Evaluation ofasystematic approach for identifying injuryscenarios

Objective-To assess theeffectiveness ofa newmultidisciplinar y methodforreconstructing thecausal sequences thatleadto childpedestrian injuries. Setting-Subjects were5-12yearold residents ofChicago, Illinois, USA,presenting forcareduetopedestrian injury at onepediatric traumacenter. Methods-Theinteractions ofmedical, child, psychosocial, andtraffic factors contributing totheinjury wereanalysed. For142cases, information aboutthevictim,his/her family, theinjury site, and theactivities justbefore theinjury, was usedinastructured mannerbyamultidisciplinary team to produceinjury scenarios. Eachscenario comprised alist ofcontributing factors, anestimate ofthe importance ofeach, andanarrative description ofthecausal sequence leading to the injuryevent.Face validity was assessed bytwooutside teamsthatperformedastructured reviewofasubsampleof cases(n= 11).Reliability was evaluated bycomparison oftheresults of parallel teamsassessing thesamecases (n= 14).Processconsistency and bias wereassessed byanalysis ofthecorrelationsoffactor-importance rating patternsbetweenmembersandovertime.