TY - JOUR
T1 - Transdiagnostic risk calculator for the automatic detection of individuals at risk and the prediction of psychosis
T2 - second replication in an independent National Health Service Trust
AU - Fusar-Poli, Paolo
AU - Werbeloff, Nomi
AU - Rutigliano, Grazia
AU - Oliver, Dominic
AU - Davies, Cathy
AU - Stahl, Daniel
AU - McGuire, Philip
AU - Osborn, David
PY - 2018/6/12
Y1 - 2018/6/12
N2 - Background
The benefits of indicated primary prevention among individuals at Clinical High Risk for Psychosis (CHR-P) are limited by the difficulty in detecting these individuals. To overcome this problem, a transdiagnostic, clinically based, individualized risk calculator has recently been developed and subjected to a first external validation in 2 different catchment areas of the South London and Maudsley (SLaM) NHS Trust.
Methods
Second external validation of real world, real-time electronic clinical register-based cohort study. All individuals who received a first ICD-10 index diagnosis of nonorganic and nonpsychotic mental disorder within the Camden and Islington (C&I) NHS Trust between 2009 and 2016 were included. The model previously validated included age, gender, ethnicity, age by gender, and ICD-10 index diagnosis to predict the development of any ICD-10 nonorganic psychosis. The model’s performance was measured using Harrell’s C-index.
Results
This study included a total of 13702 patients with an average age of 40 (range 16–99), 52% were female, and most were of white ethnicity (64%). There were no CHR-P or child/adolescent services in the C&I Trust. The C&I and SLaM Trust samples also differed significantly in terms of age, gender, ethnicity, and distribution of index diagnosis. Despite these significant differences, the original model retained an acceptable predictive performance (Harrell’s C of 0.73), which is comparable to that of CHR-P tools currently recommended for clinical use.
Conclusions
This risk calculator may pragmatically support an improved transdiagnostic detection of at-risk individuals and psychosis prediction even in NHS Trusts in the United Kingdom where CHR-P services are not provided.
AB - Background
The benefits of indicated primary prevention among individuals at Clinical High Risk for Psychosis (CHR-P) are limited by the difficulty in detecting these individuals. To overcome this problem, a transdiagnostic, clinically based, individualized risk calculator has recently been developed and subjected to a first external validation in 2 different catchment areas of the South London and Maudsley (SLaM) NHS Trust.
Methods
Second external validation of real world, real-time electronic clinical register-based cohort study. All individuals who received a first ICD-10 index diagnosis of nonorganic and nonpsychotic mental disorder within the Camden and Islington (C&I) NHS Trust between 2009 and 2016 were included. The model previously validated included age, gender, ethnicity, age by gender, and ICD-10 index diagnosis to predict the development of any ICD-10 nonorganic psychosis. The model’s performance was measured using Harrell’s C-index.
Results
This study included a total of 13702 patients with an average age of 40 (range 16–99), 52% were female, and most were of white ethnicity (64%). There were no CHR-P or child/adolescent services in the C&I Trust. The C&I and SLaM Trust samples also differed significantly in terms of age, gender, ethnicity, and distribution of index diagnosis. Despite these significant differences, the original model retained an acceptable predictive performance (Harrell’s C of 0.73), which is comparable to that of CHR-P tools currently recommended for clinical use.
Conclusions
This risk calculator may pragmatically support an improved transdiagnostic detection of at-risk individuals and psychosis prediction even in NHS Trusts in the United Kingdom where CHR-P services are not provided.
U2 - 10.1093/schbul/sby070
DO - 10.1093/schbul/sby070
M3 - Article
SN - 0586-7614
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
ER -