Findings from current measuring systemPractical Aspects of Conducting a Prospective Statewide Incidence Study: The Incidence of Serious Inflicted Traumatic Brain Injury in North Carolina
Section snippets
Study Findings
The study found a total of 152 children with TBI who met entrance criteria. Of the 152 children, 80 (53%) incurred an inflicted TBI. The rate of inflicted TBI for children aged <2 years was 17.0 (95% CI=13.3–20.7) per 100,000 person-years. Rates of inflicted TBI were higher in children in the first year of life compared to the second year of life, higher in boys than in girls, and higher in minority populations (Table 1). Factors that appeared to increase the risk of injury when compared to the
Discussion
These studies were all performed in the southeastern U.S., which is homogenous compared to the country as a whole. It is possible that incident cases of inflicted TBI could vary by geographic region, state levels of poverty, or different cultural attitudes toward child rearing in different regions of the country. Therefore, the results of these studies may not be generalizable to the U.S. as a whole. This study could be replicated in a different region over a longer time period to capture
Funding
A project of this scope requires external funding. Funding agencies had multiple concerns about the feasibility of the project including case ascertainment, credible case definitions, the likelihood of hospitals cooperating in a study of abusive injury, and the ability of gaining parental or caregiver participation for follow-up.
Case Definition
For study purposes, a case definition was required that could be applied consistently across hospitals and would allow for complete case capture. The case definition
Conclusion
The exact protocol used in the North Carolina study may not be advisable as an ongoing surveillance system. The main strengths of the system were a clear definition of a case, multiple sources of information, and ongoing quality checks in the form of investigator review of each case and review of all radiographs. The major weaknesses in the system for ongoing injury surveillance included fatigue of volunteers for the maintenance of such a time-intensive method of surveillance and that the
References (11)
- et al.
Increased incidence of inflicted traumatic brain injury in children after a natural disaster
Am J Prev Med
(2004) - et al.
Annual incidence of shaken impact syndrome in young children
Lancet
(2000) - et al.
Sensitivity of hospitals’ E-coded data in identifying causes of children’s violence-related injuries
Public Health Rep
(1995) - et al.
Underascertainment of child abuse mortality in the United States
JAMA
(1999) - et al.
A population-based study of inflicted traumatic brain injury in young children
JAMA
(2003)
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Epidemiology of abusive head trauma in West Virginia children <24 months: 2000–2010
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2017, Child Abuse and NeglectDefining an Ideal System to Establish the Incidence of Inflicted Traumatic Brain Injury. Summary of the Consensus Conference
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