Global Neurotrauma Surveillance: Are National Databases Overrated?; Comment on “Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries”

Document Type : Commentary


1 Department of Surgery, Zuckerburg San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA

2 Neurosurgery, Mulago National Referral Hospital, Kampala, Uganda

3 Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda


Injuries are a public health crisis. Neurotrauma, a specific type of injury, is a leading cause of death and disability globally, with the largest burden in low- and middle-income countries (LMICs). However, there is a lack of quality neurotrauma-specific data in LMICs, especially at the national level. Without standard criteria for what constitutes a national registry, and significant challenges frequently preventing this level of data collection, we argue that singleinstitution or regional databases can provide significant value for context-appropriate solutions. Although granular data for larger populations and a universal minimum dataset to enable comparison remain the gold standard, we must put progress over perfection. It is critical to engage local experts to explore available data and build effective information systems to inform solutions and serve as the foundation for quality and process improvement initiatives. Other items to consider include adequate resource allocation and leveraging of technology as we work to address the persistent but largely preventable injury pandemic.


  1. GBD Compare | Viz Hub. 2022; Accessed July 16, 2022, 2022.
  2. Barthélemy EJ, Hackenberg AEC, Lepard J, et al. Neurotrauma Surveillance in National Registries of Low-and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries. Int J Health Policy Manag. 2021. doi:10.34172/ijhpm.2021.167
  3. Rosenkrantz L, Schuurman N, Hameed M. Trauma registry implementation and operation in low and middle income countries: A scoping review. Global Public Health. 2019;14(12):1884-1897. doi:10.1080/17441692.2019.1622761
  4. National Trauma Data Standard (NTDS). Quality Programs 2022; Accessed July 16, 2022, 2022.
  5. User Manual Admission Year 2019. Chicago, IL, USA2022.
  6. National Trauma Data Bank (NTDB) 2016 Annual Report. Chicago, IL, USA2016.
  7. World Federation of Neurosurgical Societies. Accessed October, 2022.
  8. International Neurotrauma Society. Accessed October, 2022.
  9. World Health Organization. 2022; Accessed October, 2022.
  10. Bolivia Instituto Nacional de Estadística. 2022; Accessed July 16, 2022, 2022.
  11. WHO dataset for injury. 2020; Accessed July 16, 2022, 2022.
  12. Rosenkrantz L, Schuurman N, Arenas C, Jimenez MF, Hameed MS. Understanding the barriers and facilitators to trauma registry development in resource-constrained settings: A survey of trauma registry stewards and researchers. Injury. 2021;52(8):2215-2224. doi:
  13. Lazem M, Sheikhtaheri A. Barriers and facilitators for the implementation of health condition and outcome registry systems: a systematic literature review. Journal of the American Medical Informatics Association. 2022;29(4):723-734. doi:10.1093/jamia/ocab293
  14. Resources for Optimal Care of the Injured Patient. In: Nathens AB, ed. 2022 Standards. Chicago, IL, USA: American College of Surgeons; 2022. Accessed July 16, 2022.
  15. OpenMRS Medical Record System. 2022; Accessed July 16, 2022.
  16. Global internet penetration rate as of April 2022, by region. Internet Demographics & Use 2022; Accessed July 16, 2022.

Articles in Press, Accepted Manuscript
Available Online from 15 November 2022
  • Receive Date: 28 July 2022
  • Revise Date: 07 November 2022
  • Accept Date: 12 November 2022
  • First Publish Date: 15 November 2022