用机器学习识别美军与退伍军人自杀风险,助力早期干预
Machine Learning Applications Related to Suicide in Military and Veterans: A Scoping Literature Review
- 系统梳理32篇文献,挖掘心理、生理与人口统计学等多重风险因子
- 模型具备合理预测准确率,但假阳/假阴率评估不足
- 适合政策制定者与临床研究者参考,推动精准预防策略
自杀仍是现役军人和退伍军人中主要的可预防死亡原因。早期识别与预测对预防至关重要。近年来,机器学习技术在此领域展现出良好前景。本研究旨在评估并总结机器学习在评估和预测军事及退伍军人群体自杀意念、尝试及死亡方面的应用现状。通过在PubMed、IEEE、ACM和Google Scholar进行关键词检索,并采用PRISMA协议筛选文献,共纳入32篇符合标准的研究。这些研究一致识别出与心理健康相关的风险因素,包括抑郁、创伤后应激障碍(PTSD)、自杀意念、既往尝试史、身体健康问题及人口统计特征。应用于该领域的机器学习模型表现出合理的预测准确性。然而,仍存在若干研究空白:首先,多数研究忽视了阳性预测值和阴性预测值等区分假阳性和假阴性的关键指标,而这在自杀预防政策中极为重要;其次,应对生存数据和纵向数据的专用方法仍需深入探索;最后,多数研究集中于机器学习方法本身,缺乏与其临床逻辑的关联讨论。总体而言,机器学习分析已识别出与军事人群自杀相关的一系列广泛而复杂的风险因素,其多样性与复杂性也表明有效的预防策略必须全面且灵活。
原文摘要 · Abstract (English)
Suicide remains one of the main preventable causes of death among active service members and veterans. Early detection and prediction are crucial in suicide prevention. Machine learning techniques have yielded promising results in this area recently. This study aims to assess and summarize current research and provides a comprehensive review regarding the application of machine learning techniques in assessing and predicting suicidal ideation, attempts, and mortality among members of military and veteran populations. A keyword search using PubMed, IEEE, ACM, and Google Scholar was conducted, and the PRISMA protocol was adopted for relevant study selection. Thirty-two articles met the inclusion criteria. These studies consistently identified risk factors relevant to mental health issues such as depression, post-traumatic stress disorder (PTSD), suicidal ideation, prior attempts, physical health problems, and demographic characteristics. Machine learning models applied in this area have demonstrated reasonable predictive accuracy. However, additional research gaps still exist. First, many studies have overlooked metrics that distinguish between false positives and negatives, such as positive predictive value and negative predictive value, which are crucial in the context of suicide prevention policies. Second, more dedicated approaches to handling survival and longitudinal data should be explored. Lastly, most studies focused on machine learning methods, with limited discussion of their connection to clinical rationales. In summary, machine learning analyses have identified a wide range of risk factors associated with suicide in military populations. The diversity and complexity of these factors also demonstrates that effective prevention strategies must be comprehensive and flexible.
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