Preface
The Third International Conference on Measuring the Burden of Injury brought together a number of the experts within the international injury science community concerned with quantifying injury outcome. The objective of the conference was to review the present state of knowledge in the field and to move towards consensus on open issues. With a conference theme of “Towards Consensus,” the conference participants considered three topical areas: the use of health status measures to quantify injury outcome, the use of economic costing methods to determine injury outcome, and ancillary issues, such as data definitions.
A pre-conference report presented the results of an extensive literature survey to determine what measurement instruments have been used to measure injury outcome. This review revealed only a few instances where an instrument had been applied to injury outcome. A careful reading of these few studies shows that there are not sufficient data upon which to base rigorous discussions that could lead to consensus.
Among the issues remaining unresolved in the application of health status measures to injury is the fundamental choice between the psychometric approach and the utility-based approach. Is one “better” than the other or is there a need for both approaches? A related issue concerns from whose viewpoint is the measurement being taken: the patients’, the practitioners’, the researchers’, or society as a whole? Or, does each of these viewpoints need its own approach to measuring injury outcome?
Methods for measuring the economic outcomes of injury are currently more developed than those for health status measures, but a number of issues remain unresolved. The use of ‘willingness to pay’ or the human capital approaches to cost estimation remain an area of disagreement. The choice of specific cost categories to be included in a cost analysis does not appear to be a contentious issue, but agreement on a standard set, or sets, would be helpful.
Although not part of the formal conference program, the program committee discussed how to foster continuing efforts to improve communication among those interested in the field of injury outcomes. As the first priority, the committee sees the need to gather additional outcomes data so that a basis for agreement on standard practices can be reached. One proposal being considered is development of a clearinghouse for researchers to share their results. The advantage of this approach would be the creation of a single source for injury outcomes data from around the world. How such a clearinghouse would work and whose responsibility it would be to maintain such a venture remain an open issue.
Another outcome of informal discussions at the meeting was the suggestion that the terminology “burden of injury” be abandoned, as it has negative connotations. A few suggestions for a more objective term include “impact of injury,” “ injury consequences,” and “injury outcomes.” The program committee will consider this issue in time for the 2002 meeting in Canada.
This Third conference was highly successful in identifying issues that remain to be resolved. It also showed where more work is required to develop international standards for measuring the impact of injuries on people, their families, their communities and society as a whole. In addition, it showed the sustained interest by a global community of researchers dedicated to improving the state of knowledge of this important topic.
The proceedings contain a summary article highlighting all of the presentations, individual articles by the invited speakers, abstracts of the posters and a summary of the breakout sessions. It also includes a list of acronyms and a list of attendees.