title: Surveillance of paediatric traumatic brain injuries using the NEISS: choosing an appropriate case definition.
abstract: OBJECTIVE
  To evaluate the definition of traumatic brain injury (TBI) in the National Electronic Injury Surveillance System (NEISS) and compare TBI case ascertainment using NEISS vs. ICD-9-CM diagnosis coding.
  
  
  METHODS
  Two data samples from a NEISS participating emergency department (ED) in 2008 were compared: (1) NEISS records meeting the recommended NEISS TBI definition and (2) Hospital ED records meeting the ICD-9-CM CDC recommended TBI definition. The sensitivity and positive predictive value were calculated for the NEISS definition using the ICD-9-CM definition as the gold standard. Further analyses were performed to describe cases characterized as TBIs in both datasets and to determine why some cases were not classified as TBIs in both datasets.
  
  
  RESULTS
  There were 1834 TBI cases captured by the NEISS and 1836 TBI cases captured by the ICD-9-CM coded ED record, but only 1542 were eligible for inclusion in NEISS. There were 1403 cases classified as TBIs by both the NEISS and ICD-9-CM diagnosis codes. The NEISS TBI definition had a sensitivity of 91.0% (95% CI = 89.6-92.4%) and positive predictive value of 76.5% (95% CI = 74.6-78.4%).
  
  
  CONCLUSIONS
  Using the NEISS TBI definition presented in this paper would standardize and improve the accuracy of TBI research using the NEISS.
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital , Columbus, OH , USA .
authors.forename: Meghan C
authors.initials: MC
authors.lastname: Thompson
authors.forename: Krista K
authors.initials: KK
authors.lastname: Wheeler
authors.forename: Junxin
authors.initials: J
authors.lastname: Shi
authors.forename: Gary A
authors.initials: GA
authors.lastname: Smith
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Groner
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Haley
authors.forename: Huiyun
authors.initials: H
authors.lastname: Xiang
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000145:classification* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D038801:International Classification of Diseases; D016015:Logistic Models; D008297:Male; D011159:Population Surveillance; D012042:Registries; D012680:Sensitivity and Specificity; D014481:United States