On 16 October 2014, the Data Dictionary for the National Injury and Illness Database, Version 1 was released as a component of the Australian Institute of Sport (AIS) Best Practice Protocol. The purpose of the 10-page document was to describe the variables contained within the Athlete Management System (AMS) that pertained to injury and illness. This inaugural version of the AIS Data Dictionary provided an update for the use of injury definitions and surveillance within Australian National Sporting Organisations (NSOs). The minimum dataset collection criteria for sports injury developed by the Australian Sports Injury Data Working Party and published as the Australian Sports Injury Data Dictionary (ASIDD) in 19982 3 was used as a basis for the AIS Data Dictionary document, which was adapted to be applicable to the high performance setting. Version 1 of the Data Dictionary provided Australian NSOs and clinical staff across the National Institute Network (NIN) with a resource to provide improved clarity surrounding definitional issues related to sports injury for elite sport in Australia.
Since the release of Version 1, five years ago, there has been a substantial amount of research undertaken within both Australia and internationally that provides new information and further clarity related to sports injury definitions and surveillance methods. There has also been a substantial increase in the uptake and use of the AMS to conduct injury surveillance across NSOs and the NIN. The increasing awareness of the importance of achieving high quality and consistent longitudinal surveillance as the first stage of evidence-based injury prevention,4 5 has also led to an increasing interest in using the collected epidemiological data to help review seasonal trends and direct injury prevention strategies. Concurrently with this increased use of collected injury data, an update of the AIS Data Dictionary has been requested by many NSOs and NIN service providers to clarify new issues that have arisen regarding injury definition issues and to determine a revised benchmark for the minimum requirement of data entry regarding injury records.
Professional record keeping and the AMS
The recording and documentation of the details relating to each athlete consultation is a requirement for physiotherapists and medical doctors practicing within Australia under the guidelines provided by the Physiotherapy Board of Australia6 and the Medical Board of Australia,7 in conjunction with the Australian Health Practitioner Regulation Agency (AHPRA), under section 39 of the Health Practitioner Regulation National Law Act 2009.8 The AMS provides a platform that fulfils the medico-legal requirements relating to the collection and storage of medical records and is the platform where all injury and illness records should be recorded for athletes aligned with an NSO or NIN. Completion of the injury records by clinicians (doctors and physiotherapists) as a component of their routine workflow after consultation with injured or unwell athletes, contributes clinical data that are organised into a structured format and stored within the AMS that allow it to be used for epidemiological purposes too. The nationalised system allows for the health records of an athlete to be captured and stored within the one system, which assists in providing transparency in the transition of care if an athlete moves between clinical providers during their career. While satisfying the medico-legal requirements of medical record taking is an objective of the AMS, this objective is only one facet that the AMS aims to achieve relating to athlete health.
Planning and periodisation identifies how key training variables impacting on the acquisition and maintenance of optimal physical standards are integrated with periods of planned rest as an athlete works towards their performance goals. Effective planning can be enhanced by an interdisciplinary approach that is led by the coach of the program with collaboration from the performance support team (including but not limited to Physiology, Medicine, Strength and Conditioning, Physiotherapy, Nutrition, Psychology, Biomechanics, Skill Acquisition and Athlete Wellbeing and Engagement and other relevant practitioners). Using the collective expertise and experience of the coach, athlete and performance support team members, the following considerations can be made including (but not limited) to:
National injury surveillance system
A major objective within the healthcare of athletes is to minimise risk of ill health, while optimising health in contributing to performance outcomes. It has been well established that injuries impair both individual and team performance.9 The availability of an athlete to train and compete is necessary to achieve performance goal success and reduce the probability of failing to accomplish the benchmarks set to measure seasonal performance.10 For team sports, athlete availability for training and competition has been consistently demonstrated to correlate with the performance metrics of increased scoring,11 12 higher ladder position,11 12 and winning.11-15 Injury and reduced performance are inherently linked, as injury is usually associated with a reduction in physical capacity, opportunities for skill acquisition, general conditioning, and psychological state.15-18
The AIS prioritises prevention of injury to improve athlete availability within NSOs and the NIN, as a means to facilitate the achievement of sustained high performance outcomes. A key objective of the AMS is to deliver high quality 7 of 51 longitudinal injury surveillance to satisfy the first stage of the Translating Research into Injury Prevention Practice (TRIPP)4 framework for the prevention of sports related injury. The AMS is a repository of all athletic information including but not limited to training, competition, anthropometric, physiological, epidemiological and medical data. The AMS has been constructed to facilitate the collection and storage of these data in structured formats to enable consistent injury recording methods and to allow the data to be systematically reviewed, trends to be monitored and accurate reporting to occur. Consistent longitudinal injury surveillance provides data to identify areas of concern and direct prevention resources to areas of the greatest burden.
Intended purpose of this document
The intent of this document is to deliver an update to Version 1 of the AIS Data Dictionary provided in 2014, in response to the requests made by staff of many NSOs and across the NIN. This document aims to combine a ‘gold standard’ of surveillance procedures and principles with operational efficiency for the clinician who is required to enter the data and maintain record accuracy. As a result of improving the reporting processes across Australian sports, the sporting system will be in a greater position to progress through the prevention process to optimise athlete health and improve the probability of achieving success.
Objectives of this document
- Define the definitions of the variables collected within the AMS injury record form.
- To outline the minimum requirement for data collection pertaining to health records with the AMS.
- Provide solutions for challenges commonly raised by NSO and NIN staff relating to injury surveillance and best practice methods.
- Outline suggested methods for analysing and reporting AMS injury data.
- Inform the direction for prevention programs and research supporting high performance sport in Australia.