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Castro MYR, Orriols L, Contrand B, Dupuy M, Sztal-Kutas C, Avalos M, Lagarde E. Cohort profile: MAVIE a web-based prospective cohort study of home, leisure, and sports injuries in France. PLoS One 2021; 16:e0248162. [PMID: 33705466 PMCID: PMC7951860 DOI: 10.1371/journal.pone.0248162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 02/20/2021] [Indexed: 11/18/2022] Open
Abstract
MAVIE is a web-based prospective cohort study of Home, Leisure, and Sports Injuries with a longitudinal follow-up of French general population volunteers. MAVIE participants are voluntary members of French households, including overseas territories. Participation in the cohort involves answering individual and household questionnaires and relevant exposures and prospectively reporting injury events during the follow-up. Recruitment and data collection have been in progress since 2014. The number of participants as of the end of the year 2019 was 12,419 from 9,483 households. A total of 8,640 participants provided data during follow-up. Respondents to follow-up were composed of 763 children aged 0-14, 655 teenagers and young adults aged 15-29, 6,845 adults, and 377 people aged 75 or more. At the end of the year 2019, 1,698 participants had reported 2,483 injury events. Children, people aged 50 and more, people with poor self-perceived physical and mental health, people who engage in sports activities, and people with a history of injury during the year before recruitment were more likely to report new injuries. An interactive mobile/web application (MAVIE-Lab) was developed to help volunteers decide on personalized measures to prevent their risks of HLIs. The available data provides an opportunity to analyse multiple exposures at both the individual and household levels that may be associated with an increased risk of trauma. The ongoing analysis includes HLI incidence estimates, the determination of health-related risk factors, a specific study on the risk of home injury, another on sports injuries, and an analysis of the role of cognitive skills and mind wandering. Volunteers form a community that constitutes a population laboratory for preventative initiatives.
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Affiliation(s)
| | - Ludivine Orriols
- Bordeaux Population Health Research Center, University of Bordeaux, UMR U1219, INSERM, Bordeaux, France
| | - Benjamin Contrand
- Bordeaux Population Health Research Center, University of Bordeaux, UMR U1219, INSERM, Bordeaux, France
| | - Marion Dupuy
- Calyxis, Centre of Risk Expertise, Niort, France
| | | | - Marta Avalos
- Bordeaux Population Health Research Center, University of Bordeaux, UMR U1219, INSERM, Bordeaux, France
- SISTM Team Inria BSO, Talence, France
| | - Emmanuel Lagarde
- Bordeaux Population Health Research Center, University of Bordeaux, UMR U1219, INSERM, Bordeaux, France
- * E-mail:
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Bejko D, Ruiz-Castell M, Schritz A, Laursen B, Kisser R, Rogmans W, Lyons RA, Valkenberg H, Turner S, Bauer R, Ellsaesser G, de Rekeneire N. "To survey or to register" is that the question for estimating population incidence of injuries? ACTA ACUST UNITED AC 2018; 76:76. [PMID: 30564315 PMCID: PMC6296149 DOI: 10.1186/s13690-018-0322-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 11/07/2018] [Indexed: 11/10/2022]
Abstract
Background Measuring the true incidence of injury or medically attended injury is challenging. Population surveys, despite problems with recall and selection bias, remain the only source of information for injury incidence calculation in many countries. Emergency department (ED) registry based data provide an alternative source.The aim of this study is to compare the yearly incidence of hospital treated Home and Leisure Injuries (HLI), and Road Traffic Injuries (RTI) estimated by survey-based and register-based methods and combine information from both sources in to a comprehensive injury burden pyramide. Methods Data from Luxemburg's European Health Examination Survey (EHES-LUX), European Health Interview Survey (EHIS) and ED surveillance system Injury Data Base (IDB) collected in 2013, were used. EHES-LUX data on 1529 residents 25-64 years old, were collected between February 2013-January 2015. EHIS data on 4004 other residents aged 15+ years old, were collected between February and December 2014. Participants reported last year's injuries at home, leisure and traffic and treatment received. Two-sided exact binomial tests were used to compare incidences from registry with the incidences of each survey by age group and prevention domain. Data from surveys and register were combined to build an RTI and HLI burden pyramide for the 25-64 years old. This project was part of the European Union project BRIDGE-Health (BRidging Information and Data Generation for Evidence-based Health Policy and Research). Results Among 25-64 years old the incidence of hospital treated injuries per thousand population was 60.1 (95% CI: 59.2-60.9) according to IDB, 62.1 (95% CI: 50.6-75.4) according to EHES-LUX and 53.2 (95% CI: 45.0-62.4) according to EHIS. The incidence of hospital admissions was 3.7 (95% CI: 3.5-4.0) per thousand population from IDB-Luxembourg, 12.4 (95% CI: 7.5-19.3) from EHES-LUX and 18.0 (95% CI: 13.3-23.8) from EHIS. For 15+ years-old incidence of hospital treated HLI was 62.8 (95% CI: 62.1-63.5) per thousand population according to IDB whereas the corresponding EHIS estimate was lower at 46.9 (95% CI: 40.4-54.0). About half of HLI and RTI of the 25-64 years old were treated in hospital. Conclusion The overall incidence estimate of hospital treated injuries from both methods does not differ for the 25-64 years old. Surveys overestimate the number of hospital admissions, probably due to memory bias. For people aged 15+ years, the survey estimate is lower than the register estimate for hospital treated HLI injuries, probably due to selection and recall biases. ED based registry data is to be preferred as single source for estimating the incidence of hospital treated injuries in all age groups.
