All Wales Injury Surveillance System revised: development of a population-based system to evaluate single-level and multilevel interventions

Abstract

BackgroundInjury surveillance has been established since the 1990s, but is still largely based upon single-source data from sentinel sites. The growth of electronic health records and developments in privacy protecting linkage technologies provide an opportunity for more sophisticated surveillance systems.ObjectiveTo describe the evolution of an injury surveillance system to support the evaluation of interventions, both simple and complex in terms of organisation.MethodsThe paper describes the evolution of the system from one that relied upon data only from emergency departments to one that include multisource data and are now embedded in a total population privacy protecting data linkage system. Injury incidence estimates are compared by source and data linkage used to aid understanding of data quality issues. Examples of applications, challenges and solutions are described.ResultsThe age profile and estimated incidence of injuries recorded in general practice, emergency departments and hospital admissions differ considerably. Data linkage has enabled the evaluation of complex interventions and measurement of longer-term impact of a wide range of exposures.ConclusionsEmbedding injury surveillance within privacy protecting data linkage environment can transform the utility of a traditional single-source surveillance system to a multisource system. It also facilitates greater involvement in the evaluation of simple and complex healthcare and non-healthcare interventions and contributes to the growing evidence basis underlying the science of injury prevention and control.

Unintentional injury in England: an analysis of the emergency care data set pilot in Oxfordshire from 2012 to 2014

“…The pattern of incidence of UI attendance found in this study is identical to that found in Wales for all injuries, in particular the same highest and lowest rates for 10–14 and 65–69 years old, respectively, are evident in both settings 29. Other studies have also found similar patterns with respect to inequality, in particular sharp increases in injury rates among the most deprived.…”

“…In Wales, the All Wales Injury Surveillance System is used to evaluate injury prevention initiatives on a population scale, the effect of which may be too small to pick up in a small-scale trial or survey 29. In England, the Information Sharing to Tackle Violence initiative allows hospitals to share non-confidential ED data with Community Safety Partnerships in turn allowing police to target and prevent violent injuries in the community 34.…”

Innovative use of data sources: A Cross-sectional study of Data Linkage and Artificial Intelligence Practices across European Countries

“…For the surveillance of cancer, data linkage not only provides the opportunity to improve the population-based screening [31] but it also helps to detect different types of cancer recurrence [32] and to evaluate the socioeconomic status of patients with cancer (e.g., return to work) [33]. Linked data also allows evaluating the health interventions at various levels of the population [34]. The diversity and the volume of health information have been increasing rapidly and push to discover new parameters to improve population health with innovative approaches.…”

A cross-sectional study of child injury ambulance call-out characteristics and their utility in surveillance

“…interventions to specific injury groups and populations. Regional and national injury surveillance systems in high-and middle-income countries are well established; however systems often use data captured in hospitals only (Nelson et al 2011;Crain et al 2016;Lyons et al 2016). To our knowledge, this is the only published research in scientific journals that uses ambulance records to study child injuries.…”

“…Such data sources are used in various regional and national injury surveillance systems, e.g. Trauma and Injury Intelligence Group, England (Quigg et al 2012); All Wales Injury Surveillance System (Lyons et al 2016); National Electronic Injury Surveillance System, USA (Nelson et al 2011); Canadian Hospitals Injury Reporting and Prevention Program (Crain et al 2016). A few studies have shown some utility in the use of ambulance service data in injury surveillance; whilst not solely focused on children, they indicate that such data could also be used to develop understanding and monitoring of injury at local and regional levels (Backe and Andersson 2008;Thomas et al 2011;Quigg et al 2017).…”