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Injury Severity Score coding: Data analyst v. emerging m-health technology
R T Spence1, E Zargaran, M Hameed
1Codman Center, Massachusetts General Hospital, Boston, USA; Department of General Surgery, Faculty of Health Sciences, University of Cape Town, South Africa. spnric004@myuct.ac.za.
Summary
Mobile health technology offers a cost-effective solution for injury severity scoring in trauma care, comparable to traditional methods. This innovation improves accessibility in high-incidence trauma regions worldwide.
Area of Science:
- Trauma care and injury severity assessment.
- Mobile health (m-health) applications in medicine.
- Global health disparities in trauma management.
Background:
- The high cost of Abbreviated Injury Scale (AIS) coding limits its use in resource-limited, high-trauma incidence areas.
- Mobile health technology presents a potential cost-effective alternative to traditional AIS coding.
- This study investigated m-health utility in a South African trauma center.
Purpose of the Study:
- To evaluate the feasibility and accuracy of a mobile health application for injury severity scoring.
- To compare m-health-derived Injury Severity Scores (ISS) with traditional AIS coding methods.
- To determine if m-health technology can provide a cost-effective alternative for trauma centers globally.
Main Methods:
- A prospective study of 57 surgically managed trauma patients over one month.
- Clinician-entered data via an m-health app (ISS eTHR) and standard AIS coding (ISS VGH) were used.
- Statistical analysis included Bland-Altman plots, kappa statistics, intraclass correlation coefficients (ICC), and logistic regression models.
Main Results:
- Mean ISS difference was 0.4 (95% CI -0.8 - 1.6), with comparable model performance for predicting complications.
- Intraclass correlation coefficients (ICC) for individual and categorical ISS were 0.88 and 0.81, respectively.
- Kappa statistic for ordinal categories was 0.53, indicating moderate agreement.
Conclusions:
- Injury Severity Scores (ISS) derived from m-health technology (eTHR) are comparable to gold-standard coding (VGH).
- Emerging m-health technology offers a viable, cost-effective alternative for injury severity scoring in trauma care.
- This approach can enhance trauma data collection and management in resource-constrained settings.
