of the CPSC. Other kinds of injury were also included, classified as due to automobiles (13 percent); work related (13 percent); intentional injuries, including firearms (6 percent); food and drugs (1 percent); and other (18 percent) (CPSC, personal communication, 1998).

National estimates of the number of injury-related emergency department visits, based on the pilot study, are comparable to those reported from other databases such as the NHAMCS. However, there has been some evidence to suggest that the sensitivity of case identification was somewhat lower for intentional injuries as opposed to unintentional injuries. This discrepancy needs to be addressed.

Based on the promising results of this pilot and discussions with staff at both the NCIPC and the CPSC, the committee recommends an expansion of NEISS data collection to include all injuries treated in emergency departments to increase knowledge of the causes and severity of nonfatal injuries. Furthermore, an expanded NEISS could greatly benefit the injury field because it would provide a new and important tool for gathering national estimates and monitoring national trends in injury morbidity, for identifying emerging problems, for evaluating interventions through follow-up studies, and for providing data for policy decisions. If NEISS is expanded to collect all injury data, the committee believes that the system should remain at CPSC since the system is vital to its mission. Additionally, this expansion will be more cost-effective if it remains at CPSC because the agency has already developed the hospital sampling frame, contracted with hospitals, established relationships with hospital personnel, trained hospital coders, and developed procedures for collecting data and for quality assurance. Thus, the work and cost of expanding the current system to all causes of injury would be minimized if CPSC continues to develop the NEISS.

The committee recommends that CPSC expand its NEISS system to gather nationally representative data on all injuries treated in emergency departments to increase knowledge of the causes and severity of nonfatal injuries.

To ensure the success of an expanded NEISS, the CPSC should convene a steering committee (with representation from CPSC, NCIPC, the Department of Justice, and other relevant federal and state agencies) to set policies and procedures for the expanded NEISS and its uses. Additionally, a comprehensive evaluation of the system's cost-effectiveness should be performed, by an independent body, to determine the utility and future of the effort. The committee stresses the need to ensure that the sampling frame is adequate for intentional injuries. Additionally, training sessions for hospital personnel and onsite NEISS coders will be important, not only in improving the information gathered related to the history of the injury, but also in identifying injuries related to violence since case identification appears to be lower for this type of injury. Finally, an

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