APPLYING BIOMECHANICAL EPIDEMIOLOGY TO INJURY PREDICTION

这项提议的广泛、长期目标是创建一个 儿科创伤情况评分系统在儿科创伤中的应用 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； 生物力学原理与工程原理的并行应用 一个伤害控制研究问题。目前衡量伤害严重程度的方法 用于急性护理环境中的损伤预测，利用生理学 和临床参数随时间变化，并具有有限的能力 预测隐匿性损伤。据推测，儿科损伤 预测可以通过结合描述 受伤情况(例如，撞击的速度和方向) 生理指标。在这个研究项目中，一名儿童受伤 环境评估工具，ICE行人调查和 自行车运动员，将被开发、管理并与临床相关 结果以创建ICE分数。ICE评分的潜在应用 包括：在院前和急诊进行分流和制定护理计划 护理环境；出于研究或表现的目的调整病例组合 评估测试；确认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 汇集具有儿科、外科、医疗等专业背景的损伤研究人员 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纳入 制定《冰川调查》； 2.试行、测试、改进和管理调查，并评估其在 儿科急症护理环境：和 3.从预测实际情况的调查答复中创建ICE分数 对孩子的身体伤害。 本研究设计为一项前瞻性研究，旨在促进成绩的发展。步入 成绩发展包括： 1.基于流行病学和生物力学数据的调查构建 受伤事件： 2.管理对院前护理提供者的调查， 目击者、亲属和受伤的孩子在行人和自行车后- 相关伤害事件； 3.利用专业重建对调查业绩进行审查 将伤害事件作为“黄金标准”： 4.修改调查设计，以适应观察到的 可靠性；以及 5.调查答复与实物损害实际衡量标准之间的相关性 以伤害严重程度评分和缩写的形式发给儿童 伤害量表(AIS-90)和ICE评分的建立。在未来的一项研究中，一个 多中心试验将验证ICE评分在预测儿科疾病中的作用 身体受伤。

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.