@article{28774,
  keywords = {M-health, Injury Severity Score},
  author = {Spence R T and Zargaran E and Hameed M and Fong D and Shangguan E and Martinez R and Navsaria P and Nicol A},
  title = {Injury severity score coding: Data analyst v. emerging m-health technology.},
  abstract = {<p><strong>Background. </strong>The cost of Abbreviated Injury Scale (AIS) coding has limited its utility in areas of the world with the highest incidence of trauma. We hypothesised that emerging mobile health (m-health) technology could offer a cost-effective alternative to the current goldstandard AIS mechanism in a high-volume trauma centre in South Africa.</p>

<p><strong>Methods. </strong>A prospectively collected sample of consecutive patients admitted following a traumatic injury that required an operation during a 1-month period was selected for the study. AISs and Injury Severity Scores (ISSs) were generated by clinician-entered data using an m-health application (ISS eTHR) as well as by a team of AIS coders at Vancouver General Hospital, Canada (ISS VGH). Rater agreements for ISSs were analysed using Bland-Altman plots with 95% limits of agreement (LoA) and kappa statistics of the ISSs grouped into ordinal categories. Reliability was analysed using a two-way mixed-model intraclass correlation coefficient (ICC). Calibration and discrimination of univariate logistic regression models built to predict in-hospital complications using ISSs coded by the two methods were also compared.</p>

<p><strong>Results. </strong>Fifty-seven patients were managed operatively during the study period. The mean age of the cohort was 27.2 years (range 14 - 62), and 96.3% were male. The mechanism of injury was penetrating in 93.4% of cases, of which 52.8% were gunshot injuries. The LoA fell within –8.6 - 9.4. The mean ISS difference was 0.4 (95% CI –0.8 - 1.6). The kappa statistic was 0.53. The ICC of the individual ISS was 0.88 (95% CI 0.81 - 0.93) and the categorical ISS was 0.81 (95% CI 0.68 - 0.87). Model performance to predict in-hospital complications using either the ISS eTHR or the ISS VGH was equivalent.</p>

<p><strong>Conclusions. </strong>ISSs calculated by the eTHR and gold-standard coding were comparable. Emerging m-health technology provides a costeffective alternative for injury severity scoring.</p>
},
  year = {2016},
  journal = {South African Medical Journal},
  volume = {106},
  url = {http://www.samj.org.za/index.php/samj/article/view/10597},
  doi = {10.7196/SAMJ.2016.v106i10.10597},
  language = {eng},
}