Washington State gunshot- wound surveillance system

Context: Gunshot is the second leading mechanism of injury death in Washington State, but data on nonfatal gun-related injuries are limited. Objective: Develop and evaluate a system for surveillance of fatal and nonfatal gunshot injuries. Design: A gunshot wound surveillance system was pilot-tested. Reports from emergency departments were compared with emergency department logs and reports from medical examiners and coroners were compared with death certificates. Setting: Six Washington counties, with 57% of the state’s population. Participants: Hospital emergency departments, coroners, medical examiners, and local law enforcement agencies. Main Outcome Measures: Surveillance system simplicity, acceptability, sensitivity, and predictive value positive. Results: The pilot system was found to be simple and acceptable to data providers. The predictive value positive was 99% for reports from hospital emergency departments and 100% for reports from medical examiners and coroners. The sensitivity of hospital emergency department reporting was 76%; the sensitivity of reporting by medical examiners and coroners was 81%. Conclusions: States interested in developing gunshot-wound surveillance systems should: (1) verify the existence of a statewide gunshot-wound reporting requirement, (2) consider establishing such a requirement if one does not exist, (3) include hospital emergency departments as a data source, (4) establish the capacity to link records if multiple data sources are used, (5) limit the data reporting requirements to fit on a one-page form, preferably one-side only, (6) periodically review the data and the reporting practices of data providers, and be prepared to make changes if things are not working as planned, and (7) disseminate surveillance data and system evaluation findings on a regular basis