Injury Surveillance Data Research Articles

Multiple Logistic Regression Model for Assessing the Risk Factors of Traffic Accidents: Khon Kaen Model.

Thailand has consistently held the highest global ranking in traffic accidents since 2017, with Khon Kaen displaying the highest mortality rate in the Department of Disease Control Region 7. This study aims to utilize Injury Surveillance (IS) data to identify risk factors associated with emergency room (ER) outcomes at the Emergency Department of Khon Kaen hospital in Khon Kaen Municipality. Data from the Injury Surveillance system's (IS system) database were collected, focusing on severity outcomes, time of events, and risk behaviors from January 1, 2008, to December 31, 2021. Data analysis was conducted using the R program, employing the Chi-square or independent T test to compare results and analyze associations between potential risk factors and ER outcomes. Multiple logistic regression (MLR) was used for classification analysis, and a confusion matrix was applied to evaluate the performance of the models. MLR analysis revealed that being male, age, alcohol consumption, and nighttime driving were more likely to increase the probability of severity outcomes. Being male, age, alcohol consumption, and nighttime driving are identified as potential risk factors contributing to the development of severity outcomes following traffic accidents.

Injury rates and mechanisms of starting and replacement players

ABSTRACT To examine injury rates, injury mechanisms and injury inciting tackle characteristics of both starting and replacement players. A prospective, cohort study of four male professional Welsh Rugby Union (WRU) teams. Injury surveillance and Global Positioning System (GPS) data were collected from league matches between the 1st of July 2017 to the 31st of August 2020. Video analysis included league matches from the 1st of July 2017 to the 31st of March 2021. Player-specific GPS exposure was used to calculate injury incidence. Generalised linear mixed models were used to analyse the effect of replacement players on injuries. Tackle injury propensity (injuries/100 tackle events) and descriptive characteristics for the tackle event were reported. A total of 290 injuries were sustained by 105 players. Starting players had a higher injury incidence than replacement players (80.8 vs 57.2 injuries/1000 match hours; rate ratio: 1.41 (95% CI 1.00 – 1.98)). For every replacement used there was a 12% increase in the number of injuries (p = 0.037). However, there was no increase in the number of injuries accounting for the replacement time-in-game (p = 0.099). The injury propensity was highest for starting versus opposition replacement players (RR: 4.08, 95% CI: 2.28 – 7.29). Injury inciting tackles for starting players showed higher body positions, whereas replacement players maintained a lower body position. Match injuries were influenced by the number of replacement players, but this was mitigated when accounting for the replacement player time-in-game. Starting and replacement players have differing injury inciting tackle characteristics, suggesting that injury risk mitigation associated with the tackle should be incorporated at a player-specific level.

The Influence of Sports-Related Concussion on Cognition and Landing Biomechanics in Collegiate Athletes.

Injury surveillance data indicate that collegiate athletes are at greater risk for lower extremity (LE) injuries following sports-related concussion (SRC). While the association between SRC and LE injury appears to be clinically relevant up to 1-year post-SRC, little evidence has been provided to determine possible mechanistic rationales. Thus, we aimed to compare collegiate athletes with a history of SRC to matched controls on biomechanical and cognitive performance measures associated with LE injury risk. Athletes with a history of SRC (n = 20) and matched controls (n = 20) performed unanticipated bilateral land-and-cut tasks and cognitive assessments. Group-based analyses (ANOVA) and predictive modeling (C5.0 decision tree algorithm) were used to compare group differences on biomechanical and cognitive measures. Collegiate athletes with a history of SRC demonstrated approximately six degrees less peak knee flexion on both dominant (p = 0.03, d = 0.71) and nondominant (p = 0.02, d = 0.78) limbs during the land-and-cut tasks compared to controls. Verbal Memory, knee flexion, and Go/No Go total score (C5.0 decision tree algorithm) were identified as the strongest indicators of previous SRC injury history. Reduced knee flexion during sport-specific land-and-cut tasks may be a mechanism for increased LE injury risk in athletes with a history of SRC. There appears to be multiple biomechanical and cognitive predictors for identifying previous SRC in collegiate athletes, providing evidence to support a multifactorial SRC management strategy to reduce future injury risk.

