Belinda J Gabbe

Swansea University, Swansea, Wales, United Kingdom

Are you Belinda J Gabbe?

Claim your profile

Publications (231)1031.94 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Comparing health-related quality of life (HRQL) outcomes between studies is difficult due to the wide variety of instruments used. Comparing study outcomes and facilitating pooled data analyses requires valid "crosswalks" between HRQL instruments. Algorithms exist to map 12-item Short Form Health Survey (SF-12) responses to EQ-5D item responses and preference weights, but none have been validated in populations where disability is prevalent, such as injury. Data were extracted from the Validating and Improving injury Burden Estimates Study (Injury-VIBES) for 10,166 adult, hospitalized trauma patients, with both the three-level EQ-5D (EQ-5D-3L) and SF-12 data responses at six and 12-months postinjury. Agreement between actual (patient-reported) and estimated (mapped from SF-12) EQ-5D-3L item responses and preference weights was assessed using Kappa, Prevalence-Adjusted Bias-Adjusted Kappa statistics and Bland-Altman plots. Moderate agreement was observed for usual activities, pain/discomfort, and anxiety/depression. Agreement was substantial for mobility and self-care items. The mean differences in preference weights were -0.024 and -0.012 at six and 12 months (p < 0.001), respectively. The Bland-Altman plot limits of agreement were large compared to the range of valid preference weight values (-0.56 to 1.00). Estimated EQ-5D-3L responses under-reported disability for all items except pain/discomfort. Caution should be taken when using EQ-5D-3L responses mapped from the SF-12 to describe patient outcomes or when undertaking economic evaluation, due to the underestimation of disability associated with mapped values. The findings from this study could be used to adjust expected EQ-5D-3L preference weights when estimated from SF-12 item responses when combining data from studies that use either instrument.
    Population Health Metrics 12/2015; 13(1). DOI:10.1186/s12963-015-0047-z · 2.11 Impact Factor
  • M M Dinh · K Cornwall · K J Bein · B J Gabbe · B A Tomes · R Ivers
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to describe post-discharge outcomes, and determine predictors of 3 and 6 months health status outcomes in a population of trauma patients at an inner city major trauma centre. This was a prospective cohort study of adult trauma patients admitted to this hospital with 3 and 6 months post-discharge outcomes assessment. Outcome measures were the Physical Component Scores (PCS) and Mental Component Scores (MCS) of the Short Form 12, EQ-5D, and return to work (in any capacity) if working prior to injury. Repeated measures mixed models and generalised estimating equation models were used to determine predictors of outcomes at 3 and 6 months. One hundred and seventy-nine patients were followed up. Patients with lower limb injuries reported lower mean PCS scores between 3 and 6 months (coefficient -4.21, 95 % CI -7.58, -0.85) than those without lower limb injuries. Patients involved in pedestrian incidents or assaults and those with pre-existing mental health diagnoses reported lower mean MCS scores. In adjusted models upper limb injuries were associated with reduced odds of return to work at 3 and 6 months (OR 0.20, 95 % CI 0.07, 0.57) compared to those without upper limb injuries. Predictors of poorer physical health status were lower limb injuries and predictors of mental health were related to the mechanism of injury and past mental health. Increasing injury severity score and upper limb injuries were the only predictors of reduced return to work. The results provide insights into the feasibility of routine post-discharge follow-up at a trauma service level.
