APPLYING BIOMECHANICAL EPIDEMIOLOGY TO INJURY PREDICTION

这项建议的广泛和长期目标是建立一个 用于儿科创伤的儿科创伤情况评分系统 分类、护理和研究。实现这一目标的核心是 开发一种新的研究方法，生物力学流行病学; 生物力学和工程学原理的并行应用 一个伤害控制研究问题当前伤害严重程度的衡量标准 用于急性护理环境中的损伤预测， 以及随时间变化的临床参数， 预测隐匿性损伤据推测，小儿损伤 预测可以通过引入描述 受伤情况（例如，速度和方向的影响）， 生理措施。在这个研究项目中， 环境评估工具，ICE行人调查， 自行车运动员，将开发，管理和相关的临床 创建ICE评分的结果。ICE评分的潜在应用 包括：院前和急症的分类和制定护理计划 护理环境;出于研究或绩效目的调整病例组合 评估测试;验证损伤的生物力学模型;以及 评估预防措施。作为副产品，这项研究将 把有儿科，外科， 流行病学、统计学和生物力学。 该项目的具体目标是： 1.将生物力学和流行病学原理结合到 制定ICE调查; 2.进行试点测试，完善和管理调查，并评估其在 儿科急症护理环境：以及 3.从调查回复中创建ICE分数， 对孩子的身体伤害。 研究设计是一项关于分数发展的前瞻性研究。步骤 评分发展包括： 1.根据流行病学和生物力学数据， 伤害发生率： 2.对院前护理提供者进行调查， 目击者、亲属和行人和自行车后受伤的孩子- 相关伤害事件; 3.使用专业重建方法审查调查业绩 作为“黄金标准”的伤害事件： 4.修改勘测设计，以适应 可靠性;以及 5.调查答复与实际损害测量的相关性 以伤害严重程度评分和简化的 损伤量表（AIS-90）和ICE评分的创建。 在未来的研究中， 一项多中心试验将验证ICE评分在预测儿童 身体伤害。

The broad, long-term objective of this proposal is the creation of a pediatric injury circumstance scoring system for use in pediatric trauma triage, care and research. Central to achieving this objective is the development of a new research approach, Biomechanical Epidemiology; the concurrent application of the principles of biomechanics and engineering to an injury control research problem. Current measures of injury severity used for injury prediction in the acute care setting utilize physiological and clinical parameters that vary over time and have limited ability to predict occult injuries. It is hypothesized that pediatric injury prediction can be improved by incorporating variables describing the injury circumstances (e.g., speed and direction of impact) into the physiological measures. In this research project a pediatric Injury Circumstance Evaluation tool, the ICE Survey for pedestrians and bicyclists, will be developed, administered and correlated with clinical outcome to create the ICE Score. Potential applications for the ICE Score include: triaging and formulating care plans in the pre-hospital and acute care settings; adjusting case mix for purposes of research or performance evaluation testing; validating biomechanical models of injury; and evaluating preventive initiatives. As a byproduct, this research will bring together injury researchers with backgrounds in pediatrics, surgery, epidemiology, statistics and biomechanics. The specific aims of the project are: 1. to incorporate biomechanical and epidemiological principles into the formulation of the ICE Survey; 2. to pilot test refine, and administer the survey and evaluate its use in a pediatric acute care setting: and 3. to create the ICE Score from survey responses that predict actual physical damage to the child. The research design is a prospective study for score development. Steps in score development include: 1. survey construction based on epidemiological and biomechanical data on injury occurrence: 2. administration of the survey to pre-hospital care providers, witnesses, relatives, and the injured child after pedestrian and bicycle- related injury events; 3. review of survey performance using professional reconstruction of injury events as the "gold standard": 4. modification of survey design to accommodate observed limitations in reliability; and 5. correlation of survey responses with actual measures of physical damage to the child in the form of the Injury Severity Score and the Abbreviated Injury Scale (AIS-90) and creation of the ICE Score. In a future study, a multi-centered trial will validate the ICE Score in predicting pediatric physical injury.