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Malinda Steenkamp, M.Phil; Nikolay Lipskiy, Dr.PH (presenter); Division of Violence Prevention PowerPoint PPT Presentation


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National Violent Death Reporting System (NVDRS): Data Management Challenges and Solutions December 12, 2005. Malinda Steenkamp, M.Phil; Nikolay Lipskiy, Dr.PH (presenter); Division of Violence Prevention National Center for Injury Prevention and Control

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Malinda Steenkamp, M.Phil; Nikolay Lipskiy, Dr.PH (presenter); Division of Violence Prevention

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Malinda steenkamp m phil nikolay lipskiy dr ph presenter division of violence prevention

National Violent DeathReporting System (NVDRS): Data Management Challenges and SolutionsDecember 12, 2005

Malinda Steenkamp, M.Phil;

Nikolay Lipskiy, Dr.PH (presenter);

Division of Violence Prevention

National Center for Injury Prevention and Control

Centers for Disease Control and Prevention


Malinda steenkamp m phil nikolay lipskiy dr ph presenter division of violence prevention

NVDRS Vision:

Reduce and prevent the occurrence of violent deaths in the US through the provision of accurate, timely and comprehensive surveillance data.

NVDRS Goals:

  • Collect and analyze timely, high-quality data for monitoring the magnitude and characteristics of violent deaths at the national, state, and local levels

  • Ensure that violent death data are routinely and expeditiously disseminated to public health officials, law enforcement officials, policy makers and the public

  • Provide data for developing, implementing and evaluating strategies, programs and policies designed to prevent violent deaths and injuries at the national, state and local levels

  • Build and strengthen partnerships with organizations and communities at the national, state, and local levels to ensure that data are collected and used to reduce and prevent violent deaths and injuries

  • Expand the National Violent Death Reporting System into all 50 states, the District of Columbia and US territories


Malinda steenkamp m phil nikolay lipskiy dr ph presenter division of violence prevention

NVDRS States as of July, 2005

FY 02 (6 states)

FY 03 (7 states)

FY 04 (4 states)


Nvdrs data sources

NVDRS Data Sources

  • Primary sources:

    • Death Certificates (DC)

    • Coroner/Medical Examiner (C/ME) Records

    • Police Records (PR)

    • Crime Lab Data (Lab)

  • Secondary, optional sources:

    • Child Fatality Review Team Data (CFR)

    • Supplementary Homicide Reports (SHR)

    • Hospital (HOSP) Data

    • Emergency Department (ED) Data

    • Alcohol Tobacco, Firearms and Explosives (ATF) Trace Information on Firearms


National violent death reporting system

National Violent Death Reporting System

NVDRS collects data on all violent deaths

  • Suicides (including terrorism-related deaths)

  • Homicides (including terrorism-related deaths)

  • Legal intervention

  • Some others:

    • Deaths of undetermined intent

    • Deaths due to unintentional firearm injury

  • Excluded: acts of war and legal executions

    Case initiation:

    Abstractors initiate cases through analysis of the source specific manners of deaths, w/o ICD-10 codes


Operational definition icd 10 codes that define nvdrs cases

Operational Definition: ICD-10 Codes that Define NVDRS Cases

Excluded: acts of war and legal executions


Nvdrs case i nitiation and icd 10 codes

NVDRS: Case Initiation and ICD-10 Codes


Malinda steenkamp m phil nikolay lipskiy dr ph presenter division of violence prevention

How Does NVDRS Work?

NVDRS (CDC)

Software contractor

Med. Exam/

Coroner

Case Info

(- identifiers)

Vital Records

(Death certificate)

Crime

Lab

Disseminate findings and data in various ways

State VDRS

(17 states)

Law enforcement

(Police reports)

(SHR + NIBRS)

Also back to providers

Other


What data are collected

What Data Are Collected?

