title: Computerized Adaptive Test vs. decision trees: Development of a support decision system to identify suicidal behavior.
abstract: Several Computerized Adaptive Tests (CATs) have been proposed to facilitate assessments in mental health. These tests are built in a standard way, disregarding useful and usually available information not included in the assessment scales that could increase the precision and utility of CATs, such as the history of suicide attempts.
  
  
  
  Using the items of a previously developed scale for suicidal risk, we compared the performance of a standard CAT and a decision tree in a support decision system to identify suicidal behavior. We included the history of past suicide attempts as a class for the separation of patients in the decision tree.
  
  
  
  The decision tree needed an average of four items to achieve a similar accuracy than a standard CAT with nine items. The accuracy of the decision tree, obtained after 25 cross-validations, was 81.4%. A shortened test adapted for the separation of suicidal and non-suicidal patients was developed.
  
  
  
  CATs can be very useful tools for the assessment of suicidal risk. However, standard CATs do not use all the information that is available. A decision tree can improve the precision of the assessment since they are constructed using a priori information.
authors.affiliation: Department of Statistics, Carlos III University, Madrid, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Delgado-Gomez
authors.affiliation: Department of Psychiatry, IIS-Jimenez Diaz Foundation, CIBERSAM, Madrid, Spain; Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, United States.
authors.forename: E
authors.initials: E
authors.lastname: Baca-Garcia
authors.affiliation: Instituto Ingeniería del Conocimiento, Autonoma University of Madrid, Madrid, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Aguado
authors.affiliation: CHRU Montpellier and University of Montpellier, France; INSERM Unit 1061, Montpellier, France.
authors.forename: P
authors.initials: P
authors.lastname: Courtet
authors.affiliation: INSERM Unit 1061, Montpellier, France; CHU Nimes and University of Montpellier, France. Electronic address: jorgecastroman@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Lopez-Castroman
mesh_terms: D000328:Adult; D003663:Decision Trees; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology*; D055815:Young Adult
keywords: Classification algorithm; Evaluation; Performance; Screening; Suicide attempt