Epidemiology is an important component of clinical practice. Gender, sport, time played, age, and other factors influence sport-related injuries. When athletes are exposed to their sport for a certain period of time, some conditions are more likely to arise; the risk depends on multiple factors. Physical characteristics, position played, surface type, etc, can contribute to the risk and rate of these injuries occurring. Athletic trainers should document injury occurrence, noting who is affected, identifying where and when injuries occur, and paying particular attention to what circumstances produce the best outcome.1 Epidemiological data can inform special test selection, treatment parameters, prevention methods, etc. Clinicians must understand proper interpretation and usage of such information.
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Incidence and Prevalence
Incidence and prevalence are commonly reported rates in injury literature. Incidence is a simple measure of the new cases occurring in a defined population over a specified period of time. It is a basic representation of risk. In athletics, the number of games and practices is typically multiplied by the number of players participating to quantify the population and exposure period.
These new cases contribute to the prevalence, a measure of the total number of cases in a population at risk during a specific period of time. There are 3 ways for the prevalence to change, including the following: there is an increase in onset of the condition (incidence), people are healed of the condition, or people with the condition die. The length of time to heal or die from the condition is described as duration. If the incidence rises, the prevalence rises, unless people are being healed or are dying at a higher rate than the new conditions are occurring. Because sports epidemiology is mainly focused on new cases, true prevalence statistics are not usually reported, and some authors use incidence and prevalence interchangeably.
Incidence and prevalence are often reported as rates of 100,000 people, but in athletic injury literature, there may be variations on reporting. Athlete exposure in games or training is multiplied by the number of players participating.2 If one does not consider exposure when reporting incidence rates, one cannot reliably indicate the problem to compare injury incidence.
Another important factor of accurate reporting of incidence of injury involves the use of established definitions of injury. Objective, well-accepted measures should be used for coding and recording injuries. Best practices include having an individual record the information to increase intrarater reliability.2
For example, in a meta-analysis, Doherty et al3 examined epidemiological studies about ankle injuries. They concluded that females experience a higher incidence of ankle sprains (13.6/1000 athlete-exposures [AEs]) than males (6.94/1000 AEs). They also reported that the highest incidence on ankle sprain was in indoor/court sports at 1.37/1000 AEs and 4.9/1000 hours of exposure. In this example, the authors are reporting incidence, or new cases, in a marked period of time. They are using exposure hours, which universally includes practices and competitions. They also report scores of the risk of ankle injury in a designated time frame (1000 hours). This example is a typical representation of epidemiological reporting on athletic injury.
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