  • Mechanism type

  • - Firearm

  • - Poisonings

  • - Hanging, strangulation, suffocation

  • Victims:

  • Demographics

  • Other personal data (residence, marital status, pregnant, occupation)

  • Injury event (location, county)

  • Death (location, manner, cause)

  • Related factors (toxicology)

  • Circumstances:

  • - Suicide/Undetermined deaths

  • - Homicide

  • - Unintentional firearms

  • Person used this weapon to kill

  • Weapon killed this person

  • First purchaser

  • History of abuse

  • Caretaker

  • V-P relationship (for all pairs)

  • Alleged perpetrators:

  • Demographics


Screen shot of nvdrs software

Screen Shot of NVDRS Software


Malinda steenkamp m phil nikolay lipskiy dr ph presenter division of violence prevention

Document table

Incident tables

SV relationship

Person tables

PW relationship

Weapon tables


Nvdrs pud structure

NVDRS’ PUD Structure

Suspects

Incidents

Deaths

  • Person type

  • Demographics

  • Pregnancy status

  • Homeless status

  • State reporting incident

  • Type of location where injured

  • Injured at home/work

  • Manner of death

  • ICD-10 manner of death

  • 358/113/39 cause of death recode

  • Person attempted suicide after incident

  • History of abuse

  • Caretaker of victim

  • Victim to suspect relationship

  • Weapon type

  • Firearm type

  • Poison type

  • State reporting incident

  • Resident incident

  • Incident type

  • # of persons in incident

  • # of weapons

  • # of deaths

  • # of suspects

  • State reporting incident

  • Person type

  • Record type

  • Demographics


Approach to analyze nvdrs data

Approach To Analyze NVDRS Data

  • Created 6 data analysis files based on six entities:

    • Incident

    • Person (Victims, Suspect/Victims, Suspects)

    • Weapon

    • Victim – Suspect Relationship

    • Person – Weapon Relationship

    • Document

  • All files includes linking variables

    • Site ID, Incident ID

    • Will also include person ID in future

  • Files can be combined/merged as needed


Analyzing nvdrs data

Analyzing NVDRS Data

  • Different ways to identify cases

    • 5 manners of death

      (DC, CME, Abstractor, ICD-10, CDC Manner)

  • At different points in time – completion rates for manner differ (ICD-10 more incomplete for longer)

  • Abstractor assigned manner is a gateway variable


Analyzing nvdrs data cont

Analyzing NVDRS Data (cont.)

  • Need to know that there are gateway variables

    • Abstractor assigned manner

    • Person type

    • Circumstances known

    • Weapon type (not discussed today)

  • Need to know how to use these:

    • Person type

      • When looking at deaths - Select person types 1 (Victim) and 3 (Suspect/Victim)

        (Person type 2 = live suspects)


Cdc analysis v ariables

CDC Analysis Variables

  • Similar variables – multiple sources – combine

  • Example for sex data element:

    • Variable comes from four data sources

      • DC, CME, SHR, PR,

    • Rule of primacy

      • Created a CDC analysis variable

        (combined variable)

      • Identified by _c (e.g. Sex_C)


Preliminary nvdrs data first and second data year

Preliminary NVDRS Data:First and Second Data Year

*Six states were funded to start data collection in 2003, Alaska was funded to start data collection in 2004, but they chose to go back and also collect data on 2003.


Preliminary nvdrs results injury event 2003 7 states

Preliminary NVDRS Results: Injury Event; 2003; 7 States

NVDRS, as of March 2005


Preliminary homicide results victim to suspect relationship 2003 7 states

Preliminary Homicide Results:Victim to Suspect Relationship; 2003; 7 States

NVDRS, as of March 2005


Next steps

Next Steps

  • Develop strategic planning process incorporating data management tasks

  • Develop and release 2003 and 2004 PUDs

  • Incorporate NVDRS into Public Health Information Network (PHIN/NEDSS)

  • Continue to work on a data aggregation model

  • Use NVDRS data to guide and enhance violence prevention efforts


Summary

Summary

NVDRS improves quality and completeness of violent death data through the timely collection and aggregation of multi-source information

Major pitfalls data collection and management:

- Involvement of different agencies

- Need a standardization of data element definitions across all agencies

- Thedevelopment and implementation of QA methods for data collection and management, from a multi-source perspective,is a complex problem

Major data management challenges:

- development of a data management model for the population-based violent death surveillance system

- development of a reliable violent death data source for the public health

- to grow towards becoming a comprehensive public health measurement tool


Malinda steenkamp m phil nikolay lipskiy dr ph presenter division of violence prevention

For Additional Information, Contact:

Malinda Steenkamp, M.Phil

NVDRS Senior Advisor

(770) 488-4476

Email: [email protected]

Nikolay Lipskiy, MPH, MBA, DrPH

NVDRS Epidemiologist

(770) 488-1306

Email: [email protected]


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