    European Journal of Trauma and Emergency Surgery 08/2015; DOI:10.1007/s00068-015-0558-0 · 0.38 Impact Factor
  • Cameron S Palmer · Belinda J Gabbe · Peter A Cameron
    [Show abstract] [Hide abstract]
    ABSTRACT: The Injury Severity Score (ISS) is the most ubiquitous summary score derived from Abbreviated Injury Scale (AIS) data. It is frequently used to classify patients as 'major trauma' using a threshold of ISS >15. However, it is not known whether this is still appropriate, given the changes which have been made to the AIS codeset since this threshold was first used. This study aimed to identify appropriate ISS and New Injury Severity Score (NISS) thresholds for use with the 2008 AIS (AIS08) which predict mortality and in-hospital resource use comparably to ISS >15 using AIS98. Data from 37,760 patients in a state trauma registry were retrieved and reviewed. AIS data coded using the 1998 AIS (AIS98) were mapped to AIS08. ISS and NISS were calculated, and their effects on patient classification compared. The ability of selected ISS and NISS thresholds to predict mortality or high-level in-hospital resource use (the need for ICU or urgent surgery) was assessed. An ISS >12 using AIS08 was similar to an ISS >15 using AIS98 in terms of both the number of patients classified major trauma, and overall major trauma mortality. A 10% mortality level was only seen for ISS 25 or greater. A NISS >15 performed similarly to both of these ISS thresholds. However, the AIS08-based ISS >12 threshold correctly classified significantly more patients than a NISS >15 threshold for all three severity measures assessed. When coding injuries using AIS08, an ISS >12 appears to function similarly to an ISS >15 in AIS98 for the purposes of identifying a population with an elevated risk of death after injury. Where mortality is a primary outcome of trauma monitoring, an ISS >12 threshold could be adopted to identify major trauma patients. Level II evidence-diagnostic tests and criteria. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Injury 07/2015; DOI:10.1016/j.injury.2015.07.003 · 2.46 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The international burden of injury is an increasing concern in global healthcare. Developed trauma care systems have reduced death and disability following injury. The ideal platform for surveillance and clinical governance in trauma care quality improvement is the trauma registry. There is a great disparity in the prevalence of active trauma registries between developed and developing countries. More detailed information on lessons learnt would guide those settings, hospitals and regions looking to establish a sustainable trauma registry. The aim of this study was to explore the experiences and perceptions of trauma registry custodians regarding the development of successful and sustainable trauma registries.
    Injury 07/2015; 380. DOI:10.1016/j.injury.2015.06.032 · 2.46 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. Findings Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2·4 billion and 1·6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537·6 million in 1990 to 764·8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114·87 per 1000 people to 110·31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21·1% in 1990 to 31·2% in 2013. Interpretation Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries.
    The Lancet 06/2015; 386(9995):743–800. DOI:10.1016/S0140-6736(15)60692-4 · 45.22 Impact Factor
  • Source
    Alex Collie · Belinda Gabbe · Michael Fitzharris
    [Show abstract] [Hide abstract]
    ABSTRACT: Injuries resulting from road traffic crashes are a substantial cause of disability and death worldwide. Injured persons receiving compensation have poorer recovery and return to work than those with non-compensable injury. Case or claims management is a critical component of injury compensation systems, and there is now evidence that claims management can have powerful positive impacts on recovery, but can also impede recovery or exacerbate mental health concerns in some injured people. This study seeks to evaluate the impact of a population-based injury claims management intervention in the State of Victoria, Australia, on the health of those injured in motor vehicle crashes, their experience of the compensation process, and the financial viability of the compensation system. Evaluation of this complex intervention involves a series of linked but stand-alone research projects to assess the anticipated process changes, impacts and outcomes of the intervention over a 5-year time frame. Linkage and analysis of routine administrative and health system data is supplemented with a series of primary studies collecting new information. Additionally, a series of 'action' research projects will be undertaken to inform the implementation of the intervention. A program logic model designed by the state government Transport Accident Commission in conjunction with the research team provides the evaluation framework. Relatively few studies have comprehensively examined the impact of compensation system processes on the health of injured persons, their satisfaction with systems processes, and impacts on the financial performance of the compensation scheme itself. The wholesale, population-based transformation of an injury claims management model is a rare opportunity to document impacts of system-level policy change on outcomes of injured persons. Findings will contribute to the evidence base of information on the public health effects of injury claims management policy and practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    BMJ Open 05/2015; 5(5):e006900. DOI:10.1136/bmjopen-2014-006900 · 2.06 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: With an aging population, a growing number of older adults experience physical or cognitive decline that necessitates admission to residential aged care facilities (RACF). Each year a considerable proportion of these residents has at least 1 emergency transfer to hospital, which may result in a number of adverse outcomes. Rates of transfer from RACF to hospital can vary considerably between different RACFs suggesting the presence of potentially modifiable risk factors for emergency department (ED) transfer.
