Research Appraisalobservational

Identifying minimal risk factors for adolescent suicidal ideation and suicide attempts: A machine learning-optimized approach.

PloS onePark, Catherine, Lee, Beom-ChanDOI

Clinical Snapshot

75CEBM
Evidence: Moderateobservational

PICO Framework

P — Population90,813 Korean adolescents aged 12-18 years from the Korea Youth Risk Behavior Web-based Survey (2022-2023)
I — InterventionMachine learning-based risk factor identification using Random Forest with recursive feature elimination
C — ComparatorNot applicable - predictive model development study
O — OutcomesSuicidal ideation identification and suicide attempt prediction performance (AUC, sensitivity, specificity, accuracy, PPV, NPV)

Bottom Line

This large Korean study (n=90,813) used machine learning to identify minimal risk factors for adolescent suicidal behaviors, achieving impressive predictive performance (97% AUC for suicide attempts). Key risk factors identified were sadness, loneliness, anxiety, and stress. While the methodology is sound and sample size substantial, the extremely high performance metrics raise concerns about overfitting, and the cross-sectional design limits causal inference. The findings are based on self-reported data from Korean adolescents, requiring cultural validation before application in Australian settings. Despite these limitations, the study provides valuable insights into core psychological risk factors that could inform screening tools and prevention strategies. Clinicians should interpret these results cautiously pending external validation and consider the identified risk factors as part of comprehensive adolescent mental health assessment rather than standalone predictive tools.

Evidence: Moderate

Key Findings

  • P Value: Not reported

  • Effect Size: Sensitivity 93.49%, Specificity 90.21%

  • Primary Outcome: Suicide attempt prediction achieved AUC 97.28%

  • Nnt Or Sensitivity: PPV 90.52%, NPV 93.26% for suicide attempt prediction

  • Confidence Interval: Not reported

Clinical Application

Requires implementation of standardised screening tools and machine learning infrastructure Could inform RACGP adolescent mental health guidelines and school-based screening programs, though cultural validation needed for Australian adolescent populations Adolescents aged 12-18 years in school-based or community mental health settings

Abstract

This study aimed to develop and validate a machine learning (ML) model to identify the minimal risk factors for adolescent suicidal behaviors, including suicidal ideation and suicide attempts. Data from the Korea Youth Risk Behavior Web-based Survey (2022-2023), including 90,813 adolescents aged 12-18 years, were analyzed. Using multidimensional risk factors spanning sociodemographic, physical and mental health, and behavioral domains, we applied a Random Forest model combined with recursive feature elimination to identify a minimal subset of risk factors (optimal features). Model performance for identifying suicidal ideation and predicting suicide attempts was evaluated via area under the curve (AUC), sensitivity, specificity, and accuracy metrics across the validation datasets. Sadness, loneliness, anxiety, and stress were identified as optimal features, achieving a high AUC, sensitivity, specificity, and accuracy in identifying suicidal ideation and predicting suicide attempts. Additional factors further improved the ML model's predictive performance for suicide attempts, achieving an AUC of 97.28%, sensitivity of 93.49%, specificity of 90.21%, accuracy of 91.85%, a PPV of 90.52%, and an NPV of 93.26%. This study demonstrated the efficacy of ML-driven approaches in identifying critical risk factors for adolescent suicidal behaviors. The findings highlight the potential of ML frameworks to transform suicide prevention strategies and improve mental health outcomes in adolescents.

References

  1. 1.Park, C., & Lee, B. C. (2026). Identifying minimal risk factors for adolescent suicidal ideation and suicide attempts: A machine learning-optimized approach. PLoS One. https://doi.org/10.1371/journal.pone.0346050
Share:XLinkedIn

This content is for educational purposes for healthcare professionals only and does not constitute clinical advice. Clinical decisions should be based on individual patient assessment, current guidelines, and appropriate specialist consultation. Editorial Standards · Privacy Policy · Terms of Service