Center for Harmonizing and Improving Interventions to Prevent Suicide (CHIIPS)

背景：在过去的20年里，美国的自杀死亡率上升了30%以上。 美国退伍军人的自杀率上升得更快。而退伍军人只占8.5%， 他们占美国成年人自杀死亡人数的18%。虽然最近的下降， 退伍军人中的自杀死亡率可能是一些不确定性的原因，他们也掩盖了 自杀死亡率和弱势群体预防干预措施的有效性。此外，虽然我们 确实有方法按风险水平对个人进行分层，并采取干预措施， 就减少自杀企图而言，这些工具远非完美。仍迫切需要确定 哪些可用的自杀预防干预措施可能是最有效的一个给定的个人在一个给定的 时间意义：拟议中的自杀预防临床资源中心（SP-CRC）对以下问题做出了反应： CSRD征求VA研究机构的申请，以建立一个SP-CRC，将服务于自杀 预防调查员，提供高度关键的研究资源，以促进方案和科学研究， 需求我们的SP-CRC的使命，协调和改善干预措施，以防止 自杀（CHIIPS）将推进自杀预防研究的精准医学方法。CHIIPS 内容区域中心将包括预测分析、生物标志物、识别、筛选、评估、社交 决定因素/差异、干预措施和（v）培训和教育创新及影响： 建立一个VA SP-CRC，明确侧重于促进预防自杀的精准医学，我们 将改善个人自杀预防的结果，解决标准化的 治疗，促进将不同的患者表现，特征和需求纳入 治疗计划和自杀预防研究，改善系统和人口水平的结果，并增加 有效利用有限的资源（人员、资金、基础设施）。交付的资源：在完成此 项目，我们将提供几个资源，以退伍军人事务部自杀预防研究界包括：1） VA自杀预防研究组合项目的组合审查，2）数据集 用于VA自杀预防研究人员进行二次分析的存储库，3）建立 精准医学自杀预防研究博士后奖学金，4）创建和传播 对自杀预防研究的临床试验方法和安全协议的几项建议， 5)为自杀预防研究人员提供各种精准医学相关的教育资源，以促进 胜任的精准医学自杀预防研究，6）统计和研究设计咨询 服务，7）为精准医学自杀预防试点研究提供资金，或为正在进行的 研究，8）迄今为止所有精确医学自杀预防研究的文献综述。协同 SPRINT：CHIIPS将与自杀预防研究影响网络（SPRINT）密切合作， 中心，以优化协同作用，避免两个中心之间的重复工作。我们的目标是提高 目前的SPRINT活动，通过利用其网络和基础设施，专注于精准医学 接近。SPRINT和CHIIPS将共同帮助VA研发办公室创建一个愿景， 并确定优先事项，以及建立一个精确的医学自杀预防研究组合， 推进科学的发展，帮助退伍军人事务部实现其使命， 退伍军人自杀

Background: The rate of death by suicide has risen by more than 30% in the past 20 years in the U.S. The rate of death by suicide among U.S. Veterans has risen even faster. Whereas Veterans only constitute 8.5% of the population, they account for 18% of all suicide deaths among U.S. adults. Although recent declines in suicide mortality among Veterans may be cause for some hopefulness, they also obscure the dynamics of suicide mortality and effectiveness of preventive interventions across vulnerable groups. Further, although we do have methods available to stratify individuals by risk level and interventions that can have positive effects in terms of reducing suicide attempts, these tools are far from perfect. There is still an urgent need to determine which available suicide prevention interventions might be the most effective for a given individual at a given time. Significance: The proposed suicide prevention clinical resource center (SP-CRC) is responsive to CSRD’s solicitation of applications from VA research facilities to establish an SP-CRC that will serve suicide prevention investigators by providing highly critical research resources to facilitate programmatic and scientific needs. The mission of our SP-CRC, the Center for Harmonizing and Improving Interventions to Prevent Suicide (CHIIPS), will be to advance a precision medicine approach to suicide prevention research. CHIIPS content area hubs will include Predictive Analytics, Biomarkers, Identification, Screening, Assessment, Social Determinants/Disparities, Interventions, and (v) Training and Education Innovation and Impact: By establishing a VA SP-CRC with an explicit focus on promoting precision medicine for suicide prevention, we will improve individual suicide prevention outcomes, address unsatisfactory response rates for standardized treatments, promote the incorporation of diverse patient presentations, characteristics, and needs into treatment plans and suicide prevention research, improve system and population-level outcomes, and increase efficient use of finite resources (staff, funds, infrastructure). Resources Delivered: At the completion of this project, we will have provided several resources to the VA suicide prevention research community including: 1) a portfolio review of VA suicide prevention research portfolio projects on precision medicine, 2) a dataset repository for use by VA suicide prevention researchers to conduct secondary analyses, 3) the establishment of precision medicine suicide prevention research postdoctoral fellowships, 4) creation and dissemination of several recommendations for clinical trials methodology and safety protocols for suicide prevention research, 5) various precision medicine related educational resources for suicide prevention researchers to promote competent precision medicine suicide prevention research, 6) a statistical and research design consultation service, 7) funding for precision medicine suicide prevention pilot studies or supplemental funding for ongoing studies, 8) a literature review of all precision medicine suicide prevention research to date. Coordination with SPRINT: CHIIPS will work closely with the Suicide Prevention Research Impact Network (SPRINT) PIs and hubs to optimize synergies and avoid duplication of effort between the two centers. Our goal is to enhance current SPRINT activities, by leveraging their network and infrastructure to focus on precision medicine approaches. Together, SPRINT and CHIIPS will help VA Office of Research and Development create a vision and set priorities for as well as build a precision medicine suicide prevention research portfolio that will advance the state of the science and help VA achieve its mission of significantly reducing the number of Veteran suicides.