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National Collegiate Athletic Association Injury Surveillance System

The NCAA ISS data collection system has been in place since 1982. It is the largest continuous ISS in the United States. Its mission is to provide current and reliable data on injury trends in intercollegiate athletics to optimize student-athlete health and safety.20 In 2003, the ISS transitioned from pen and paper to a Web-based system. The initial collection focused on 15 sports. Data are now collected on all NCAA championship sports. In conjunction with Datalys, a national nonprofit organization that conducts sport injury research, the NCAA has collected several decades of data.2,4,5,9 These longitudinal data allow for trends and patterns of injury to emerge. The NCAA has set the standards for defining injury occurrence, severity, and exposure. A significant weakness of the system is the lack of data accessibility to researchers and clinicians. Annual summary reports are no longer available to the public.2,4,5,9 However, publications and other information are available on the Datalys website (http://datalyscenter.org/programs/ncaa-injury-surveillance-program/).

National Center for Catastrophic Sport Injury Research

The National Center for Catastrophic Sport Injury Research (NCCSIR) is based out of Chapel Hill, North Carolina, and collects data on death and permanent disability injuries that occur in sport. The NCCSIR partners with the National Football League, NCAA, National Federation of High School Associations, and the American Football Coaches Association. Since its inception in 1965, NCCSIR monitors cases with a systematic data reporting system that allows for longitudinal investigation of athletes suffering from catastrophic injuries and illnesses. NCCSIR is not representative of all sport injuries; only catastrophic injuries are included in the center’s database. Injury data are accessible on their website (http://nccsir.unc.edu/).

Center for Injury Research and Policy-Reporting Information Online

An Internet-based system developed in 2004, Reporting Information Online (RIO), is a surveillance system of time-loss injuries for high schools in the United States. It was designed using the footprint of the NCAA ISS. Based out of Children’s Hospital in Columbus, Ohio, high schools across the country are invited to participate in the data collection process each year. Annual summary reports are provided to the public. Data can be pulled on injury patterns and trends, specific sporting activities, participant demographics, and specific body parts that were injured.2,4,5 Injury data are available on their website (www.nationwidechildrens.org/cirp-rio).

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United States Consumer Product Commission National Electronic Injury Surveillance System

For more than 30 years, the United States Consumer Product Commission National Electronic Injury Surveillance System (NEISS) has collected demographic data, injury type, severity, mechanism of injury, injury location, and products involved. Patient information is collected from each NEISS hospital for every emergency visit involving an injury associated with consumer products. This system allows for tracking of injuries associated with sports protective equipment, such as helmets and shoulder pads. Analysis can identify faulty equipment and can lead to the recalls of the equipment. Information is available on their website (www.cpsc.gov/en/Research–Statistics/NEISS-Injury-Data/).

Issues With Data Collection

The quality of any injury statistic is dependent upon the standardization of definitions, statistical terms, and the population at risk. The struggle with comparing data collection systems/ ISS is that there is not full consensus on the definition of a reportable injury, injury severity, and risk exposure.1,2,4 In addition, the quality of the data may be confounded by personnel collecting the data, the frequency of the recording of data, the system’s ease of use, and the process for submitting the data.

Who Is Collecting the Data?

Data entry and quality control may vary based on the professional entering the information.2,5,24 For example, data collected by a medical professional may be more reliable than that of a coach, and that of a coach may be more reliable than that of a parent. Because of the need for a working knowledge of the terms being used, individuals who are trained in ISS data entry tend to report findings more thoroughly.24 Data entered by medical professionals is of higher quality than that entered by a coach or reported by a parent.4,13,24 A confounding factor for physicians or the athletic trainers may be whether the data are entered as part of the professional’s job description vs considering the data entry as extra work.2 Athletic trainers or other sports injury specialists are not the ones entering the data in many cases. Sport epidemiology could be enhanced if there was a focus on increasing the number of athletic trainers in each public and private high school who were responsible for injury surveillance. The Fairfax County (Virginia) Public School System Injury Surveillance Database is an example of this type of model. As part of their job description, certified athletic trainers, at each of the public high schools in the county, are required to enter data on all injuries through a computerized data collection system called Sport Injury Management System. Athletes are followed throughout their 4-year careers. As a result, Fairfax County has more than 12 years of cumulative data with more than 15 million AEs.2