Development, implementation, and validation of the Canadian intercollegiate sport injury registry

Purpose: To outline the development and implementation of the Canadian Inte rcollegiate Sport Injury Registry (CISIR), to examine its validity, includi ng the data collection forms, the recording of athlete exposure, and the me chanism of injury, and to determine the ability of the CISIR to meet its st ated objectives of assessing rates and risks of injury. Design: Prospective cohort study. Setting: Canadian intercollegiate athletics. Subjects: 344 varsity football players from five western Canadian universit ies. Assessment of Risk Factors and Outcome Measures: Three data collection inst ruments were developed to capture the principle types of information formin g the cornerstones of the CISIR: a medical form for preseason assessment of risk factors, a weekly exposure sheet (WES) for the documentation of daily individual athlete participation, and an individual injury report form (II RF) for collection of injury-related information. Design and implementation input was provided by therapists and physicians through initial meetings, pilot testing, site visits, questionnaire, and final consensus meeting. The completeness of injury reporting was assessed through crossreferencing wit h participation time loss data. An item analysis was conducted on the princ ipal elements of the ILRF. The categorization of participation itself was a lso examined, as was the diagnostic agreement between the therapists and ph ysicians involved in data collection. The recorded mechanism of injury was compared with that noted through a video analysis for game-related injuries . Lastly, a test analysis was conducted to extract data and compute rates a nd risks of injury. Results: This developmental phase was successful, with 99.7% subject enroll ment, high therapist satisfaction, and good flow of data. A relational data base, incorporating dual-entry data verification, was designed and function ed well. The collection process revealed that 100% of the WESs were submitt ed, and the data therein was 99.7% complete. The injuries resulting in part icipation time loss were recorded on an IIRF 97.9% of the time. The exposur e (participation) codes were thought to be overly precise, and a simplifica tion of these categories is suggested. The diagnostic agreement between phy sicians and therapists was 70%. It was possible to validate game exposures, but no standard was identified to permit validation of the categories of e xposure. Likewise, the mechanism of injury as recorded by the therapists wa s thought to be more precise than the video analysis. After two modificatio ns in the table structure of the relational database, it was possible to ex tract data relating to rates and risks of injury. Conclusions: This study demonstrated a high degree of validity for many ele ments of the CISIR. One limitation was that no reference standard existed f or some components, limiting some aspects of validity assessment. With the suggested revisions, the CISIR represents the current standard in athletic injury reporting in terms of individual injury risk assessment. This system will be used in the future to explore the prediction and prevention of spo rt injuries.