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THE Feasibility of IMPROVED DATA Collection METHODOLOGIES for SPORTS INJURIES

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M 0 N ASH UN I V E R SIT Y AUSTRALIA THE FEASIBiliTY OF IMPROVED DATA COllECTION METHODOLOGIES FOR SPORTS INJURIES Project funded by National Sports Research Centre and Victorian Health Promotion Foundation ~ notional sports research centre VicHealth ACCIDENT RESEARCH C ENT R E THE FEASIBiliTY OF IMPROVED DATA COLLECTION METHODOLOGIES FOR SPORTS INJURIES by Caroline Finch Joan Ozanne-Smith Fiona Williams January 1995 Report No. 69 ISBN 0 7326 0069 3 MONASH UNIVERSITY ACCIDENT RESEARCH CENTRE REPORT DOCUMENTATION PAGE Report No. Date ISBN Pages 69 January 1995 0732600693 188 Title and sub-title: The feasibility of improved data collection methodologies for sports injuries Author(s) Type of Report & Period Covered: Finch C General,1989-1994 Ozanne-Smith J Williams F Sponsoring Organisation(s}: National Sports Research Program, Australian Sports Commission Victorian Health Promotion Foundation Abstract: Sports and recreational injuries are a cost burden on both individuals and society with respect to the duration and nature of treatment, the amount of sports and working time lost, permanent damage and disability, reduced quality of life and monetary costs. Their prevention must be a major public health goal. Whilst there has been an increased awareness of the occurrence of sports injuries, and some successful countermeasures have been used to prevent a limited number of such injuries, the picture in Australia remains fragmented. In particular, there is a lack of data about the circumstances of injury and potential points of intervention in the chain of events leading to injury. Furthermore, comprehensive information on participation rates and player hours is needed to determine the relative risks of injury in various sports and to target interventions. Given a framework for injury prevention, it is important that a system of sports injury surveillance is developed. The current lack of clear, coherent and relevant data for Australia makes this a priority. This report therefore provides the results of a feasibility study of improved data collection methodologies for sports injuries for Australia. This study summarises the existing data collections that provide information on sports injuries within Australia and overseas, including their limitations. The results of a survey of key sports and other relevant professional bodies are also presented to describe the current barriers to sports injury data collections. Together, these form the basis for determining the feasibility of establishing improved data collection methodologies for sports injury in Australia. Recommendations include the identification of a lead agency, collaboration between the health and sports sectors, increased involvement of sports bodies in data collection activities, provision of infrastructure support for these activities, enhancement of government data collections, development of standardised data collection procedures and coding systems and improved training. KeyWords: Disclaimer: injury, data collection, surveillance, sport, This report is disseminated in the interests of