Suicide prediction with natural language processing of electronic health records

Suicide attempts are one of the most challenging psychiatric outcomes and have great importance in clinical practice. However, they remain difficult to detect in a standardised way to assist prevention because assessment is mostly qualitative and often subjective. As digital documentation is increasingly used in the medical field, Electronic Health Records (EHRs) have become a source of information that can be used for prevention purposes, containing codified data, structured data, and unstructured free text. This study aims to provide a quantitative approach to suicidality detection using EHRs, employing natural language processing techniques in combination with deep learning artificial intelligence methods to create an algorithm intended for use with medical documentation in German. Using psychiatric medical files from in-patient psychiatric hospitalisations between 2013 and 2021, free text reports will be transformed into structured embeddings using a German trained adaptation of Word2Vec, followed by a Long-Short Term Memory (LSTM) – Convolutional Neural Network (CNN) approach on sentences of interest. Text outside the sentences of interest will be analysed as context using a fixed size ordinally-forgetting encoding (FOFE) before combining these findings with the LSTM-CNN results in order to label suicide related content. This study will offer promising ways for automated early detection of suicide attempts and therefore holds opportunities for mental health care. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: ethics committee of the University of Luebeck, Germany on September 28th, 2021 (reference: 21-256). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors