How Are the Data Being Collected?
The goal is to collect the widest range of injuries possible while also collecting the data to calculate AEs accurately. The method of data collection varies depending on geographical location and the organization of sport in that area.1 Many ISSs have moved from paper to computer for convenience. One example of paper reporting decreasing over time is with the improvement of the RIO.2 As previously discussed, adding to one’s workload can result in poor data collection. Easier data entry would ensure that an athletic trainer is able to perform the task. Further improving data collection, a single system for ISS, and clinical recordkeeping is needed. There are several athletic injury management software systems that have several fields that parallel ISS databases. Furthermore, several of these systems have the ability to export to the Datalys managed by the NCAA ISS.2,5 This allows data in regular daily recordkeeping to be automatically exported to the NCAA ISS, which significantly decreases the workload. The more electronic medical records systems that can be interfaced with many of these national surveillance systems, the more likely the records collected will have higher-quality controls.2,5 Datalys currently has 3 certified vendors, including ATS, NExTT solutions, and Sport Injury Management System. This approach reduces, if not eliminates, the need for double data entry.5
How Often Are the Data Being Collected?
Frequency of reporting is another variable that may affect the quality of the data. It appears that data entered daily or on a real-time basis are more accurate than when reported weekly or monthly.2,5 In 1998, when the NCAA ISS began its data collection, pen and paper forms were
mailed from the participating athletic trainer/college to the NCAA and were then entered by hand into the database. In the 1990s, they began to electronically scan the forms but still had to enter the information into the database by hand. Since the 2004-2005 season, the NCAA ISS has converted to a completely online system. This has decreased the time from injury to data submission. Historically, data were submitted by season, month, or week to the NCAA. Now, with electronic, Web-based systems, the accuracy of the data has increased because of the real-time submission of data.5 Early sport epidemiological studies reported injuries for a specific group for a specific period of time (ie, one soccer team for one season).2,7 ISS reporting in real-time or daily tends to be more reliable than weekly or monthly.5 Most sport ISS systems require weekly data entry.3-5,9
The NCAA is not the only Internet-based ISS. The Center for Injury Research developed RIO. These types of systems are increasing the ability of athletic trainers, coaches, and parents5 to provide real-time reporting.2 These Web-based systems have led to the ability to evaluate the reliability of these ISSs. The Centers for Disease Control and Prevention has established criteria to evaluate these systems.4
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Who Is Using Injury Surveillance System Data?
ISS data have been referenced in journal articles and medical textbooks and have been applied to modification of sports rules, policies, and issues by a variety of administrative and sports medicine groups.1 These data have been used in studies of IRs by sport, gender, position, concussion rates, and on the effectiveness of prophylactic knee braces and football helmets. Surveillance data collection has led to collaboration between the American Medical Society for Sports Medicine, American College of Sports Medicine, American Orthopedic Society for Sports Medicine, Centers for Disease Control and Prevention, and the National Athletic Trainers’ Association (NATA).20 Collaboration efforts have benefited collegiate athletics, as well as the entire sports medicine community. The NATA, NCAA, and high school athletic associations continue to use ISS to improve the health and safety of all athletes.
Outcomes of Injury Surveillance
Surveillance databases are important resources that can affect sport rules, safety equipment, and sports medicine administration and policy.20 Due to the potential to use incidence rates and risk factors associated with athletic injury to alter sport rules or modify equipment, much of the ISS has been driven by government agencies or sports associations.2,4,22 Others may use the data to identify injury causes in an attempt to develop better equipment or injury prevention protocols. Although all types of information are critical for athletic trainers,2,4 athletic trainers may also use these data to assess needs for staffing and coverage.20 For example, the primary audience for the ISS system was originally the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports and relevant NCAA sport rules committees, who used the information as a resource upon which to base recommendations, rules, and policies impacting student-athlete health and welfare.20 Other reliable ISS databases are also used by sport rules committees at the Olympic,14 professional,8 high school,5 or youth level.3,13 However, the audiences interested in this information have expanded to include individual colleges and universities, sports medicine researchers, other administrative and sports medicine organizations, the media, and the general public.20
Rule and Equipment Changes
Sport injury surveillance and epidemiological data have had a significant impact on rules and equipment changes. After reviewing longitudinal data from several sport injury database systems, rules committees have implemented rule changes. The most noticeable measure to decrease rates of severe injury in sport is to decrease AE. Of late, the NCAA has attempted to implement this concept with new rules limiting the number of contact days allowed for spring football.7 Although some rule changes have been instituted to decrease IRs of specific injuries within that sport, other rule changes are specific to readiness, age, and physical maturity.7 Youth sport competition is organized by age group. However, some sports also allow movement between age groups. Each organization requires additional information based on readiness or maturity. An example of a multifactorial determination of participation occurs within the rules for USA Gymnastics competition. A participant can petition to participate in a higher level of competition with submission of age verification and proof of skill level development with participation at the preceding competition level. However, to compete at the highest levels, gymnasts must have documentation of minimum scores at those preceding levels to be eligible for competition at the platinum and diamond division.25 Rule and equipment changes have been most evident in football. Cervical spine injuries have decreased with the banning of spear tackling, and knee injuries have decreased with the banning of chop blocking. Moreover, there have been changes to the type of helmet used (leather to plastic), the strength of the helmet (polycarbonate material), and the requirement of the face mask.7 Requirements for additional safety equipment have increased across types of sport and levels of participation. Post 11 describes changes in rules and equipment as a way of preventing injury. These types of changes are an attempt to make sport safer; although physical activity has an inherent risk of injury, these modifications can significantly reduce risk.1,22 Governing organizations will continue to use ISS data to implement changes in rules, policies, and equipment.
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