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Harmonising data collection for burns
  1. D R Meddings
  1. Correspondence to Dr D R Meddings, Department of Violence and Injury Prevention and Disability, 20 Avenue Appia, 1211 Geneva 27, Switzerland; meddingsd{at}who.int

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The WHO and a global network of epidemiologists and burn care practitioners have developed a new data collection form for patients with burns. The data collection form, known as the Global Burn Registry Form, can be used in either high-income or low-income and middle-income settings and is intended to be administered for patients with burn injuries who are admitted to a health facility for at least 24 h.

Burns are a major global public health problem. In 2011, there were an estimated 265 000 burn-related deaths globally, of which over 95% occurred in low-income and middle-income countries. Many of the primary prevention strategies for burns that have a strong evidence base (eg, smoke alarms, child-resistant lighters, laws on hot water temperature, etc) have limited applicability in low-income and middle-income countries. Prioritising the selection, development and testing of primary prevention interventions for burns in low-income and middle-income countries can and should be informed by the epidemiology of burns in these settings.

There were three objectives borne in mind by the network that developed the Global Burn Registry Form. First, the form had to characterise the main risk factors and mechanisms for burns requiring inpatient care. Second, it needed to characterise the main risk groups for burns requiring inpatient care. Finally, the form needed to be designed so it could be used around the world without modification. Given the overwhelming burden of serious burn injury occurs in low-income and middle-income countries, the form was designed with these settings foremost in mind, both to reveal the aetiology of burns in these settings and to serve as a tool to enable prevention programming.

The form is just entering a phase of pilot testing in hospitals around the world. Pilot testing will end during the first half of 2014. The form exists in Arabic, English, French and Spanish. Based on the development phase, the expectation is that completion of the form for a single patient will take 5–10 min. Burn injuries requiring inpatient admission are well suited to data collection, as hospital stays for burns severe enough to require hospitalisation tend to be measured in days, if not weeks. Therefore, completion of the registry form can take place after the patient has been admitted to the ward and does not interfere with resuscitation or the acute care phase.

The Global Burn Registry Form records the mechanism of the burn, a nested set of follow-up questions for each main mechanism, contributing factors, intentionality and severity of burn. In addition, the form gathers basic demographic and admission data, along with discharge date and status and whether a surgical procedure was performed. The information gathered should provide a sufficiently detailed degree of contextual information about serious burns so that in each setting the main risk groups and the major contexts in which burns are sustained can be identified. This is an essential component of the public health approach and a necessary first step for a more effective public health engagement on burn prevention, particularly in low-income and middle-income countries.

Another benefit of this work is the global harmonisation of data collection around burns. Presently data collection for burns is very fragmented and generally not comparable, certainly within low-income and middle-income settings. Burn registries in high-income settings do exist and have some contextual information on burn aetiology. However, on the whole they are oriented towards clinical care aspects as opposed to characterising targets for primary intervention. Therefore, use of this data collection form will provide a means by which the burden of severe burns may be characterised at an international level, and international priorities for intervention identified. WHO hopes in particular that it will catalyse further action on prevention of burns in low-income and middle-income settings and allow those working on burns in these settings to consider their own data within an internationally comparative context.

The Global Burn Registry Form is designed to be completed in paper form and should be filled out by a clinical staff member (ideally a doctor caring for the patient, but also a nurse could complete the form). Once the paper form is completed, it is provided to the personnel assigned to carry out the electronic phase of data entry. For the pilot test phase, the electronic phase of data entry will make use of DataCol (Data Collector). DataCol is a web-based platform designed, developed and supported by WHO. It allows for external users with an internet connection to upload data provided they have been issued with a username and password. Access to one's own data is available through a username and password, and data may be exported into Excel for further analysis.

WHO is actively recruiting hospitals to participate in the pilot testing of the Global Burn Registry Form. Criteria for a hospital to participate in the pilot testing of the instrument are as follows:

  1. Hospitals have an anticipated burn inpatient load of at least six burn-related inpatient admissions per month.

  2. Hospitals must register basic information about their facility using a brief on-line registration form.

  3. Hospitals agree to use the form for a minimum of 3 months on all burn-related inpatients.

  4. Hospitals agree to upload their burn-related inpatient data from use of the form on a web-based data entry platform.

  5. Hospitals agree to complete the on-line pilot phase evaluation form.

The intention of the pilot test is to pilot test the instrument and make any necessary changes, not to analyse individual facility data although these data will be available to participating hospitals through their usernames and passwords. The main focus of the network that has developed the Global Burn Registry Form will be the data from the pilot phase evaluation form. WHO expects that by the second half of 2014, the Global Burn Registry Form can be finalised and put into wide circulation. Individuals who would like to learn more about the pilot testing phase, or who would like to make colleagues aware, can visit the WHO burns website at: http://www.who.int/violence_injury_prevention/other_injury/burns/en/index.html

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Footnotes

  • Competing interests DRM is a staff member of the WHO. He alone is responsible for the views expressed in this publication and they do not necessarily represent the decisions or policies of the WHO.

  • Provenance and peer review Commissioned; internally peer reviewed.

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