In Reply We thank Van der Vliet et al for their insightful comments. Regarding data in US trauma systems, there is room to learn from the Dutch example and others who have taken a more inclusive approach to trauma registries. We also agree with their assertion that trauma registries should include all patients admitted for trauma because we have previously shown the utility of this broader inclusion criterion for US trauma registries.¹ Compared with standardized US trauma registry inclusion,² capturing all admitted patients regardless of hospital missed fewer postinjury deaths (23.3% vs 62.1%), seriously injured patients (10.5% vs 39.2%), and patients requiring early critical resources (13.1% vs 23.8%).¹ However, such a suggestion is counterbalanced by the resources, logistics, and funding required to operationalize these changes. As we mention in our article,³ it is time to consider full-scale changes to US trauma registries that move away from labor-intensive and relatively inefficient processes, such as medical record abstraction, to more automated techniques based on electronic health record data, natural language-processing software, health information exchanges, and other existing data platforms that span multiple hospitals and health systems. Some manual extraction may still be required to ensure high data quality, but we live in an increasingly electronic data–heavy world that could be leveraged to further optimize our ability to track, study, and optimize care for injured patients.

在答复中，我们感谢Van der Vliet等人的有见地的评论。关于美国创伤系统中的数据，可以借鉴荷兰的例子以及其他对创伤登记采取更具包容性的方法的案例。我们也同意他们的观点，即创伤登记处应包括所有因创伤而收治的患者，因为我们之前已经证明了这一更广泛的纳入标准对美国创伤登记处的实用性。¹与标准的美国创伤登记册相比，²捕获所有住院患者而不论其医院遗失的死亡人数更少（23.3％vs 62.1％），重伤患者（10.5％vs 39.2％）以及需要早期关键资源的患者（13.1％vs 23.8％）。^1个但是，这种建议被实施这些更改所需的资源，物流和资金所抵消。正如我们在文章中提到的^3，现在是时候考虑对美国创伤登记机构进行全面变更了，这些变更已从劳动密集型和效率相对较低的流程（例如病历提取）转移到了基于电子病历数据的更加自动化的技术，自然语言处理软件，健康信息交换以及跨多个医院和卫生系统的其他现有数据平台。为了确保高质量的数据，可能仍需要进行一些手动提取，但是我们生活在一个电子数据繁重的世界中，可以利用它来进一步优化我们跟踪，研究和优化受伤患者护理的能力。