Which Chart Elements Accurately Identify Emergency Department Visits for Suicidal Ideation or Behavior?

Arch Suicide Res. 2019 Jul-Sep;23(3):382-390. doi: 10.1080/13811118.2018.1472691. Epub 2019 Jun 11.

Abstract

In an emergency department (ED) sample, we investigated the concordance between identification of suicide-related visits through standardized comprehensive chart review versus a subset of 3 specific chart elements: ICD-9-CM codes, free-text presenting complaints, and free-text physician discharge diagnoses. The method for this study was review of medical records for adults (≥18 years) at 8 EDs across the United States. A total of 3,776 charts were reviewed. A combination of the 3 chart elements (ICD-9-CM, presenting complaints, and discharge diagnoses) provided the most robust data with 85% sensitivity, 96% specificity, 92% PPV, and 92% NPV. These findings highlight the use of key discrete fields in the medical record that can be extracted to facilitate identification of whether an ED visit was suicide-related.

Keywords: chart review; electronic health records; emergency department; suicide.

MeSH terms

  • Adult
  • Data Collection
  • Electronic Health Records*
  • Emergency Service, Hospital*
  • Female
  • Humans
  • International Classification of Diseases
  • Male
  • Middle Aged
  • Patient Discharge Summaries
  • Suicidal Ideation*
  • Suicide, Attempted*
  • United States