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Affiliation(s)
- Dritan Bejko
- 1Luxembourg Institute of Health, Strassen, Luxembourg
| | | | - Anna Schritz
- 1Luxembourg Institute of Health, Strassen, Luxembourg
| | - Bjarne Laursen
- 2National Institute of Public Health, Copenhagen, Denmark
| | | | | | - Ronan A Lyons
- 5Farr Institute Swansea University, Medical School, Swansea, UK.,6Public Health Wales NHS Trust, Swansea, UK
| | | | - Samantha Turner
- 5Farr Institute Swansea University, Medical School, Swansea, UK
| | | | - Gabrielle Ellsaesser
- Landesamt Brandenburg für Umwelt, Gesundheit und Verbraucherschutz, Berlin, Germany
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Bhattarai AK, Zarrin A, Lee J. Applications of information and communications technologies to public health: A scoping review using the MeSH term: "public health informatics". Online J Public Health Inform 2017; 9:e192. [PMID: 29026457 PMCID: PMC5630279 DOI: 10.5210/ojphi.v9i2.7985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To investigate the public health domains, key informatics concepts, and information and communications technologies (ICTs) applied in articles that are tagged with the MeSH term "public health informatics" and primarily focus on applying ICTs to public health. MATERIALS AND METHODS The MeSH term "public health informatics" was searched on MEDLINE-PubMed. The results of the search were then screened in two steps in order to only include articles about applying ICTs to public health problems. First, articles were screened based on their titles and abstracts. Second, a full-text review was conducted to ensure the relevance of the included articles. All articles were charted based on public health domain, information technology, article type, and informatics concept. RESULTS 515 articles were included. Communicable disease monitoring (N=235), public health policy and research (N=201), and public health awareness (N=85) constituted the majority of the articles. Inconsistent results were found regarding the validity of syndromic surveillance and the effectiveness of PHI integration within the healthcare systems. DISCUSSION PHI articles with an ICT focus cover a wide range of themes. Collectively, the included articles emphasized the need for further research in interoperability, data quality, appropriate data sources, accessible health information, and communication. The limitations of the study include:1) only one database was searched; 2) by using MeSH tags as a selection criterion, PHI articles without the "public health informatics" MeSH term were excluded. CONCLUSION Due to the multi-disciplinary nature of PHI, MeSH identifiers were not assigned consistently. Current MeSH-tagged articles indicate that a comprehensive approach is required to integrate PHI into the healthcare system.
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Affiliation(s)
- Arjun Kumar Bhattarai
- Health Data Science Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Aein Zarrin
- Health Data Science Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Joon Lee
- Health Data Science Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Cryer C, Miller TR, Lyons RA, Macpherson AK, Pérez K, Petridou ET, Dessypris N, Davie GS, Gulliver PJ, Lauritsen J, Boufous S, Lawrence B, de Graaf B, Steiner CA. Towards valid 'serious non-fatal injury' indicators for international comparisons based on probability of admission estimates. Inj Prev 2016; 23:47-57. [PMID: 27501735 DOI: 10.1136/injuryprev-2016-042020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 05/25/2016] [Accepted: 06/24/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND Governments wish to compare their performance in preventing serious injury. International comparisons based on hospital inpatient records are typically contaminated by variations in health services utilisation. To reduce these effects, a serious injury case definition has been proposed based on diagnoses with a high probability of inpatient admission (PrA). The aim of this paper was to identify diagnoses with estimated high PrA for selected developed countries. METHODS The study population was injured persons of all ages who attended emergency department (ED) for their injury in regions of Canada, Denmark, Greece, Spain and the USA. International Classification of Diseases (ICD)-9 or ICD-10 4-digit/character injury diagnosis-specific ED attendance and inpatient admission counts were provided, based on a common protocol. Diagnosis-specific and region-specific PrAs with 95% CIs were calculated. RESULTS The results confirmed that femoral fractures have high PrA across all countries studied. Strong evidence for high PrA also exists for fracture of base of skull with cerebral laceration and contusion; intracranial haemorrhage; open fracture of radius, ulna, tibia and fibula; pneumohaemothorax and injury to the liver and spleen. Slightly weaker evidence exists for cerebellar or brain stem laceration; closed fracture of the tibia and fibula; open and closed fracture of the ankle; haemothorax and injury to the heart and lung. CONCLUSIONS Using a large study size, we identified injury diagnoses with high estimated PrAs. These diagnoses can be used as the basis for more valid international comparisons of life-threatening injury, based on hospital discharge data, for countries with well-developed healthcare and data collection systems.
