Background: Despite decades of research to better understand suicide risk and to develop detection and prevention methods, suicide is still one of the leading causes of death globally. While large-scale studies using real-world evidence from electronic health records can identify who is at risk, they have not been successful at pinpointing when someone is at risk. Personalized social media and online search history data, by contrast, could provide an ongoing real-world datastream revealing internal thoughts and personal states of mind. Objective: We conducted this study to determine the feasibility and acceptability of using personalized online information-seeking behavior in the identification of risk for suicide attempts. Methods: This was a cohort survey study to assess attitudes of participants with a prior suicide attempt about using web search data for suicide prevention purposes, dates of lifetime suicide attempts, and an optional one-time download of their past web searches on Google. The study was conducted at the University of Washington School of Medicine Psychiatry Research Offices. The main outcomes were participants’ opinions on internet search data for suicide prediction and intervention and any potential change in online information-seeking behavior proximal to a suicide attempt. Individualized nonparametric association analysis was used to assess the magnitude of difference in web search data features derived from time periods proximal (7, 15, 30, and 60 days) to the suicide attempts versus the typical (baseline) search behavior of participants. Results: A total of 62 participants who had attempted suicide in the past agreed to participate in the study. Internet search activity varied from person to person (median 2-24 searches per day). Changes in online search behavior proximal to suicide attempts were evident up to 60 days before attempt. For a subset of attempts (7/30, 23%) search features showed associations from 2 months to a week before the attempt. The top 3 search constructs associated with attempts were online searching patterns (9/30 attempts, 30%), semantic relatedness of search queries to suicide methods (7/30 attempts, 23%), and anger (7/30 attempts, 23%). Participants (40/59, 68%) indicated that use of this personalized web search data for prevention purposes was acceptable with noninvasive potential interventions such as connection to a real person (eg, friend, family member, or counselor); however, concerns were raised about detection accuracy, privacy, and the potential for overly invasive intervention. Conclusions: Changes in online search behavior may be a useful and acceptable means of detecting suicide risk. Personalized analysis of online information-seeking behavior showed notable changes in search behavior and search terms that are tied to early warning signs of suicide and are evident 2 months to 7 days before a suicide attempt.

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中文翻译：

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个人谷歌搜索历史的感知效用和特征，以检测与先前尝试过自杀的个人的自杀尝试接近的数据模式：试点队列研究

背景：尽管进行了数十年的研究以更好地了解自杀风险并开发检测和预防方法，但自杀仍然是全球死亡的主要原因之一。虽然使用来自电子健康记录的真实世界证据的大规模研究可以确定谁处于危险之中，但他们未能成功地确定某人何时处于危险之中。相比之下，个性化的社交媒体和在线搜索历史数据可以提供持续的真实世界数据流，揭示内部思想和个人心理状态。目的：我们进行了这项研究，以确定使用个性化在线信息寻求行为来识别自杀未遂风险的可行性和可接受性。方法：这是一项队列调查研究，旨在评估先前有自杀企图的参与者对使用网络搜索数据预防自杀的态度、终生自杀企图的日期，以及他们过去在 Google 上的网络搜索的可选一次性下载。该研究是在华盛顿大学医学院精神病学研究办公室进行的。主要结果是参与者对自杀预测和干预的互联网搜索数据的看法，以及与自杀企图接近的在线信息寻求行为的任何潜在变化。个体化非参数关联分析用于评估从接近自杀企图的时间段（7、15、30 和 60 天）与参与者的典型（基线）搜索行为得出的网络搜索数据特征的差异幅度。结果：共有 62 名过去曾企图自杀的参与者同意参加这项研究。互联网搜索活动因人而异（平均每天搜索 2-24 次）。在自杀未遂前 60 天，与自杀未遂相关的在线搜索行为发生了明显的变化。对于一部分尝试（7/30, 23%），搜索功能在尝试前 2 个月到一周显示了关联。与尝试相关的前 3 个搜索结构是在线搜索模式（9/30 次尝试，30%）、搜索查询与自杀方法的语义相关性（7/30 次尝试，23%）和愤怒（7/30 次尝试，23%） ）。参与者 (40/59, 68%) 表示，将这种个性化的网络搜索数据用于预防目的是可以接受的，并且可以通过非侵入性潜在干预措施，例如与真实的人（例如，朋友、家人、或辅导员）；然而，人们对检测准确性、隐私和过度侵入性干预的可能性提出了担忧。结论：在线搜索行为的变化可能是检测自杀风险的有用且可接受的方法。对在线信息寻求行为的个性化分析显示，搜索行为和搜索词发生了显着变化，这些变化与自杀的早期预警信号有关，并且在自杀未遂前 2 个月至 7 天很明显。

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