Assessing the quality of emergency department data for injury surveillance in Victoria, Australia: a comparative analysis of two Victorian hospital data sources

ObjectiveThe emergency department (ED) is pivotal in treating serious injuries, making it a valuable source for population-based injury surveillance. In Victoria, information that is relevant to injury surveillance is collected...

EMS injury cause codes more accurate than emergency department visit ICD-10-CM codes for firearm injury intent in North Carolina.

The timeliness, accuracy, and completeness of data for firearm injury surveillance is crucial for public health surveillance efforts and informing injury prevention measures. While emergency department (ED) visit data can provide near real-time information on firearms injuries, there are concerns surrounding the accuracy of intent coding in these data. We examined whether emergency medical service (EMS) data provide more accurate firearm injury intent coding in comparison to ED data. We applied a firearm injury definition to EMS encounter data in NC's statewide syndromic surveillance system (NC DETECT), from January 1, 2021, through December 31, 2022. We manually reviewed each record to determine intent, and the corresponding manual classifications were compared to the injury cause codes entered in the EMS data and to ED visit records where EMS-ED record linkage was possible. We then calculated the sensitivity, specificity, positive and negative predictive values for each intent classification in SAS 9.4 using the manually reviewed intent classifications as the gold standard. We identified 9557 EMS encounters from January 1, 2021, through December 31, 2022 meeting our firearm injury definition. After removing false positives and duplicates, 8584 records were available for manual injury classification. Overall, our analysis demonstrated that manual and EMS injury cause code classifications were comparable. However, for the 3401 EMS encounters that could be linked to an ED visit record, sensitivity of the ED ICD-10-CM codes was low for assault and intentional self-harm encounters at 18.2% (CI 16.5-19.9%) and 22.2% (CI 16-28.5%), respectively. This demonstrates a marked difference in the reliability of the intent coding in the two data sources. This study illustrates both the value of examining EMS encounters for firearm injury intent, and the challenges of accurate intent coding in the ED setting. EMS coding has the potential for more accurate intent coding than ED coding within the context of existing hospital-based coding guidance. This may have implications for future firearm injury research, especially for nonfatal firearm injuries.

Ascertaining injury risk issues through big data analysis: text-mining based analysis of national emergency response data.

Injury prevention can be achieved through various interventions, but it faces challenges due to its comprehensive nature and susceptibility to external environmental factors, making it difficult to detect risk signals. Moreover, the reliance on standardized systems leads to the construction and statistical analysis of numerous injury surveillance data, resulting in significant temporal delays before being utilized in policy formulation. This study was conducted to quickly identify substantive injury risk problems by employing text mining analysis on national emergency response data, which have been underutilized so far. With emerging issue and topic analyses, commonly used in science and technology, we detected problematic situations and signs by deriving injury keywords and analyzing time-series changes. In total, 65 injury keywords were identified, categorized into hazardous, noteworthy, and diffusion accidents. Semantic network analysis on hazardous accident terms refined the injury risk issues. An increased risk of winter epidemic fractures due to extreme weather, self-harm due to depression (especially drug overdose and self-mutilation), and falls was observed in older adults. Thus, establishing effective injury prevention strategies through inter-ministerial and interagency cooperation is necessary.

Understanding Stakeholder Dissemination Preferences for an Agriculture, Forestry, and Fishing Injury Surveillance System

ABSTRACT Researchers and epidemiologists are working to improve the capture of agriculture, forestry, and fishing (AgFF) injuries in a variety of ways. A critical component of any surveillance system is the dissemination of information. The purpose of this paper is to report on a survey conducted with AgFF injury surveillance stakeholders to understand preferred dissemination strategies. The survey was distributed using REDCap via web link to organizational stakeholders, which included advisory board members, safety trainers, industry managers and workers, and research collaborators. In total, there were 75 respondents (21% response rate). Occupation and industry influenced preference in update methods. Regarding the length and breadth of updates, 63% of respondents prefer reports (one to five pages), followed by 57% desiring a summary (less than one page), while only 24% wanted a detailed analysis. Social media and news preferences were also different among stakeholders. Surveillance data were desired for 1) trend analysis, 2) tailoring activities and solutions for education, training, outreach and interventions and 3) for research purposes such as grant proposals and evaluation. The dissemination of injury surveillance data should be tailored to the intended audience. Greater attention needs to be paid to the ways in which we share our findings.

