title: Classification Algorithm for the Determination of Suicide Attempt and Suicide (CAD-SAS). Development and psychometric properties.
abstract: BACKGROUND
  One methodological difficulty in research into suicide attempts and suicide is distinguishing these phenomena from nonsuicidal self-harming behaviors and accidents. This is problematic because a reliable assessment of the presence or absence of the outcome variable is fundamental for the validity of the findings.
  
  
  OBJECTIVE
  To develop a standardized rating system, the Classification Algorithm for the Determination of Suicide Attempt and Suicide (CAD-SAS), and to investigate its psychometric properties.
  
  
  METHODS
  To examine the test-retest reliability, one investigator rated 217 narratives of real-life self-harming incidents at initial assessment and 4 weeks later. To establish the interrater reliability, three independent raters assessed a random sample of 70 narratives using the CAD-SAS. To examine the validity, one investigator using the CAD-SAS compared ratings to clinical judgments made by a consultant psychiatrist without the CAD-SAS on the same random set of 70 narratives.
  
  
  RESULTS
  Test-retest reliability was excellent (97.2% agreement) and interrater reliability was substantial (70.0% agreement, κ = 0.70). Agreement in the classification of incidents with the "real-world" clinical judgments supports the validity of the CAD-SAS (64.3% agreement, κ = 0.46).
  
  
  CONCLUSIONS
  The reliability and validity of future studies can be enhanced through the standardized assessment and classification of incidents.
authors.affiliation: School of Psychological Science, La Trobe University, Melbourne, VIC 3086, Australia. izabela.fedyszyn@gmail.com
authors.forename: Izabela E
authors.initials: IE
authors.lastname: Fedyszyn
authors.forename: Meredith G
authors.initials: MG
authors.lastname: Harris
authors.forename: Jo
authors.initials: J
authors.lastname: Robinson
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Paxton
mesh_terms: D000293:Adolescent; D000465:Algorithms; D005260:Female; D006801:Humans; D008297:Male; D011594:Psychometrics; D015203:Reproducibility of Results; D016728:Self-Injurious Behavior / Q000145:classification*; D013405:Suicide / Q000145:classification*; D013406:Suicide, Attempted / Q000145:classification*; D055815:Young Adult