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Affiliation(s)
- Colin Cryer
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Ted R Miller
- Pacific Institute for Research and Evaluation, Calverton, Maryland, USA.,Curtin University Centre for Health Policy Research, Perth, Australia
| | - Ronan A Lyons
- Farr Institute, Swansea University Medical School, Swansea, UK
| | - Alison K Macpherson
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Katherine Pérez
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain.,CIBER Epidemiología y Salud Pública, Institute of Biomedical Research (IIBSP), Barcelona, Spain
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nick Dessypris
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Gabrielle S Davie
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Pauline J Gulliver
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jens Lauritsen
- Injury Prevention Group, Odense University Hospital, Odense, Denmark.,Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark
| | - Soufiane Boufous
- Transport and Road Safety Research, University of New South Wales, Sydney, New South Wales, Australia
| | - Bruce Lawrence
- Pacific Institute for Research and Evaluation, Calverton, Maryland, USA
| | - Brandon de Graaf
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Claudia A Steiner
- Division of Healthcare Delivery Data, Measures and Research, Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (AHRQ), Rockville, Maryland, USA
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Barss P, Grivna M, Al-Hanaee A, Al-Dhahab A, Al-Kaabi F, Al-Muhairi S. Baby walker injury, disability, and death in a high-income middle eastern country, as reported by siblings. Inj Epidemiol 2016; 3:17. [PMID: 27747554 PMCID: PMC4942486 DOI: 10.1186/s40621-016-0082-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 07/06/2016] [Indexed: 11/26/2022] Open
Abstract
Background Baby walkers (BWs) are frequent causes of infant injuries. Little research is reported from the Middle East and few population-based studies anywhere. Methods Using multistage random sampling in a city of the United Arab Emirates, 4 of 8 female Arab government high schools and 3 final-year classes each from science and arts tracks were selected. Structured self-administered questionnaires assessed prevalence, frequency, severity, and external causes of BW incidents and injuries, and residential hazards. Results Response was 100 %, 696 students, 55 % (n = 385) Emirati citizens. 87 % (n = 605) of families used/had used BWs. Among 646 injuries were 118 ER (emergency) visits, 42 hospitalizations, 11 disabilities, and 3 deaths. Average risk was 1 incident/user, 1 injury/4 users, 1 ER visit/20, 1 hospitalization/55, 1 disability/200, 1 death/1000. Odds ratios for >1:1 floor levels were 2.3 (95 % confidence interval: 1.2, 4.3) for hospitalization, 16.8 (95 % CI: 2.1, 132.5) disability. Incidents included hitting objects 48 % (n = 1322), overturning 23 % (n = 632), accessing hazardous objects 17 % (n = 473), and falling down stairs 11 % (n = 300); 1 % (n = 32) fell into swimming pools. In 49 % (n = 297/605) of user families, ≥1 child had been injured. Conclusions Despite causing many injuries including disabilities and fatalities, BWs were used by nearly all families. Governments should consider Canada’s lead in prohibiting importation, sales, and advertising of BWs.
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Affiliation(s)
- Peter Barss
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Michal Grivna
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates.
| | - Amna Al-Hanaee
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
| | - Ayesha Al-Dhahab
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
| | - Fatima Al-Kaabi
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
| | - Shamma Al-Muhairi
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
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O'Reilly GM, Gabbe B, Moore L, Cameron PA. Classifying, measuring and improving the quality of data in trauma registries: A review of the literature. Injury 2016; 47:559-67. [PMID: 26830127 DOI: 10.1016/j.injury.2016.01.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 12/12/2015] [Accepted: 01/09/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Globally, injury is a major cause of death and disability. Improvements in trauma care have been driven by trauma registries. The capacity of a trauma registry to inform improvements in the quality of trauma care is dependent upon the quality of data. The literature on data quality in disease registries is inconsistent and ambiguous; methods used for classifying, measuring, and improving data quality are not standardised. The aim of this study was to review the literature to determine the methods used to classify, measure and improve data quality in trauma registries. METHODS A scoping review of the literature was performed. Databases were searched using the term "trauma registry" and its synonyms, combined with multiple terms denoting data quality. There was no restriction on year. Full-length manuscripts were included if the classification, measurement or improvement of data quality in one or more trauma registries was a study objective. Data were abstracted regarding registry demographics, study design, data quality classification, and the reported methods used to measure and improve the pre-defined data quality dimensions of accuracy, completeness and capture. RESULTS Sixty-nine publications met the inclusion criteria. Four publications classified data quality. The most frequently described methods for measuring data accuracy (n=47) were checks against other datasets (n=18) and checks of injury coding (n=17). The most frequently described methods for measuring data completeness (n=47) were the percentage of included cases, for a given variable or list of variables, for which there was an observation in the registry (n=29). The most frequently described methods for measuring data capture (n=37) were the percentage of cases in a linked reference dataset that were also captured in the primary dataset being evaluated (n=24). Most publications dealing with the measurement of a dimension of data quality did not specify the methods used; most publications dealing with the improvement of data quality did not specify the dimension being targeted. CONCLUSION The classification, measurement and improvement of data quality in trauma registries is inconsistent. To maintain confidence in the usefulness of trauma registries, the metrics and reporting of data quality need to be standardised.
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Affiliation(s)
- Gerard M O'Reilly
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Commercial Rd, Melbourne, 3004, Australia; Emergency and Trauma Centre, Alfred Health, Commercial Rd, Melbourne, Victoria, 3004, Australia.
