Use of risk assessment instruments to predict violence and antisocial behaviour in 73 samples involving 24 827 people: systematic review and meta-analysis.
Use of risk assessment instruments to predict violence and antisocial behaviour in 73 samples involving 24 827 people: systematic review and meta-analysis.
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DOI：
10.1136/bmj.e4692
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发表时间：
2012-07-24
期刊：
影响因子：
--
通讯作者：
Grann M
中科院分区：
文献类型：
--
作者：
Fazel S;Singh JP;Doll H;Grann M
目的 调查常用来评估暴力、性和犯罪行为风险的工具的预测有效性。遵循 PRISMA 指南设计重复研究的系统回顾和表格荟萃分析。数据来源 PsycINFO、Embase、Medline 和美国刑事司法参考服务摘要。审查方法 我们纳入了 1995 年 1 月 1 日至 2011 年 1 月 1 日期间的复制研究，前提是这些研究提供了工具旨在预测的违规结果的应急数据。我们计算了诊断比值比、敏感性、特异性、曲线下面积、阳性预测值、阴性预测值、防止一次犯罪所需拘留的人数，以及一个新的绩效指标——安全释放的人数。我们使用元回归和亚组分析研究了异质性的潜在来源。结果 对 73 个样本进行了风险评估，其中包括来自 13 个国家的 24 847 名参与者，其中 5879 名 (23.7%) 的犯罪时间平均为 49.6 个月。当用于预测暴力犯罪时，风险评估工具产生低至中等的阳性预测值（中位数 41%，四分位数间距 27-60%）和较高的阴性预测值（91%、81-95%），相应的拘留所需中位数为 2 人（2-4），安全出院人数为 10 人（4-18）。旨在预测暴力犯罪的工具比旨在预测性犯罪或一般犯罪的工具表现更好。结论 尽管风险评估工具广泛应用于临床和刑事司法环境中，但其预测准确性取决于其使用方式。它们似乎能够高度准确地识别低风险个人，但目前的证据并不支持将它们用作拘留、量刑和释放的唯一决定因素。需要进一步的研究来检验它们对治疗和管理的贡献。
Objective To investigate the predictive validity of tools commonly used to assess the risk of violence, sexual, and criminal behaviour. Design Systematic review and tabular meta-analysis of replication studies following PRISMA guidelines. Data sources PsycINFO, Embase, Medline, and United States Criminal Justice Reference Service Abstracts. Review methods We included replication studies from 1 January 1995 to 1 January 2011 if they provided contingency data for the offending outcome that the tools were designed to predict. We calculated the diagnostic odds ratio, sensitivity, specificity, area under the curve, positive predictive value, negative predictive value, the number needed to detain to prevent one offence, as well as a novel performance indicator—the number safely discharged. We investigated potential sources of heterogeneity using metaregression and subgroup analyses. Results Risk assessments were conducted on 73 samples comprising 24 847 participants from 13 countries, of whom 5879 (23.7%) offended over an average of 49.6 months. When used to predict violent offending, risk assessment tools produced low to moderate positive predictive values (median 41%, interquartile range 27-60%) and higher negative predictive values (91%, 81-95%), and a corresponding median number needed to detain of 2 (2-4) and number safely discharged of 10 (4-18). Instruments designed to predict violent offending performed better than those aimed at predicting sexual or general crime. Conclusions Although risk assessment tools are widely used in clinical and criminal justice settings, their predictive accuracy varies depending on how they are used. They seem to identify low risk individuals with high levels of accuracy, but their use as sole determinants of detention, sentencing, and release is not supported by the current evidence. Further research is needed to examine their contribution to treatment and management.
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影响因子：
2.1
作者：
Bonta, J
通讯作者：
Bonta, J
影响因子：
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作者：
Fazel, Seena;Lichtenstein, Paul;Langstrom, Niklas
通讯作者：
Langstrom, Niklas
影响因子：
3.4
作者：
Archer, Robert P.;Buffington-Vollum, Jacqueline K.;Handel, Richard W.
通讯作者：
Handel, Richard W.
影响因子：
24
作者：
Cooney, Marie Therese;Dudina, Alexandra L.;Graham, Ian M.
通讯作者：
Graham, Ian M.
影响因子：
3.4
作者：
AEgisdottir, S;White, MJ;Rush, JD
通讯作者：
Rush, JD