Leveraging Computer Vision to Augment Suicide Risk Prediction

摘要 自伤行为在青少年中的发生率高得惊人，自杀居第二位 是15-24岁人群的主要死因既往自伤史，包括非自杀性自伤， 伤害和自杀性自残（例如，自杀企图），一直被发现是最强的预测 有证据表明，这种行为越严重， 未来自我伤害的风险。然而，重要的是，我们目前评估先前自伤严重程度的方法是 几乎完全依赖于自我报告，尽管事实上，自我伤害经常留下有形的身体 标志.尽管机器学习在医学图像分析中的应用呈指数级增长， 没有人试图通过自动分析自我导向组织来增加自杀风险检测 损害利用计算机视觉自动评估组织损伤图像有可能 ·完全依赖患者主观报告的自伤严重程度特征。因此，目标 该提案的一个目的是利用计算机视觉技术来自动评估假设的自伤 视觉严重性指示器，学习新的视觉严重性指示器，并确定这些视觉信号的效用 预测未来自杀企图的风险。将招募16至18岁的社区青少年 在Facebook和Instagram上，如果他们目前有可见的身体标记继发于自伤。 参与者将安全地上传故意自伤造成的标记图像。的子集 参与者将被纵向跟踪三个月，以评估潜在的自杀企图。我们将 采用深度卷积神经网络（一种人工神经网络）来开发算法， 检测自伤的严重程度指数，并检查其预测短期预期自杀的准确性 风险我们将通过将算法应用于单独的临床试验来评估算法子集的可推广性。 年龄在16至18岁的精神病住院青少年样本。这项概念验证研究将为 该阶段确定追求我们将这项技术整合到 精神病护理入口点（例如，急诊科，住院部），以评估这项技术是否 可以增强目前的自杀风险评估模型，反过来，作为临床决策支持工具， 帮助临床医生评估自杀风险。这项研究的重要性在于它与NIMH/国家行动保持一致 自杀预防联盟的优先研究议程自杀预防的理想目标2 使用可行和有效的评估确定不同人群和环境中的自杀风险 方法，以及目标3，即寻找新的方法来评估即将发生的自杀风险，因为我们的目标 预测期为三个月。

Abstract Self-injurious behaviors occur at alarmingly high rates among adolescents, with suicide ranking as the second leading cause of death among those ages 15-24. A history of prior self-injury, including both nonsuicidal self- injury and suicidal self-injury (e.g., suicide attempts), has been consistently found to be the strongest predictor of future suicidal behavior, with evidence suggesting that the more severe such behaviors are, the greater the risk for future self-injury. Importantly, however, our current means of assessing severity of prior self-injury is almost entirely reliant on self-report, despite the fact that self-injury frequently leaves tangible physical markings. Although applications of machine learning in medical image analysis are growing exponentially, none have attempted to augment suicide risk detection through automated analysis of self-directed tissue damage. Leveraging computer vision to automatically assess images of tissue damage has the potential to obviate complete reliance on subjective patient report of self-injury severity characteristics. Thus, the objective of this proposal is to utilize computer vision techniques to automate the assessment of hypothesized self-injury visual severity indicators, learn new visual severity indicators, and determine the utility of these visual signals in predicting prospective suicide attempt risk. Community adolescents ages 16 to 18 years old will be recruited on Facebook and Instagram if they have currently visible physical marking(s) secondary to self-injury. Participants will securely upload images of markings secondary to intentional self-injury. A subset of participants will be followed longitudinally for three months to assess prospective suicide attempts. We will employ deep convolutional neural networks, a class of artificial neural networks, to develop algorithms to detect severity indices of self-injury and to examine their accuracy in predicting short-term prospective suicide risk. We will assess the generalizability of a subset of algorithms by applying them to a separate clinical sample of psychiatrically hospitalized adolescents ages 16 to 18 years old. This proof-of-concept study will set the stage to determine the feasibility of pursuing our long-term goal of integrating this technology into psychiatric care entry-points (e.g., emergency departments, inpatient units) to assess whether this technology can augment current suicide risk assessment models and in turn, serve as a clinical decision-support tool to help clinicians assess suicide risk. This research is significant in that it aligns with the NIMH/National Action Alliance for Suicide Prevention’s Prioritized Research Agenda for Suicide Prevention’s Aspirational Goal 2 of determining suicide risk in diverse populations and settings using feasible and effective assessment approaches, and Goal 3 of finding novel ways to assess for imminent suicide risk, given that our target prediction period is three months.