Evidence-based guidelines for the interpretation of the 9-item Concise Health Risk Tracking - Self-Report (CHRT-SR9) measure of suicidal risk.

Abstract

Background: The 9-item Concise Health Risk Tracking - Self-Report (CHRT-SR₉) is a widely used patient-reported outcome measure of suicidal risk. The goal of this article is to provide an evidence-based interpretation of the CHRT-SR₉ total score in terms of four clinically actionable categories of suicidal risk (none, mild, moderate, and severe).

Methods: Data from two large programs involving adolescents and adults were combined in this paper. In these studies, the CHRT-SR₉ was anchored against an independent measure of suicidal risk, the suicide item (Item #9) in the Patient Health Questionnaire (PHQ-9), with categories 0 (none), 1 (mild), 2 (moderate), and 3 (severe). In the combined data (n = 1945), we calculated the cumulative percentage of data across these four categories and the percentile score of the CHRT-SR₉ total score that corresponded to these percentages; from this, we developed ranges of the CHRT-SR₉ total score that corresponded to the four categories of Item #9 of PHQ-9. We also calculated similar ranges for two broad subscales of the CHRT-SR₉ total score; Propensity and Suicidal Thoughts. To assess the robustness of our findings, we repeated the analysis at another timepoint across studies.

Results: Findings indicated that the CHRT-SR₉ total score (range: 0-36) can be categorized as none (0-14), mild (15-21), moderate (22-26), and severe (27-36). Similar categories were calculated for the Propensity and Suicidal Thoughts subscales. The findings were the same when repeated at another timepoint.

Conclusion: This categorization of the CHRT-SR₉ total score can place patients into clinically meaningful and actionable categories of suicidal risk.