| | - Belinda Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Commercial Rd, Melbourne, 3004, Australia; Swansea University, United Kingdom
| | | | - Peter A Cameron
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Commercial Rd, Melbourne, 3004, Australia; Emergency and Trauma Centre, Alfred Health, Commercial Rd, Melbourne, Victoria, 3004, Australia; Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
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The effect of injuries on health measured by short form 8 among a large cohort of Thai adults. PLoS One 2014; 9:e88903. [PMID: 24551187 PMCID: PMC3923825 DOI: 10.1371/journal.pone.0088903] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 01/16/2014] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION We investigate the links between health and injury in Thailand. This is important because of the high burden of injury in transitional countries and limited information for public health. METHODS We analyse 2005 baseline and 2009, 4-year follow-up data from distance learning students of Sukhothai Thammathirat Open University residing nationwide (n = 60569). Injury was reported for the past year in both periods. Medical Outcome Study Short-Form (SF-8™) health status was reported and Physical and Mental Component Summary Scores (PCS and MCS) were calculated. Analyses used covariate-adjusted multivariate linear regression. RESULTS In 2009, increasing numbers of traffic injuries (0, 1, 2, 3, 4+) associated with declining PCS scores (49.8, 48.4, 46.9, 46.2, 44.0), along with a similar monotonic decline for MCS scores (47.6, 46.0, 44.2, 42.7, 40.6). A similar (but smaller) dose-response gradient was found between non-traffic injuries and SF-8 scores. Longitudinal analyses showed those with incident injury (no injury 2005, injury 2009) had lower PCS and MCS scores compared to those with no injury in both periods. Individuals with reverting injury status (injury 2005, no injury 2009) reported improvement in PCS and MCS scores over the four-year period. CONCLUSION We found significant and epidemiologically important associations between increasing injury frequency and worse health in the past year, especially traffic injuries. Longitudinal 2005-2009 results were supportive and revealed statistically significant adverse 4-year effects of incident injury on health. If injury reverted over four years, low initial scores improved greatly. Findings highlight the importance of injury prevention as a public health priority.
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Bonaldi C, Ricard C, Nicolau J, Bouilly M, Thélot B. Estimates of home and leisure injuries treated in emergency departments in the adult population living in metropolitan France: a model-assisted approach. Popul Health Metr 2014; 12:2. [PMID: 24495484 PMCID: PMC3923095 DOI: 10.1186/1478-7954-12-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 01/28/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Home and leisure injuries (HLIs) are currently a major public health concern, because of their frequency, associated consequences, and considerable medical costs. As in many other countries in Europe, in France the population coverage of the surveillance system of HLIs is low. In this study, a model-assisted approach is developed to estimate the incidence rates of HLIs in adults treated in emergency departments (EDs) in metropolitan France between 2004 and 2008. METHODS Using a sample of the hospitals participating in the French ED-based surveillance system, a generalized linear mixed model was applied, which describes the relationship between the numbers of ED visits for HLIs and the sex and age of the patients on the basis of the number of injury-related stays recorded by the hospitals. Statistics on hospital stays were provided by the French hospital discharge databases in the participating hospitals. The same statistics were available at the national level, which made it possible to extrapolate national incidence estimates. RESULTS Over the 2004-2008 period, the estimated incidence rate of HLIs age-standardized on the European population aged 15 years and over was 48.7 per 1,000 person-years (95% confidence interval: 39.4-58.0), and displayed little variability over time. This rate corresponded to an average of 2.5 million emergency hospital visits each year due to an HLI in people aged over 15 in France. CONCLUSIONS The method made it possible to use medico-administrative datasets available nationwide to provide informative estimates despite the small number of participating EDs. The consequences and costs generated by hospital emergency visits can sometimes be onerous, and these estimated rates confirm the scale of the problem and the need to continue investing in preventive actions.
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Affiliation(s)
- Christophe Bonaldi
- Department of Chronic Diseases and Injuries, French Institute for Health Surveillance, 12 rue du Val d'Osne, Saint Maurice F 94 415, France.
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Antonopoulos CN, Sergentanis TN, Daskalopoulou SS, Petridou ET. Nasal continuous positive airway pressure (nCPAP) treatment for obstructive sleep apnea, road traffic accidents and driving simulator performance: a meta-analysis. Sleep Med Rev 2010; 15:301-10. [PMID: 21195643 DOI: 10.1016/j.smrv.2010.10.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Revised: 10/27/2010] [Accepted: 10/28/2010] [Indexed: 01/08/2023]
Abstract
We used meta-analysis to synthesize current evidence regarding the effect of nasal continuous positive airway pressure (nCPAP) on road traffic accidents in patients with obstructive sleep apnea (OSA) as well as on their performance in driving simulator. The primary outcomes were real accidents, near miss accidents, and accident-related events in the driving simulator. Pooled odds ratios (ORs), incidence rate ratios (IRRs) and standardized mean differences (SMDs) were appropriately calculated through fixed or random effects models after assessing between-study heterogeneity. Furthermore, risk differences (RDs) and numbers needed to treat (NNTs) were estimated for real and near miss accidents. Meta-regression analysis was performed to examine the effect of moderator variables and publication bias was also evaluated. Ten studies on real accidents (1221 patients), five studies on near miss accidents (769 patients) and six studies on the performance in driving simulator (110 patients) were included. A statistically significant reduction in real accidents (OR=0.21, 95% CI=0.12-0.35, random effects model; IRR=0.45, 95% CI=0.34-0.59, fixed effects model) and near miss accidents (OR=0.09, 95% CI=0.04-0.21, random effects model; IRR=0.23, 95% CI=0.08-0.67, random effects model) was observed. Likewise, a significant reduction in accident-related events was observed in the driving simulator (SMD=-1.20, 95% CI=-1.75 to -0.64, random effects). The RD for real accidents was -0.22 (95% CI=-0.32 to -0.13, random effects), with NNT equal to five patients (95% CI=3-8), whereas for near miss accidents the RD was -0.47 (95% CI=-0.69 to -0.25, random effects), with NNT equal to two patients (95% CI=1-4). For near miss accidents, meta-regression analysis suggested that nCPAP seemed more effective among patients entering the studies with higher baseline accident rates. In conclusion, all three meta-analyses demonstrated a sizeable protective effect of nCPAP on road traffic accidents, both in real life and virtual environment.