recreation, sports participation information exchange. The views expressed are those of the authors, and not necessarily those of Monash University. Reproduction of this page is authorised Monash University Accident Research Centre, Wellington Road, Clayton, Victoria, 3168, Australia. Telephone: +61 3 905 4371 Fax: +61 39054363 ,,' I' TABLE OF CONTENTS LIST OF TABLES LIST OF FIGURES ACKNOWLEDGMENTS EXECUTIVE SUMMARY CHAPTER 1: INTRODUCTION 1 1.1 BACKGROUND 1 1.2 PROJECT AIMS 3 1.3 ABOUT THIS REPORT 4 CHAPTER 2: SPORTS INJURY DATA ISSUES 5 2.1 SPORTS INJURY AS A PUBLIC HEALTH PROBLEM 5 2.2 SPORTS INJURY DATA SOURCES 6 2.3.1 Sport versus recreational activity 6 2.3.2 Sports participants 11 2.3.3 Injury severity 12 2.3 DEFINITIONAL ISSUES 9 2.4 SPORTS INJURY SURVEILLANCE NEEDS 14 2.4.1 Current limitations 14 2.4.2 Features of a sports injury surveillance system 15 CHAPTER 3: WHAT IS INJURY SURVEILLANCE? 17 3.1 INTRODUCTION 17 3.2 THE ROLE OF INJURY SURVEILLANCE 17 3.3 TYPES OF INJURY SURVEILLANCE SYSTEMS 18 3.3.1 Continuous surveillance 18 3.3.2 Sampling 19 3.3.3 Sentinel systems 19 3.3.4 Reportable injury systems 19 3.3.5 Time-limited studies 20 3.3.6 Passive versus active surveillance 20 3.4 DATA SOURCES FOR INJURY SURVEILLANCE 20 3.4.1 Use of single versus multiple sources 20 3.4.2 Geographic coverage 21 3.4.3 Mortality data 21 3.4.3.1 Death certincates 21 3.4.3.2 Autopsy and coronial records 22 3.4.4 Sources of morbidity data 22 3.4.4.1 Hospital records 22 3.4.4.2 General practitioner records 23 3.4.4.3 Other records 23 3.5 ISSUES IN THE DESIGN OF DATA COLLECTION SYSTEMS 23 3.6 DATA CLASSIFICATION SYSTEMS 24 3.6.1 The issues 24 3.6.2 The International Classification of Diseases system 24 3.6.3 Injury Surveillance Intelligence System (ISIS) 26 3.6.4 Minimum data sets for injury surveillance 27 3.6.5 The Australian National Minimum Data Set (NMDS) for Injury Surveillance 28 3.6.6 Combining surveillance systems 28 3.7 DATA ACCESS AND DISSEMINATION 29 3.8 FUTURE DIRECTIONS 29 CHAPTER 4: LITERATURE REVIEW OF SPORTS INJURY SURVEILLANCE SYSTEMS 31 4.1 INTRODUCTION 31 4.2 HOSPITAL-BASED DATA COLLECTIONS 31 4.3 MORTALITY DATA 34 4.4 SPORTS MEDICINE CLINICS 35 4.5 MEDICAL COVERAGE SERVICES 35 4.6 SPORTS-BASED INJURY SURVEILLANCE SYSTEMS 36 4.7 SPORTING-BODY DATA COLLECTIONS 37 4.8 SPECIAL PURPOSE SURVEILLANCE SYSTEMS - EVENT SPECIFIC 37 4.9 SCHOOL SURVEILLANCE 38 4.10 WORKERS COMPENSATION STATISTICS 39 4.11 INSURANCE DATABASES 39 4.12 COMMUNITY SURVEYS 40 4.13 POPULATION-BASED SURVEILLANCE 40 4.14 LONGITUDINAL STUDIES OF ATHLETES AND SPORTS PARTICIPANTS 40 4.15 SURVEYS OF SPORTS PARTICIPANTS 41 4.16 COMBINING DATA SOURCES 41 CHAPTER 5: THE CONSULTATION PROCESS 43 5.1 INTRODUCTION 43 5.2 MAIL-OUT SURVEY QUESTIONNAIRE 43 5.2.1 The questionnaire 44 5.2.2 Profile of the responding organisations and individuals 45 5.2.3 Recommendations for improving sports injury and sports participation data collections 48 5.2.4 Current barriers to the collection of sports participation and sports injury data 48 5.3 FACE-TO-FACE INTERVIEWS 49 5.4 SPORTS FORUM 50 5.5 OTHER CONSULTATION 54 CHAPTER 6: HOSPITAL-BASED SPORTS INJURY DATA COLLECTIONS IN AUSTRALIA 55 6.1 INTRODUCTION 55 6.2 EVIDENCE FROM PRESENTATIONS AT HOSPITAL EMERGENCY DEPARTMENTS 55 6.2.1 