{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:37:34Z","timestamp":1787017054365,"version":"build-2736575974"},"reference-count":25,"publisher":"BMJ","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Inj Prev"],"published-print":{"date-parts":[[2006,10]]},"abstract":"<jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    To classify poisoning deaths of undetermined intent as either suicide or unintentional and to estimate the extent of underreported poisoning suicides.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    Based on 2002 statewide death certificate and medical examiner data in Utah, the authors randomly selected one half of undetermined and unintentional poisoning deaths for data abstraction and included all suicides. Bivariate analyses assessed differences in demographics, death characteristics, forensic toxicology results, mental health history, and other potentially contributing factors. Classification and regression tree (CART) analysis used information from unintentional and suicide poisoning deaths to create a classification tree that was applied to undetermined poisoning deaths.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    The authors analyzed 41 unintentional, 87 suicide, and 84 undetermined poisonings. Undetermined and unintentional decedents were similar in the presence of opiates, physical health problems, and drug abuse. Although none of the undetermined decedents left a suicide note, previous attempt or intent to commit suicide was reported for 11 (13%) of these cases. CART analysis identified suicidal behavior, drug abuse, physical health problems, depressed mood, and age as discriminating between suicide and unintentional poisoning. It is estimated that suicide rates related to poisoning are underreported by approximately 30% and overall suicide rates by 10%. Unintentional poisoning death rates were underreported by 61%.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    This study suggests that manner of death determination relies on circumstance dependent variables that may not be consistently captured by medical examiners. Underreporting of suicide rates has important implications in policy development, research funding, and evaluation of prevention programs.\n                  <\/jats:p>","DOI":"10.1136\/ip.2005.011171","type":"journal-article","created":{"date-parts":[[2006,10,3]],"date-time":"2006-10-03T13:54:24Z","timestamp":1159883664000},"page":"338-343","source":"Crossref","is-referenced-by-count":70,"title":["Classifying undetermined poisoning deaths"],"prefix":"10.1136","volume":"12","author":[{"given":"A E","family":"Donaldson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G Y","family":"Larsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Fullerton-Gleason","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L M","family":"Olson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2006,10,3]]},"reference":[{"key":"2025092503504060000_12.5.338.1","unstructured":"Institute of Medicine. Reducing suicide: a national imperative. Goldsmith SK, Pellmar TC, Kleinman AM, Bunney WE (eds). Washington DC: The National Academies Press, 2002."},{"key":"2025092503504060000_12.5.338.2","unstructured":"Public Health Service. National strategy for suicide prevention: goals and objectives for action. Silverman MM, Frankel MJ, Miller AC (eds). 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National Center for Injury Prevention and Control. Web-based injury statistics query and reporting system. Available at http:\/\/www.cdc.gov\/ncipc\/dvp\/dvp.htm (accessed November 2005)."},{"key":"2025092503504060000_12.5.338.12","unstructured":"Harvard Injury Control Research Center. National Violent Injury Statistics System Workgroup. Uniform data elements: National Violent Injury Statistics System, release 2, 0. Available at http:\/\/www.hsph.harvard.edu\/nviss\/documents\/Version2UDE3.pdf (accessed May 2005)."},{"key":"2025092503504060000_12.5.338.13","doi-asserted-by":"publisher","DOI":"10.1136\/ip.2003.003434"},{"key":"2025092503504060000_12.5.338.14","unstructured":"Lewis RJ. An introduction to classification and regression tree (CART) analysis. Available at http:\/\/www.saem.org\/download\/lewis1.pdf (accessed May 2005)."},{"key":"2025092503504060000_12.5.338.15","unstructured":"Breiman L, Friedman JH, Olshen RA, et al. Classification and regression trees. New York: Chapman and Hall, 1993."},{"key":"2025092503504060000_12.5.338.16","doi-asserted-by":"publisher","DOI":"10.1023\/A:1010933404324"},{"key":"2025092503504060000_12.5.338.17","unstructured":"Breiman L, Cutler A. Random forests. Available at http:\/\/oz.berkeley.edu\/users\/breiman\/RandomForests\/cc_home.htm (accessed March 2006)."},{"key":"2025092503504060000_12.5.338.18","doi-asserted-by":"crossref","first-page":"150","DOI":"10.2105\/AJPH.91.1.150","volume":"91","year":"2001","journal-title":"Am J Public Health"},{"key":"2025092503504060000_12.5.338.19","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.133.6.542"},{"key":"2025092503504060000_12.5.338.20","doi-asserted-by":"publisher","DOI":"10.1159\/000049297"},{"key":"2025092503504060000_12.5.338.21","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1177\/002580240104100205","volume":"41","year":"2001","journal-title":"Med Sci Law"},{"key":"2025092503504060000_12.5.338.22","unstructured":"Hanzlick R, Hunsaker JC, Davis GJ. National Association of Medical Examiners. A guide for manner of death classification. Available at http:\/\/www.thename.org\/Library\/MannerRev.pdf (accessed June 2005)."},{"key":"2025092503504060000_12.5.338.23","first-page":"49","volume":"50","year":"2002","journal-title":"Rev Epidemiol Sante Publique"},{"key":"2025092503504060000_12.5.338.24","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.178.5.465"},{"key":"2025092503504060000_12.5.338.25","doi-asserted-by":"publisher","DOI":"10.1097\/00000433-199709000-00003"}],"container-title":["Injury Prevention"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/ip.2005.011171","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T10:50:52Z","timestamp":1758797452000},"score":1,"resource":{"primary":{"URL":"https:\/\/injuryprevention.bmj.com\/lookup\/doi\/10.1136\/ip.2005.011171"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,10]]},"references-count":25,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2006,10,3]]},"published-print":{"date-parts":[[2006,10]]}},"alternative-id":["10.1136\/ip.2005.011171"],"URL":"https:\/\/doi.org\/10.1136\/ip.2005.011171","relation":{},"ISSN":["1353-8047","1475-5785"],"issn-type":[{"value":"1353-8047","type":"print"},{"value":"1475-5785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,10]]}}}