Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study: protocol for a population-representative nested case–control study of suicide attempts in Catalonia, Spain

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-...

Full description

Saved in:
Bibliographic Details
Main Authors: Lars Mehlum, Ronald C Kessler, Rosa Morros, Gemma Vilagut, Jordi Alonso, Philippe Mortier, Beatriz Puértolas Gracia, Ana De Inés Trujillo, Itxaso Alayo Bueno, Laura Ballester Coma, María Jesús Blasco Cubedo, Narcís Cardoner, Cristina Colls, Matilde Elices, Anna Garcia-Altes, Manel Gené Badia, Javier Gómez Sánchez, Mario Martín Sánchez, Bibiana Prat Pubill, Ping Qin, Diego Palao, Víctor Pérez Sola
Format: Article
Language:English
Published: BMJ Publishing Group 2020-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/7/e037365.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850117700097933312
author Lars Mehlum
Ronald C Kessler
Rosa Morros
Gemma Vilagut
Jordi Alonso
Philippe Mortier
Beatriz Puértolas Gracia
Ana De Inés Trujillo
Itxaso Alayo Bueno
Laura Ballester Coma
María Jesús Blasco Cubedo
Narcís Cardoner
Cristina Colls
Matilde Elices
Anna Garcia-Altes
Manel Gené Badia
Javier Gómez Sánchez
Mario Martín Sánchez
Bibiana Prat Pubill
Ping Qin
Diego Palao
Víctor Pérez Sola
author_facet Lars Mehlum
Ronald C Kessler
Rosa Morros
Gemma Vilagut
Jordi Alonso
Philippe Mortier
Beatriz Puértolas Gracia
Ana De Inés Trujillo
Itxaso Alayo Bueno
Laura Ballester Coma
María Jesús Blasco Cubedo
Narcís Cardoner
Cristina Colls
Matilde Elices
Anna Garcia-Altes
Manel Gené Badia
Javier Gómez Sánchez
Mario Martín Sánchez
Bibiana Prat Pubill
Ping Qin
Diego Palao
Víctor Pérez Sola
author_sort Lars Mehlum
collection DOAJ
description 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.
format Article
id doaj-art-d3e8f285a72e48199daeac60e78d92ca
institution OA Journals
issn 2044-6055
language English
publishDate 2020-07-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-d3e8f285a72e48199daeac60e78d92ca2025-08-20T02:36:02ZengBMJ Publishing GroupBMJ Open2044-60552020-07-0110710.1136/bmjopen-2020-037365Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study: protocol for a population-representative nested case–control study of suicide attempts in Catalonia, SpainLars Mehlum0Ronald C Kessler1Rosa Morros2Gemma Vilagut3Jordi Alonso4Philippe Mortier5Beatriz Puértolas Gracia6Ana De Inés Trujillo7Itxaso Alayo Bueno8Laura Ballester Coma9María Jesús Blasco Cubedo10Narcís Cardoner11Cristina Colls12Matilde Elices13Anna Garcia-Altes14Manel Gené Badia15Javier Gómez Sánchez16Mario Martín Sánchez17Bibiana Prat Pubill18Ping Qin19Diego Palao20Víctor Pérez Sola21National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway3 Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USAMedicines Research Unit, Institut de Recerca en Atencio Primaria Jordi Gol, Barcelona, Catalonia, SpainCIBERESP, Madrid, Comunidad de Madrid, SpainHealth Services Research Unit, Institut Municipal d`InvestigaciÓ Mèdica, Barcelona, SpainCIBER Epidemiología y Salud Pública (CIBERESP), Madrid, SpainHealth Services Research Group, Institut Hospital del Mar d`Investigacions Mediques, Barcelona, SpainHealth Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, SpainCIBER Epidemiología y Salud Pública (CIBERESP), Madrid, SpainHealth Services Research Group, Institut Hospital del Mar d`Investigacions Mediques, Barcelona, SpainHealth Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, SpainDepression and Anxiety Program, Department of Mental Health, Parc Taulí Sabadell, Hospital Universitari, Sabadell, SpainAgència de Qualitat i Avaluació Sanitàries de Catalunya - Health Evaluation and Quality Agency of Catalonia (AQuAS), Catalan Health Department, Barcelona, SpainCentro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, SpainInstitut d’Investigació Biomèdica (IIB Sant Pau), Barcelona, SpainLegal Medicine Unit, Faculty of Medicine, University of Barcelona, Barcelona, SpainHealth Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, SpainPreventive Medicine and Public Health Training Unit PSMar-UPF-ASPB, Parc de Salut Mar, Agència de Salut Pública de Barcelona, Pompeu Fabra University, Barcelona, SpainMaster Plan on Mental Health and Addictions, Ministry of Health, Catalan Government, Barcelona, SpainShanghai DNovo Pharmatech, Shanghai, ChinaMental Health Department, Neuroscience and Mental Health Research Area, Institut d’Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, CIBERSAM, Sabadell, SpainDepartment of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola Del Vallès, Barcelona, SpainIntroduction 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.https://bmjopen.bmj.com/content/10/7/e037365.full
spellingShingle Lars Mehlum
Ronald C Kessler
Rosa Morros
Gemma Vilagut
Jordi Alonso
Philippe Mortier
Beatriz Puértolas Gracia
Ana De Inés Trujillo
Itxaso Alayo Bueno
Laura Ballester Coma
María Jesús Blasco Cubedo
Narcís Cardoner
Cristina Colls
Matilde Elices
Anna Garcia-Altes
Manel Gené Badia
Javier Gómez Sánchez
Mario Martín Sánchez
Bibiana Prat Pubill
Ping Qin
Diego Palao
Víctor Pérez Sola
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
title Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study: protocol for a population-representative nested case–control study of suicide attempts in Catalonia, Spain
title_full Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study: protocol for a population-representative nested case–control study of suicide attempts in Catalonia, Spain
title_fullStr Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study: protocol for a population-representative nested case–control study of suicide attempts in Catalonia, Spain
title_full_unstemmed Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study: protocol for a population-representative nested case–control study of suicide attempts in Catalonia, Spain
title_short Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study: protocol for a population-representative nested case–control study of suicide attempts in Catalonia, Spain
title_sort catalonia suicide risk code epidemiology csrc epi study protocol for a population representative nested case control study of suicide attempts in catalonia spain
url https://bmjopen.bmj.com/content/10/7/e037365.full
work_keys_str_mv AT larsmehlum cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT ronaldckessler cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT rosamorros cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT gemmavilagut cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT jordialonso cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT philippemortier cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT beatrizpuertolasgracia cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT anadeinestrujillo cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT itxasoalayobueno cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT lauraballestercoma cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT mariajesusblascocubedo cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT narciscardoner cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT cristinacolls cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT matildeelices cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT annagarciaaltes cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT manelgenebadia cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT javiergomezsanchez cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT mariomartinsanchez cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT bibianapratpubill cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT pingqin cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT diegopalao cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain
AT victorperezsola cataloniasuicideriskcodeepidemiologycsrcepistudyprotocolforapopulationrepresentativenestedcasecontrolstudyofsuicideattemptsincataloniaspain