    Journal of the American Medical Directors Association 04/2015; 16(7). DOI:10.1016/j.jamda.2015.03.007 · 4.78 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Road traffic injuries are a large and growing public health burden, especially in low and middle income countries where 90% of the world's deaths due to road traffic injuries are estimated to occur. India is one of the fastest growing economies, with rapid motorisation and increasing road traffic burden. However, there are limited data addressing the problem of non-fatal road traffic injuries, with existing data being of poor quality, non-representative and difficult to access, and encompassing a limited number of relevant variables. This study aims to determine the outcomes of road traffic injuries on function and health-related quality of life, to assess their social impact and to weigh the economic cost of road traffic crashes in an urban setting in India. This prospective observational study will recruit approximately 1500 participants injured in road traffic crashes, who are admitted to hospital for >24 h at any of three participating hospitals in Chandigarh, India. Face-to-face baseline interviews will be conducted by telephone at 1, 2, 4 and 12 months postinjury. Standardised tools will be used to collect data on health and social outcomes, and on the economic impact of road traffic crashes. Descriptive analysis and multivariate models will be used to report outcome data and associations. The qualitative in-depth interviews will be analysed thematically using content analysis. This study will provide the first comprehensive estimates on outcomes of serious road traffic injury in India, including economic and social costs, and the impact on individuals and families. Primary ethics approval was received from the Postgraduate Institute for Medical Education and Research, institute's ethics committee, Chandigarh, India. Results will be disseminated via the usual scientific forums including peer-reviewed publications and presentations at international conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    BMJ Open 01/2015; 5(8):e008884. DOI:10.1136/bmjopen-2015-008884 · 2.06 Impact Factor
  • Belinda J Gabbe · Dina M Watterson · Yvonne Singer · Anne Darton
    [Show abstract] [Hide abstract]
    ABSTRACT: Most studies about burn injury focus on admitted cases. To compare outpatient and inpatient presentations at burn centers in Australia to inform the establishment of a repository for outpatient burn injury. Data for sequential outpatient presentations were collected at seven burn centers in Australia between December 2010 and May 2011 and compared with inpatient admissions from these centers recorded by the Burns Registry of Australia and New Zealand for the corresponding period. There were 788 outpatient and 360 inpatient presentations. Pediatric outpatients included more children <3 years of age (64% vs 33%), scald (52% vs 35%) and contact burns (39% vs 24%). Adult outpatients included fewer males (58% vs 73%) and intentional injuries (3.3% vs 10%), and more scald (46% vs 30%) and contact burns (24% vs 13%). All pediatric, and 98% of adult, outpatient presentations involved a %TBSA<10. The pattern of outpatient presentations was consistent between centers. Outpatient presentations outnumbered inpatient admissions by 2.2:1. The pattern of outpatient burns presenting to burn centers differed to inpatient admission data, particularly with respect to etiology and burn severity, highlighting the importance of the need for outpatient data to enhance burn injury surveillance and inform prevention. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.
