Biomedical subjects

D R MacKinnon

Publications and source records attributed to D R MacKinnon.

3 recordsLinked to original sources

PubMed1978

The certification of suicide in eleven western states: an inquiry into the validity of reported suicide rates.

From Durkheim's time to the present social researchers interested in the problem of suicide have relied upon officially reported rates of suicide to develop and test their theories. Despite the fact that the validity of any theory rests upon the accuracy of its underlying data, the relative accuracy of reported suicide rates have rarely been questioned or systematically evaluated. This paper investigates the process of death certification as practiced by a sample of 191 coroners in 11 western states. Findings indicate extensive variation in the backgrounds, professional resources, operating procedures, and governing statutes of coroners and coroners' offices and in policies concerning the use of the suicide mode. Since the coroner is generally charged with the official responsibility for certifying the mode of death when unnatural mode is suspect, the extent of variation found here calls into question the validity and comparability of reported suicide rates.

Coroners and Medical Examiners↗

PubMed1976

An assessment of the utility of suicide prediction.

Efforts to predict a future event assume varying levels of confidence depending on its base rate and the error rate of the prediction instrument. Most researchers working with suicide prediction instruments seem tacitly to assume they will be able to predict a future suicide most of the time. Applying basic decision theory on a neuropsychiatric hospital population indicates that researchers using a prediction schedule will be unlikely to predict a future suicide beyond a 20% level of efficiency. Contrary to the general clinical view, eliminating false negatives was shown to be more practical than eliminating false positives in increasing the efficiency of a predictive schedule.

Diagnostic Errors↗

PubMedDate not supplied

Suicide: who's counting?

A study of suicide certifications explored their accuracy in the light of the difficulties inherent in the certification of death. The primary question addressed was whether the variation in reported suicide rates was significantly related to the structure, function, and procedures of coroners' offices, in comparison with traditional social aspects of the community, such as demographic factors, socioeconomic status, and residential mobility. A stratified sample of 202 counties in the 11 continental western States was selected, and data on coroners' offices were obtained from 191 of these counties. These data were analyzed by means of weighted least squares, which separately related coroner's office variables and community variables to indirectly age-standardized suicide rates. Data for counties with populations of 30,000 or more and those with less than 30,000 were also separately analyzed. Assessment of the multiple regression analyses suggests that the coroner's office variables compare favorably with the community variables in predicting suicide rates, provided a distinction is made between large and small counties. The coroner's office variables in counties with 30,000 or more population explained 37 percent of the variation in reported suicide rates, whereas the community characteristics explained 41 percent. In the counties with less than 30,000 coroner's office variables explained 24 percent of the variation, while community variables explained 13 percent. In the more populous counties, the characteristics of the coroners most predictive of the suicide rates were a nonrejecting attitude toward suicide, an interest in the personal aspects of the deceased, and concern with the physical circumstances of the death. In the less populous counties, the variables most predictive of the suicide rates were related to the physical aspects of the death.

Adolescent↗