Injury surveillance and OSICS

[Whoskins]

Hi, I am conducting an injury surveillance. I want to use the OSICS system and the protocols as per Orchard & Seward 2002. Using the OSICS system the diagnoses for a hamstring injury (for example) include: biceps femoris strain, distal medial hamstring strain, hamstring strain/tear, proximal (medial) hamstring strain, etc etc

The AFL injury surveillance only reports on "hamstring injuries" as a group and doesn't specify the diagnosis. Do the club recorders document a specific injury using the OSICS system or do they just record "hamstring injury"? If the specific injury is recorded how do you take into account wrong diagnosis, or does it really matter if they all get grouped as the one injury for statistical purposes?

Would it be much easier to document an injury just using the categories presented in Table 3 of Orchard & Seward 2002 (ie: those presented for statistical analysis)?

Our difficulty at this stage is a club doctor believes the workload on them to document an injury for the surveillance is too great. If we didn't have to give a specific diagnosis, a club official (non medical) could communicate with the club doctor (as he has to give a general diagnosis for the injury anyway) and record the injury. Just using the categories in Table 3 would be much easier on the club. Would that be a flaw in our methodology?

Any advice you can provide on assisting a club with the injury surveillance would be beneficial, bearing in mind we may not have a club doctor or physiotherapist etc willing to participate.

Thanks

PS: Can you please provide me with a spread sheet that is used by the AFL clubs for recording of injuries on a week-to-week basis? The sample on the website isn't opening.

[hhh]

My experience with the OSICS system is that you are required to write a 3 digit code for each injury. I do not profess to be the man when it comes to conducting an injury surveillance so sorry I cannot assist with the rest of your questionning. One criticism of the OSICS system is that with the 1000 or so possible diagnoses it is not even possible with the most advanced imaging procedures to give an accurate diagnosis for some conditions. Perhaps a reliabilty study could be performed? My guess if help isn't forthcoming is just use the primary categories that are required for statistical analysis - but I stress it is only a guess. You don't want to risk having a massive error with your study.

With regards to club doctor or physiotherapist participation, obviously you cannot do it yourself. if you require the highest quality study, you need to ensure the procedure is blinded. There is one word which will help: honararium. I have never known a GP to knock back a few dinners, a set of golf clubs, a holiday or two or even a 'brown paper bag'. Throw in a few notepads, posters, pens and other material and I'd be very surprised if help wasn't forthcoming.

Keep me informed how you get on with the study and if you require an additional co-author

[injuryupdate]

In terms of reliability, Dr Katherine Rae has just completed a study comparing OSICS to ICD-10 for common sports injury diagnoses. Not a lot of competition in ICD-10, as sports injuries are pretty much ignored in this system, but at least it is a start.

OSICS works well for elite sports where there is almost always an accurate diagnosis made by professional medical staff for each significant injury.

It has limitations, not the least of which is that it is a 'freebie' that won't get updated unless someone has the time to do it.

Maybe this website could have an OSICS Forum for suggestions on improvements to the code.

Dr Rae's study is being submitted to journals in early 2005, which means it may get published in early 2006, with any luck!

[Whoskins]

I am not concerned with the reliability and think OSICS is one of the best mechanisms for injury surveillance available. Can you help me with a couple of things:

* Do club recorders enter the specific diagnosis or the general diagnosis (ie that which appears for statistical analysis)?

* Would the methodology be flawed if a club official recorded data on behalf of the cub doctor?

* Can you put a link to the spread sheets used by the AFL clubs to record player status each week? This would save a lot of hassle.

* Is there another method outside of an 'honararium' (as suggested by hhh) to get assistance from club doctors. I beleive there was some trouble getting 100% club compliance at the AFL level for some time. If not, how much is best placed in the paper bag?

Thanks in advance for your help.