    Burns: journal of the International Society for Burn Injuries 12/2014; 41(3). DOI:10.1016/j.burns.2014.11.013 · 1.84 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To determine associations between the number of injuries sustained and three measures of disability 12-months post-injury for hospitalised patients. Data from 27,840 adult (18+ years) participants, hospitalised for injury, were extracted for analysis from the Validating and Improving injury Burden Estimates (Injury-VIBES) Study. Modified Poisson and linear regression analyses were used to estimate relative risks and mean differences, respectively, for a range of outcomes (Glasgow Outcome Scale-Extended, GOS-E; EQ-5D and 12-item Short Form health survey physical and mental component summary scores, PCS-12 and MCS-12) according to the number of injuries sustained, adjusted for age, sex and contributing study. More than half (54%) of patients had an injury to more than one ICD-10 body region and 62% had sustained more than one Global Burden of Disease injury type. The adjusted relative risk of a poor functional recovery (GOS-E<7) and of reporting problems on each of the items of the EQ-5D increased by 5-10% for each additional injury type, or body region, injured. Adjusted mean PCS-12 and MCS-12 scores worsened with each additional injury type, or body region, injured by 1.3-1.5 points and 0.5 points, respectively. Consistent and strong relationships exist between the number of injury types and body regions injured and 12-month functional and health status outcomes. Existing composite measures of anatomical injury severity such as the NISS or ISS, which use up to three diagnoses only, may be insufficient for characterising or accounting for multiple injuries in disability studies. Future studies should consider the impact of multiple injuries to avoid under-estimation of injury burden.
    PLoS ONE 12/2014; 9(12):e113467. DOI:10.1371/journal.pone.0113467 · 3.23 Impact Factor
  • Source
    be active 2014: National Sports Injury Prevention Conference. Canberra, Pages e139–e140; 12/2014
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: It is assumed when exercise-based sports injury prevention programs are implemented, that coaches can provide appropriate instruction to enable players to perform the exercises correctly. This assumption has important ramifications for implementation strategies and, therefore, how effective the programs are in preventing injuries. However, the actual quality of exercise performance, or exercise fidelity, has rarely been evaluated. The aim of this research was to evaluate exercise fidelity in an injury prevention program using a purpose-designed observational tool. Methods: The FootyFirst injury prevention program was specifically designed for community Australian Football. The program resources were designed for coaches to deliver the program to their players. In these, correct techniques were strongly emphasised with detailed images and descriptions of teaching points and common faults. The FootyFirst program contains 12 warm-up exercises and 5–6 exercises within 5 progressive levels. Performing each FootyFirst exercise with a high level of fidelity was considered essential to ensure the program injury prevention benefits. The FootyFirst Observational Tool (FOT) was developed to assess exercise fidelity by breaking the exercises down into 3–5 criteria describing correct technique, volume and intensity. Correct performance of each criteria was recorded as either 'yes' or 'no'. Two assessors independently used the FOT to assess exercise fidelity performed by players while participating in FootyFirst as part of their regular training. Attainment of exercise fidelity for each exercise was when all criteria were rated as 'yes' by both assessors. Results: The assessors agreed on 61 of 70 observations. The nine observations where the assessors disagreed could not be assessed for fidelity as it is not known which assessor was correct. Of the 61 agreed observations, exercise fidelity was achieved in 41 observations (67%), indicating that these players performed the observed exercise as intended. At least one essential criteria of an exercise was given a 'no' in 20 exercises (33%), indicating the exercise was performed incorrectly. Across all exercises, the most frequently incorrect exercise performance criteria was volume. Discussion: Results from this study suggest that one third of players participating in FootyFirst may not have received the desired injury prevention benefits because they did not perform the exercises exactly as prescribed. Simply asking players/coaches if they are using a program is not enough; exercises should be observed to see how well they are performed. The insights from evaluating exercise fidelity will be used to modify the way the program is delivered.
