Computerized adaptive screen for suicide best for teens with psych symptoms

The Ask Suicide-Screening Questions (ASQ) and the Computerized Adaptive Screen for Suicidal Youth (CASSY) instrument are equally effective for universal screening of teens presenting in the emergency department, according to a study published online Feb. 15 in JAMA Network Open.

David A. Brent, M.D., from the University of Pittsburgh School of Medicine, and colleagues compared the ASQ and the CASSY instrument for the prediction of suicidal behavior among adolescents. The analysis included 2,740 adolescents seen in the emergency department from July 24, 2017, through Oct. 29, 2018, with a three-month follow-up to assess the occurrence of suicidal behavior.

The researchers found that the ASQ and the CASSY showed a similar sensitivity (0.951 and 0.945, respectively), specificity (0.588 and 0.643, respectively), positive predictive value (0.127 and 0.144, respectively), and negative predictive value (both 0.995). For patients with physical symptoms, area under the receiver operating characteristic curve findings were similar (0.88 and 0.94 for ASQ and CASSY, respectively). However, among patients with psychiatric symptoms, CASSY performed better than the ASQ (0.72 versus 0.57).

"Emergency department clinicians will need to decide which measure is best suited to their milieu and patient mix," the authors write. "Both the ASQ and the CASSY are worthy of consideration for identifying youths in the emergency department at risk for suicide."