Methodological challenges in collecting and analysing data on child unintentional injuries: Insights from the CHILD Vigilance project (CHIVI) on parents’ attitudes and practices

Abstract Injuries are among the top ten conditions affecting children according to WHO's latest evidence on years lived with disability. Despite this fact, EU countries are still missing strong information systems for enabling efficient response to the problem. Data on child unintentional injuries are still inconsistently collected in Europe due to substantial deficiencies in injury surveillance data as well as differences in coding systems and legal policies on reporting requirements. Apart from specific countries (e.g. Norway) there is no population-based monitoring of child unintentional injuries in Europe, while initiatives to collect EU-wide information on child unintentional injuries such as the Eurosafe study, seems to be scarce. Improving data availability will require greater investments in country health information systems, vital statistics systems, and household survey programmes. Technical advisory groups indicate the need to develop standard data collection procedures and ensure that indicators are harmonised across global initiatives. Building country capacity in collecting, analysing and increasing the use of child injury data for decision making at global, regional, and national levels, is important. The current presentation will discuss the methodological challenges identified in collecting and analysing data on child unintentional injuries based on the CHILD Vigilance project (CHIVI), which is being conducted in two countries (Portugal, Greece) under the umbrella of EUPHA INJ and aims at assessing parenting attitudes and supervision practices in children aged 0-14 years. Based on 577 valid responses, involving 890 children (53.1% male; 46.8% female) the study revealed major challenges in defining child unintentional injuries, identifying validated tools to accurately measure injuries and their impact on children as well as the challenges in defining the most appropriate determinants of child unintentional injuries.

Addressing health disparities using multiply imputed injury surveillance data

BackgroundAssessing disparities in injury is crucial for injury prevention and for evaluating injury prevention strategies, but efforts have been hampered by missing data. This study aimed to show the utility and reliability of the injury surveillance system as a trustworthy resource for examining disparities by generating multiple imputed companion datasets.MethodsWe employed data from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) for the period 2014–2018. A comprehensive simulation study was conducted to identify the appropriate strategy for addressing missing data limitations in NEISS-AIP. To evaluate the imputation performance more quantitatively, a new method based on Brier Skill Score (BSS) was developed to assess the accuracy of predictions by different approaches. We selected the multiple imputations by fully conditional specification (FCS MI) to generate the imputed companion data to NEISS-AIP 2014–2018. We further assessed health disparities systematically in nonfatal assault injuries treated in U.S. hospital emergency departments (EDs) by race and ethnicity, location of injury and sex.ResultsWe found for the first time that significantly higher age-adjusted nonfatal assault injury rates for ED visits per 100,000 population occurred among non-Hispanic Black persons (1306.8, 95% Confidence Interval [CI]: 660.1 – 1953.5), in public settings (286.3, 95% CI: 183.2 – 389.4) and for males (603.5, 95% CI: 409.4 – 797.5). We also observed similar trends in age-adjusted rates (AARs) by different subgroups for non-Hispanic Black persons, injuries occurring in public settings, and for males: AARs of nonfatal assault injury increased significantly from 2014 through 2017, then declined significantly in 2018.ConclusionsNonfatal assault injury imposes significant health care costs and productivity losses for millions of people each year. This study is the first to specifically look at health disparities in nonfatal assault injuries using multiply imputed companion data. Understanding how disparities differ by various groups may lead to the development of more effective initiatives to prevent such injury.

Shoulder Check: Investigating Shoulder Injury Rates, Types, Severity, Mechanisms, and Risk Factors in Canadian Youth Ice Hockey.