    National Sports Injury Prevention Conference (NSIPC) (SMA BeActive2014), Canberra; 12/2014
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Far fewer injury surveillance systems exist within community sport than elite sport. As a result, most epidemiological data on sports injuries have limited relevance to community-level sporting populations. There is potential for data from community club-based injury surveillance systems to provide a better understanding of community sports injuries. This study aimed to describe the incidence and profile of community-level Australian football injuries reported using a club-based injury surveillance system.DesignProspective, epidemiological study.Methods Sports trainers from five community-level Australian football leagues recorded injury data during two football seasons using the club-based system. An online surveillance tool developed by Sports Medicine Australia (‘Sports Injury Tracker’) was used for data collection. The injury incidence, profile and match injury rate were reported.ResultsInjury data for 1205 players were recorded in season one and for 823 players in season two. There was significant variability in injury incidence across clubs. However, aggregated data were consistent across football seasons, with an average of 0.7 injuries per player per season and 38–39 match injuries per 1000 h match exposure. A large proportion of injuries occurred during matches, involved the lower limb and resulted from contact.Conclusions Data from the club-based system provided a profile of injuries consistent with previous studies in community-level Australian football. Moreover, injury incidence was consistent with other studies using similar personnel to record data. However, injury incidence was lower than that reported in studies using player self-report or healthcare professionals and may be an underestimate of true values.KeywordsSportsEpidemiologyDatabaseSports Injury TrackerSports trainers
    Journal of Science and Medicine in Sport 11/2014; DOI:10.1016/j.jsams.2014.11.390 · 3.08 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: residential aged care facility (RACF) resident numbers are increasing. Residents are frequently frail with substantial co-morbidity, functional and cognitive impairment with high susceptibility to acute illness. Despite living in facilities staffed by health professionals, a considerable proportion of residents are transferred to hospital for management of acute deteriorations in health. This model of emergency care may have unintended consequences for patients and the healthcare system. This review describes available evidence about the consequences of transfers from RACF to hospital.
    Age and Ageing 10/2014; 43(6). DOI:10.1093/ageing/afu117 · 3.11 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The global burden of injury is enormous, especially in developing countries. Trauma systems in highincome countries have reduced mortality and disability. An important component of trauma quality improvement programmes is the trauma registry which monitors the epidemiology, processes and outcomes of trauma care. There is a severe deficit of trauma registries in developing countries and there are few resources to support the development of trauma registries. Specifically, publicly available information of trauma registry methodology in developed trauma registries is sparse. The aim of this study was to describe and compare trauma registries globally.
    Injury 09/2014; 46(2). DOI:10.1016/j.injury.2014.09.010 · 2.46 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives To explore the financial and employment impacts following serious injury. Design Semi-structured telephone administered qualitative interviews with purposive sampling and thematic qualitative analysis. Participants: 118 patients (18-81 years) registered by the Victorian State Trauma Registry or Victorian Orthopaedic Trauma Outcomes Registry 12-24 months post-injury. Results Key findings of the study were that although out-of-pocket treatment costs were generally low, financial hardship was prevalent after hospitalisation for serious injury, and was predominantly experienced by working age patients due to prolonged absences from paid employment. Where participants were financially pressured prior to injury, injury further exacerbated these financial concerns. Reliance on savings and loans and the need to budget carefully to limit financial burden were discussed. Financial implications of loss of income were generally less for those covered by compensation schemes, with non-compensable participants requiring welfare payments due to an inability to earn an income. Most participants reported that the injury had a negative impact on work. Loss of earnings payments from injury compensation schemes and income protection policies, supportive employers, and return to work programs were perceived as key factors in reducing the financial burden of injured participants. Employer-related barriers to return to work included the employer not listening to the needs of the injured participant, not understanding their physical limitations, and placing unrealistic expectations on the injured person. While the financial benefits of compensation schemes were acknowledged, issues accessing entitlements and delays in receiving benefits were commonly reported by participants, suggesting that improvements in scheme processes could have substantial benefits for injured patients. Conclusions Seriously injured patients commonly experienced substantial financial and work-related impacts of injury. Participants of working age who were unemployed prior to injury, did not have extensive leave accrual at their pre-injury employment, and those not covered by injury compensation schemes or income protection insurance clearly represent participants “at risk” for substantial financial hardship post-injury. Early identification of these patients, and improved provision of information about financial support services, budgeting and work retraining could assist in alleviating financial stress after injury
