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 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

Trends in 4 NZ road safety indicators

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.