{
  "abstract": "Objectives: To determine whether statewide health information exchange (HIE) data can support practice-level prediction of short-term psychiatric emergency presentation, and to compare a locally trained model with general-purpose clinical risk scores.\n\nMaterials and Methods: Retrospective cohort of patients at 1 Montana psychiatry practice with records in the Big Sky Care Connect statewide HIE. Structured HIE data were linked to zip code-level Social Vulnerability Index and Area Deprivation Index measures. Each observation was a patient snapshot. Logistic regression, random forest, and LightGBM models were tuned with 5 × 5 nested cross-validation and evaluated on a temporally held-out test set. The primary outcome was psychiatric or substance-related emergency department (ED) presentation within 30 days. Discrimination was compared with a parsimonious clinical baseline and the LACE and Elixhauser indices.\n\nResults: The test set contained 16 469 snapshots, of which 343 (2.1%) preceded a qualifying ED presentation (102 visits among 68 patients). A random forest model achieved area under the receiver-operator characteristic curve 0.85 (95% CI, 0.75-0.91). At a threshold targeting one-third recall, precision was 0.29 (0.12-0.44) and number needed to evaluate 3.4 (2.3-8.1). Discrimination exceeded the clinical baseline (Δ area under the curve 0.10), LACE (0.19), and Elixhauser (0.27); all P values less than .001.\n\nDiscussion: Structured HIE data, without clinical notes, supported a practice-specific model that outperformed general-purpose scores such as LACE and Elixhauser. Wide CIs reflect a small event count and constrain point-estimate claims.\n\nConclusion: health information exchange infrastructure may allow participating practices to build locally calibrated psychiatric risk models. Prospective study of clinical utility is needed.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "name": "John L Havlik"
    },
    {
      "name": "Ben Tyrrell"
    },
    {
      "name": "Jeanette Polaschek"
    },
    {
      "name": "Nathan Bell"
    },
    {
      "name": "Eric R Arzubi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/956nq3yq4rqkf.bib",
  "cited_by": 0,
  "doi": "10.1093/jamiaopen/ooag215",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13725626/?tool=EBI",
  "id": "956nq3yq4rqkf",
  "issns": [
    "2574-2531"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13725626",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00010"
    ],
    [
      "heading",
      "AcademicSubjects/SCI01060"
    ],
    [
      "heading",
      "AcademicSubjects/SCI01530"
    ],
    [
      "heading",
      "Research and Applications"
    ],
    [
      "openalex",
      "3203|Psychiatric care and mental health services"
    ]
  ],
  "openalex": "W7167258574",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13725626/pdf/?tool=EBI",
  "pmcid": "PMC13725626",
  "pmid": "42974260",
  "published": "2026-10-01",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/956nq3yq4rqkf.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:51Z",
      "native_id": "PMC:PMC13725626",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13725626"
    },
    {
      "first_seen": "2026-11-04T12:23:58Z",
      "native_id": "PMC13725626",
      "source": "pmc",
      "url": "https://doi.org/10.1093/jamiaopen/ooag215"
    },
    {
      "first_seen": "2026-11-04T15:20:49Z",
      "native_id": "MED:42974260",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42974260"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:3203|Psychiatric care and mental health services",
      "subfield": "psychiatry"
    }
  ],
  "title": "A local outpatient practice-level prediction model for short-term psychiatric emergency presentation",
  "title_text": "A local outpatient practice-level prediction model for short-term psychiatric emergency presentation",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:21:49Z",
  "url": "https://research.draconitic.com/paper/956nq3yq4rqkf",
  "venue": "JAMIA open",
  "versions": []
}