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Clinical prediction guide
The Manchester Self Harm Rule had good sensitivity but poor specificity for predicting repeat self harm or suicide

https://doi.org/10.1136/ebm.12.3.89

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    Cooper J, Kapur N, Dunning J, et al. A clinical tool for assessing risk after self-harm. Ann Emerg Med 2006;48:459–66.
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 Q In patients who present to the emergency department (ED) with self harm, can a simple clinical rule predict repetitions of self harm or suicide in the next 6 months?

    Clinical impact ratings Paediatrics (general) ★★★★★★☆ Psychiatry ★★★★★★☆ Emergency medicine ★★★★★☆☆

    METHODS

    Embedded ImageDesign:

    prospective cohort study with separate derivation and validation data sets.

    Embedded ImageSetting:

    5 EDs in Manchester and Salford, UK.

    Embedded ImagePatients:

    9086 episodes of self harm (intentional self poisoning or self injury) in patients 11–98 years of age (median age 30 y, 56% women). Patients who did not wait for assessment or refused treatment were excluded.

    Embedded ImageDescription of prediction guide:

    the patient was considered to be at moderate or high risk of repeat self harm or suicide if any 1 of the 4 components of the Manchester Self Harm Rule was present: (1) history of self harm, (2) previous psychiatric treatment, (3) current psychiatric treatment, or …

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    Footnotes

    • For correspondence: Dr J Cooper, Centre for Suicide Prevention, University of Manchester, Manchester, UK. jayne.cooper{at}manchester.ac.uk

    • Sources of funding: Manchester Health Authority; South Manchester University Hospitals NHS Trust; Central Manchester and Manchester Children’s University Hospitals NHS Trust; Pennine Acute NHS Trust; Mental Health Services of Salford NHS Trust.