To describe shoulder-related injury rates (IRs), types, severity, mechanisms, and risk factors in youth ice hockey players during games and practices. Secondary analysis of data from a 5-year prospective cohort study, Safe-to-Play (2013-2018). Canadian youth ice hockey. Overall, 6584 player-seasons (representing 4417 individual players) participated. During this period, 118 shoulder-related games and 12 practice injuries were reported. An exploratory multivariable mixed-effects Poisson regression model examined the risk factors of body checking policy, weight, biological sex, history of injury in the past 12 months, and level of play. Injury surveillance data were collected from 2013 to 2018. Injury rates with 95% confidence interval (CI) were estimated using Poisson regression. The shoulder IR was 0.35 injuries/1000 game-hours (95% CI, 0.24-0.49). Two-thirds of game injuries (n = 80, 70%) resulted in >8 days of time-loss, and more than one-third (n = 44, 39%) resulted in >28 days of time-loss. An 83% lower rate of shoulder injury was associated with policy prohibiting body checking compared with leagues allowing body checking (incidence rate ratio [IRR], 0.17; 95% CI, 0.09-0.33). A higher shoulder IR was observed for those who reported any injury in the last 12-months compared with those with no history (IRR, 2.00; 95% CI, 1.33-3.01). Most shoulder injuries resulted in more than 1 week of time-loss. Risk factors for shoulder injury included participation in a body-checking league and recent history of injury. Further study of prevention strategies specific to the shoulder may merit further consideration in ice hockey.

Foot and Ankle Injuries in Elite South African Cricketers: A Descriptive Analysis of Injury Surveillance Data

IntroductionInjury surveillance is an important part of injury risk reduction in the sporting population. This study describes the type, side (dominant or non-dominant), occurrence, impact, activity of onset, and severity of foot and ankle injuries in elite South African male and female cricketers.MethodsFoot and ankle injuries sustained by elite cricket players between 2018 and 2021, obtained from the records of Cricket South Africa, were descriptively analysed.ResultsA total of 104 foot and ankle injuries in 82 players were recorded. The majority (n = 100; 96%) of injuries were on the non-dominant side. Bowling (n = 31; 30%) and fielding (n = 20; 19%) contributed to most injuries. The majority were first-time (n = 83; 80%) and non-impact injuries (n = 62; 60%). Fifty percent (n = 52) of injuries rendered players unable to participate in at least one match or practice session. Lateral ankle ligament injury was the most common injury sustained (n = 36; 35%).ConclusionThe findings from this study can inform future researchers and assist healthcare service needs relating to injury risk reduction and management programmes. Effective rehabilitation programmes may reduce the risk of reinjury. Ideally, these programmes need to be role specific.

Risk factors associated with football injury among male players from a specific academy in Ghana: a pilot study

There seems to be no information on the incidence of injury and associated risk factors for academy football players in Ghana. We determine the risk factors associated with match and training injuries among male football players at an academy in Ghana. Preseason measurements of players’ height, weight, and ankle dorsiflexion (DF) range of motion (ROM) were measured with a stadiometer (Seca 213), a digital weighing scale (Omron HN-289), and tape measure, respectively. The functional ankle instability (FAI) of players was measured using the Cumberland Ankle Instability Tool (CAIT), and dynamic postural control was measured with the Star Excursion Balance Test. Injury surveillance data for all injuries were collected by resident physiotherapists throughout one season. Selected factors associated with injury incidence were tested using Spearman’s rank correlation at a 5% significance level. Age was negatively associated with overall injury incidence (r = − 0.589, p = 0.000), match (r = − 0.294, p = 0.008), and training incidence (r = − 0.314, p = 0.005). Previous injury of U18s was associated with training injuries (r = 0.436, p = 0.023). Body mass index (BMI) was negatively associated with overall injury incidence (r = − 0.513, p = 0.000), and training incidence (r = − 0.395, p = 0.000). CAIT scores were associated with overall injury incidence (n = 0.263, p = 0.019) and match incidence (r = 0.263, p = 0.029). The goalkeeper position was associated with match incidence (r = 0.241, p = 0.031) while the U16 attacker position was associated with training incidence. Exposure hours was negatively associated with overall injury incidence (r = − 0.599, p = 0.000). Age, BMI, previous injury, goalkeeper and attacker positions, ankle DF ROM, and self-reported FAI were associated with injury incidence among academy football players in Ghana.

Association Between Magnetic Resonance Imaging Findings and Time to Return to Sport After Muscle Injuries in High-Level Youth Athletes.

