CAMS Relational Agent System (CAMS-RAS) for Suicide Prevention

项目摘要 在美国，每年有超过44000人死于自杀，成为自杀的第十大杀手 总体死因和10-44人中的第二大死因。此外，980万 成年人每年都会考虑自杀，有100万人会试图自杀。从2006年到2013年， 成年人因自杀意念而前往急症室就诊的个案，平均每年增加12%。而数百万的人 每年致力于防止自杀，美国的自杀率正在上升。我们的最终目标是通过以下方式减少死亡 自杀，同时减少不必要的住院、急诊科(ED)和医院 通过使用创新技术，停止紧急危机护理的旋转门。 在第一阶段，我们建议：(1)开发并科学验证供有自杀倾向的ED患者使用的化身 这提供了自杀行为的协同评估和管理(CAMS)，这是一种有效和 由David Jobes博士开发的具有成本效益的干预措施；以及(2)设计临床支持工具和Just-in-in- 时间培训，供急诊医疗提供者使用，以加强他们提供循证自杀方案 并促进以证据为基础的方法进行出院处置。我们的工作也是由第一阶段指导的 评论家的担忧。全面实现和超额完成项目目标。最值得注意的是，我们创建了一个15分钟的化身 (《戴夫医生》)，他在CAMS自杀状态访谈中做了一部分，很受欢迎 与“戴夫医生”互动的有自杀倾向的勃起功能障碍患者描述为有帮助。 在第二阶段，我们建议完成虚拟CAMS患者和提供者工具的开发，并 准备好将EHR整合到EPIC中。我们将再次使用敏捷的开发流程，并寻求反馈 来自目标终端用户。不同的顾问小组将向我们提供咨询，以确保产品卓越和 为商业化做好准备。为了确保对产品的提供商和患者工具进行彻底测试，我们将 使用两种条件的随机研究来评估虚拟CAMS在预防自杀行为和 不适当/不必要的入院，以及提高应对急性痛苦的自我效能。

PROJECT ABSTRACT Over 44,000 people die annually by suicide in the United States (US) making suicide the 10th leading cause of death overall and the second leading cause of death among those 10-44. In addition, 9.8 million adults contemplate suicide annually, and one million will make a suicide attempt. From 2006 to 2013, the rate of ED visits for suicidal ideation among adults increased by 12% on average annually. While millions are devoted annually to prevent suicide, suicide rates are rising in the US. Our ultimate aim is to reduce deaths by suicide while also reducing unnecessary hospitalization, emergency department (ED) and hospital readmissions, and stop the revolving-door of acute crisis care through the use of innovative technologies. In Phase I, we proposed to: (1) develop and scientifically validate an avatar for use by suicidal ED patients that delivers the Collaborative Assessment and Management of Suicidality (CAMS), an efficacious and cost-effective intervention developed by David Jobes, PhD; and (2) to design clinical support tools and Just-in- Time training for use by ED medical providers to enhance their delivery of an evidence-based suicide protocol and facilitate an evidence-based approach to discharge disposition. Our work was also guided by Phase I reviewers’ concerns. We fully met and exceeded project aims. Most notably, we created a 15-minute avatar (“Dr. Dave”) who performed a portion of the CAMS Suicide Status Interview which was well-liked and described as helpful by suicidal ED patients who interacted with “Dr. Dave.” In Phase II, we propose to complete the development of Virtual CAMS patient and provider tools and to ready it for EHR integration into EPIC. We will again use an agile process of development and seek feedback from target end-users. A diverse group of advisors will consult to us to ensure product excellence and readiness for commercialization. To ensure thorough testing of the product’s provider and patient tools, we will use a two-condition, randomized study to evaluate Virtual CAMS’ efficacy in preventing suicidal behaviors and inappropriate/unnecessary hospital admissions, and improving self-efficacy for coping with acute distress.