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Evaluating model generalizability for suicide attempt risk prediction: traditional machine vs deep learning

Josselyn, Nicholas
Sawant, Sahil
Davis-Martin, Rachel E
Rundensteiner, Elke A
Gerber, Ben S
Wang, Bo
Rothschild, Anthony J
Agu, Emmanuel
Boudreaux, Edwin D
Liu, Feifan
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Abstract

Suicide remains a leading cause of death and a significant public health concern in the United States. A majority (83%) of suicide decedents had a healthcare visit within the prior 365 days, presenting unique opportunities to utilize healthcare data for AI-based interventions. While previous works applied machine learning (ML) to analyze healthcare records for suicide attempt risk prediction (SARP), they lack external validation. Additionally, advantages of deep learning (DL) over ML for tabular SARP remains understudied. We performed external validation of a state-of-the-art SARP model from the Mental Health Research Network using over 750,000 UMass Memorial Health patient encounters. We further compared ML vs DL, assessing cross-setting healthcare generalizability. We found existing models did not generalize well, ML significantly outperformed DL on most metrics, and DL achieved higher sensitivity. These findings underscore the need for developing robust, generalizable SARP models for diverse healthcare contexts, improving identification of individuals at risk.

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Josselyn N, Sawant S, Davis-Martin RE, Rundensteiner EA, Gerber BS, Wang B, Rothschild AJ, Agu E, Boudreaux ED, Liu F. Evaluating model generalizability for suicide attempt risk prediction: traditional machine vs deep learning. Npj Ment Health Res. 2026 Apr 30. doi: 10.1038/s44184-026-00209-2. Epub ahead of print. PMID: 42062536.

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10.1038/s44184-026-00209-2
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42062536
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© The Author(s) 2026. Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.