Validation of the Ask Suicide-Screening Questions for Adult Medical Inpatients: A Brief Tool for All Ages.

Abstract Background Few brief suicide risk screening instruments are validated for use in both adult and pediatric medical populations. Using the pediatric Ask Suicide-Screening Questions (ASQ) development study as a model, this study aimed to determine whether the ASQ is a valid suicide risk screening instrument for use among adults medical patients, as well as to evaluate a set of other potential screening questions for use in adults. Methods Adult patients hospitalized on inpatient medical/surgical units from four hospitals were recruited to participate in a cross-sectional instrument validation study. The four-item ASQ and other candidate items were compared against the 25-item, previously validated Adult Suicidal Ideation Questionnaire (ASIQ), as the criterion standard. Results A total of 727 adult medical inpatients completed the screening process. As compared to the ASIQ, the ASQ performed best among the full set of candidate items, demonstrating strong psychometric properties, with a sensitivity of 100% (95% CI = 90% - 100%), a specificity of 89% (95% CI = 86% - 91%), and a negative predictive value of 100% (95% CI = 99% - 100%). A total of 4.8% (35/727) of the participants screened positive for suicide risk based on the standard criterion ASIQ. Conclusions The ASQ is a valid and brief suicide risk screening tool for use among adults. Screening medical/surgical inpatients for suicide risk can be done effectively for both adult and pediatric patients using this brief, primary screener.