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Affiliation(s)
- Constantine N Antonopoulos
- Center for Research and Prevention of Injuries (CEREPRI), Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, 75 Mikras Asias Str., 11527 Athens, Greece.
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Jan Meerding W, Polinder S, Lyons RA, Petridou ET, Toet H, van Beeck F, Mulder S. How adequate are emergency department home and leisure injury surveillance systems for cross-country comparisons in Europe? Int J Inj Contr Saf Promot 2010; 17:13-22. [DOI: 10.1080/17457300903523237] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Alexandrescu R, O'Brien SJ, Lecky FE. A review of injury epidemiology in the UK and Europe: some methodological considerations in constructing rates. BMC Public Health 2009; 9:226. [PMID: 19591670 PMCID: PMC2720963 DOI: 10.1186/1471-2458-9-226] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Accepted: 07/10/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Serious injuries have been stated as a public health priority in the UK. However, there appears to be a lack of information on population-based rates of serious injury (as defined by a recognised taxonomy of injury severity) at national level from either official statistics or research papers. We aim to address this through a search and review of literature primarily focused within the UK and Europe. METHODS The review summarizes research papers on the subject of population based injury epidemiology published from 1970 to 2008. We examined critically methodological approaches in measuring injury incident rates including data sources, description of the injury pyramid, matching numerator and denominator populations as well as the relationship between injury and socioeconomic status. RESULTS National representative rates come from research papers using official statistics sources, often focusing on mortality data alone. Few studies present data from the perspective of an injury pyramid or using a standardized measure of injury severity, i.e. Injury Severity Score (ISS). The population movement that may result in a possible numerator - denominator mismatch has been acknowledged in five research studies and in official statistics. The epidemiological profile shows over the past decades in UK and Europe a decrease in injury death rates. No major trauma population based rates are available within well defined populations across UK over recent time periods. Both fatal and non-fatal injury rates occurred more frequently in males than females with higher rates in males up to 65 years, then in females over 65 years. Road traffic crashes and falls are predominant injury mechanisms. Whereas a straightforward inverse association between injury death rates and socio-economic status has been observed, the evidence of socioeconomic inequalities in non-fatal injuries rates has not been wholly consistent. CONCLUSION New methodological approaches should be developed to deal with the study design inconsistencies and the knowledge gaps identified across this review. Trauma registries contain injury data from hospitals within larger regions and code injury by Abbreviated Injury Scale enabling information on severity; these may be reliable data sources to improve understanding of injury epidemiology.
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Affiliation(s)
- Roxana Alexandrescu
- Trauma Audit and Research Network, Clinical Science Building, Hope Hospital, University of Manchester, Manchester, UK.
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Rural-urban differences in injury hospitalizations in the U.S., 2004. Am J Prev Med 2009; 36:49-55. [PMID: 19095165 DOI: 10.1016/j.amepre.2008.10.001] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2008] [Revised: 09/17/2008] [Accepted: 10/03/2008] [Indexed: 11/24/2022]
Abstract
BACKGROUND Despite prior research demonstrating higher injury-mortality rates among rural populations, few studies have examined the differences in nonfatal injury risk between rural and urban populations. The objective of this study was to compare injury-hospitalization rates between rural and urban populations using population-based national estimates derived from patient-encounter data. METHODS A cross-sectional analysis of the 2004 Nationwide Inpatient Sample was conducted in 2007. Rural-urban classifications were determined based on residence. SUDAAN software and U.S. Census population estimates were used to calculate nationally representative injury-hospitalization rates. Injury rates between rural and urban categories were compared with rate ratios and 95% CIs. RESULTS An estimated 1.9 million (95% CI=1,800,250-1,997,801) injury-related hospitalizations were identified. Overall, injury-hospitalization rates generally increased with increasing rurality; rates were 27% higher in large rural counties (95% CI=10%, 44%) and 35% higher in small rural counties (95% CI=16%, 55%). While hospitalization rates for assaults were highest in large urban counties, the rates for unintentional injuries from motor vehicle traffic, falls, and poisonings were higher in rural populations. Rates for self-inflicted injuries from poisonings, cuttings, and firearms were higher in rural counties. The total estimated hospital charges for injuries were more than $50 billion. On a per-capita basis, hospital charges were highest for rural populations. CONCLUSIONS These findings highlight the substantial burden imposed by injury on the U.S. population and the significantly increased risk for those residing in rural locations. Prevention and intervention efforts in rural areas should be expanded and should focus on risk factors unique to these populations.
