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F֪x譢'b`2^k>8'׶+1>4ڸ<=(6[ACT{|l\4QBsDK{%O?\~яˎ r,96FAOd?1އi2ͯT_u۠_[G΄ _B [xoޅwg ]%`jy~0~?/ˍkܯr܆Ck!oӼ?MyI`'o]"-D?{̾ҕtBisNkEۚK V}sUutгg|_\R>O]*,}zn>|{g c?S_nK2#Wi V[o=   %Other findings from our discussions: &%(%  DDefinition of an indicator needed Precise definition of an injury needs to be included We need some statement about standardisation / comparability / harmonisation. Criteria should be split into >1 dimension, eg. quality usefulness practicality of measurement Hierarchy of criteria needed how much fuzziness can we tolerate^/#.#4  p  >A walk in the cherry blossoms & %Post-meeting thoughts there is much work to be done much could be done in parallel I can take some work further Others are better placed to take other work forward eg. development of indicators for priority setting Mechanism needed: Encourage greater participation - all work to our strengths v3<3< Proposal put to ICEIInGThe work of the group be addressed in discrete projects clear achievable objectives outputs papers (peer review journals / conferences) ICEIInG report collection of papers, with introduction and linking statementsb8$,?8$, ? Method of workingVThose with interest / expertise - encouraged to take the initiative. This PI email a proposal to ICEIInG Comments from ICEIInG members if major concerns, not embraced by ICE Collaborators take the work forward keep ICEIInG informed periodically Publication author list +  & on behalf of the ICEIInG t'$# *'$# *  A proposal of workUse the validation criteria to assess national indicators used in setting road safety targets Canada New Zealand United Kingdom Indicators and how criteria used handout L^"! ^"!  %Trends in 4 NZ road safety indicators&%$ Discussion of the criteria (1) Case definition - high variability UK1/2 (2) Serious outcomes - variability (3) Ascertainment - OK, but variable UK1 (4) Inclusive - OK (5) Source data - N/a (6) Fully specified - N/a -Proposed additional criteria - for discussion(H) The indicator should measure accurately the entity that it aims to reflect. [cf (B)] (I) The indicator should be derived from data that is complete and is accurately coded [cf (D)]. (J) There should have been no substantial changes / differences in coding frames or in coding practice between place or over time (ie. comparability etc.) (K) A sound indicator should reflect the occurrence of injuries across personal characteristics, place and time [cf (D), (E)]. >Q^ # For discussion& ?  Proposed new criteria, or further comments on the old ones. Comments / questions on the assessment of road safety indicators The need for other country demonstrations? Describe related work that you have done.  /   ! " $ ` ̙33` ` ff3333f` 333MMM` f` f` 3>?" dd@,|?" dd@   " @ ` n?" dd@   @@``PR    @ ` ` p>> $(    6>' P ' T Click to edit Master title style! !  0@'  ' RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S  0E' `` ' X*  04K' `  ' Z*  0N' `  ' Z*H  0޽h ? ̙33 $Blank Presentation 0 @P(  P P 00l5 P   5 T*   P 0`5    5 V*  d P c $ ?  5 P 085  @ 5 RClick to edit Master text styles Second level Third level Fourth level Fifth level!    S  P 6F5 `P  5 T*   P 6\L5 `  5 V*  H P 0޽h ? ̙33@ p$( @ $ $ 0* P   5 X*  $ 0(*    5 Z*  $ 6/ `P  5 X*  $ 65 `  5 Z* H $ 0޽h ? ̙33  $(  r  S 4o'p ' r  S 4\' `   ' H  0޽h ? ̙33  P( s@ l  C L'P  ' l  C k' ' H  0޽h ? ̙33   (   l  C ޚP   l  C lߚ  H  0޽h ? ̙33  $(  r  S fP   r  S Lg  H  0޽h ? ̙33  $(  r  S (P   r  S |  H  0޽h ? ̙33   $(   r  S P   r  S   H  0޽h ? ̙33  ,$(  ,r , S 1 dimension& Particularly if the number of criteria grows, these need to be grouped under sensible headings to aid use. Hierarchy of criteria are needed - since it was felt by some that greater weight should be attributed to some criteria over other criteria. H l 0޽h ? ̙33 0 0p( P  pR p 3 P    p C պP @   &|During the Washington meeting, we were encouraged to go into central Washington to see the spectacular cherry blossoms. I am glad I di, since not only did I thoroughly enjoy the sights, my walk amongst the cherry blossom allowed me to collect my thoughts from the 2 days. The meeting highlighted how much work there is to do, and I guess this was gnawing at me during this period on my own. The thoughts that came to me to deal with this were that much of the work can be done in parallel I can take some work forward others are better placed to take other work forward & ..