• This is the analysis of helmet documentation given by PFR management

Part of PFR Management view on Helmets

Correspondence re brain injury data between CELOS and the Brain Injury Association of Canada (BIAC)

Letter from Jutta Mason of CELOS to the Brain Injury Association of Canada (BIAC) on March 29, 2014

Parks and Recreation Toronto has the following information, attributed to your organization, in a document called "Summary of research articles": "7. A new research reported by Dr. Angela Colantonio for the Ontario Neurotrauma Foundation shows that there were 17,482 emergency room visits and/or hospitalizations for traumatic brain injury in Ontario in 2006, the majority are young men. Approximately 3,600 hospitalizations end in deaths. (Brain Injury Association of Canada)" That point is closely followed by this one, perhaps also sourced from your material: "Almost half a million (473,947) emergency department visits for TBI are made annually by children aged 0 to 14 years." Could you let me know the references for these numbers, if indeed they are quoted by your organization?

Response from Harry Zarins of BIAC April 1, 2014:

Thank You for your question. We will be getting back to you with the references. Can I ask you why you are looking at this?

From CELOS, April 1 2014:

I'm looking at this because both of the numbers are puzzling. The "3600" death count, which is referenced as coming from the BIAC, seems to relate to the sentence before it ("there were 17,482 emergency room visits and/or hospitalizations for traumatic brain injury in Ontario in 2006"). But that proportion of deaths is not really credible. Prof.Colantonio's survey shows 4743 total hospitalizations for that year. It seems unlikely that 75% of those hospitalized patients died. Could you let me know if the mortality number was taken out of context, and if so, where is it on your website? E.g. did it refer to a long time period? In the second case, almost half a million children aged 0-14 are said to visit E.D.'s for TBI "annually." In a sample year (2005/6) in Prof.Colantonio's survey, the number for that age group was 4167. If the half million figure is supposed to cover the whole country, that's still not plausible, since Ontario is 38% of the country's population. It's possible that the second number was not taken from your website -- if so, could you confirm that? Risk is a hot topic for municipal departments, but it's important that the evidence is as accurate as possible. It may be that Parks and Recreation's "fact sheet" about brain injury and sports needs some corrections, which we will be happy to pass along to them.

From CELOS, April 22 2014: I'm assuming that your lack of answer to my March 29 2014 injury/mortality data question means that that there is no link on your website to support the two brain injury numbers that puzzled me in the Toronto Parks and Recreation fact sheet. Please let me know if I'm wrong in making that assumption. If there are in fact such links, I would much appreciate you sending them to me.

From BIAC April 22, 2014:

Here is the link to the Canadian stats Hopefully this will shed some light.

From CELOS, April 23 2014: Thanks for sending me that CIHI article. It appears to have no relationship to the numbers quoted in the Toronto Parks and Recreation traumatic brain injury information sheet. The P&R information sheet referred to 17,482 E.D.visits and/or hospitalizations "for traumatic brain injury in Ontario in 2006." But the CIHI article referred to 16,811 hospitalizations for all types of trauma Canada-wide in 2003/04. The numbers are not comparable. The Toronto Parks and Recreation information sheet implied that there were 3600 deaths among the 4743 persons hospitalized in 2006 as a result of traumatic brain injury in Ontario. The CIHI article said that 1368 of the Canada-wide hospitalizations for traumatic brain injury in 2003/4 ended in death. The Toronto Parks and Recreation information sheet asserted that "Almost half a million (473,947) emergency department visits for TBI are made annually [no year specified] by children aged 0 to 14 years." The CIHI article made no reference to emergency department admissions for that age group. The earlier Colantino article that you attached, for Ontario TBI's, seems to have numbers that cannot be compared with either the later Colantino article supposedly referenced by Toronto Parks and Recreation, nor with the CIHI article you linked for me.

Since the Toronto Parks and Recreation information sheet points to the BIAC as the source for its injury data, and since the data you sent me seem to have no relation to the Toronto numbers, I assume that the numbers cited by Parks and Recreation do not exist in the literature the BIAC holds. Is that fair?

Or is there other 2006 material put out by BIAC that I still ought to look at?

From BIAC April 23, 2014: Thanks for your note. I will try to drill down further. Since I am the sole employee and am presently on the road I will see what I can find by searching all the sources I have available.

But there was no more follow-up.