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Capturing paediatric injury in Ontario: differences in injury incidence using self-reported survey and health service utilisation data
  1. Heather L White1,
  2. Alison K Macpherson2,3
  1. 1Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
  2. 2School of Kinesiology and Health Science, York University, Toronto, Canada
  3. 3The Institute for Clinical Evaluative Sciences, Toronto, Canada
  1. Correspondence to Heather L White, Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, 29 Moffatt Lane, Guelph, ON N1G 5E8, Canada; heatherlynn.white{at}


Objective Population-based health surveys are increasingly popular sources of data on injury occurrence. Self-reported surveys can yield estimates of the total incidence of non-fatal injuries while simultaneously capturing a rich repository of contextual data that may be informative for exploring determinants of injury risk. Although survey data are rarely recognised as complete, several researchers have expressed concerns about the sensitivity and validity of self-reported injury data, questioning whether captured cases are representative of the population experience of injury, particularly among children and youth. The present study sought to compare the population incidence of paediatric injury estimated from self-reported survey responses to those documented by a complete-capture health service utilisation database among Ontario children.

Methods Injury incidence rates documented from the National Longitudinal Survey of Children and Youth and the National Population Health Survey were compared with those reported in Canada's National Ambulatory Care Reporting System for Ontario youth aged 0–19 years for fiscal year 2002/3, stratified by the child's age and geographical location of residence.

Results The two self-reported health surveys underestimated the population incidence of injury among Ontario children by at least 49% and 53%, respectively. Systematic errors exist in survey data capture such that injuries in infants and preschoolers (<4 years of age) and urban residents were most likely to be missed by the population health surveys.

Conclusion Injury incidence estimated through self-report is not representative of the population burden and experience of paediatric injury for Ontario children, and may produce biased estimates of risk when analysed as independent sources of data.

  • Behaviour change
  • bicycle
  • burden of disease
  • Canada
  • child
  • concussion
  • descriptive epidemiology
  • epidemiologic
  • epidemiology
  • health disparities
  • helmet
  • implementation/translation
  • injury epidemiology
  • methodology
  • pedestrian
  • public health
  • reliability and validity
  • risk/determinants
  • risk factor research
  • sensitivity and specificity
  • standards
  • surveillance
  • traffic

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  • Data for this study were provided by the Canadian Institute for Health Information under the Graduate Student Data Access Program and by the Social Sciences and Humanities Research Council. The findings, opinions and conclusions are those of the authors and do not necessarily reflect the views of either organisation.

  • Funding HLW is supported by a student-mentorship grant from the Ontario Neurotrauma Foundation [no 2005-PREV-MS-354].

  • Competing interests None.

  • Patient consent Secondary analysis of administrative databases. Consent is granted under the collection of the original databases.

  • Ethics approval This study was conducted with the approval of the York University Research Ethics Board.

  • Provenance and Peer review Not commissioned; externally peer reviewed.