Improved Data Quality by Pen Computer-Assisted Emergency Room Data Recording Following Major Trauma in the Military Setting

Introduction: The characteristics of combat injuries differ from those of injuries encountered in civilian practice. Capturing detailed combat casualty data is therefore of importance. Experts classify the data sources for combat injuries as "inadequate" and request a better and more accurate record keeping. Within the civilian setting it has been shown that "point of care - computer-assisted" recording techniques are superior to conventional "paper-based" data recording techniques regarding accuracy of data recording. Subject of this study is to proof the quality of a "point of care - computer-assisted" data recording technique within a "military setting".

Method: Prospective emergency room study at the multinational-staffed German Field Hospital Kabul/Afghanistan. A standardized emergency room data recording - using "TraumaWatch" - was performed parallel to the emergency room procedures; in each patient a tablet-PC-based technique ("pen group") as well as a traditional paper-based technique ("paper group") was used simultaneously by two nurses of the emergency room team. Data quality was defined as level of dataset completeness.

Results: During a 3-month study period, a total number of 171 major trauma cases underwent emergency room management. There was no correlation between degree of injury severity and level of dataset completeness. Total dataset completeness was significantly higher within the "pen group" (93.9 ± 15.5% vs. 50.1 ± 21.8%; p < 0.01); the same applies to the core dataset (Utstein style) completeness (94.8 ± 15.1% vs. 48.9 ± 18.7%; p < 0.01).

Conclusion: Defining data quality as level of dataset completeness, a tablet-PC-based recording technique, which allows easy and fast - real-time - data acquisition during emergency room management, seems to be superior to the conventional paper-based technique - even under the conditions of a military mission.