Researchers have developed a Computerized Adaptive Test (CAT) to screen and identify youth at-risk for attempting suicide. Adaptive Testing Technologies (ATT), the leader in the design, testing, and implementation of large-scale mental health assessment tools announces the Computerized Adaptive Screen for Suicidal Youth (CASSY) is available for license.
According to data published in JAMA Psychiatry, the CASSY algorithm has demonstrated a sensitivity of 82.4% and a specificity of 80% in predicting a future suicide attempt in the 3 months following their emergency department visit. CASSY goes beyond a simple dichotomization of risk and provides the probability of a suicide attempt within the next 3 months. The results suggest this screener could serve as an easy-to-use way for providers to detect youth suicide risk in emergency department settings. The study was funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health.
“The CASSY is a new, well-validated, and easy-to-use tool for recognizing suicide risk in young people,” said study lead, Cheryl King, Ph.D., a professor of psychiatry at the University of Michigan, Ann Arbor. “Developed specifically to screen youth in emergency departments, the CASSY requires less than two minutes of a youth’s time to complete — then provides information to the care team about the youth’s level of suicide risk and suicide warning signs. The CASSY has the potential to be a game-changer in our suicide prevention efforts.”
A suicide screener that can quickly and accurately identify youth suicide risk would help emergency department providers, for example, implement universal screening in these settings. Five institutions within the U.S. Pediatric Emergency Care Applied Research Network (PECARN), including researchers out of the University of Michigan, Ann Arbor, recruited youth between the ages of 12 and 17 in collaboration with 13 emergency departments.
Youth who were admitted to an emergency department at the study sites during randomly selected shifts completed self-report questionnaires assessing suicide ideation and rumination; history of suicide attempts; self-injury; depression; hopelessness; alcohol and drug misuse; family, school, and social connectedness; physical and sexual abuse; and other factors that have been found to be related to suicide risk. Youth and their parents then received follow-up calls three months after the initial screening to learn if the youth had tried to end their life in the intervening months. The researchers used these data, and data that resulted from the second phase of the study that tested the ability of CASSY to predict suicide risk in a new set of youth, aged 12 to 17, who presented to 14 PECARN emergency departments and one Indian Health Service emergency department, to create the CASSY.
The Computerized Adaptive Screen for Suicidal Youth (CASSY) is the first prospectively validated universal screen for suicide attempt risk in pediatric emergency departments. The CASSY is a computerized adaptive test (CAT) that represents a scientific breakthrough in pediatric suicide risk screening and measurement. The 72-question item bank covers suicidal ideation and behavior, and suicide-related items drawn from the domains of psychopathology, PTSD, social adjustment, sleep, substance use, anger, and aggression. The mean number of adaptively administered items is 11 (range, 5-21). In an average of 84 seconds, youth can be adaptively screened for suicide risk and their suicide risk quantified in terms of the probability of a suicide attempt in the next 3 months. This process can be used on a standalone basis or integrated via an API so that the CASSY can be seamlessly integrated with an electronic health record system. The CASSY is available in English and Spanish, with built-in optional audio to aid in literacy issues and further ease of use. The Flesch Reading Ease score for the CASSY is 80.4 with a Flesch-Kincaid Grade Level of 6.0.
About Adaptive Testing Technologies
Adaptive Testing Technologies (ATT) is the leader in the design, testing, and implementation of large-scale mental health assessment tools based on multidimensional Computerized Adaptive Testing (CAT) and Computerized Adaptive Diagnostic (CAD) technologies. These tools are utilized by health professionals to assess a variety of mental health conditions – including depression, anxiety, mania, psychosis, PTSD, substance use disorder, suicide risk, ADHD, and assess Social Determinants of Health. The CAT-MH™ and K-CAT® represent the first and only validated, comprehensive, multidimensional item-response-theory-based adaptive screening and measurement systems in the world. They provide levels of precision and accuracy that is far beyond what can be achieved using traditional fixed-length mental health assessment scales and can be administered anywhere at any frequency, in or out of the clinic, to any sized population. ATT’s tools are currently being utilized in emergency departments, psychiatric and primary care clinics, telemedicine, student health clinics, perinatal medicine clinics, child welfare settings, substance use disorder programs, federal and state mental health programs, employee assistance programs, criminal justice systems, and the SAMHSA national mental health and substance use disorder prevalence study. The tools are available worldwide and are currently being used in the United States, Canada, the United Kingdom, Sweden, India, and Chile.
Matt Birnholz, MDPeer