The Minimum Dataset and Inclusion Criteria for the National Trauma Registry of Iran: A Qualitative Study

Authors

1 Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, IR Iran

2 Trauma Research Center, Kashan University of Medical science, Kashan, IR Iran

3 Burn Research Center, Iran University of Medical Sciences, Tehran, IR Iran

4 Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran

5 Shiraz Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran

6 Trauma Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran

7 Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Guilan, IR Iran

8 Electronic Health Institute, Amirkabir University of Technology, Tehran, IR Iran

10.5812/atr.39725

Abstract

Background
Burden of injuries is an important public health problem, especially in developing countries. However, a national standard tool for data collection of trauma registry has not been developed in Iran yet.


Objectives
The present study aimed to describe the steps undertaken in the development of the minimum dataset (MDS) and define the inclusion and exclusion criteria for a case of trauma registry by the national trauma registry of Iran (NTRI).


Methods
The working group consists of sixteen elected expert representatives from seven established countrywide active trauma research centers. Following a structured extensive review of the literature, the working party identified the data variables that included key registry goals for pre-hospital and hospital, outcome and quality assurance information. We used data variables from three trauma registry centers: National trauma data standard questionnaire, European trauma care (UT stein version), and Sina trauma and surgery research center. Then, we performed two email surveys and three focus group discussions and adapted, modified and finally developed the optimized MDS in order to prepare the quality care registry for injured patients.


Results
The finalized MDS consisted of 109 data variables including demographic information (n = 24), injury information (n = 19), prehospital information (n = 26), emergency department information (n = 25), hospital procedures (n = 2), diagnosis (n = 2), injury severity (n = 3), outcomes (n = 5), financial (n = 2), and quality assurance (n = 1). For a patient sustained one or more traumatic injury in a defined diagnostic ICD-10 codes, the inclusion criteria considered as one of the followings: If the patient stayed > 24 hours in the hospital, any death after hospital arrival, any transfer from another hospital during the first 24 hours from injury.


Conclusions
This study presents how we developed the MDS in order to uniform data reporting in the NTRI and define our inclusion and exclusion criteria for trauma registry. Applying the MDS and the case definition in pilot studies are needed in next steps.