To describe the relationship between magnetic resonance imaging (MRI) findings and time to return to sport (RTS) from muscle injuries in youth athletes. Prospective collection of injury surveillance data over 6 seasons (2014-2015 to 2019-2020) and reanalysis of MRIs by a radiologist blinded to RTS time after the data collection period. National sports academy and sports medicine hospital. Male youth (11-19 years) athletes participating in the football (soccer) or athletics (track and field) programs with a muscle injury. Magnetic resonance imaging findings (eg, grade and location) in time-loss muscle injuries. Injury incidence, distributions, and RTS time. In total, 353 time-loss muscle injuries were recorded for 1089 athlete-seasons, of which 85 satisfied our inclusion criteria (MRI within 14 days). Return to sport time was significantly longer for reinjuries compared with index injuries. Associations between MRI findings and RTS time were specific to the muscle group, with significant differences in RTS time observed between categories of structure, location, and grade. The largest number of injuries was to the hamstrings (n = 46), where injuries involving the tendon were more severe than those involving the myotendinous junction and muscle, proximal injuries were more severe than mid-portion and distal, and longer RTS time was observed for higher injury grade ( P < 0.05). Muscle injuries in youth are diverse and cannot be treated as a single injury type. Specific injury durations can be expected depending on injury characteristics such as reinjury, location, structure, and grade.

Factors Associated with Lost Time Injury among Paramedics in Victoria, Australia

Background The dynamic and uncontrolled nature of paramedic work frequently exposes these workers to physical and psychological injury. Often paramedic injury rates are estimated based on national injury surveillance data or compensation databases. These data sources tend to only capture cases of a more serious nature and overlook the broader factors that contribute to injury. This limits our understanding of the true burden of paramedic injury and the characteristics associated with increased injury severity. Objectives To describe the incidence and proportions of paramedic occupational injury in Victoria, Australia, and to determine the injury-related characteristics associated with lost time from work. Methods A retrospective analysis of paramedic injury report data from the single state-wide ambulance service in Victoria, Australia – Ambulance Victoria. Injuries reported between 1 January 2015 and 30 June 2020 were included. Chi-square tests of independence were used to explore shift and injury characteristic variables that may be associated with time lost from work. Results Over the study period, 7,591 paramedic injuries were reported that met the inclusion criteria, of which 2,124 (28%) resulted in lost time from work. The cumulative incidence of paramedic injury was 333.8 injuries per 1,000 FTE workers per year, and the rate of lost time injury was 93.0 per 1,000 FTE workers per year. Musculoskeletal injuries were the most frequently reported injury type irrespective of lost time status. Manual handling followed by psychological stressors were the two leading mechanisms of injury based on incidence. Psychological injury was associated with lost time from work (X2= 384.2, p < 0.001). Conversely, injury to the head and neck (X2= 7.5, p = 0.006), and upper limb injuries (X2= 104.5, p < 0.001), were more strongly associated with no lost time from work. Conclusions Paramedics working in Victoria have a higher rate of work-related injury than other Australian workers. Injury-related factors that are often overlooked, such as time, shift type, location, and injury characteristics, all contribute to an increased risk of lost time injury. An understanding of the factors that contribute to an increase in injury severity may facilitate the development and targeting of appropriate interventions.

Comparison of injury profiles between elite Australian male and female cricket players.

