TY - JOUR
T1 - Validation and recalibration of OxMIV in predicting violent behaviour in patients with schizophrenia spectrum disorders
AU - Lamsma, Jelle
AU - Yu, Rongqin
AU - Fazel, Seena
AU - van Amelsvoort, Therese
AU - Bartels-Velthuis, Agna
AU - Cahn, Wiepke
AU - de Haan, Lieuwe
AU - Schirmbeck, Frederike
AU - Simons, Claudia
AU - Genetic Risk and Outcome of Psychosis (GROUP) Investigators
N1 - Funding Information:
The GROUP project was supported by the Geestkracht program of The Netherlands Organization for Health Research and Development (Grant number 10-000-1001) and matching funds from the coordinating university hospitals (Academic Medical Centre, Maastricht University Medical Centre, University Medical Centre Gron-ingen and University Medical Centre Utrecht), their affiliated mental healthcare institutions (Altrecht, Arkin, Delta, Dimence, Dijk en Duin, Erasmus University Medical Centre, GGNet, GGZ Breburg, GGZ Centraal, GGZ Drenthe, GGZ Eindhoven en De Kempen, GGZ Friesland, GGZ inGeest, Mondriaan, GGZ Noord-Holland-Noord, GGZ Oost-Brabant, GGZ Overpelt, GGZ Rivierduinen, Lentis, Mediant GGZ, Met GGZ, Parnassia Psycho-Medical Centre, Psychiatric Centre Ziekeren, Psychiatric Hospital Sancta Maria, Public Centre for Mental Health Rekem, The Collaborative Antwerp Psychiatric Research Institute, Vincent van Gogh voor Geestelijke Gezondheid, Virenze riagg, University Psychiatric Centre Sint Jozef, Yulius and Zuyderland GGZ) and participating pharmaceutical companies (Lundbeck, AstraZeneca, Eli Lilly and Janssen Cilag). S.F. is funded by a Wellcome Trust Senior Research Fellowship in Clinical Science (202836/Z/16/Z). We are grateful to the patients and their family members who generously took the time and effort to participate in the GROUP project. We also would like to thank all research personnel involved, and in particular: Joyce van Baaren, Erwin Veermans, Ger Driessen, Truda Driesen, Karin Pos, Erna van ’t Hag, Jessica de Nijs, Atiqul Islam, Wendy Beuken and Debora Op’t Eijnde.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/1/10
Y1 - 2022/1/10
N2 - Oxford Mental Illness and Violence (OxMIV) addresses the need in mental health services for a scalable, transparent and valid tool to predict violent behaviour in patients with severe mental illness. However, external validations are lacking. Therefore, we have used a Dutch sample of general psychiatric patients with schizophrenia spectrum disorders (N = 637) to evaluate the performance of OxMIV in predicting interpersonal violence over 3 years. The predictors and outcome were measured with standardized instruments and multiple sources of information. Patients were mostly male (n = 493, 77%) and, on average, 27 (SD = 7) years old. The outcome rate was 9% (n = 59). Discrimination, as measured by the area under the curve, was moderate at 0.67 (95% confidence interval 0.61–0.73). Calibration-in-the-large was adequate, with a ratio between predicted and observed events of 1.2 and a Brier score of 0.09. At the individual level, risks were systematically underestimated in the original model, which was remedied by recalibrating the intercept and slope of the model. Probability scores generated by the recalibrated model can be used as an adjunct to clinical decision-making in Dutch mental health services.
AB - Oxford Mental Illness and Violence (OxMIV) addresses the need in mental health services for a scalable, transparent and valid tool to predict violent behaviour in patients with severe mental illness. However, external validations are lacking. Therefore, we have used a Dutch sample of general psychiatric patients with schizophrenia spectrum disorders (N = 637) to evaluate the performance of OxMIV in predicting interpersonal violence over 3 years. The predictors and outcome were measured with standardized instruments and multiple sources of information. Patients were mostly male (n = 493, 77%) and, on average, 27 (SD = 7) years old. The outcome rate was 9% (n = 59). Discrimination, as measured by the area under the curve, was moderate at 0.67 (95% confidence interval 0.61–0.73). Calibration-in-the-large was adequate, with a ratio between predicted and observed events of 1.2 and a Brier score of 0.09. At the individual level, risks were systematically underestimated in the original model, which was remedied by recalibrating the intercept and slope of the model. Probability scores generated by the recalibrated model can be used as an adjunct to clinical decision-making in Dutch mental health services.
U2 - 10.1038/s41598-021-04266-9
DO - 10.1038/s41598-021-04266-9
M3 - Article
C2 - 35013451
SN - 2045-2322
VL - 12
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 461
ER -