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Van de Voorde P, Sabbe M, Calle P, Lesaffre E, Rizopoulos D, Tsonaka R, Christiaens D, Vantomme A, De Jaeger A, Matthys D. Paediatric trauma and trauma care in Flanders (Belgium). Methodology and first descriptive results of the PENTA registry. Eur J Pediatr 2008; 167:1239-49. [PMID: 18202851 DOI: 10.1007/s00431-007-0660-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2007] [Revised: 12/08/2007] [Accepted: 12/12/2007] [Indexed: 11/30/2022]
Abstract
Paediatric injury surveillance and prevention are definite priorities for the European, Belgian, and Flemish authorities. Current available data for Flanders (Belgium) are fragmentary and out-of-date. The PENTA registry (PaEdiatric Network around TraumA) was therefore set up to obtain recent population-based data on trauma and trauma care in children and youngsters in Flanders. Data were collected prospectively in a representative sample (n = 18) of Flemish emergency departments (ED). All children (age 0-17 years) who presented at the ED in 2005 or died prehospital due to trauma were included. The registry was split into two levels. The basic A registry ('all' trauma) consisted of 30 variables, and the more exhaustive B registry ('severe trauma', defined as length of hospitalisation >48 hours, including all nonsurvivors) collected data on 291 variables. The incidence for paediatric trauma presenting at Flemish ED was approximately 119/1000/year. Further data were collected in a random sample of 7,879 cases (21.9% of 35,900 eligible patients). Of all cases, 0.8% were considered 'severe' and included in the B registry. In conclusion, the 'burden' of injury in Flanders is still enormous. PENTA provides the first population-based data about the circumstances and the extent of injury in children and youngsters for the Flemish region. In this article we present in detail the surplus value of the methods used, the difficulties encountered, and the most relevant epidemiological findings from the registry.
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Affiliation(s)
- Patrick Van de Voorde
- Department of Paediatrics and Paediatric Intensive Care Unit, University Hospital Gent, Gent, Belgium.
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Backe S, Ericson L, Janson S, Timpka T. Rock climbing injury rates and associated risk factors in a general climbing population. Scand J Med Sci Sports 2008; 19:850-6. [PMID: 19508652 DOI: 10.1111/j.1600-0838.2008.00851.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The objective was to examine injury rates and associated risk factors in a representative sample of climbers. A random sample (n=606) of the Swedish Climbing Association members was sent a postal survey, with an effective response rate of 63%. Self-reported data regarding climbing history, safety practices and retrospective accounts of injury events (recall period 1.5 years) were obtained. Descriptive statistical methods were used to calculate injury incidences, and a two-step method including zero-inflated Poisson's regression analysis of re-injuries was used to determine the combination of risk factors that best explained individual injury rates. Overall, 4.2 injuries per 1000 climbing hours were reported, overuse injuries accounting for 93% of all injuries. Inflammatory tissue damages to fingers and wrists were the most common injury types. The multivariate analysis showed that overweight and practicing bouldering generally implied an increased primary injury risk, while there was a higher re-injury risk among male climbers and a lower risk among the older climbers. The high percentage of overuse injuries implies that climbing hours and loads should be gradually and systematically increased, and climbers regularly controlled for signs and symptoms of overuse. Further study of the association between body mass index and climbing injury is warranted.
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Affiliation(s)
- S Backe
- Division of Public Health Sciences, Karlstad University, Karlstad, Sweden.
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Burgess JA, Walters EH, Byrnes GB, Wharton C, Jenkins MA, Abramson MJ, Hopper JL, Dharmage SC. Who remembers whether they had asthma as children? J Asthma 2007; 43:727-30. [PMID: 17169822 DOI: 10.1080/02770900601028587] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To assess misclassification in adults reporting childhood asthma. METHODS The Tasmanian Asthma Survey commenced in 1968 when 8,583 7-year-old children attending school in Tasmania (participants) were studied. In 1991-1993, a stratified sample of 1,494 participants was studied. Their recall of childhood asthma was compared to their parents' prospectively gathered report. RESULTS Where participants had childhood asthma, those with current asthma, severe eczema, or hay fever were less likely to misclassify while females were more likely to misclassify. Where participants had no childhood asthma, misclassification was associated with current asthma, hay fever, or allergies. CONCLUSIONS Retrospective self-assessment of childhood asthma is unreliable.
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Affiliation(s)
- John A Burgess
- Centre for Molecular, Environmental, Genetic and Analytical Epidemiology, The University of Melbourne, 723 Swanston Street, Carlton, Victoria 3053, Australia.
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Abstract
Emergency medicine plays a significant role in injury prevention through the use of public health models that link injury data to prevention programming, research, and advocacy. The day-to-day experiences in the emergency department provide a picture of the injury problem in a given community and give the emergency practitioner a real-world basis for injury prevention efforts. This article covers the basics or injury prevention, including defining the problem, discussing data and conceptual aspects of injury prevention, and systematically identifying successful approach to reducing the burden of injuries.
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Affiliation(s)
- Linda C Degutis
- Section of Emergency Medicine, Department of Surgery, Yale University School of Medicine, New Haven, CT 06520, USA.
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18
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Crichlow R, Williamson S, Geurin M, Heggem H. Self-reported injury history in Native American professional rodeo competitors. Clin J Sport Med 2006; 16:352-4. [PMID: 16858221 DOI: 10.1097/00042752-200607000-00012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Evaluation of rodeo injury and the use of protective equipment. DESIGN Cross-sectional survey. SETTING Indian National Finals Rodeo 2004 in San Jacinto, CA. PARTICIPANTS One hundred sixty-nine native American, professional rodeo competitors. ASSESSMENT On-site survey completed before competition. A total of 180 native American competitors received the survey. Respondents reported the event of participation, prior injury histories (including number, type and disability), use of protective equipment, and access to health care. MAIN OUTCOME MEASUREMENTS Main outcomes were determined before survey distribution and included self-reported injury rate, time away from rodeo secondary to injury, and protective equipment usage during competition. RESULTS Total 94% response rate. There was a range of injury history-from 100% of bull riders to only 24% of tie-down ropers-reporting a history of injuries. Forty percent of competitors reported using protective equipment; of these, 32% reported wearing vests. Twenty-six percent of the competitors had a history of injury that prevented them from working an average of 3.2 months. CONCLUSIONS As hypothesized, a greater injury rate resulted from rough stock events; older competitors are more likely to have had work time loss from injury; and vests are the most frequently used protective equipment in rodeo.