Keywords


1. Twijnstra MJ, Moons KG, Simmermacher RK, Leenen LP. Regional trauma system reduces mortality and changes admission rates: a before and after study. Ann Surg. 2010;251(2):339–43. doi: 10.1097/SLA.0b013e3181c0e910. [PubMed: 20010086].
 2. Cameron PA, Gabbe BJ, Cooper DJ, Walker T, Judson R, McNeil J. A statewide system of trauma care in Victoria: effect on patient survival. Med J Aust. 2008;189(10):546–50. [PubMed: 19012550].
 3. McDermott FT, Cordner SM. Victoria’s trauma care system: national implications for quality improvement. Med J Aust. 2008;189(10):540– 2. [PubMed: 19012548].
 4. Tohira H, Jacobs I, Mountain D, Gibson N, Yeo A. International comparison of regional trauma registries. Injury. 2012;43(11):1924–30. doi: 10.1016/j.injury.2012.08.024. [PubMed: 22921381].
5. Moore L, Clark DE. The value of trauma registries. Injury. 2008;39(6):686–95. doi: 10.1016/j.injury.2008.02.023. [PubMed: 18511052]. 6. Mann NC, Mullins RJ, MacKenzie EJ, Jurkovich GJ, Mock CN. Systematic review of published evidence regarding trauma system effectiveness. J Trauma. 1999;47(3 Suppl):25–33. [PubMed: 10496607].
7. MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathens AB, Frey KP, Egleston BL, et al. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006;354(4):366–78. doi: 10.1056/NEJMsa052049. [PubMed: 16436768].
 8. Mann NC, Guice K, Cassidy L, Wright D, Koury J. Are statewide trauma registries comparable? Reaching for a national trauma dataset. Acad Emerg Med. 2006;13(9):946–53. doi: 10.1197/j.aem.2006.04.019. [PubMed: 16902047].
 9. Engel DC. Standardizing data collection in severe trauma: call for linking up. Crit Care. 2012;16(1):105. doi: 10.1186/cc10561. [PubMed: 22277684].
 10. Stevenson M, Segui-Gomez M, Lescohier I, Di Scala C, McDonald-Smith G. An overview of the injury severity score and the new injury severity score. Inj Prev. 2001;7(1):10–3. [PubMed: 11289527].
 11. Tarighi P, Tabibi SJ, Motevalian SA, Tofighi S, Maleki MR, Delgoshaei B, et al. Designing a model for trauma system management using public health approach: the case of Iran. Acta Med Iran. 2012;50(1):9–17. [PubMed: 22267372].
 12. Mock C, Juillard C, Brundage S, Goosen J, Joshipura M. Guidelines for quality improvement programmes. Geneva: World Health Organization; 2009.
 13. National Trauma Data Bank . National Trauma Data Standard: Data Dictionary. USA: American College of Sergeons; 2016.
 14. Centers for Disease Control and Prevention . National Center for Health Statistics: International Classification of Diseases Clinical Modification (ICD-9-CM). 9 ed. Atlanta: USA governmental agencies; 2011.
 15. Centers for Disease Control and Prevention . National Center for Health Statistics: International Classification of Diseases Clinical Modification (ICD-10-CM). 9 ed. Atlanta: USA governmental agencies; 2011.
 16. Ringdal KG, Coats TJ, Lefering R, Di Bartolomeo S, Steen PA, Roise O. The Utstein trauma template for uniform reporting of data following major trauma: data dictionary. European Trauma Registry Network; 2008.
 17. Hawes C, Morris JN, Phillips CD, Fries BE, Murphy K, Mor V. Development of the nursing home Resident Assessment Instrument in the USA. Age Ageing. 1997;26 Suppl 2:19–25. [PubMed: 9464550].
 18. Haider AH, Saleem T, Leow JJ, Villegas CV, Kisat M, Schneider EB, et al. Influence of the National Trauma Data Bank on the study of trauma outcomes: is it time to set research best practices to further enhance its impact? J Am Coll Surg. 2012;214(5):756–68. doi: 10.1016/j.jamcollsurg.2011.12.013. [PubMed: 22321521].
 19. Canadian Institute for Health Information . National Trauma Registry Comprehensive Data Set. Ottawa, Ontario: Canadian Institute for Health Information,; 2013.
 20. The University of Manchester . The Trauma Audit & Research Network. UK: Health care commission; 2012.
 21. Osler T, Baker SP, Long W. A modification of the injury severity score that both improves accuracy and simplifies scoring. J Trauma. 1997;43(6):922–5. [PubMed: 9420106].
 22. Datta I, Findlay C, Kortbeek JB, Hameed SM. Evaluation of a regional trauma registry. Can J Surg. 2007;50(3):210–3. [PubMed: 17568493].
 23. Mohammed SA, Yusof MM. Towards an evaluation framework for information quality management (IQM) practices for health information systems–evaluation criteria for effective IQM practices. J Eval Clin Pract. 2013;19(2):379–87. doi: 10.1111/j.1365-2753.2012.01839.x. [PubMed: 22502634].
 24. Palmer CS, Davey TM, Mok MT, McClure RJ, Farrow NC, Gruen RL, et al. Standardising trauma monitoring: the development of a minimum dataset for trauma registries in Australia and New Zealand. Injury. 2013;44(6):834–41. doi: 10.1016/j.injury.2012.11.022. [PubMed: 23265787]. 25. WHO Regional Office for the Western Pacific . Improving data quality: a guide for developing countries. Manila, Philippines: WHO Regional Office for the Western Pacific,; 2003.
 26. TraumaRegister DGU. 20 years of trauma documentation in Germany–actual trends and developments. Injury. 2014;45 Suppl 3:14–9. doi: 10.1016/j.injury.2014.08.012. [PubMed: 25284227].