4 research outputs found
Implications of estimating road traffic serious injuries from hospital data
To determine accurately the number of serious injuries at EU level and to compare serious injury rates between different countries it is essential to use a common definition. In January 2013, the High Level Group on Road
Safety established the definition of serious injuries as patients with an injury level of MAIS3+(Maximum Abbreviated Injury Scale). Whatever the method used for estimating the number or serious injuries, at some point it is always necessary to use hospital records. The aim of this paper is to understand the implications for (1) in/exclusion criteria applied to case selection and (2) a methodological approach for converting ICD
(International Classification of Diseases/Injuries) to MAIS codes, when estimating the number of road traffic
serious injuries from hospital data. A descriptive analysis with hospital data from Spain and the Netherlands was carried out to examine the effect of certain choices concerning in- and exclusion criteria based on codes of the ICD9-CM and ICD10. The main parameters explored were: deaths before and after 30 days, readmissions, and external injury causes. Additionally, an analysis was done to explore the impact of using different conversion tools to derive MAIS3 + using data from Austria, Belgium, France, Germany, Netherlands, and Spain. Recommendations are given regarding the in/exclusion criteria and when there is incomplete data to ascertain a
road injury, weighting factors could be used to correct data deviations and make more real estimations
Practical guidelines for the registration and monitoring of serious traffic injuries, D7.1 of the H2020 project SafetyCube
BACKGROUND AND OBJECTIVES
Crashes also cause numerous serious traffic injuries, resulting in considerable economic and human costs. Given the burden of injury produced by traffic, using only fatalities as an indicator to monitor road safety gives a very small picture of the health impact of traffic crashes, just the tip of the iceberg. Moreover, in several countries during the last years the number of serious traffic injuries has not been decreasing as fast as the number of fatalities. In other countries the number of serious traffic injuries has even been increasing (Berecki-Gisolf et al., 2013; IRTAD Working Group on Serious Road Traffic Casualties, 2010; Weijermars et al., 2015).Therefore, serious traffic injuries are more commonly being adopted by policy makers as an additional indicator of road safety. Reducing the number of serious traffic injuries is one of the key priorities in the road safety programme 2011-2020 of the European Commission (EC, 2010).
To be able to compare performance and monitor developments in serious traffic injuries across Europe, a common definition of a serious road injury was necessary. In January 2013, the High Level Group on Road Safety, representing all EU Member States, established the definition of serious traffic injuries as road casualties with an injury level of MAIS ≥ 3. The Maximum AIS represents the most severe injury obtained by a casualty according to the Abbreviated Injury Scale (AIS).
Traditionally the main source of information on traffic accidents and injuries has been the police registration. This provides the official data for statistics at national and European level (CARE Database). Data reported by police usually is very detailed about the circumstances of the crash particularly if there are people injured or killed. But on the other hand police cannot assess the severity of injuries in a reliable way, due, obviously to their training. Therefore, police based data use to classify people involved in a crash as fatality, severe injured if hospitalised more than 24 hours and slight injured if not hospitalised. Moreover, it is known that even a so clear definition as a fatality is not always well reported and produces underreporting. This is due to several factors such as lack of coverage of police at the scene or people dying at hospital not followed by police (Amoros et al., 2006; Broughton et al., 2007; Pérez et al., 2006).
Hospital records of patients with road traffic injuries usually include very little information on circumstances of the crash but it does contain data about the person, the hospitalisation (date of hospitalisation and discharge, medical diagnosis, mechanism or external cause of injury, and interventions). Hospital inpatient Discharge Register (HDR) offers an opportunity to complement police data on road traffic injuries. Medical diagnoses can be used to derive information about severity of injuries. Among others, one of the possible scales to measure injury severity is the Abbreviated Injury Scale (AIS).
The High Level group identified three main ways Member States can collect data on serious traffic injuries (MAIS ≥ 3):
1) by applying a correction on police data,
2) by using hospital data and
3) by using linked police and hospital data.
Once one of these three ways is selected, several additional choices need to be made. In order to be able to compare injury data across different countries, it is important to understand the effects of methodological choices on the estimated numbers of serious traffic injuries. A number of questions arise: How to determine the correction factors that are to be applied to police data? How to select road traffic casualties in the hospital data and how to derive MAIS ≥ 3 casualties? How should police and hospital data be linked and how can the number of MAIS ≥ 3 casualties be determined on the basis of the linked data sources?
Currently, EU member states use different procedures to determine the number of MAIS ≥ 3 traffic injuries, dependent on the available data. Given the major differences in the procedures being applied, the quality of the data differs considerably and the numbers are not yet fully comparable between countries. In order to be able to compare injury data across different countries, it is important to understand the effects of methodological choices on the estimated numbers of serious traffic injuries.
Work Package 7 of SafetyCube project is dedicated to serious traffic injuries, their health impacts and their costs. One of the aims of work package 7 is to assess and improve the estimation of the number of serious traffic injuries.
The aim of this deliverable (D7.1) is to report practices in Europe concerning the reporting of serious traffic injuries and to provide guidelines and recommendations applied to each of the three main ways to estimate the number of road traffic serious injuries.
Specific objectives for this deliverable are to:
Describe the current state of collection of data on serious traffic injuries across Europe
Provide practical guidelines for the estimation of the number of serious traffic injuries for each of the three ways identified by the High Level Group
Examine how the estimated number of serious traffic injuries is affected by differences in methodology
Physical and psychological consequences of serious road traffic injuries, deliverable 7.2 of the H2020 project SafetyCube
SafetyCube aims to develop an innovative road safety Decision Support System (DSS) that will
enable policy-makers and stakeholders to select the most appropriate strategies, measures and
cost-effective approaches to reduce casualties of all road user types and all severities. Work Package
7 of SafetyCube is dedicated to serious road traffic injuries, their health impacts and their costs. This
Deliverable discusses health impacts of (serious) road traffic injuries
Implications of estimating road traffic serious injuries from hospital data
To determine accurately the number of serious injuries at EU level and to compare serious injury rates between different countries it is essential to use a common definition. In January 2013, the High Level Group on Road Safety established the definition of serious injuries as patients with an injury level of MAIS3+(Maximum Abbreviated Injury Scale)