title: All Wales Injury Surveillance System revised: development of a population-based system to evaluate single-level and multilevel interventions.
abstract: BACKGROUND
  Injury surveillance has been established since the 1990s, but is still largely based upon single-source data from sentinel sites. The growth of electronic health records and developments in privacy protecting linkage technologies provide an opportunity for more sophisticated surveillance systems.
  
  
  OBJECTIVE
  To describe the evolution of an injury surveillance system to support the evaluation of interventions, both simple and complex in terms of organisation.
  
  
  METHODS
  The paper describes the evolution of the system from one that relied upon data only from emergency departments to one that include multisource data and are now embedded in a total population privacy protecting data linkage system. Injury incidence estimates are compared by source and data linkage used to aid understanding of data quality issues. Examples of applications, challenges and solutions are described.
  
  
  RESULTS
  The age profile and estimated incidence of injuries recorded in general practice, emergency departments and hospital admissions differ considerably. Data linkage has enabled the evaluation of complex interventions and measurement of longer-term impact of a wide range of exposures.
  
  
  CONCLUSIONS
  Embedding injury surveillance within privacy protecting data linkage environment can transform the utility of a traditional single-source surveillance system to a multisource system. It also facilitates greater involvement in the evaluation of simple and complex healthcare and non-healthcare interventions and contributes to the growing evidence basis underlying the science of injury prevention and control.
authors.affiliation: Farr Institute, Swansea University Medical School, Swansea, UK Public Health Wales NHS Trust, Cardiff, UK.
authors.forename: Ronan A
authors.initials: RA
authors.lastname: Lyons
authors.affiliation: Farr Institute, Swansea University Medical School, Swansea, UK.
authors.forename: Samantha
authors.initials: S
authors.lastname: Turner
authors.affiliation: Farr Institute, Swansea University Medical School, Swansea, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Lyons
authors.affiliation: Farr Institute, Swansea University Medical School, Swansea, UK.
authors.forename: Angharad
authors.initials: A
authors.lastname: Walters
authors.affiliation: Farr Institute, Swansea University Medical School, Swansea, UK.
authors.forename: Helen A
authors.initials: HA
authors.lastname: Snooks
authors.affiliation: Public Health Wales NHS Trust, Cardiff, UK.
authors.forename: Judith
authors.initials: J
authors.lastname: Greenacre
authors.affiliation: Public Health Wales NHS Trust, Cardiff, UK.
authors.forename: Ciaran
authors.initials: C
authors.lastname: Humphreys
authors.affiliation: Public Health Wales NHS Trust, Cardiff, UK.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Jones
mesh_terms: D016494:Computer Security; D003625:Data Collection / Q000379:methods* / Q000592:standards; D057286:Electronic Health Records / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008498:Medical Record Linkage / Q000379:methods; D011159:Population Surveillance / Q000379:methods*; D014947:Wounds and Injuries / Q000517:prevention & control*
keywords: Interventions