    Injury 09/2014; 45(9). DOI:10.1016/j.injury.2014.01.019 · 2.46 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: To compare 6 month and 12 month health status and functional outcomes between regional major trauma registries in Hong Kong and Victoria, Australia. Summary Background Data: Multicentres from trauma registries in Hong Kong and the Victorian State Trauma Registry (VSTR). Methods: Multicentre, prospective cohort study. Major trauma patients and aged >= 18 years were included. The main outcome measures were Extended Glasgow Outcome Scale (GOSE) functional outcome and risk-adjusted Short-Form 12 (SF-12) health status at 6 and 12 months after injury. Results: 261 cases from Hong Kong and 1955 cases from VSTR were included. Adjusting for age, sex, ISS, comorbid status, injury mechanism and GCS group, the odds of a better functional outcome for Hong Kong patients relative to Victorian patients at six months was 0.88 (95% CI: 0.66, 1.17), and at 12 months was 0.83 (95% CI: 0.60, 1.12). Adjusting for age, gender, ISS, GCS, injury mechanism and comorbid status, Hong Kong patients demonstrated comparable mean PCS-12 scores at 6-months (adjusted mean difference: 1.2, 95% CI: -1.2, 3.6) and 12-months (adjusted mean difference: -0.4, 95% CI: -3.2, 2.4) compared to Victorian patients. Keeping age, gender, ISS, GCS, injury mechanism and comorbid status, there was no difference in the MCS-12 scores of Hong Kong patients compared to Victorian patients at 6-months (adjusted mean difference: 0.4, 95% CI: -2.1, 2.8) or 12-months (adjusted mean difference: 1.8, 95% CI: -0.8, 4.5). Conclusion: The unadjusted analyses showed better outcomes for Victorian cases compared to Hong Kong but after adjusting for key confounders, there was no difference in 6-month or 12-month functional outcomes between the jurisdictions.
    PLoS ONE 08/2014; 9(8):e103396. DOI:10.1371/journal.pone.0103396 · 3.23 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Traumatic injury is a leading contributor to the overall global burden of disease. However, there is a worldwide shortage of population data to inform understanding of non-fatal injury burden. An improved understanding of the pattern of recovery following trauma is needed to better estimate the burden of injury, guide provision of rehabilitation services and care to injured people, and inform guidelines for the monitoring and evaluation of disability outcomes. Objective To provide a comprehensive overview of patient outcomes and experiences in the first 5 years after serious injury. Design This is a population-based, nested prospective cohort study using quantitative data methods, supplemented by a qualitative study of a seriously injured participant sample. Participants All 2547 paediatric and adult major trauma patients captured by the Victorian State Trauma Registry with a date of injury from 1 July 2011 to 30 June 2012 who survived to hospital discharge and did not opt-off from the registry. Analysis To analyse the quantitative data and identify factors that predict poor or good outcome, whether there is change over time, differences in rates of recovery and change between key participant subgroups, multilevel mixed effects regression models will be fitted. To analyse the qualitative data, thematic analysis will be used to identify important themes and the relationships between themes. Contribution to the field The results of this project have the potential to inform clinical decisions and public health policy, which can reduce the burden of non-fatal injury and improve the lives of people living with the consequences of severe injury.
    Injury Prevention 08/2014; DOI:10.1136/injuryprev-2014-041336 · 1.94 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Previous research aimed at improving injury surveillance standards has focused mainly on issues of data quality rather than upon the implementation of surveillance systems. There are numerous settings where injury surveillance is not mandatory and having a better understanding of the barriers to conducting injury surveillance would lead to improved implementation strategies. One such setting is community sport, where a lack of available epidemiological data has impaired efforts to reduce injury. This study aimed to i) evaluate use of an injury surveillance system following delivery of an implementation strategy; and ii) investigate factors influencing the implementation of the system in community sports clubs. Methods A total of 78 clubs were targeted for implementation of an online injury surveillance system (approximately 4000 athletes) in five community Australian football leagues concurrently enrolled in a pragmatic trial of an injury prevention program called FootyFirst. System implementation was evaluated quantitatively, using the RE-AIM framework, and qualitatively, via semi-structured interviews with targeted-users. Results Across the 78 clubs, there was 69% reach, 44% adoption, 23% implementation and 9% maintenance. Reach and adoption were highest in those leagues receiving concurrent support for the delivery of FootyFirst. Targeted-users identified several barriers and facilitators to implementation including personal (e.g. belief in the importance of injury surveillance), socio-contextual (e.g. understaffing and athlete underreporting) and systems factors (e.g. the time taken to upload injury data into the online system). Conclusions The injury surveillance system was implemented and maintained by a small proportion of clubs. Outcomes were best in those leagues receiving concurrent support for the delivery of FootyFirst, suggesting that engagement with personnel at all levels can enhance uptake of surveillance systems. Interview findings suggest that increased uptake could also be achieved by educating club personnel on the importance of recording injuries, developing clearer injury surveillance guidelines, increasing club staffing and better remunerating those who conduct surveillance, as well as offering flexible surveillance systems in a range of accessible formats. By increasing the usage of surveillance systems, data will better represent the target population and increase our understanding of the injury problem, and how to prevent it, in specific settings.
