CG123 Common mental health disorders - National Institute for ...

Further assessment of risk and need for treatment, and routine outcome monitoringTable 23: Study information table for systematic reviews of risk assessmentStudy IDMCMILLAN2007Method used to synthesise Meta-analysisevidenceDesign of included studiesEvidence searchNo. of included studiesReview qualityInstrument/method ofassessment reviewedReference standard usedby primary studiesCohortCINAHL, EMBASE, MEDLINE (1950 to January2006) and PsycINFO.19 (ten studies included in the diagnostic accuracymeta-analysis)Moderate risk of bias (quality of included studiesnot assessed/reported)BHSNumber of people with the outcome (suicide orself-harm)6.2.4 Summary of evidence from existing NICE guidelinesThe method used to review existing NICE guidelines relevant to common mental healthdisorders can be found in the review of formal assessment reported in the previouschapter (see Section 5.3). The Depression, Obsessive-compulsive Disorder and PosttraumaticStress Disorder guidelines (NICE, 2009a, 2005a and 2005b, respectively)contained recommendations about risk assessment, and these are summarised in Table24. These recommendations were used to inform the development of recommendationsthat were either common to all common mental health disorders or disorder specific.6.2.5 Clinical evidence from existing systematic reviewsMCMILLAN2007 assessed the ability of the BHS to predict non-fatal self-harm andsuicide by systematically searching for studies that used a cohort design. The reviewidentified ten studies (four on suicide and six on self-harm), with varying lengths offollow-up. All but one study used adult samples. Random-effects meta-analysis wasused to synthesise data to obtain pooled estimates of sensitivity, specificity, LR andLR–, and a summary diagnostic OR.139