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This document discusses the validation criteria for injury indicators and proposes a work plan for the Injury Indicators Group (ICEIInG). It includes a presentation of previous work, revisiting the validation criteria, and a discussion on the proposed additional criteria. The document also highlights the need for standardization, comparability, and harmonization in defining injury indicators.
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Injury Indicators Group(ICEIInG) Colin Cryer CHSS, University of Kent, England on behalf of ICEIInG
Agenda • Where we got to at the last meeting • who joined ICEIInG (page 1) • Post meeting thoughts • A proposal of work • Progress since Washington 2001 • Revisit the validation criteria • Discussion
The last meeting…. • Presentation of the work of ICEIInG • the validation criteria • Discussion by ICE • Workshop discussion • Presentation and further discussion • Revised validation criteria
Criteria - slide 1 • (A) The indicator should reflect the occurrence of injury satisfying some case definition of anatomical or physiological damage. • (B) The indicator should reflect a well defined information objective. • (C) It should be possible to use existing data systems, or it should be practical to develop new systems, to provide data for computing the indicator.
Criteria - slide 2 • (D) The probability of a case being ascertained should be independent of social, economic, and demographic factors, as well as health service supply and access factors. • (E) The indicator should be derived from data that are inclusive or representative of the target population that the indicator aims to reflect. • [Note: the intention is that (E) also implies not going beyond the bounds of the target population]
Criteria - slide 3 • (F) The indicator should be based on events that are associated with significantly increased risk of impairment, functional limitation, disability, or death, decreased quality of life, or increased cost. • (G) The indicator should be fully specified to allow calculation to be consistent at any place and at any time.
Other findings from our discussions: • Definition of an indicator needed • Precise definition of an injury needs to be included • We need some statement about standardisation / comparability / harmonisation. • Criteria should be split into >1 dimension, eg. • quality • usefulness • practicality of measurement • Hierarchy of criteria needed • how much fuzziness can we tolerate
A walk in the cherry blossoms … • Post-meeting thoughts • there is much work to be done • much could be done in parallel • I can take some work further • Others are better placed to take other work forward • eg. development of indicators for priority setting • Mechanism needed: • Encourage greater participation - all work to our strengths
Proposal put to ICEIInG • The work of the group be addressed in discrete projects • clear achievable objectives • outputs • papers (peer review journals / conferences) • ICEIInG report • collection of papers, with introduction and linking statements
Method of working • Those with interest / expertise - encouraged to take the initiative. • This PI email a proposal to ICEIInG • Comments from ICEIInG members • if major concerns, not embraced by ICE • Collaborators take the work forward • keep ICEIInG informed periodically • Publication • author list + “…on behalf of the ICEIInG”
A proposal of work • Use the validation criteria to assess national indicators used in setting road safety targets • Canada • New Zealand • United Kingdom • Indicators and how criteria used • handout
Discussion of the criteria • (1) Case definition - high variability UK1/2 • (2) Serious outcomes - variability • (3) Ascertainment - OK, but variable UK1 • (4) Inclusive - OK • (5) Source data - N/a • (6) Fully specified - N/a
Proposed additional criteria - for discussion • (H) The indicator should measure accurately the entity that it aims to reflect. [cf (B)] • (I) The indicator should be derived from data that is complete and is accurately coded [cf (D)]. • (J) There should have been no substantial changes / differences in coding frames or in coding practice between place or over time (ie. comparability etc.) • (K) A sound indicator should reflect the occurrence of injuries across personal characteristics, place and time [cf (D), (E)].
For discussion…? • Proposed new criteria, or further comments on the old ones. • Comments / questions on the assessment of road safety indicators • The need for other country demonstrations? • Describe related work that you have done.