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Bebbington E, Kakola M, Nagaraj S, Guruswamy S, McPhillips R, Majgi SM, Rajendra R, Krishna M, Poole R, Robinson C. Development of an electronic burns register: Digitisation of routinely collected hospital data for global burns surveillance. Burns 2024; 50:395-404. [PMID: 38172021 DOI: 10.1016/j.burns.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/05/2023] [Accepted: 08/10/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Burn registers provide important data that can track injury trends and evaluate services. Burn registers are concentrated in high-income countries, but most burn injuries occur in low- and middle-income countries where surveillance data are limited. Injury surveillance guidance recommends utilisation of existing routinely collected data where data quality is adequate, but there is a lack of guidance on how to achieve this. Our aim was to develop a rigorous and reproducible method to establish an electronic burn register from existing routinely collected data that can be implemented in low resource settings. METHODS Data quality of handwritten routinely collected records (register books) from a tertiary government hospital burn unit in Mysore, India was assessed prior to digitisation. Process mapping was conducted for burn patient presentations. Register and casualty records were compared to assess the case ascertainment rate. Register books from February 2016 to February 2022 were scanned and anonymised. Scans were quality checked and stored securely. An online data entry form was developed. All data underwent double verification. RESULTS Process mapping suggested data were reliable, and case ascertainment was 95%. 1930 presentations were recorded in the registers, representing 0.84% of hospital all-cause admissions. 388 pages were scanned with 4.4% requiring rescanning due to quality problems. Two-step verification estimated there to be errors remaining in 0.06% of fields following data entry. CONCLUSION We have described, using the example of a newly established electronic register in India, methods to assess the suitability and reliability of existing routinely collected data for surveillance purposes, to digitise handwritten data, and to quantify error during the digitisation process. The methods are likely to be of particular interest to burn units in countries with no active national burns register. We strongly recommend mobilisation of resources for digitisation of existing high quality routinely collected data as an important step towards developing burn surveillance systems in low resource settings.
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Affiliation(s)
- Emily Bebbington
- Centre for Mental Health and Society, School of Medical and Health Sciences, Bangor University, Wrexham, LL13 7YP, UK.
| | - Mohan Kakola
- Department of Plastic Surgery and Burns, Mysore Medical College and Research Institute, KR hospital, Irwin Road, Mysuru, Karnataka 570001, India
| | - Santhosh Nagaraj
- South Asia Self-harm Initiative, JSS Hospital, Mahatma Gandhi Road, Mysuru, Karnataka 570004, India
| | - Sathish Guruswamy
- South Asia Self-harm Initiative, JSS Hospital, Mahatma Gandhi Road, Mysuru, Karnataka 570004, India
| | - Rebecca McPhillips
- Social Care and Society, School of Health Sciences, Faculty of Biology, Medicine and Health, Ellen Wilkinson Building, Oxford Road, Manchester M13 9PL, UK
| | - Sumanth Mallikarjuna Majgi
- Department of Community Medicine, Mysore Medical College and Research Institute, Mysuru, Karnataka 570001, India
| | - Rajagopal Rajendra
- Department of Psychiatry, Mysore Medical College and Research Institute, Mysuru, Karnataka 570001, India
| | - Murali Krishna
- Centre for Mental Health and Society, School of Medical and Health Sciences, Bangor University, Wrexham, LL13 7YP, UK
| | - Rob Poole
- Centre for Mental Health and Society, School of Medical and Health Sciences, Bangor University, Wrexham, LL13 7YP, UK
| | - Catherine Robinson
- Social Care and Society, School of Health Sciences, Faculty of Biology, Medicine and Health, Ellen Wilkinson Building, Oxford Road, Manchester M13 9PL, UK
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