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Evaluation of a Novel Medicolegal Death Investigator–Based Suicide Surveillance System to the National Violent Death Reporting System

Repp, Kimberly K. PhD, MPH*; Hawes, Eva MPH, CHES*; Rees, Kathleen J. MSPH*; Lovato, Charles AAS*; Knapp, Adam BA*; Stauffenberg, Michele MD

The American Journal of Forensic Medicine and Pathology: May 21, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PAF.0000000000000491
Original Article: PDF Only

The abundance of actionable information available in a medicolegal suicide investigation is often inaccessible and underutilized in public health to the detriment of prevention efforts. Epidemiologists obtained the Washington County subset of the Oregon Violent Death Reporting System (OR-VDRS). To determine if additional information beyond the OR-VDRS was available through a standard death investigation, an epidemiologist shadowed medicolegal death investigators (MDIs) for nearly 2 years. The MDIs and epidemiologist developed a novel, real-time, MDI-entered surveillance system, the Suicide Risk Factor Surveillance System (SRFSS), to capture suicide risk factor data with greater timeliness and accuracy than available through the OR-VDRS. To evaluate the performance of each surveillance system, differences in the prevalence of suicide risk factor data from SRFSS were compared with the county OR-VDRS subset for the same 133 suicides occurring in 2014–2015. Across 27 suicide risk factors and circumstances, the median difference in prevalence was 10.5 percentage points between the OR-VDRS and the SRFSS, with the higher prevalence in SRFSS. The prevalence was significantly different between the 2 surveillance systems for 21 (78%) of 27 variables. This study demonstrates the truly exceptional data quality and timeliness of MDI information over traditional sources.

From the *Washington County Health & Human Services, Hillsboro; and

Oregon State Medical Examiner, Clackamas, OR.

Manuscript received January 21, 2019; accepted March 27, 2019.

The authors do not report receiving funding for this work.

This work was presented at the 2018 Annual Meeting of the National Association of Medical Examiners. K.K.R. won the Susan P. Baker Public Health Impact Award for this work.

The authors report no conflict of interest.

Reprints: Kimberly K. Repp, PhD, MPH, 155 N First Ave MS-5A, Hillsboro, OR 97124. E-mail:

© 2019 by Lippincott Williams & Wilkins.