ABSTRACT Background Sample Clauses

ABSTRACT Background. Risk estimation models integrated into Electronic Health Records (EHRs) can deliver innovative approaches in psychiatry, but clinicians’ endorsement and their real-world usability are unknown. This study aimed to investigate the real-world feasibility of implementing a transdiagnostic, clinically-based, lifespan-inclusive, individualised risk calculator to automatically screen EHRs and detect individuals at-risk for psychosis. Methods Feasibility implementation study encompassing an in-vitro phase (March 2018 to May 2018) and in-vivo phase (May 2018 to April 2019). The in-vitro phase addressed implementation barriers and embedded the risk calculator (predictors: age, gender, ethnicity, index cluster diagnosis, age*gender) into the local EHR. The in-vivo phase investigated the real-world feasibility of screening all individuals accessing secondary mental healthcare at the South London and Maudsley NHS Trust (SLaM). The primary outcome was adherence of clinicians to automatic EHR screening, defined by the proportion of clinicians who responded to alerts from the risk calculator, over those contacted. Results in-vitro phase: implementation barriers were identified/overcome with clinician and service user engagement, and the calculator was successfully integrated into the local EHR. in-vivo phase: 3,722 individuals were automatically screened and 115 were detected. Clinician adherence was 74% without outreach and 85% with outreach. One-third of clinicians responded to the first email (37.1%) or phone calls (33.7%). Among those detected, cumulative risk of developing psychosis was 0.12 at six-month follow-up.
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Related to ABSTRACT Background

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