Highlights of the International Collaborative Effort on Injury Statistics, Paris Meeting, April 2003

ICE Workgroup Project Areas

Ice Injury Indicators Group

Much of the discussion was on the criteria for validating injury indicators. The group agreed that an ideal indicator should:

  • have a case definition based on diagnosis,
  • focus on serious injury,
  • have unbiased case ascertainment,
  • come from data that are representative of the target population,
  • be based on existing data systems, and
  • be fully specified.

Selecting a main injury from among the multiple causes of death

  • In certain circumstances, selecting a main injury from the multiple causes is necessary for international comparisons.
  • The selection rules for main injury changed between ICD-9 and ICD-10.
  • The Mortality Reference Group has concerns about the new rules.
  • ICE will analyze multiple cause data from several countries and develop methodologies for selecting a main injury.

Household Injury Survey Comparison

  • Currently, there is no international consensus on the questions or inclusion criteria.
  • A multi-country report of 10 national household survey questions is being finalized.
  • Findings from this report will be used as a guide for developing a standard injury module.

Occupational ICE on Injury

  • Collaborative work has resulted in three journal articles on fatal work-related injuries between US, New Zealand, and Australia.
  • The collaborative group is exploring an international comparison of work-related motor vehicle fatalities (leading cause of death to workers).
  • The Occupational ICE group is seeking information from other ICE members on their data systems for occupational fatal injuries.
  • An inquiry on ICD-10 activity codes will be conducted through the ICE Listserv (these codes in ICD-10 were incorporated to provide data on the activity at the time of the death, but their actual use may be infrequent).
  • An international comparison of occupational drowning incidents was proposed and partners are being sought for this effort.

Proposed methodology for building multiple injury profiles

  • Currently there is no uniform/universal tool for the analysis and description of multiple injuries.
  • A method for building multiple injury profiles that uses the Barell Matrix was developed: ICD-9-CM are allocated to matrix cells, the units of reference become matrix cells.
  • This process was agreed upon and accepted by discussion group members, the group is exploring the possibility of excluding injuries that are of an Abbreviated Injury Scale severity of 1.


Incorporating Disability Measures Into Injury Measurement

  • Nonfatal injuries have the potential for contributing to long-term consequences: these limitations or restrictions in tasks or other social role activities are conceptualized as disability.
  • Two theoretical models of disability commonly in use: Institute of Medicine model and the International Classification of Functioning model.
  • To translate from the conceptual models to the measurement of disability, the Washington City Group Measurement Matrix can be used as a guide for data collection which varies depending on the research goals.
  • No single measure of “disability.”
  • Measures developed at the Washington City Group for use in international measurement will be shared with and assessed by the workgroups.

Strategic Planning

Strategic Planning Work Group-Summary of efforts to Date

  • Continued funding is an issue, both for annual meeting and for actual project work.
  • With the goal of increased funding is the need to increase accountability (via a strategic plan).
  • To aid in the development of the strategic plan, results from a survey identified seven critical components: infrastructure, research, dissemination/outreach, training, evaluation with measurable objectives, collaborators, and operations.

Five-Year Strategic Plan for ICE on Injury Statistics Components

  • General guidance and steps were developed for the following components:
  • Infrastructure: Develop an expanded infrastructure to support the work of the ICE.
  • Research: Develop and implement a research agenda related to the ICE mission.
  • Dissemination & Outreach (marketing): Develop a marketing and training plan.
  • Training
  • Evaluation of ICE with measurable objectives
  • Collaborators: Expand ICE member countries
  • Operations: Funding, Participants, Meetings, and Products

ICE Updates

  • Results of the ICD-10 bridge coding study in England and Wales
  • European Union Public Health Programme: 2003 to 2008
  • International Classification of External Cause of Injuries (ICECI): an update
  • ECOSA Working Group on quantifying post-injury levels of functioning and disability
  • Developing a set of indicators for injuries/accidents for the European Union: a practical approach
  • Update on injury registration in the Nordic countries
  • Deaths Due to Terror Acts – Coding the external cause for statistical purposes
  • Poison-ICE Update
  • Continued discussion on: What is an injury?