\)Q)Q*   H p 0޽h ? ̙33 0 |Pt(  tR t 3 P    t C ]P @   " H t 0޽h ? ̙33(  0 pxx( @@L@ xR x 3 P    x C P @   @This proposal is captured on the email on page 3 of the handout.AAA H x 0޽h ? ̙33H  0 |(  |R | 3 P    | C b'P @   `First bullet point then& The particular indicators that were considered in this work are shown at the bottom of page 4 of the handout. The 6 validation criteria that were used to assess the indicators are shown in the middle of page 4. The validation criteria were scored on a 0-10 scale by 3 of the team - Susan Mackenzie, John Langley and Steve Jarvis (University of Newcastle, England). On this scale: 0 = validation criterion not satisfied 10= validation criterion completely satisfied 1-9 = validation criterion incompletely satisfied - the magnitude of the score indicating the degree to which the criterion is satisfied. The results of this part of the work is shown here also. H | 0޽h ? ̙33h   0 (   (  R  3 P   '&   C ,}'P @  ' Failure to satisfy the validation criteria matters  trends in injury rates depends on the indicator used. As an illustration, this slide shows trends in 4 New Zealand road safety indicators. The dark blue line is the trend for indicator NZ3: reported injuries resulting from motor vehicle traffic crashes (MVTCs) per 100,000 people. The red line is the trend for NZ4: the number of hospitalised people for injuries resulting from MVTCs. Neither of these indicators scored well on the validation criteria. The green and the crimson lines show the age-adjusted hospitalisation rates resulting from MVTCs for injuries with maximum AIS severity of 3 or more, and of 4 or more respectively. These latter 2 indicators pretty much satisfy all of our criteria. It can be seen that the trend lines are different. This matters. If the target was the reduction of non-fatal injury by 10% between 1988 and 1995, the less valid current indicators would suggest that the target had been met, whereas the more valid AIS-based indicators would suggest otherwise. Your conclusions depend on the choice of indicator  and our choice should be valid indicators. Lk`b3  w      H  0޽h ? ̙33R  0  (  R  3 P   '  C 'P @  ' ^Another view of this work is to ask how well the criteria have performed. 1. There is a great deal of variation in the ratings for the UK indicators. One rater give high marks on the basis of the existence of a case definition, another rated as 0 on the basis that part of the definition was based on utilisation of service or reports to the police, and the final rater gave mid-range marks to reflect equal weightings to the part of the definition based on diagnosis and the part based on utilisation / reports. 2. There was quite a lot of inconsistency of assessment across all indicators 3. For the third criterion dealing with Ascertainment, the ratings were reasonably consistent with the exception of UK1 - the reason for this is unclear. 4. The fourth criterion dealing with inclusiveness of the target population, again assessments were reasonably consistent across all indicators 5. Consideration of the consistency of assessment did not seem appropriate for criteria (5) and (6). (5) deals with the existence of data to derive the indicator - and this is always the case for existing indicators. (6) is not applicable since for non of the indicators was a specification available so this should have attracted a low score. As a result of the inconsistencies found, it was proposed that documentation be developed and tested with an aim of increasing consistency. _^  _ H  0޽h ? ̙33   0   J (  R  3 P   '  C L'P @  ' X.Finally, the following additional validation criteria were proposed to deal with some of the apparent deficiencies in the criteria that were applied to the road safety indicators& . (H)& This arose from consideration of NZ1-NZ3, each of which are based on the same numerators, but have different denominators. They appear to aim to measure different population parameters or entities. Generally, a goal is to define indicators that measure explicit population parameters or entities. (I) & (J) come from a recognition that quality and stability of data sources affects the accuracy of indicators. (K) & . There was a concern when assessing the road safety indicators that non-coding related changes could, for example change over time that effects the performance of the indicator. For example patterns of reporting to the police could changeover time or differ from place to place that would compromise the indicator. This proposed new criteria is related to criteria (D) and (E) and so some rationalisation of these criteria should be necessary.  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