1
|
Mortier P, Vilagut G, Puértolas Gracia B, De Inés Trujillo A, Alayo Bueno I, Ballester Coma L, Blasco Cubedo MJ, Cardoner N, Colls C, Elices M, Garcia-Altes A, Gené Badia M, Gómez Sánchez J, Martín Sánchez M, Morros R, Prat Pubill B, Qin P, Mehlum L, Kessler RC, Palao D, Pérez Sola V, Alonso J. Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study: protocol for a population-representative nested case-control study of suicide attempts in Catalonia, Spain. BMJ Open 2020; 10:e037365. [PMID: 32660952 PMCID: PMC7359191 DOI: 10.1136/bmjopen-2020-037365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/02/2020] [Accepted: 05/29/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Suicide attempts represent an important public health burden. Centralised electronic health record (EHR) systems have high potential to provide suicide attempt surveillance, to inform public health action aimed at reducing risk for suicide attempt in the population, and to provide data-driven clinical decision support for suicide risk assessment across healthcare settings. To exploit this potential, we designed the Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study. Using centralised EHR data from the entire public healthcare system of Catalonia, Spain, the CSRC-Epi study aims to estimate reliable suicide attempt incidence rates, identify suicide attempt risk factors and develop validated suicide attempt risk prediction tools. METHODS AND ANALYSIS The CSRC-Epi study is registry-based study, specifically, a two-stage exposure-enriched nested case-control study of suicide attempts during the period 2014-2019 in Catalonia, Spain. The primary study outcome consists of first and repeat attempts during the observation period. Cases will come from a case register linked to a suicide attempt surveillance programme, which offers in-depth psychiatric evaluations to all Catalan residents who present to clinical care with any suspected risk for suicide. Predictor variables will come from centralised EHR systems representing all relevant healthcare settings. The study's sampling frame will be constructed using population-representative administrative lists of Catalan residents. Inverse probability weights will restore representativeness of the original population. Analysis will include the calculation of age-standardised and sex-standardised suicide attempt incidence rates. Logistic regression will identify suicide attempt risk factors on the individual level (ie, relative risk) and the population level (ie, population attributable risk proportions). Machine learning techniques will be used to develop suicide attempt risk prediction tools. ETHICS AND DISSEMINATION This protocol is approved by the Parc de Salut Mar Clinical Research Ethics Committee (2017/7431/I). Dissemination will include peer-reviewed scientific publications, scientific reports for hospital and government authorities, and updated clinical guidelines. TRIAL REGISTRATION NUMBER NCT04235127.
Collapse
Affiliation(s)
- Philippe Mortier
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Beatriz Puértolas Gracia
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ana De Inés Trujillo
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Social Psychology, Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain
| | - Itxaso Alayo Bueno
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Laura Ballester Coma
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Psychology, University of Girona (UdG), Girona, Spain
| | - María Jesús Blasco Cubedo
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - Narcís Cardoner
- Depression and Anxiety Program, Department of Mental Health, Parc Taulí Sabadell, Hospital Universitari, Sabadell, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola Del Vallès, Barcelona, Spain
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Barcelona, Spain
| | - Cristina Colls
- Agència de Qualitat i Avaluació Sanitàries de Catalunya - Health Evaluation and Quality Agency of Catalonia (AQuAS), Catalan Health Department, Barcelona, Spain
| | - Matilde Elices
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Neurosciences Research Programme, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Anna Garcia-Altes
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Qualitat i Avaluació Sanitàries de Catalunya - Health Evaluation and Quality Agency of Catalonia (AQuAS), Catalan Health Department, Barcelona, Spain
- Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| | - Manel Gené Badia
- Legal Medicine Unit, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Javier Gómez Sánchez
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Mario Martín Sánchez
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB, Parc de Salut Mar, Agència de Salut Pública de Barcelona, Pompeu Fabra University, Barcelona, Spain
| | - Rosa Morros
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, Barcelona, Spain
- Institut Català de la Salut (ICS), Metropolitana Nord, Barcelona, Spain
| | - Bibiana Prat Pubill
- Master Plan on Mental Health and Addictions, Ministry of Health, Catalan Government, Barcelona, Spain
| | - Ping Qin
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars Mehlum
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Diego Palao
- Depression and Anxiety Program, Department of Mental Health, Parc Taulí Sabadell, Hospital Universitari, Sabadell, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola Del Vallès, Barcelona, Spain
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Barcelona, Spain
| | - Víctor Pérez Sola
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola Del Vallès, Barcelona, Spain
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Neurosciences Research Programme, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Jordi Alonso
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| |
Collapse
|