Computerized Adaptive Test vs. decision trees: Development of a support decision system to identify suicidal behavior Articles uri icon

publication date

  • December 2016

start page

  • 204

end page

  • 209


  • 206

International Standard Serial Number (ISSN)

  • 0165-0327

Electronic International Standard Serial Number (EISSN)

  • 1573-2517


  • Background: Several Computerized Adaptive Tests (CATs) have been proposed to facilitate assessments in mental health. These tests are built in a standard way, disregarding useful and usually available information not included in the assessment scales that could increase the precision and utility of CATs, such as the history of suicide attempts. Methods: Using the items of a previously developed scale for suicidal risk, we compared the performance of a standard CAT and a decision tree in a support decision system to identify suicidal behavior. We included the history of past suicide attempts as a class for the separation of patients in the decision tree. Results: The decision tree needed an average of four items to achieve a similar accuracy than a standard CAT with nine items. The accuracy of the decision tree, obtained after 25 cross-validations, was 81.4%. A shortened test adapted for the separation of suicidal and non-suicidal patients was developed. Conclusion: CATs can be very useful tools for the assessment of suicidal risk. However, standard CATs do not use all the information that is available. A decision tree can improve the precision of the assessment since they are constructed using a priori information. (C) 2016 Elsevier B.V. All rights reserved.


  • suicide attempt; classification algorithm; evaluation; screening; performance; borderline personality-disorder; rating-scale; depression; risk; cat; simulation