Development of the Self-Injury Risk Assessment Protocol for Corrections (SIRAP-C).

OBJECTIVE: We developed the Self-Injury Risk Assessment Protocol for Corrections (SIRAP-C) to meet legal mandates for self-directed violence (SDV) risk assessment standards in correctional settings. We focused on two empirical aims: (1) factor structure and internal consistency and (2) subscale associations with SDV and intervention recommendation outcomes. HYPOTHESES: We expected a multifactorial SIRAP-C structure with acceptable internal consistency. We further expected SIRAP-C subscales would distinguish history of SDV events while incarcerated, current SDV event category, and treatment recommendation. METHOD: We drew electronic health record data for adult incarcerated persons (N = 3,929) from state Division of Prisons records from 2016 to 2020. Clinical records included demographic and correctional institutional information, as well as SIRAP-C records. Factor analyses assessed Aim 1. Regression models tested Aim 2. RESULTS: Factor analyses supported a seven-factor SIRAP-C structure (27 items) comprising Depressive Symptoms, Reasons for Living, History of Self-Directed Violence, Current Suicidal Thinking, Family History of Self-Directed Violence, Coping Skills, and Social Connectedness. Subscales displayed acceptable internal consistency, with the exception of social connectedness in the confirmatory factor analysis subsample. Lower depressive symptoms and coping skills, as well as higher history of SDV, were associated with increased risk for a prior SDV assessment event while incarcerated. Lower depressive symptoms, current suicidal thinking, and coping skills and higher history of SDV marked worse risk for self-injurious behavior. Higher depressive symptoms and current suicidal thinking, as well as lower reasons for living, demarcated suicidal acts from self-injury. Higher history of SDV and lower coping skills indicated outpatient/residential treatment. Elevated depressive symptoms and history of SDV, as well as lower reasons for living and coping skills, were associated with inpatient hospitalization. CONCLUSIONS: The SIRAP-C represents a promising clinical approach advancing correctional SDV risk assessment. We offer future research, policy, and implementation recommendations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Developing a Data Quality Standard Primer for Cardiovascular Risk Assessment from Electronic Health Record Data Using the DataGauge Process.

The learning health systems aim to support the needs of patients with chronic diseases, which require methods that account for electronic health recorded (EHR) data limitations. EHR data is often used to calculate cardiovascular risk scores. However, it is unclear whether EHR data presents high enough quality to provide accurate estimates. Still, there is currently no open standard available to assess data quality for such applications. We applied the DataGauge process to develop a data quality standard based on expert clinical, analytical and informatics knowledge by conducting four interviews and one focus group that produced 61 individual data quality requirements. These requirements covered all standard data quality dimensions and uncovered 705 quality issues in EHR data for 456 patients. These requirements will be expanded and further validated in future work. Our work initiates the development of open and explicit data quality standards for specific secondary uses of clinical data.