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August 1993

In Rates We Trust

Author Affiliations

National Center for Injury Prevention and Control (K-60) Centers for Disease Control and Prevention Public Health Service US Department of Health and Human Services 4770 Buford Hwy NE Chamblee, GA 30341

Am J Dis Child. 1993;147(8):813. doi:10.1001/archpedi.1993.02160320015004

In this issue, Leland et al1 calculate an injury rate for children in day-care centers that is expressed as the number of injuries per "child day." Computation of such incidence rates helps determine the relative importance of different settings and activities in the occurrence of injury. Rates are also important for evaluating the effect of control measures. However, choosing appropriate numerators and denominators for calculating rates can be difficult.

What constitutes an injury worthy of counting, ie, what belongs in the numerator? Leland et al1 count all injuries, no matter how trivial, as long as they were recorded in a logbook and involved physical or emotional distress. For some purposes, this definition may be useful; however, for public health and epidemiologic purposes, it may be less useful. The reasons are twofold. First, minor injuries, like bumps and scrapes, are difficult to define consistently. Such injuries may be more