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Affiliation(s)
- Renée Crichlow
- Montana Family Medicine Residency Program, University of Washington WWAMI Network, USA.
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Maziak W, Ward KD, Rastam S. Injuries in Aleppo, Syria; first population-based estimates and characterization of predominant types. BMC Public Health 2006; 6:63. [PMID: 16533384 PMCID: PMC1459131 DOI: 10.1186/1471-2458-6-63] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2005] [Accepted: 03/13/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the growing burden of injuries worldwide, Syria and many other Arab countries still lack population-based estimates of different types of injuries. This study aims to provide first population-based estimates of major injuries in Syria and characterize groups at increased risk. METHODS An interviewer-administered population-based survey of adults 18-65 years residing in Aleppo, Syria was conducted in 2004. The study sample involved 2038 household representatives in Aleppo (45.2% men, mean age 35.3 +/- 12.1, response rate 86%). We inquired about participants self-reported injuries in the past year that required medical attention as well as injuries among their household members. When reported, injuries were further assessed according to type, place, and outcome. RESULTS Overall, there was 153 self-reported injuries in the past year (77.3 per 1000 adult respondents, 93.1 per 1000 in men and 64.4 per 1000 in women, p = 0.02). Other than gender, injuries differed by age (the older age group being least affected), and place of occurrence, as men were more likely to sustain traffic injuries and be injured outside the home. Injuries were reported among 236 household members (21.0 per 1000), and were slightly more frequent in children than adults (22.0 per 1000 for children, and 19.7 per 1000 for adults, p = 0.2). Traffic injuries, falls, and poisoning (food) were by far the most common types of injury experienced by participants as well as their household members. Falls and traffic injuries seem to have caused most morbidity for the injured, while burns, although not frequently reported, were associated with an unfavorable outcome in the majority of cases. CONCLUSION This information provides baseline information about the burden of different injuries in Syria, and the sociodemographic factors related to them.
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Affiliation(s)
- Wasim Maziak
- Syrian Center for Tobacco Studies, Aleppo, Syria
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - Kenneth D Ward
- Syrian Center for Tobacco Studies, Aleppo, Syria
- Department of Health & Sport Sciences, and Center for Community Health, University of Memphis, Memphis, TN, USA
| | - Samer Rastam
- Syrian Center for Tobacco Studies, Aleppo, Syria
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Schluter PJ, Paterson J, Percival T. Non-fatal injuries among Pacific infants in Auckland: data from the Pacific Islands families first two years of life study. J Paediatr Child Health 2006; 42:123-8. [PMID: 16509912 DOI: 10.1111/j.1440-1754.2006.00810.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Child injury is the leading cause of mortality and morbidity in developed countries. While Pacific infant death rates are relatively high in New Zealand, little is known about non-fatal injury rates. We seek to describe maternally reported injury in Pacific infants aged between 0-24 months. METHODS A cohort of Pacific infants born during 2000 in Auckland, New Zealand, was followed. Maternal home interviews were conducted at 6 weeks, 12 months and 24 months postpartum and injury events were recalled. Marginal models using generalized estimating equations (GEEs) were used to analysis the longitudinal data. RESULTS The inception cohort included 1398 infants at 6 weeks, 1241 infants at 12 months and 1161 infants at 24 months. The age-specific injury incidence per 1000 person-years exposure was estimated at 48 (95% CI: 23, 88) injuries for infants aged 0-6 weeks, 106 (95% CI: 88, 127) injuries for infants aged 7 weeks-12 months and 174 (95% CI: 151, 199) injuries for infants aged 13-24 months. In the multivariable GEE model, older infants (P < 0.001), infants who were male (P = 0.01), born to Pacific Island fathers and non-Pacific Island mothers (P < 0.001), and in higher or unknown income groups (P = 0.01) were significantly more likely to suffer injury events. No significant two-factor interaction with infant age was identified. CONCLUSIONS Among Pacific infants, non-fatal injury is common and injury incidence rates are considerably higher than national levels. Male infants and those born into ethnically mixed families, where the father was of Pacific Island ethnicity and the mother was non-Pacific, were at increased relative risk of injury and might benefit from specific injury prevention targeting. However, given the high injury incidence levels found, we advocate that investigation and targeting of culturally appropriate prevention strategies for all Pacific families with young children is required to reduce injury rates for Pacific infants in New Zealand.
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Affiliation(s)
- Philip J Schluter
- Faculty of Health and Environmental Sciences, AUT, Auckland, New Zealand.
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Xiang H, Stallones L, Chen G, Hostetler SG, Kelleher K. Nonfatal injuries among US children with disabling conditions. Am J Public Health 2005; 95:1970-5. [PMID: 16195515 PMCID: PMC1449470 DOI: 10.2105/ajph.2004.057505] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We investigated the risk of nonfatal injury in US children with disabilities. Disability was defined as a long-term reduction in the ability to conduct social role activities, such as school or play, because of a chronic physical or mental condition. METHODS Among 57 909 children aged 5-17 years who participated in the 2000-2002 National Health Interview Survey, we identified 312 children with vision/hearing disabilities, 711 with mental retardation, 603 with attention-deficit/hyperactivity disorder (ADD/HD), and 403 with chronic asthma. We compared nonfatal injuries in the past 3 months between children with disabling conditions and those without using injury rates and logistic regression analyses. RESULTS Compared with children without a disability, a higher percentage of children with disabilities reported nonfatal injuries (4.2% for vision disability, 3.2% for mental retardation, 4.5% for attention-deficit/hyperactivity disorder, and 5.7% for asthma vs 2.5% for healthy children). After we controlled for confounding effects of sociodemographic variables, children with disabilities, with the exception of mental retardation, had a statistically significantly higher injury risk than those without disabling conditions. CONCLUSIONS Children with a disabling condition from vision/hearing disability, ADD/HD, or chronic asthma had a significantly higher risk for nonfatal injuries compared with children without a disabling condition. These data underscore the need to promote injury control and prevention programs targeting children with disabilities.
