<p>US veterans are significantly more likely than civilians to die by suicide. Machine-learning models have been developed to target high-risk transitioning service members for suicide prevention interventions to reduce veteran suicides. These models are suicide method-agnostic. However, firearms are involved in most veteran suicides, and firearm-specific preventions exist. We used data from US Army veterans from 2010 to 2019 (<i>N</i> = 800,579) to develop and compare firearm-specific machine-learning models with a method-agnostic model to predict firearm suicides among transitioning Army veterans up to 10 years after discharge. The models performed comparably overall (area under the receiver operating characteristic curve = 0.710–0.708; integrated calibration index = 0.0003–0.0005% for firearm-specific and method-agnostic models, respectively), with the best model depending on the intervention threshold. Results from this study show the method-agnostic model was better at predicting firearm suicides at the highest intervention threshold, whereas the firearm-specific model was better at lower thresholds. When considering fairness with respect to sex and race/ethnicity, the firearm-specific model was best across all thresholds. Thus, model choice depends on weighing numerous factors, and optimal thresholds might differ for coordinated firearm-specific and method-agnostic interventions.</p>

错误:搜索内容不能为空,请输入英文关键词
错误:关键词超出字数限制,请精简
高级检索

Predicting firearm suicide among US Army veterans transitioning from active service

  • Claire Houtsma,
  • Chris J. Kennedy,
  • Howard Liu,
  • Emily R. Edwards,
  • Nancy A. Sampson,
  • Joe C. Geraci,
  • Brian P. Marx,
  • Matthew K. Nock,
  • James Wagner,
  • Murray B. Stein,
  • Robert J. Ursano,
  • Ronald C. Kessler

摘要

US veterans are significantly more likely than civilians to die by suicide. Machine-learning models have been developed to target high-risk transitioning service members for suicide prevention interventions to reduce veteran suicides. These models are suicide method-agnostic. However, firearms are involved in most veteran suicides, and firearm-specific preventions exist. We used data from US Army veterans from 2010 to 2019 (N = 800,579) to develop and compare firearm-specific machine-learning models with a method-agnostic model to predict firearm suicides among transitioning Army veterans up to 10 years after discharge. The models performed comparably overall (area under the receiver operating characteristic curve = 0.710–0.708; integrated calibration index = 0.0003–0.0005% for firearm-specific and method-agnostic models, respectively), with the best model depending on the intervention threshold. Results from this study show the method-agnostic model was better at predicting firearm suicides at the highest intervention threshold, whereas the firearm-specific model was better at lower thresholds. When considering fairness with respect to sex and race/ethnicity, the firearm-specific model was best across all thresholds. Thus, model choice depends on weighing numerous factors, and optimal thresholds might differ for coordinated firearm-specific and method-agnostic interventions.