Cochrane Injuries Group

The evidence based approach to healthcare is steadily making headway but there is much to do to build the evidence base on injury. Making an important contribution is the Cochrane Injuries Group (CIG) (www.cochrane-injuries.lshtm.ac.uk), one of the 49 systematic review groups of the Cochrane Collaboration. CIG’s remit includes the prevention and treatment of injury. Of the 45 reviews CIG has published to date, 12 deal with interventions for injury prevention and more are on the way. This regular column in Injury Prevention will look at new developments at the CIG editorial base, at the London School of Hygiene and Tropical Medicine. The School is a World Health Organization Collaborating Centre for Research and Training in Injury and Violence Prevention.

Road traffic injuries

Road traffic injuries are the leading cause of death by injury, taking 1.2 million lives around the world each year. With this year’s World Health Day having focused on road safety, we are at CIG taking stock of what we have done in this area so far and trying to identify our future priorities.

Eight of our published systematic reviews deal with road safety:

• Area-wide traffic calming for preventing traffic related injuries.

• Graduated driver licensing for reducing motor vehicle crashes among young drivers.

• Helmets for preventing head and facial injuries in bicyclists.

• Interventions for increasing pedestrian and cyclist visibility for the prevention of death and injuries.

• Motorcycle helmets for preventing injury in motorcyclists.

• Post-licence driver education programmes for the prevention of traffic crashes.

• Safety education of pedestrians for injury prevention.

• School based driver education for the prevention of traffic crashes.

We have more in the pipeline, having published protocols for reviews of a further six interventions:

• Alcohol-ignition interlock programmes for reducing drink driving recidivism.

• Increasing motorcycle and rider conspicuity for preventing death and injury in motorcyclists.

• Interventions for promoting use of booster seats for children aged 4–6 travelling in cars.

• Non-legislative interventions for the promotion of cycle helmet wearing in children.

• Street lighting for the prevention of road traffic crashes.

• Speed enforcement detection devices for preventing road traffic injuries.

The last of these (speed cameras) has been hotly debated in the UK media over the last few months. Most of the popular press takes the line that speed cameras are not effective, except in creating extra income for the government. The debate has highlighted the need for a proper review of the evidence. Everyone has their own views as to whether speed cameras work or not, but, as yet, we cannot be sure who is right. Lively debate can of course serve to highlight important issues but if such debate is not informed by evidence then it will generate more heat than light.

There are many other interventions now in widespread use intended to cut death and injury on the road which have yet to be the subject of a systematic review. It would be helpful to know what readers of Injury Prevention think should be the priorities for new reviews. We would welcome any suggestions. Better still, we would be pleased to hear from anyone who would like to volunteer to write a review for us.