presence of suicidal behavior and a higher capacity to identify its absence in the requests received. OES provide key information on suicidal behavior requests as they can be one of the first places people with this problem go to. It would therefore be extremely useful to improve the classification systems for requests related to suicidal behavior.
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References
Blanco-Sánchez, I., Barrera-Escudero, M., Martínez-Martínez, S., Mejías-Martín, Y., Morales-García, J. A., & García-Caro, M. P. (2018). Experiencia de los profesionales en la determinación de la situación de intento de suicidio en urgencias extrahospitalarias. Revista Presencia, 14, e11658. Retrieved from http://ciberindex.com/c/p/e11658
Feldman, M. J., Verbeek, P. R., Lyons, D. G., Chad, S. J., Craig, A. M., & Schwartz, B. (2006). Comparison of the Medical Priority Dispatch System to an Out-of-hospital Patient Acuity Score. Academic Emergency Medicine, 13(9), 954-960. doi: 10.1197/j.aem.2006.04.018
Fernández, C., García, G., Romero, R., & Marquina. A. J. (2008). Intoxicaciones agudas en las urgencias extrahospitalarias. Emergencias: Revista de la Sociedad Española de Medicina de Urgencias y Emergencias, 20(5), 328-331.
Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., Huang, X., … Nock, M. K. (2017). Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychological Bulletin, 143(2), 187-232. doi: 10.1037/bul0000084
García-Haro, J., García-Pascual, H., González, M., Barrio-Martínez, S., & García-Pascual, R. (2020). Suicidioytrastornomental: Unacrnecesaria. Papeles del Psicólogo, 41(1), 35-42. doi: 10.23923/pap.psicol2020.2919
Gräff, I., Goldschmidt, B., Glien, P., Bogdanow, M., Fimmers, R., Hoeft, A., … Grigutsch, D. (2014). The German Version of the Manchester Triage System and its quality criteria –first assessment of validity and reliability. PLoS One, 9(2), e88995. doi: 10.1371/journal.pone.0088995
Grosgurin, O., Gayet-Ageron, A., Suppan, L., Simon, J., Villar, A., Trombert, V., … Rutschmann, O. T. (2019). Reliability and performance of the Swiss Emergency Triage Scale used by paramedics. European Journal of Emergency Medicine, 26(3), 188-193. doi: 10.1097/MEJ.0000000000000530
Guzmán-Parra, J., Martínez-García, A. I., Guillén-Benítez, C., Castro-Zamudio, S., Jiménez-Hernández, M., & Moreno-Küstner, B. (2016). Factores asociados a las demandas psiquiátricas a los servicios de urgencias prehospitalarios de Málaga (España). Salud Mental, 39(6), 287-294. doi: 10.17711/SM.0185-3325.2016.033
Instituto Nacional de Estadística [INE]. (2019). Estadísticas de Defunción según la Causa de Muerte 2018 [Fichero de datos]. Retrieved from https://www.ine.es/jaxi/Datos.htm?path=/t15/p417/a2018/l0/&file=02002.px#!tabs-tabla
Jiménez-Hernández, M., Castro-Zamudio, S., Guzmán-Parra, J., Martínez-García, A. I., Guillén-Bentez,C., & Moreno-Küstner, B. (2017). Las demandas por conducta suicida a los servicios de urgencias prehospitalarios de Málaga. Anales del Sistema Sanitario de Navarra, 40(3), 379-389. doi: 10.23938/ASSN.0047
Mejías-Martín, Y., García-Caro, M. P., Schmidt, J., Quero, A., & Gorlat, B. (2011). Estudio preliminar de las características del intento de suicidio en la provincia de Granada. Anales del Sistema Sanitario de Navarra, 34(3), 431-441. doi: 10.4321/S1137-66272011000300009
Mejías-Martín, Y., Luna, J. D., Rodríguez-Mejías, C., Martí-García, C., Valencia-Quintero, J. P., & García-Caro, M. P. (2019). Factors Associated with Suicide Attempts and Suicides in the General Population of Andalusia (Spain). International Journal of Environmental Research and Public Health, 16(22), 4496. doi: 10.3390/ijerph16224496
