PHE 505 Module 3 Annotated Bibliography Example

Five Studies, Weighed: An Annotated Bibliography on Helmet Use and Scooter Head Injuries

[Student Name]

Southern New Hampshire University

PHE 505: Research Methods in Public Health

Module Three Annotated Bibliography

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

Five Studies, Weighed: An Annotated Bibliography on Helmet Use and Scooter Head Injuries

This bibliography gathers the five peer-reviewed studies most relevant to a proposed study of helmet use and head injury among adults treated after shared electric scooter crashes. Sources were found by searching PubMed and Google Scholar for electric scooter, e-scooter, micromobility, helmet and head injury, and by checking the reference lists of the first studies found. Each annotation summarizes the study, appraises its quality and explains its use in the proposal. The search covered studies published from 2018 onward, when shared scooters first appeared in American cities, plus the most recent meta-analysis on bicycle helmets.

Trivedi et al. (2019)

Summary. Trivedi and colleagues reviewed the records of all 249 patients treated for injuries associated with standing electric scooters at two Southern California emergency departments over one year, and observed riders at public intersections for seven hours. Head injuries occurred in about 40% of patients and fractures in about a third. Only 4.4% of injured riders were documented as wearing helmets, and 94% of 193 observed riders had none. Most patients were discharged from the emergency department.

Appraisal. The study was the first to describe scooter injuries systematically, and pairing record review with street observation was a strength. Lacking any comparison group, the series cannot estimate how much helmets protect. Helmet use was recorded only when clinicians noted it, which may undercount it. Use: background on injury patterns and evidence that helmet use is very low.

Bloom et al. (2021)

Summary. Bloom and colleagues reviewed 248 patients treated after standing scooter incidents across an urban hospital network over ten months, using local internet searches about scooters as a rough measure of how much riding occurred. Loss of balance caused nearly half of injuries, 9% of patients were under 18, only 3% of riders wore helmets and no rider with a brain injury had been wearing one. Costs were higher for patients under the influence of alcohol or marijuana.

Appraisal. Covering a whole network reduced the bias of a single hospital, and the cost data are useful. With only eight helmeted riders, the finding that no helmeted rider had a brain injury is striking but statistically fragile. The study did not adjust for other factors. Use: supports the hypothesis and shows that substance use should be measured as a covariate.

Namiri et al. (2020)

Summary. Namiri and colleagues used the national emergency department injury surveillance system to estimate scooter injuries and hospital admissions in the United States from 2014 to 2018, showing steep increases in both, with head injuries forming a large share.

Appraisal. National weighting gives the study a reach no single hospital could, but the surveillance system relies on brief narratives and cannot reliably distinguish shared from privately owned scooters or record helmet use. As a short research letter, it gives limited methodological detail. Use: establishes the national trend and the significance of the problem.

Cicchino et al. (2021)

Summary. Cicchino and colleagues compared adults treated in a Washington, DC, emergency department after riding e-scooters in 2019 with those injured while cycling in earlier years. Scooter riders were less often hit by vehicles, more often women and older adults, far less likely to wear helmets, 2% against 66%, and more likely to have concussions with loss of consciousness. Per mile traveled, emergency visits were higher among scooter riders.

Appraisal. The comparison group is a strength, and estimating rates per mile is unusual and valuable. Different time periods for the two groups and a single hospital limit generalizability. Use: shows that scooter crashes differ from bicycle crashes, which cautions against assuming bicycle helmet evidence transfers directly.

Olivier and Creighton (2017)

Summary. This systematic review and meta-analysis pooled 40 studies of more than 64,000 injured cyclists. Helmeted cyclists had roughly half the odds of a head injury, a third of the odds of serious head injury and lower odds of fatal head injury, with no clear association with neck injury and no evidence of publication bias.

Appraisal. It is the strongest evidence in this bibliography, drawing on many studies with consistent results. Its limits for this proposal are that the included studies were observational and concerned bicycles, not scooters. Use: provides the expected size of a helmet effect and a model for analysis, since most included studies used the same case-control logic the proposal will use.

Sources Considered and Left Out

Several sources were read but not annotated. City and company reports on scooter safety were informative but not peer reviewed. Studies from Europe and Asia were relevant to injury patterns but come from places with different street design, rules and helmet norms. Studies of privately owned scooters and of children were set aside because the proposal concerns adults on shared scooters. These choices will be revisited if the literature review needs broader context.

Comparison of the Sources

Table 1 compares the five studies.

Table 1. Appraisal summary

Note. Designs are listed as reported by the authors.

What the Bibliography Shows

The scooter studies agree that helmet use is very low and head injuries common, but none estimates the protective effect of helmets with adjustment for other factors. The bicycle meta-analysis shows such an estimate is possible with the right design. That combination confirms the gap identified in Milestone One and points to a design that compares injured riders with and without head injuries.

The bibliography also identifies the measures the proposal will need. Helmet use comes mostly from clinicians' notes in every scooter study, so the proposal must check how reliably it is recorded. Alcohol involvement and age appear repeatedly as factors linked to injury, so they belong among the covariates.

References

Bloom, M. B., Noorzad, A., Lin, C., Little, M., Lee, E. Y., Margulies, D. R., & Torbati, S. S. (2021). Standing electric scooter injuries: Impact on a community. American Journal of Surgery, 221(1), 227-232. https://doi.org/10.1016/j.amjsurg.2020.07.020

Cicchino, J. B., Kulie, P. E., & McCarthy, M. L. (2021). Injuries related to electric scooter and bicycle use in a Washington, DC, emergency department. Traffic Injury Prevention, 22(5), 401-406. https://doi.org/10.1080/15389588.2021.1913280

Namiri, N. K., Lui, H., Tangney, T., Allen, I. E., Cohen, A. J., & Breyer, B. N. (2020). Electric scooter injuries and hospital admissions in the United States, 2014-2018. JAMA Surgery, 155(4), 357-359. https://doi.org/10.1001/jamasurg.2019.5423

Olivier, J., & Creighton, P. (2017). Bicycle injuries and helmet use: A systematic review and meta-analysis. International Journal of Epidemiology, 46(1), 278-292. https://doi.org/10.1093/ije/dyw153

Trivedi, T. K., Liu, C., Antonio, A. L. M., Wheaton, N., Kreger, V., Yap, A., Schriger, D., & Elmore, J. G. (2019). Injuries associated with standing electric scooter use. JAMA Network Open, 2(1), Article e187381. https://doi.org/10.1001/jamanetworkopen.2018.7381