The importance of operational definitions in design of a combat casualty information system

Attention to the quality of information in design of a medical information system is fundamental to the success of that system. This point is made using WWI and WWII combat casualty statistics. While the analyses presented are legitimate, serious problems of interpretation arise from the operational definitions used in gathering and analyzing these data. The impact of this is illustrated in a hypothetical battle, a model emphasizing the introduction of biases resulting from an apparent inattention to operational definitions on the part of combat care managers in WWII. The paper concludes with some broad recommendations.