An index system for evaluating the data security in trauma centers: a modified Delphi study in China

In response to the characteristics of frequent data interactions between pre-hospital emergency care and multi-departmental in-hospital systems, along with complex transmission pathways, we established a dynamic assessment methodology covering the entire data lifecycle and analyzed the status of data security risks within China's trauma care system. This study aims to develop a security risk assessment index for trauma data security (TDSI).

Evaluation indicators were established through qualitative interviews, literature reviews, and Delphi expert consultations. The weight for indicators was determined using the analytic hierarchy process (AHP). National surveillance employing a multi-stage random cluster sampling method was conducted at 80 trauma centers in 31 provincial-level administrative units in China in 2023. The Delphi expert consultation recruited administrators, clinicians, and data specialists from trauma centers across various regions of China. Twenty experts from various regions of China were recruited for the Delphi study.

The response rate for the final survey was 95%. The TDSI system consisted of three dimensions and 36 indicators. The weight was 0.388 for trauma care data management from the clinical department, 0.342 for information security technologies from the IT department, and 0.270 for data security policies from the management department. The overall TDSI across all trauma centers was 60.27, varying from 25.7 to 82.1 across trauma centers. The northern region had the highest TDSI (66.32).

This study developed a TDSI using a modified Delphi method. This index system is a scoring framework that focuses on clinical, management, and IT capabilities that determine the prioritization of data security enhancements for trauma centers.