This study presents seven seasons of injury surveillance data for both elite Australian male and female cricket players, revealing injury statistics and allowing for comparison between sexes. Retrospective cohort. Participants were elite Australian male and female cricket players who were contracted to play for a national and/or state/territory team and/or T20 franchise between 2015-16 and 2021-22 (7 seasons). Injury data was recorded in Cricket Australia's Athlete Management System database and combined with match data. The STROBE-SIIS statement was used as the relevant guideline for this study. Data for 1345 male player seasons and 959 female player seasons revealed sex-related differences in the injury incidence rates and prevalence. Males had higher incidence (average 136 vs 101 injuries per 1000 match days) and prevalence of match time-loss injuries (average 10.4% vs 6.5% players unavailable). However, the overall incidence of all medical attention injuries were similar between sexes (Incidence Rate Ratio (IRR) 0.9, 95%CI 0.8-1.0). The most frequent match time-loss injuries for males were hamstring strains (7.4 new injuries per 100 players per season), side and abdominal strains (5.5), concussion (5.0), lumbar stress fractures (4.3), and wrist and hand fractures (3.9). The most frequent match time-loss injuries for females over the 7 seasons were hamstring strains (3.1), concussion (2.3), quadriceps strains (2.4) and shin/foot/ankle stress fractures (2.0). The IRR of medical attention injuries for males compared to females was higher for lumbosacral stress fractures (IRR 2.3), elbow and forearm injuries (1.5), and concussion (1.4), and lower for lower leg, foot, and ankle stress fractures (0.6), shoulder and upper arm injuries (0.7), and quadriceps strains (0.6). Robust long-term injury surveillance enabled the injury profiles of elite Australian male and female cricket players to be understood and compared. Males had a higher incidence and prevalence of match time-loss injuries, likely reflecting a higher match exposure.

A-187 Prior Concussion History and Recovery Time Following Sport-Related Concussion in High School Athletes

Abstract Objective: To examine whether adolescents with prior concussions take longer to return to school and/or sports following a subsequent sport-related concussion. Method: Injury surveillance data for 780 adolescents (M age=16.3, SD=1.3 years) were analyzed. Adolescents were divided into three groups: (a) no prior concussion history (69%; n=538), (b) history of one prior concussion (19.2%; n=150), and (c) history of two or more prior concussions (11.8%; n=92). We analyzed between-group differences in time to return to school and sports. Results: Groups did not differ in time to return to school (K-W: χ2(2)=0.95, p=.62; Log Rank: χ2 (2)=2.83, p=.24) or sports (K-W: χ2(2)=2.19, p=0.33; Log Rank: χ2 (2)=3.95, p=.14). However, a greater proportion of student athletes with two or more prior concussions had not returned to their sport at 28 days postinjury compared to those with no prior concussions (23.5% vs. 12.7%; OR=2.10, 95% CI 1.18-3.73). Of note, the two or more prior concussion group contained a higher proportion of adolescents with potential pre-injury risk factors for complicated recovery, namely, depression and migraines. Conclusions: Prior concussion history was not associated with longer time to return to school nor return to sport when examined as a continuous variable. However, at 28 days postinjury, a greater proportion of athletes with two or more prior concussions remained out of sports compared to those with no prior concussions.

Injuries Affecting Intercollegiate Water Polo Athletes: A Descriptive Epidemiologic Study.

Background:There are few data on injuries suffered by collegiate water polo athletes.Purpose:To describe the epidemiology of injuries suffered by National College Athletic Association (NCAA) male and female water polo players by using injury surveillance data over a 5-year period.Study Design:Descriptive epidemiology study.Methods:Deidentified data on all water polo injuries and illnesses recorded in the Pac-12 Sports Injury Research Archive from July 2016 through June 2021 were obtained and analyzed. Three men’s and 4 women’s teams were observed for the entire 5-year period, and 1 men’s and 1 women’s team was observed from July 2018 through June 2021.Results:During the observation period, 729 injuries were recorded in the database, with no differences in overall injury rates between male and female athletes (relative risk [RR] = 1.0; 95% CI, 0.9-1.2); 33.7% of injuries required a physician encounter, and 3.6% required surgery. The shoulder was the most injured body part, making up 20.6% of all injuries, followed by the head/face (18.8%) and hand/wrist/forearm (11.7%). Shoulder tendinopathy was the most common shoulder injury diagnosis (4.5% of all injuries). Concussion was the most common injury diagnosis overall, making up 11.4% of injuries, and 81.9% of concussions occurred outside of competition. Male athletes were significantly more likely than female athletes to have a concussion in an off-season practice (RR, 3.25; 95% CI, 1.2-8.8) and via contact with another player (RR, 2.9; 95% CI, 1.3-6.4). Half of the 26 surgical procedures occurring over the observation period were for chronic joint trauma of the groin/hip/pelvis/buttock, with 9 of those 13 being for femoroacetabular impingement specifically.Conclusion:Among NCAA water polo athletes, the shoulder was the most injured body part; however, shoulder injuries rarely required missed time from sport or necessitated surgical intervention. Concussions were the most common injury diagnosis, had the worst return-to-play outcomes among common diagnoses, and were mostly sustained outside of competition. Femoroacetabular impingement was found to be the dominant diagnosis for which surgical intervention was required.