Infonnation about sports injuries 56 6.3 CHilD SPORTS INJURIES IDENTIFIED FROM INJURY SURVEilLANCE SYSTEMS 58 6.3.1 Sports and recreational activities 58 6.3.2 location and context of the activity 61 6.3.3 Nature of injury 61 6.3.4 Severity of Injury 65 6.3.5 The value of narratives 66 6.4 ADULT SPORTS INJURIES IDENTIFIED FROM EMERGENCY DEPARTMENT INJURY SURVEilLANCE SYSTEMS 66 6.4.1 Sports and Recreational Activities 66 6.4.2 location and context of the activity 69 6.4.3 Nature of injury 69 6.4.4 Severity of Injury 69 6.5 HOSPITAL ADMISSIONS DATA 74 6.6 THE VICTORIAN INPATIENT MORBIDITY DATABASE 75 6.7 THE NEW SOUTH WALES HEALTH DEPARTMENT CODING SCHEME 77 6.8 EXTRAPOLATION OF RESULTS FROM THE NEW ZEALAND HOSPITAL ADMISSIONS DATABASE 79 CHAPTER 7: OTHER CURRENT AUSTRALIAN SPORTS AND RECREATIONAL INJURY DATA COLLECTIONS 81 7.1 INTRODUCTION 81 7.2 AUSTRALIAN BUREAU OF STATISTICS (ABS) MORTALITY DATA 81 7.3 CORONIAl DATA 81 7.4 SPORTS AND RECREATION RELATED SPINAL INJURY 82 7.5 MEDICAL COVERAGE SERVICES OF SPORTING EVENTS 83 7.6 SPORTS MEDICINE AND OTHER CLINICS 83 7.7 GENERAL PRACTITIONER DATA 84 7.8 THE ORCHARD SYSTEM 84 7.9 INSURANCE DATA BASES 84 7.10 SPORTS BODY COLLECTIONS 85 7.11 THE SPORTS INJURY SURVEY FOR NSW 85 7.12 OTHER SPORTS INJURY DATA COLLECTIONS· SURVEY RESULTS 85 CHAPTER8: PARTICIPATIONDATA 89 8.1 INTRODUCTION 89 8.2 SURVEYS OF PHYSICAL ACTIVITY LEVELS IN THE AUSTRALIAN POPULATION 89 8.3 AUSTRALIAN BUREAU OF STATISTICS DATA COLLECTIONS 90 8.3.1 National surveys 90 8.3.2 Victorian surveys 91 8.3.3 Queensland survey 91 8.3.4 Tasmanian participation data 92 8.3.5Other issues 92 8.4 MARKET RESEARCH SURVEYS 92 8.5 THE NATIONAL SPORT AND RECREATION INDUSTRY STATISTICAL FRAMEWORK 92 8.6 THE INTERNATIONAL COMMITTEE FOR SPORTS STATISTICS ERROR! BOOKMARK NOT DEFINED. 8.7 SPORT-SPECIFIC DATABASES 94 8.8 THE VICSPORT DATABASE 94 8.9 THE WESTERN AUSTRALIA SPORTS CENSUS 94 8.10 RESEARCH STUDIES· THE VALUE OF JOINTLY COLLECTING PARTICIPATION AND INJURY DATA 95 8.11 OTHER DATABASES 95 8.12 OTHER SPORTS PARTICIPATION DATA COLLECTIONS - SURVEY RESULTS 96 8.12.1 Participation Data Obtained On Groups Of Individuals 96 8.12.2 Participation Data Collected On Individuals 98 CHAPTER9: SUMMARYOF FINDINGS 101 9.1 INTRODUCTION 101 9.2 REASONS FOR THE LIMITED CURRENT SPORTS INJURY DATA COLLECTION ACTIVITIES 101 9.3 BARRIERS TOWARDS SPORTS INJURY AND PARTICIPATION DATA COLLECTION ACTIVITIES 102 " I 9.4 CURRENT CATA COLLECTIONS 103 9.4.1 Injury data bases 103 9.4.1.1 Umitations 103 9.4.1.2 Suggested improvements 104 9.4.2 Participation data bases 104 9.4.2.1 Limitations 104 9.5 SUGGESTIONS MADE BY SPORTS BODIES FOR IMPROVING DATA COLLECTION ACTIVITIES 105 9.6 CONCLUSIONS 106 CHAPTER 10: DISCUSSIONAND RECOMMENDATIONS 107 10.1INTRODUCTION 107 10.2 INFRASTRUCTURE PRE-REQUISITES FOR SPORTS INJURY PREVENTION 108 10.3INFORMATIONPRE-REQUISITESFORSPORTSINJURYPREVENTION 108 10.3.1 Sports injury and participation data needs 108 10.3.2 Injury prevention strategy needs 110 10.4RESEARCHNEEDSTO PROGRESSINJURYPREVENTIONACTIVITIES 110 10.5A FRAMEWORKFORSPORTSANDRECREATIONALINJURYDATACOLLECTION ACTIVITIES 112 10.5.1 Potential sources of sports injury data 112 10.5.2A proposed framework for sports
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