{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:23:50Z","timestamp":1792038230391,"version":"4.4.0"},"reference-count":28,"publisher":"Royal College of General Practitioners","issue":"749","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"accepted":{"date-parts":[[2024,7,9]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Early detection could reduce the duration of untreated psychosis. GPs are a vital part of the psychosis care pathway, but find it difficult to detect the early features. An accurate risk prediction tool, P Risk, was developed to detect these.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To externally validate P Risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>This retrospective cohort study used a validation dataset of 1 647 934 UK Clinical Practice Research Datalink (CPRD) primary care records linked to secondary care records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The same predictors (age; sex; ethnicity; social deprivation; consultations for suicidal behaviour, depression\/anxiety, and substance misuse; history of consultations for suicidal behaviour; smoking history; substance misuse; prescribed medications for depression\/anxiety\/post-traumatic stress disorder\/obsessive compulsive disorder; and total number of consultations) were used as for the development of P Risk. Predictive risk, sensitivity, specificity, and likelihood ratios were calculated for various risk thresholds. Discrimination (Harrell\u2019s C-index) and calibration were calculated. Results were compared between the development (CPRD GOLD) and validation (CPRD Aurum) datasets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Psychosis risk increased with values of the P Risk prognostic index. Incidence was highest in younger age groups and, in the main, higher in males. Harrell\u2019s C was 0.79 (95% confidence interval = 0.78 to 0.79) in the validation dataset and 0.77 in the development dataset. A risk threshold of 1.0% gave sensitivity of 65.9% and specificity of 86.6%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Further testing is required, but P Risk has the potential to be used in primary care to detect future risk of psychosis.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgp.2024.0017","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T10:35:13Z","timestamp":1721039713000},"page":"e854-e860","source":"Crossref","is-referenced-by-count":7,"title":["External validation of a prognostic model to improve prediction of psychosis: a retrospective cohort study in primary care"],"prefix":"10.3399","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1446-8478","authenticated-orcid":false,"given":"Sarah A","family":"Sullivan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7240-4563","authenticated-orcid":false,"given":"Richard","family":"Morris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6392-6690","authenticated-orcid":false,"given":"Daphne","family":"Kounali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5333-132X","authenticated-orcid":false,"given":"David","family":"Kessler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1611-1373","authenticated-orcid":false,"given":"Willie","family":"Hamilton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5205-8245","authenticated-orcid":false,"given":"Glyn","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippa","family":"Lilford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irwin","family":"Nazareth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"issue":"1","key":"2024112817354473000_74.749.e854.1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1038\/s41537-022-00301-4","article-title":"Three-year outcomes and predictors for full recovery in patients with early-stage psychosis","volume":"8","author":"Li","year":"2022","journal-title":"Schizophrenia (Heidelb)"},{"key":"2024112817354473000_74.749.e854.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2006.00942.x"},{"key":"2024112817354473000_74.749.e854.3","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2019.18060721"},{"key":"2024112817354473000_74.749.e854.4","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.9.975"},{"issue":"S43","key":"2024112817354473000_74.749.e854.5","doi-asserted-by":"crossref","first-page":"S73","DOI":"10.1192\/bjp.181.43.s73","article-title":"Duration of untreated psychosis and pathways to care in first-episode psychosis. Investigation of help-seeking behaviour in primary care","volume":"181","author":"Skeate","year":"2002","journal-title":"Br J Psychiatry Suppl"},{"key":"2024112817354473000_74.749.e854.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.307.6895.32"},{"key":"2024112817354473000_74.749.e854.7","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-006-0117-4"},{"key":"2024112817354473000_74.749.e854.8","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.191.51.s133"},{"key":"2024112817354473000_74.749.e854.9","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-7-117"},{"key":"2024112817354473000_74.749.e854.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1614.2005.01714.x"},{"issue":"1\u20133","key":"2024112817354473000_74.749.e854.11","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.schres.2015.03.013","article-title":"Actigraphic-measured sleep disturbance predicts increased positive symptoms in adolescents at ultra high-risk for psychosis: a longitudinal study","volume":"164","author":"Lunsford-Avery","year":"2015","journal-title":"Schizophr Res"},{"issue":"7","key":"2024112817354473000_74.749.e854.12","doi-asserted-by":"crossref","first-page":"e185174","DOI":"10.1001\/jamanetworkopen.2018.5174","article-title":"Association of primary care consultation patterns with early signs and symptoms of psychosis","volume":"1","author":"Sullivan","year":"2018","journal-title":"JAMA Netw Open"},{"key":"2024112817354473000_74.749.e854.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2022.06.031"},{"key":"2024112817354473000_74.749.e854.14","doi-asserted-by":"publisher","DOI":"10.7326\/M14-0698"},{"key":"2024112817354473000_74.749.e854.15","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz034"},{"key":"2024112817354473000_74.749.e854.16","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv098"},{"key":"2024112817354473000_74.749.e854.17","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-13-33"},{"key":"2024112817354473000_74.749.e854.18","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4"},{"key":"2024112817354473000_74.749.e854.19","unstructured":"Office for National Statistics Ethnic group by age and sex, England and Wales: Census 2021, https:\/\/www.google.com\/search?q=proportion+of+white+population+in+uk&rlz=1C1GCEA_enGB1018GB1018&oq=proportion+of+wh&aqs=chrome.0.0i512l2j69i57j0i512l3j0i22i30l4.6648j1j15&sourceid=chrome&ie=UTF-8 (accessed 31 Jul 2024)."},{"key":"2024112817354473000_74.749.e854.20","doi-asserted-by":"publisher","DOI":"10.1002\/sim.6787"},{"key":"2024112817354473000_74.749.e854.21","unstructured":"Research Group TRIPOD TRIPOD checklist: prediction model validations, https:\/\/www.tripod-statement.org\/resources\/ (accessed 4 Oct 2024)."},{"key":"2024112817354473000_74.749.e854.22","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j2099"},{"key":"2024112817354473000_74.749.e854.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2004.04.006"},{"key":"2024112817354473000_74.749.e854.24","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0036468"},{"key":"2024112817354473000_74.749.e854.25","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291706008774"},{"issue":"7","key":"2024112817354473000_74.749.e854.26","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1017\/S0033291716003494","article-title":"Prediction of transition to psychosis in patients with a clinical high risk for psychosis: a systematic review of methodology and reporting","volume":"47","author":"Studerus","year":"2017","journal-title":"Psychol Med"},{"issue":"1","key":"2024112817354473000_74.749.e854.27","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/schbul\/sby189","article-title":"Using machine learning and structural neuroimaging to detect first episode psychosis: reconsidering the evidence","volume":"46","author":"Vieira","year":"2020","journal-title":"Schizophr Bull"},{"key":"2024112817354473000_74.749.e854.28","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-017-0430-8"}],"container-title":["British Journal of General Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.3399\/BJGP.2024.0017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T01:37:46Z","timestamp":1732844266000},"score":1,"resource":{"primary":{"URL":"http:\/\/bjgp.org\/lookup\/doi\/10.3399\/BJGP.2024.0017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,15]]},"references-count":28,"journal-issue":{"issue":"749","published-online":{"date-parts":[[2024,11,28]]},"published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.3399\/BJGP.2024.0017"],"URL":"https:\/\/doi.org\/10.3399\/bjgp.2024.0017","relation":{},"ISSN":["0960-1643","1478-5242"],"issn-type":[{"value":"0960-1643","type":"print"},{"value":"1478-5242","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,15]]}}}