# Development and clinical interpretation of machine learning emergency department suicide prediction algorithms using electronic health records and claims

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2022 · $726,197

## Abstract

Project Summary
 Preventing suicide is one of the great public health challenges facing the US health care
system. People who seek emergency care for mental health complaints are at high short-term
risk of non-fatal suicide events and suicide. Yet identifying high-risk patients is challenging as
risk fluctuates in a poorly understood manner. It is especially difficult to evaluate risk in
emergency settings, where access to the patient's mental health history is often limited. The
proposed project seeks to address this critical knowledge gap by pairing data mining and
machine learning methods with rich data sources in order to develop short-term prediction
models of non-fatal suicidal events and suicide for patients presenting to EDs with mental health
problems.
 The specific aims of this study are to 1) apply advanced machine learning data analytic
techniques to electronic health record (EHR) data to develop a clinically rich description of ED
mental health patient characteristics that predict suicide and non-fatal suicidal events over a 90-
day follow-up period; 2) use longitudinal and temporal features of EHR and claims data from the
180 days preceding the ED mental health visit to generate clinically interpretable suicide and
suicidal event risk scores; and 3) convene ED physicians to enhance model development,
clinical interpretability, and utility of a suicide risk assessment clinical decision support tool.
 We will achieve these aims by leveraging several different sophisticated machine learning
analytic methods of existing longitudinal clinical and service use information. We seek to
develop point-in-time, short-term risk scores for suicidal symptoms and suicide death and the
clinical features that drive that risk that may be used to inform clinical risk assessment and
management of patients who present to EDs with mental health complaints. Risk algorithms will
be developed and validated using health information from a large combined EHR and claims
dataset with over 24 million commercially insured patients, which is linked to the National Death
Index. Findings will yield new insights regarding patient-specific risk factors and potential targets
for intervention. By drawing on data sources common to most health care systems and using
efficient computer algorithms this approach has the potential to develop clinically interpretable
suicide risk scores at the point of ED evaluation and following disposition. This will help front-
line clinicians focus their efforts on high risk patients during high risk periods to inform
intervention decisions about suicide risk.

## Key facts

- **NIH application ID:** 10462646
- **Project number:** 5R01MH126895-02
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** STEVEN C MARCUS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $726,197
- **Award type:** 5
- **Project period:** 2021-08-05 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10462646

## Citation

> US National Institutes of Health, RePORTER application 10462646, Development and clinical interpretation of machine learning emergency department suicide prediction algorithms using electronic health records and claims (5R01MH126895-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10462646. Licensed CC0.

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