Examining the sensitivity of an injury surveillance program using population-based estimates

Abstract

This study uses population-based estimates to assess the sensitivity and representativeness of an injury surveillance system using a 1-year population-based approach. Data from the Ottawa Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) site (Children's Hospital of Eastern Ontario) were compared with those from six expansion sites. The overall sensitivity of CHIRPP was 43% of all treated injuries and 57% of injuries treated at emergency departments. CHIRPP was less likely to be representative for older children and more likely to capture children with more severe injuries. The limitations related to using CHIRPP for representing population-based injury remain fairly stable over time. A one-time population-based sample can provide useful information to add to routinely collected injury surveillance.

Surveillance alone is not the answer

“…Macpherson et al 2 make no mention of data use, no doubt because that is not the subject of the paper; Shipton and Stone1 tell us that local public health officials were “pleased to have the system in place”. But, to be blunt—so what?…”

“…The paper by Macpherson and her colleagues2 is an elegant, well-reported study of the sensitivity and representativeness of the Canadian version of CHIRPP as it operates in Ottawa. The results suggest that both elements are disappointing, although I suspect the results might be better at other sites.…”

“…That, admittedly extreme, view applies when surveillance fails to achieve its most critical objective while consuming resources that could be better directed elsewhere. Two papers in this issue identify limitations in one such emergency department (ED)-based system, the Canadian Injury Reporting and Prevention Program (CHIRPP), but neither speaks directly to my main concern 1 2…”

“…But my involvement could equally prompt me to be critical or laudatory. On the one hand, you might assume I would defend CHIRPP in spite of the shortcomings both papers1 2 reveal. On the other hand, as is true when a child disappoints its parents, my frustration from its failure to improve prevention might make me unduly critical.…”

Injuries related to off-road vehicles in Canada

“…Over two million records have been collected nationally since CHIRPP's establishment in 1990 (Mackenzie and Pless, 1999). Although not population-based, a number of studies have shown CHIRPP to be representative in some contexts (Macpherson et al, 2008;Pickett et al, 2000;Kang et al, 2013;Macarthur and Pless, 1999a,b).…”