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Global inventory and audit of road injury data systems: a descriptive study using the Road Injury Chain of Survival
Tim Nutbeam1,2,3, Emily Foote4, Lauren R Rodgers5
1IMPACT: Centre for Post-Collision Research, Innovation and Translation, Devon Air Ambulance, Exeter, UK. timnutbeam@nhs.net.
Background:
Road injury causes an estimated 1.19 million deaths annually and tens of millions of non-fatal injuries worldwide. Despite this burden, post-collision data remain fragmented across police, transport, and health sectors, impeding system-level improvement. The recently proposed Road Injury Chain of Survival framework provides a structure for mapping data needs across five sequential links: Early Recognition, Early Rescue, Early Initial Care, Early Transport, and Early Hospital Care & Rehabilitation. This study aims to identify and describe national and major regional road injury datasets worldwide and to assess their coverage against a novel RICS-derived sub-indicator framework.
Methods:
A structured, descriptive global audit was undertaken to identify and characterise national and major regional road injury datasets. Searches included government and institutional portals, international repositories, and peer-reviewed literature. Eligible datasets provided national or nationally aggregated information on road traffic collisions, injuries, or trauma care. Each dataset was assessed against 20 sub-indicators (four per chain link) using a three-point coding system: 1 (present), 0.5 (partial/proxy), 0 (absent), or U (unverified).
Results:
A total of 349 national and major regional road injury data systems were identified worldwide, representing 357 datasets after disaggregation of linked systems. Police crash databases were the most common data source across all income groups and were near-universal in low-income countries. Mortality-focused datasets predominated in lower-income countries while higher-income countries demonstrated greater diversity, including emergency medical services, fire and rescue, and trauma registry data. Formal cross-sector data linkage was rare, and most datasets were available only in aggregated form. Mapping to the Road Injury Chain of Survival showed that data were most frequently available for Early Recognition, with substantially less coverage for the remaining links in the chain.
Conclusions:
This global audit of road injury datasets reveals extensive fragmentation across the post-collision care continuum. Few systems link crash, rescue, prehospital, and hospital data, severely limiting opportunities for quality improvement and outcome evaluation. Development of harmonised, interoperable datasets aligned with the Road Injury Chain of Survival is essential to enable benchmarking, guide investment, and improve outcomes from road injury worldwide.
Pre-Registered:
Open Science Framework: https://doi.org/10.17605/OSF.IO/VXE6S.
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