American Journal of Epidemiology Vol. 154, No. 3 : 285-286
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
BOOK REVIEWS |
Injury Control: A Guide to Research and Program Evaluation
1 Department of Public Health Sciences University of Toronto Toronto, Ontario, Canada M5S 1A8
Despite the contribution that injury makes to mortality and morbidity in many countries, especially for persons of younger ages, it is often regarded as a "poor cousin" in health research, attracting few research resources and little attention from epidemiologists and health research workers. However, the skills learned in studying the epidemiology of infectious or chronic diseases stand in good stead when the causes, management, and prevention of injury are examined. Nevertheless, the problems faced in addressing injury control have some special features not experienced in cancer or tuberculosis research. Material that addresses these features, especially when placed in the context of classical epidemiologic research, is welcome.
This is the third recently published book I have seen on the use of epidemiology in the research and practice of prevention and management of injury (1
, 2). The others were written by one or two people; this one is an anthology and exhibits both the strengths and weaknesses of an anthology. The editors have assembled authors with an impressive range of expertise, at the expense of some unevenness in both style and depth of coverage. In 20 chapters, with 30 contributing authors, the editors have brought together a very useful and thoughtful compendium of material, however. They have highlighted a number of issues that differentiate the methods available to epidemiologists and others in injury research from those concerned with other diseases: the range of denominators for rates of disease, the range of data sources, and some issues of case definition when studying injury by type (e.g., head injury), by external cause (e.g., falls, traffic crashes), or by person affected (e.g., cyclists, pedestrians).
The intended audience is also broad, from epidemiologists and researchers in health care delivery to surgeons, intensive care specialists, and emergency medicine physicians. Consequently, the authors make few assumptions about the background knowledge of their readers but are careful to include the basic facts, whether about the variable definitions of "rates" or the clinical quandary of whether to order radiographs of an injured ankle. They include numerous summary tables, which, for the most part, make good use of limited space. Each chapter has an extensive bibliography for readers needing information in greater depth.
The first six chapters of the book address fundamental data issues: how injury may be defined, how the severity of injury is measured, and how injury data are, or can be, collected. These chapters contain essential elements that anyone who works with injury data must know, and the material has been carefully organized and presented. The next eight chapters describe a variety of study designs that have been used to study injury. Included are qualitative studies and systematic reviews as well as the usual range of epidemiologic designs. I was particularly impressed by the presentation of case-control and ecologic studies; there is a sensible discussion of problems associated with conducting them, but their strengths (and, in injury research, they are often considerable) are also emphasized. The final chapters cover a mixture of broad questions (e.g., program evaluation, economic effects, ethics) and more specific clinical questions (e.g., developing clinical decision rules, measuring disability after injury). Perhaps because of the diverse nature of these issues, these chapters seemed weaker in comparison to the remainder of the book
Should most readers read the book from start to finish, or is it designed for a more selective approach? As a reviewer, I was expected to read the book through, and I appreciated the orderly and logical presentation of the subject matter and the frequent cross-references to other papers in the book. Selective readers, in my experience, read the topics with which they are already most familiar; such readers may be disappointed by the depth of coverage of their favorite subject. The strength of this book is in its breadth of coverage of issues that concern research in injury control. Although not mentioned as a potential audience, students and others new to the subject would find this a very useful text in a course on injury epidemiology and control.
NOTES
Edited by F. P. Rivara, P. Cummings, T. D. Koepsell, D. C. Grossman, and R. V. Maier ISBN 0-521-66152-8, Cambridge University Press, Cambridge, United Kingdom (http://www.cambridge.org), 2001, 304 pp., $95.00
REFERENCES
- Robertson LS. Injury epidemiology. 2nd ed. Research and control strategies. New York, NY: Oxford University Press, 1998.
- Christoffel T, Gallagher SS. Injury prevention and public health. Practical knowledge, skills and strategies. Gaithersburg, MD: Aspen Publishers Inc, 1999.
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