Computerized Adaptive Suicidal Risk Stratification and Prediction

项目摘要 将使用该SBIR创建的软件，即计算机化自杀自适应测验-扩展 (CAT-SSE)，将帮助医疗保健系统以更强大和有效的方式识别和监控自杀风险 比目前所做的更多。在第二阶段的最后阶段，我们建议将经过验证的CAT-SSE与 EPIC，马萨诸塞州大学纪念医疗系统使用的EHR。值得注意的是，这 双向、深度整合将使我们能够引入MHRN指标，并将其用于CAT-SSE风险 分层方程，并在EHR中提供结果和临床决策支持，供临床医生访问 并在关爱的时刻采取行动。 通过第一个行政补充(R44MH118780-01A1)，我们与EPIC整合的目标是 (1)构建去身份模型(见图)，以及(2)构建工具以促进该方法的翻译 在其他地方。自那以后，我们部署了一个多层体系结构，将CAT-SSE构建到EPIC中，以便 患者标识不与ATT共享。我们能够成功地在ATT和 在Epic测试环境中使用大量Epic服务器。在本第二阶段行政补充资料中，我们 请求为UMassIT提供资金，以完成CAT-SSE与其 史诗般的EHR实例。 综合改进的主要结果将是：(1)开发确保临床的要素 可用性和可解释性得到最大化。这些元素包括但不限于数据可视化， 指导语言和史诗警报。(2)开发远程和面对面CAT-SSE交付选项 CAT-SSE参与者。(3)成功从利用MHRN数据的ATT实时导入CAT-SSE成绩 来计算自杀风险预测。据估计，总共需要370小时的IT工作才能完成 上述结果。 不幸的是，由于新冠肺炎的原因，该项目遇到了重大的招生延迟，这迫使该研究 团队修改最初的招生目标，并转移所有可用资金，以最大限度地提高学科招生人数。在……里面 此外，马萨诸塞州大学IT部门改变了优先事项，以推进与COVID相关的患者护理项目(例如 远程医疗)而不是研究项目。由于大流行后IT劳动力的增加，并利用所有可用的 资源以弥补在COVID高峰期的投保损失，我们需要额外的资金来完成这项工作 这是项目的重要组成部分。预算中概述了如何使用这些资金的细节 正当性。

Project Summary The software to be created with this SBIR, the Computerized Adaptive Test for Suicide Scale – Expanded (CAT-SSE), will help healthcare systems to identify and monitor suicide risk in a more robust and valid way than is currently done. In the final stage of Phase 2, we proposed to integrate the validated CAT-SSE with Epic, the EHR used at the University of Massachusetts Memorial Healthcare (UMass) system. Notably, this two-way, deep integration will allow us to import the MHRN indicators and use them in the CAT-SSE risk stratification equations and deliver the results and clinical decision support in the EHR for clinicians to access and act on at the point of care. Through the first administrative supplement (R44MH118780-01A1), our aims with the Epic integration were to (1) build the de-identification model (see Figure), and (2) build the tools to facilitate translation of this approach at other sites. We have since deployed a multi-tier architecture for building the CAT-SSE into Epic such that patient identifiers are not shared with ATT. We were able to successfully transfer data between ATT and the UMass Epic servers within an Epic test environment. In this Phase 2 administrative supplement, we are requesting funds for UMass IT to complete the refinement of the existing integration of the CAT-SSE into their Epic EHR instance. The main outcomes of the integration refinement will be: (1) Development of elements that ensure clinical usability and interpretability are maximized. These elements include but are not limited to data visualization, guidance language, and Epic alerts. (2) Development of remote and in-person CAT-SSE delivery options for CAT-SSE participants. (3) Successful real-time import of CAT-SSE scores from ATT that leverage MHRN data to calculate a suicide risk prediction. It is estimated that a total of 370 hours of IT work are required to complete the above outcomes. Unfortunately, Due to COVID-19, the project encountered major enrollment delays, which forced the study team to revise the initial enrollment targets and divert all available funds to maximize subject enrollments. In addition, UMass IT department changed its priorities to advance COVID-related patient care projects (e.g. telehealth) over research projects. Because of the increased IT labor post-pandemic, and utilizing all available resources to recover the enrollment loss during COVID peaks, we will need additional funds to complete this important part of the project. Details on how these funds will be used are summarized in the budget justification.