Evid Based Nurs 10:61 doi:10.1136/ebn.10.2.61
  • Clinical prediction guide

The Manchester Self Harm Rule had good sensitivity but poor specificity for predicting repeat self harm or suicide

 Q In patients who present to the emergency department (ED) with self harm, can a simple clinical rule predict repetitions of self harm or suicide in the next 6 months?



prospective cohort study with separate derivation and validation data sets.


5 EDs in Manchester and Salford, UK.


9086 episodes of self harm (intentional self poisoning or self injury) in patients 11–98 years of age (median 30 y, 56% women). Patients who did not wait for assessment or refused treatment were excluded.

GraphicDescription of prediction guide:

patients were considered to be at moderate or high risk of repeat self harm or suicide if any 1 of the 4 components of the Manchester Self Harm Rule was present: history of self harm, previous …

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