The development and validation of a dashboard prototype for real-time suicide mortality data

Introduction/Aim

Data visualisation is key to informing data-driven decision-making, yet this is an underexplored area of suicide surveillance. By way of enhancing a real-time suicide surveillance system model, an interactive dashboard prototype has been developed to facilitate emerging cluster detection, risk profiling and trend observation, as well as to establish a formal data sharing connection with key stakeholders via an intuitive interface.

Materials and Methods

Individual-level demographic and circumstantial data on cases of confirmed suicide and open verdicts meeting the criteria for suicide in County Cork 2008-2017 were analysed to validate the model. The retrospective and prospective space-time scan statistics based on a discrete Poisson model were employed via the R software environment using the "rsatscan" and "shiny" packages to conduct the space-time cluster analysis and deliver the mapping and graphic components encompassing the dashboard interface.

Results

Using the best-fit parameters, the retrospective scan statistic returned several emerging non-significant clusters detected during the 10-year period, while the prospective approach demonstrated the predictive ability of the model. The outputs of the investigations are visually displayed using a geographical map of the identified clusters and a timeline of cluster occurrence.

Discussion

The challenges of designing and implementing visualizations for suspected suicide data are presented through a discussion of the development of the dashboard prototype and the potential it holds for supporting real-time decision-making.

Conclusions

The results demonstrate that integration of a cluster detection approach involving geo-visualisation techniques, space-time scan statistics and predictive modelling would facilitate prospective early detection of emerging clusters, at-risk populations, and locations of concern. The prototype demonstrates real-world applicability as a proactive monitoring tool for timely action in suicide prevention by facilitating informed planning and preparedness to respond to emerging suicide clusters and other concerning trends.

A repeated cross-sectional study of factors associated with pregabalin-positive poisoning deaths in Ireland

BACKGROUND

The increasing use of pregabalin and the presence of pregabalin in poisoning deaths, particularly with opioids, highlight it as a potential drug of abuse. In this study we examined factors associated with pregabalin-positive poisoning deaths (PPPD) between 2013 and 2016 in Ireland.

METHODS

Data were extracted from the National Drug-Related Deaths Index (NDRDI). Analysis included univariate and multivariate logistic regression to estimate unadjusted and adjusted odds ratios (OR) and 95 % confidence intervals (CI) for factors associated with PPPD (primary outcome) by logistic regression models for the total sample and stratified by gender.

RESULTS

Pregabalin was present on 240 (16 %) toxicology reports of 1489 poisoning deaths; significantly rising from 15 (4.5 %) in 2013 to 94 (26 %) in 2016. Women (AOR 2.69, 95 % CI: 1.95-3.70), opioid misuse (AOR 1.74, 95 % CI: 1.17-2.59), in receipt of treatment for problem drug use (AOR 1.95, 95 % CI: 1.33-2.86) and year of death (2016 vs 2013) (AOR 7.95, 95 % CI: 4.58-13.79) were associated with increased odds of PPPD. Alcohol dependence was associated with reduced odds of PPPD (AOR 0.59, 95 % CI: 0.41-0.85). For men, opioid misuse, in receipt of treatment for problem drug use, and year of death were associated with increased odds of PPPD, while alcohol dependence was associated with reduced odds of PPPD. For women, in receipt of treatment for problem drug use and year of death were associated with increased odds of PPPD.

CONCLUSIONS

Enhanced training to prescribers and treatment providers on the potential risks associated with pregabalin, particularly among people who use drugs, is required.

[Time-related aspects of suicides - suicide frequency related to birthday, major holidays, day of the week, season, month of birth and zodiac signs]

BACKGROUND

Suicides are generally the consequence of overchallenged coping strategies of individual for psychological, social or internal and external biological strain factors. Timing of the suicide, too, may be influenced by external factors. Studies so far have yielded in part inconsistent results concerning the association of suicides with particular days or periods of the year. Even less is known regarding a potential effect of the time of birth on suicide risk.

METHODS

The Tyrol Suicide Register (TSR) provides data on suicides occurring in the Austrian State of Tyrol including birthday of the suicide victim and day of the suicide. In the present study the frequency of suicides was analyzed with regard to birthday, day of the week, major holidays and season over a period of 17 years. Further, a potential association with month of birth and zodiac signs was studied.

RESULTS

We found a significant variation in suicide frequency concerning day of the week with a peak on Mondays and Tuesdays and seasonality with increased numbers in spring and summer months.

CONCLUSIONS

The increase of suicide numbers at the beginning of the week may be explained by the "broken-promise effect" which has been described as the consequence of frustrated expectations concerning the weekend. Possible explanations for the suicide peaks in spring and summer may be biological, specifically serotonergic alterations as well as the experience of depressed patients perceiving the social and emotional contrast to people who are able to enjoy these periods of pleasure and outdoor activities.

Differing Procedures for Recording Mortality Statistics in Scandinavia

BACKGROUND

There may be various reasons for differences in suicide rates between countries and over time within a country. One reason can be different registration practices.

AIMS

The purpose of this study was to describe and compare the present procedures for mortality and suicide registration in the three Scandinavian countries and to illustrate potential sources of error in the registration of suicide.

METHOD

Information about registration practices and classification procedures was obtained from the cause of death registers in Norway, Sweden, and Denmark. In addition, we received information from experts in the field in each country.

RESULTS

Sweden uses event of undetermined intent more frequently than Denmark does, and Denmark more frequently than Norway. There seems to be somewhat more uncertainty among deaths classified as ill-defined and unknown cause of mortality in Norway, compared with the other two countries. Sweden performs more forensic autopsies than Norway, and Norway more than Denmark. In Denmark, in cases of a suspected unnatural manner of death, a thorough external examination of the deceased is performed.

CONCLUSION

Differences in the classification of causes of death and in postmortem examinations exist in Scandinavian countries. These differences might influence the suicide statistics in Scandinavia.