Mejías-Martín, Y., Martí-García, C., Rodríguez-Mejías, C., Valencia-Quintero, J. P., García-Caro, M. P., & Luna, J. D. (2018). Suicide attempts in Spain according to prehospital healthcare emergency records. PLoS One, 13(4), e0195370. doi: 10.1371/journal.pone.0195370
Miret, M., Nuevo, R., Morant, C., Sainz-Cortón, E., Jiménez-Arriero, M. Á., López-Ibor, J. J., … Ayuso-Mateos, J. L. (2010). Calidad de los informes médicos sobre personas que han intentado suicidarse. Revista de Psiquiatría y Salud Mental, 3(1), 13-18. doi: 10.1016/S1888-9891(10)70003-3
Morales-Vallejo, P. (2012). Tamaño necesario de la muestra: ¿Cuántos sujetos necesitamos? En Estadística Aplicada a las Ciencias Sociales. Retrieved from https://web.upcomillas.es/personal/peter/investigacion/Tama%f1omuestra.pdf
Moreno-Küstner, B., & González Sánchez, F. (2020). Subregistro de los suicidios en el Boletín Estadístico de Defunción Judicial en Málaga. Gaceta Sanitaria, 34(6), 624-626. doi: 10.1016/j.gaceta.2019.09.003
Moreno-Küstner, B., del Campo-Ávila, J., Ruíz-Ibáñez, A., Martínez-García, A. I, Castro-Zamudio, S., Ramos-Jiménez, G., & Guzmán-Parra, J. (2019). Epidemiology of Suicidal Behavior in Malaga (Spain): An Approach from the Prehospital Emergency Service. Frontiers in Psychiatry, 10, 111. doi: 10.3389/fpsyt.2019.00111
Organización Mundial de la Salud [OMS]. (1979). Clasificación Internacional de Enfermedades, Novena Revisión. Ginebra: OMS.
Organización Mundial de la Salud [OMS]. (2014). Prevención del suicidio: un imperativo global. Retrieved from https://www.who.int/publications/i/item/9789241564779
Organización Mundial de la Salud [OMS]. (2019). Suicidio. Retrieved from https://www.who.int/es/news-room/fact-sheets/detail/suicide
Pacheco Tabuenca, T., & Robles Sánchez, J. I. (2011). Emergencias extrahospitalarias: el paciente suicida. Sanidad Militar, 67(4), 345-353. doi: 10.4321/S1887-85712011000500003
Parenti, N., Bacchi Reggiani, M. L., Iannone, P., Percudani, D., & Dowding, D. (2014). A systematic review on the validity and reliability of an emergency department triage scale, the Manchester Triage System. International Journal of Nursing Studies, 51(7), 1062-1069. doi: 10.1016/j.ijnurstu.2014.01.013
Parra-Uribe, I., Blasco-Fontecilla, H., García-Parés, G., Martínez-Naval. L., Valero-Coppin, O., Cebrià-Meca, A., … Palao-Vidal, D. (2017). Risk of re-attempts and suicide death after a suicide attempt: A survival analysis. BMC Psychiatry, 17(1), 163. doi: 10.1186/s12888-017-1317-z
Pita Fernández, S., & Pértegas Díaz, S. (2003). Pruebas diagnósticas: Sensibilidad y especificidad. Cadernos de Atención Primaria, 10, 120-124.
Servicio Andaluz de Salud. (2018). Protocolos de coordinación de la asistencia extrahospitalaria urgente y emergente del sistema sanitario público de Andalucía. Retrieved from https://www.sspa.juntadeandalucia.es/servicioandaluzdesalud/publicaciones/protocolos-de-coordinacion-de-la-asistencia-extrahospitalaria-urgente-y-emergente-del-sistema
Shah, M. N., Karuza, J., Rueckmann, E., Swanson, P., Conwell, Y., & Katz, P. (2009). Reliability and validity of prehospital case finding for depression and cognitive impairment. Journal of the American Geriatrics Society, 57(4), 697-702. doi: 10.1111/j.1532-5415.2009.02185.x
Silverman, M. M., Pirkis, J. E., Pearson, J. L., & Sherrill, J. T. (2014). Reflections on expert recommendations for U.S. research priorities in suicide prevention. American Journal of Preventive Medicine, 47(3), S97-101. doi: 10.1016/j.amepre.2014.05.025
Williamson, K., Gochman, R., Bullaro, F., Kaufman, B., & Krief, W. (2018). Acuity Prediction Using Emergency Medical Services Prenotifications in a Pediatric Emergency Department. Pediatric Emergency Care, 34(4), 253-257. doi: 10.1097/PEC.0000000000001015
