{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:09:40Z","timestamp":1788786580742,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Suicide &amp; Life Threat Behav"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Literature on how to translate information extracted from clinical progress notes into numeric scores for 3\u2010step theory of suicide (3ST) factors is nonexistent. We determined which scoring option would best discriminate between patients who will attempt or die by suicide and patients with neither suicidal ideation nor attempts, and we tested hypotheses related to the 3ST.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used terminology\u2010driven natural language processing (NLP) to extract information from Veterans Health Administration (VHA) clinical progress notes. Counts of those extractions served as input to evaluate candidate scoring options for each 3ST factor (psychological pain, hopelessness, connectedness, capability for suicide). Logistic regression models adjusted for common demographic characteristics were used to test the 3ST hypotheses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Optimal contrasts between groups were obtained with\n                      <jats:italic>P\u2009\u2212\u2009A<\/jats:italic>\n                      for psychological pain, hopelessness, and capability for suicide, and  for connectedness, where\n                      <jats:italic>P<\/jats:italic>\n                      and\n                      <jats:italic>A<\/jats:italic>\n                      , respectively, indicate the patient\u2010level number of extractions indicating presence and absence of the factor.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations<\/jats:title>\n                    <jats:p>Additional research is necessary to verify whether our conclusions hold in a cohort that is more reflective of the general VHA population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Terminology\u2010driven 3ST factor scores discriminate patients who attempt or die by suicide from patients without suicidal ideation or attempts. Our results corroborate the validity of the 3ST for VHA patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/sltb.70004","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T07:58:23Z","timestamp":1737705503000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Computing 3\u2010Step Theory of Suicide Factor Scores From Veterans Health Administration Clinical Progress Notes"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5367-0978","authenticated-orcid":false,"given":"Esther L.","family":"Meerwijk","sequence":"first","affiliation":[{"name":"VA Health Systems Research, Center for Innovation to Implementation (Ci2i) VA Palo Alto Health Care System  Menlo Park California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asqar S.","family":"Shotqara","sequence":"additional","affiliation":[{"name":"VA Health Systems Research, Center for Innovation to Implementation (Ci2i) VA Palo Alto Health Care System  Menlo Park California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea K.","family":"Finlay","sequence":"additional","affiliation":[{"name":"VA Health Systems Research, Center for Innovation to Implementation (Ci2i) VA Palo Alto Health Care System  Menlo Park California USA"},{"name":"VA National Center on Homelessness Among Veterans  USA"},{"name":"Division of Health Systems Science, Department of Medicine UMass Chan Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth M.","family":"Reeves","sequence":"additional","affiliation":[{"name":"VA Tennessee Valley Healthcare System  Nashville Tennessee USA"},{"name":"Department of Biomedical Informatics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne R.","family":"Tamang","sequence":"additional","affiliation":[{"name":"VA Health Systems Research, Center for Innovation to Implementation (Ci2i) VA Palo Alto Health Care System  Menlo Park California USA"},{"name":"Department of Medicine Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Ilgen","sequence":"additional","affiliation":[{"name":"VA Health Systems Research Center for Clinical Management Research  Ann Arbor Michigan USA"},{"name":"Department of Psychiatry University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex H. S.","family":"Harris","sequence":"additional","affiliation":[{"name":"VA Health Systems Research, Center for Innovation to Implementation (Ci2i) VA Palo Alto Health Care System  Menlo Park California USA"},{"name":"Department of Surgery Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.1697"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.22531"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0037562"},{"key":"e_1_2_8_5_1","first-page":"273","article-title":"Selection of Clinical Text Features for Classifying Suicide Attempts","volume":"2020","author":"Buckland R. 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L.2024.\u201cAssessing Demographic Bias in Terminology Driven Natural Language Processing of VHA Clinical Progress Notes. A Between Patients Comparison of Psychological Pain Hopelessness Connectedness and Capacity for Suicide [Oral].\u201dVA\/DoD Suicide Prevention Conference Portland OR July 18 2024."},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2023.104582"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102022\u2010065088"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2021.07.009"},{"key":"e_1_2_8_32_1","unstructured":"Python Software Foundation. n.d.\u201cPython.\u201dhttps:\/\/www.python.org\/."},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-55865-8_8"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.2019.1496"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/096228029900800203"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1943-278X.1998.tb00854.x"},{"key":"e_1_2_8_37_1","unstructured":"Tamang S. 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