    07/2014; 1(19). DOI:10.1186/s40621-014-0019-y
  • Source
    Christina L Ekegren · Belinda J Gabbe · Caroline F Finch
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: In recent reports, Australian football has outranked other team sports in the frequency of hospitalizations and emergency department (ED) presentations. Understanding the profile of these and other "medical-attention" injuries is vital for developing preventive strategies that can reduce health costs. The objective of this review was to describe the frequency and profile of Australian football injuries presenting for medical attention. Data Sources: A systematic search was carried out to identify peer-reviewed articles and reports presenting original data about Australian football injuries from treatment sources (hospitals, EDs, and health-care clinics). Data extracted included injury frequency and rate, body region, and nature and mechanism of injury. Main Results: Following literature search and review, 12 publications were included. In most studies, Australian football contributed the greatest number of injuries out of any sport or recreation activity. Hospitals and EDs reported a higher proportion of upper limb than lower limb injuries, whereas the opposite was true for sports medicine clinics. In hospitals, fractures and dislocations were most prevalent out of all injuries. In EDs and clinics, sprains/strains were most common in adults and superficial injuries were predominant in children. Most injuries resulted from contact with other players or falling. Conclusions: The upper limb was the most commonly injured body region for Australian football presentations to hospitals and EDs. Strategies to prevent upper limb injuries could reduce associated public health costs. However, to understand the full extent of the injury problem in football, treatment source surveillance systems should be supplemented with other datasets, including community club-based collections.
    Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine 07/2014; 25(2). DOI:10.1097/JSM.0000000000000108 · 2.01 Impact Factor

Publication Stats

5k Citations
1,031.94 Total Impact Points

Institutions

  • 2012–2015
    • Swansea University
      • College of Medicine
      Swansea, Wales, United Kingdom
  • 2002–2015
    • Monash University (Australia)
      • Department of Epidemiology and Preventive Medicine
      Melbourne, Victoria, Australia
    • Victoria University Melbourne
      Melbourne, Victoria, Australia
  • 2006–2014
    • University of Vic
      Vic, Catalonia, Spain
    • La Trobe University
      • Department of Physiotherapy
      Melbourne, Victoria, Australia
  • 2004–2014
    • Alfred Hospital
      • • Department of Department of Epidemiology and Preventive Medicine (DEPM)
      • • Department of Emergency and Trauma Centre
      Melbourne, Victoria, Australia
  • 2012–2013
    • University of Washington Seattle
      • Institute for Health Metrics and Evaluation
      Seattle, Washington, United States
  • 2006–2008
    • Royal Melbourne Hospital
      Melbourne, Victoria, Australia
  • 2003
    • The Chinese University of Hong Kong
      • Prince of Wales Hospital
      Hong Kong, Hong Kong
  • 2002–2003
    • University of Melbourne
      • Department of Physiotherapy
      Melbourne, Victoria, Australia
  • 1999–2000
    • University of Victoria
      Victoria, British Columbia, Canada
    • Deakin University
      Geelong, Victoria, Australia