# CDR Administrative Supplement for COVID-19 Impacted NIMH Research

> **NIH NIH R01** · UNIV OF MASSACHUSETTS MED SCH WORCESTER · 2022 · $294,929

## Abstract

ABSTRACT
Significance: As recent national controversy over Joint Commission mandates proves, universal suicide risk
screening in emergency departments (ED) will not achieve widespread adoption because confusion remains
around which specific risk indicators to assess, and clinicians fear that such screening will lead to massive
surges in psychiatric evaluations. To address these two implementation barriers, this study was funded to
derive a clinical decision rule to support universal risk detection and optimize patient care workflow in adults.
Investigators: The Project Team has extensive expertise in ED-based suicide risk screening and assessment
(Boudreaux, Larkin), clinical decision rule design (Boudreaux, Stiell), predictive analytics (Wang, Liu, Simon),
machine learning and informatics (Liu, Simon), industrial engineering (Johnson), and healthcare economics
(Clements). A Clinical Advisory Panel ensures that the proposal is grounded in the practical realities of the ED.
Innovation: The study will be the first to apply industry standards for deriving decision rules to suicide risk and
will directly inform the controversy regarding the relative strengths and weaknesses of universal versus
targeted screening. We will pioneer new statistical innovations for rule derivation and will integrate simulation
of potential workflow impact using industrial engineering modeling and economic analyses.
Approach: We have developed a pool of empirically supported clinician-acceptable candidate suicide risk
indicators. Data on these candidate indicators are being collected by trained research staff on adult medical
and psychiatric patients from a large ED. Participants are undergoing a comprehensive suicide risk
assessment by a research clinician, blinded to the indicators, who assigns the participant to a criterion
reference risk group: Negligible, Mild-Moderate, or High risk. Participants are being followed for 24 weeks after
the visit to assess suicidal behavior, our secondary outcome. In Aim 1, we will derive a universal screening
decision rule for “all comers,” as well as a variant to be used with patients presenting with a psychiatric chief
complaint (targeted). In Aim 2, we will test whether a previously validated risk stratification algorithm using
data from the electronic health record improves the performance of the decision rules. In Aim 3, we will model
the potential operational impact of the rules through dynamic modeling of clinical workflow and economic costs
and assessing clinician and patient acceptability in a new sample of 100 ED clinician-patient dyads.
Environment: UMass has demonstrated its capability to support this study through several key preliminary
studies, including the ED-SAFE studies, System of Safety, and other suicide-related studies set in the ED.
Impact: By providing clear, evidence-based recommendations on universal screening and optimized workflow
using standards accepted by emergency clinicians, this study will address two p...

## Key facts

- **NIH application ID:** 10617502
- **Project number:** 3R01MH118220-04S1
- **Recipient organization:** UNIV OF MASSACHUSETTS MED SCH WORCESTER
- **Principal Investigator:** Edwin D Boudreaux
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $294,929
- **Award type:** 3
- **Project period:** 2022-05-31 → 2024-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10617502

## Citation

> US National Institutes of Health, RePORTER application 10617502, CDR Administrative Supplement for COVID-19 Impacted NIMH Research (3R01MH118220-04S1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10617502. Licensed CC0.

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