Comparison of two methods for assessing injuries among preschool children

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Abstract
Background: Most studies of injuries use health services records or recall rather than prospective methods, and there is no information on how these different methods compare. This study was aimed at comparing a report (retrospective) with a diary (prospective) for recording childhood injuries. Methods: The study included 1273 and 620 children, the retrospective and prospective subsamples, respectively, from a population based birth cohort in Pelotas, southern Brazil. The reported incidence of injuries in the preceding month were compared with those reported over month by diary (prospective study). Results: Both methods were well accepted and 92.7% of the diaries were returned. One or more injuries per child month were reported for 20.8% (retrospective) and 48.4% (prospective) of the children. The total number of reported injuries for the 620 children were 145 (retrospective) and 715 (prospective). Using the prospective method as the gold standard, the retrospective method detected only 20.2% of all injuries. Under-reporting did not vary significantly with maternal education, but was greater (51.8%) for injuries requiring medical care than for those managed at home (18.3%; p=0.003). Conclusions: The diary was well accepted and resulted in higher incidences of reported injuries than the recall method, particularly for injuries that did not require medical care. Use of this method should be promoted to provide more complete epidemiological information to guide preventive strategies.