Defining an Ideal System to Establish the Incidence of Inflicted Traumatic Brain Injury: Summary of the Consensus Conference

A conference addressing how to establish the incidence of inflicted traumatic brain injury in young children provided the opportunity to examine issues of definitions, passive versus active surveillance, study designs, proxy measures, and statistical issues. Data were presented that had been collected in alternative ways. The participants concluded that an ideal system for measurement of the incidence does not yet exist. A new surveillance system will take a significant amount of time and money to establish. Such a system will require a combination of ascertainment approaches, attention to case finding, a large population, careful attention to coding and data quality. The ethical issues involved in measuring stigmatized and illegal behavior are not inconsequential. In an ideal system data from different sources—medical, legal, and social service, among others—will need to be linked. Perhaps most importantly, any surveillance approach will need to be maintained so that trend data can be used to assess the effectiveness of prevention efforts.