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Affiliation(s)
- Huiyun Xiang
- Center for Injury Research and Policy, Columbus Children's Hospital, OH 43205, USA.
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22
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Betz ME, Li G. Epidemiologic patterns of injuries treated in ambulatory care settings. Ann Emerg Med 2005; 46:544-51. [PMID: 16308072 DOI: 10.1016/j.annemergmed.2005.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2005] [Revised: 06/20/2005] [Accepted: 07/01/2005] [Indexed: 11/19/2022]
Abstract
STUDY OBJECTIVE Epidemiologic studies of injury morbidity have relied primarily on data from emergency departments (EDs) and hospital admissions. We seek to assess the incidences and characteristics of acute injuries treated at EDs and other ambulatory care settings. METHODS Using data from the 2002 National Health Care Survey on initial visits for acute injuries to EDs, physician offices, and hospital outpatient departments, we estimated the frequencies and incidence rates of medically attended injury by patient characteristics and care setting. RESULTS In the United States in 2002, 76 million nonfatal acute injuries received initial medical attention at EDs (46.2%), physician offices (47.8%), and outpatient departments (6.0%). The overall annual incidence rate of medically attended injury was 26.8 per 100 population (95% confidence interval 24.4 to 29.7). Falls accounted for 16.7% of all medically attended injuries. Injury patients who were black or uninsured were significantly more likely to visit EDs than other care settings for treatment. More than 2.4 million (3.2%) injury patients were admitted to hospitals, 96.6% of them through EDs. CONCLUSION Fewer than half of all medically attended acute injuries in the United States receive initial treatment in EDs. Injury severity and characteristics vary among care settings.
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Affiliation(s)
- Marian E Betz
- Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Potter BK, Manuel D, Speechley KN, Gutmanis IA, Campbell MK, Koval JJ. Is there value in using physician billing claims along with other administrative health care data to document the burden of adolescent injury? An exploratory investigation with comparison to self-reports in Ontario, Canada. BMC Health Serv Res 2005; 5:15. [PMID: 15720709 PMCID: PMC554767 DOI: 10.1186/1472-6963-5-15] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2004] [Accepted: 02/18/2005] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Administrative health care databases may be particularly useful for injury surveillance, given that they are population-based, readily available, and relatively complete. Surveillance based on administrative data, though, is often restricted to injuries that result in hospitalization. Adding physician billing data to administrative data-based surveillance efforts may improve comprehensiveness, but the feasibility of such an approach has rarely been examined. It is also not clear how injury surveillance information obtained using administrative health care databases compares with that obtained using self-report surveys. This study explored the value of using physician billing data along with hospitalization data for the surveillance of adolescent injuries in Ontario, Canada. We aimed i) to document the burden of adolescent injury using administrative health care data, focusing on the relative contribution of physician billing information; and ii) to explore data quality issues by directly comparing adolescent injuries identified in administrative and self-report data. METHODS The sample included adolescents aged 12 to 19 years who participated in the 1996-1997 cross-sectional Ontario Health Survey, and whose survey responses were linked to administrative health care datasets (N = 2067). Descriptive analysis was used to document the burden of injuries as a proportion of all physician care by gender and location of care, and to examine the distribution of both administratively-defined and self-reported activity-limiting injuries according to demographic characteristics. Administratively-defined and self-reported injuries were also directly compared at the individual level. RESULTS Approximately 10% of physician care for the sample was identified as injury-related. While 18.8% of adolescents had self-reported injury in the previous year, 25.0% had documented administratively-defined injury. The distribution of injuries according to demographic characteristics was similar across data sources, but congruence was low at the individual level. Possible reasons for discrepancies between the data sources included recall errors in the survey data and errors in the physician billing data algorithm. CONCLUSION If further validated, physician billing data could be used along with hospital inpatient data to make an important and unique contribution to adolescent injury surveillance. The limitations inherent in different datasets highlight the need to continue rely on multiple information sources for complete injury surveillance information.
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Affiliation(s)
- Beth K Potter
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Canada
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada
| | - Douglas Manuel
- Institute for Clinical Evaluative Sciences, Toronto, Canada
- Department of Public Health Sciences, University of Toronto, Toronto, Canada
| | - Kathy N Speechley
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Canada
- Children's Health Research Institute, London, Canada
- Department of Paediatrics, University of Western Ontario, London, Canada
| | - Iris A Gutmanis
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Canada
- Southwest Region Health Information Partnership, London, Canada
| | - M Karen Campbell
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Canada
- Children's Health Research Institute, London, Canada
- Department of Paediatrics, University of Western Ontario, London, Canada
- Department of Obstetrics and Gynecology, University of Western Ontario, London, Canada
| | - John J Koval
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Canada
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