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Editor,—In the paper by Barker et alon injuries and disabilities in teenagers and young adults the information obtained from the patients would appear to have been largely, if not wholly, derived from questionnaires,1which is likely to have been subjective and therefore biased. Specifically, ‘disability’ is a highly subjective term and may be perceived and interpreted differently by different individuals. In addition, patients may have had a variety of reasons for responding ‘yes’ to the question, ‘Has this...... accident(s) resulted in any permanent disability ?’. The authors do not state whether the patients’ disabilities were independently assessed.
Secondly, although their data may be correct, implicit within their conclusion is the suggestion, perhaps unintentionally, that for economic reasons preventative measures, and therefore resources should be directed at reducing only the less serious (though more common) injuries, potentially at the expense of ignoring those equally preventable factors that predispose to a more serious injury— and therefore disability. A more serious disability, though less common, does not make it less of a disability—for the patient, their family, or the community.
Finally, a significant reduction in the frequency of the more common (but less serious) injuries may be extremely difficult, if not impossible, to achieve because of the obvious and marked heterogeneity of the causes of these injuries. As a consequence this could, theoretically, result in an inefficient and uneconomic use of available resources in attempting to prevent what may be largely unpreventable.
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