Injury surveillance in community cricket: A new inning for South Africa.

Published injury rates amongst elite and club-level youth cricketers highlight the need to implement injury risk-reducing strategies amongst the youth cricketing population. Data from sports injury surveillance systems are a prerequisite for the development and evaluation of strategies to reduce injury risk. Therefore, collecting injury surveillance data is a positive move towards reducing injuries in cricket. In South Africa, a systematic, standardised, evidence-informed injury surveillance system currently does not exist for community levels of play, namely, in cricket-playing high schools and cricket clubs. Although injury surveillance systems exist at elite levels, the obvious differences in elite versus community cricket settings mean that these systems cannot be implemented in their current form at community-level cricket. An innovative model is required to implement an injury surveillance system in community cricket.Clinical implicationsThis article proposes and describes a new research–practice partnership model to implement a systematic, standardised, evidence-informed injury surveillance system at cricket-playing high schools or cricket clubs within South Africa. Once this model has been employed, database systems will need to be established to allow long-term data management and sharing.

Improving injury surveillance data quality: a study based on hospitals contributing to the Victorian Emergency Minimum Dataset

ObjectiveIn this paper, we describe the design and baseline data of a study aimed at improving injury surveillance data quality of hospitals contributing to the Victorian Emergency Minimum Dataset (VEMD). MethodsThe sequential study phases include a baseline analysis of data quality, direct engagement and communication with each of the emergency department (ED) hospital sites, collection of survey and interview data and ongoing monitoring. ResultsIn 2019/20, there were 371,683 injury‐related ED presentations recorded in the VEMD. Percentage unspecified, the indicator of (poor) data quality, was lowest for ‘body region’ (2.7%) and ‘injury type’ (7.4%), and highest for ‘activity when injured’ (29.4%). In the latter, contributing hospitals ranged from 3.0–99.9% unspecified. The ‘description of event’ variable had a mean word count of 10; 16/38 hospitals had a narrative word count of <5. ConclusionsBaseline hospital injury surveillance data vary vastly in data quality, leaving much room for improvement and justifying intervention as described. Implications for public healthHospital engagement and feedback described in this study is expected to have a marked effect on data quality from 2021 onwards. This will ensure that Victorian injury surveillance data can fulfil their purpose to accurately inform injury prevention policy and practice.

Application of a Machine Learning-Based Decision Support Tool to Improve an Injury Surveillance System Workflow.

Emergency department (ED)-based injury surveillance systems across many countries face resourcing challenges related to manual validation and coding of data. This study describes the evaluation of a machine learning (ML)-based decision support tool (DST) to assist injury surveillance departments in the validation, coding, and use of their data, comparing outcomes in coding time, and accuracy pre- and postimplementations. Manually coded injury surveillance data have been used to develop, train, and iteratively refine a ML-based classifier to enable semiautomated coding of injury narrative data. This paper describes a trial implementation of the ML-based DST in the Queensland Injury Surveillance Unit (QISU) workflow using a major pediatric hospital's ED data comparing outcomes in coding time and pre- and postimplementation accuracies. The study found a 10% reduction in manual coding time after the DST was introduced. The Kappa statistics analysis in both DST-assisted and -unassisted data shows increase in accuracy across three data fields, that is, injury intent (85.4% unassisted vs. 94.5% assisted), external cause (88.8% unassisted vs. 91.8% assisted), and injury factor (89.3% unassisted vs. 92.9% assisted). The classifier was also used to produce a timely report monitoring injury patterns during the novel coronavirus disease 2019 (COVID-19) pandemic. Hence, it has the potential for near real-time surveillance of emerging hazards to inform public health responses. The integration of the DST into the injury surveillance workflow shows benefits as it facilitates timely reporting and acts as a DST in the manual coding process.