Multiple information sources in the analysis of a disaster


  • Stephanie Barnhart, DO
  • Patrick M. Cody, DO
  • David E. Hogan, DO, MPH, FACEP



research, information sources, denominator data, explosion, fire


Objective: Disasters are complex events making epidemiologic studies and determination of accurate denominators difficult due to the poor nature of available records. However, these data are essential to perform useful calculations and accurate descriptions of disaster medical impacts. This study was undertaken to identify the availability and utility of various information sources in the analysis of a mass casualty disaster. In addition, characteristics of cases presenting for care are described.
Design: This is a retrospective cohort study abstracting medical records and other documents relating to an explosion and fire. Public domain documents are obtained by written request or by filing a Freedom of Information Act (FOIA) request.
Setting: A rural EMS and tertiary hospital.
Cases: Individuals directly exposed to the forces of the explosion.
Outcome Measures: The number of cases detected by various information sources. In addition, the demographics, dispositions, and nature of the physical injuries of the cases are reported.
Results: Seven sources of case information were identified. The most cases were identified by investigative agencies (33) and the fewest by medical records (18). Rates include; injury 0.68, admission 0.20, and operative 0.14, with no deaths. Case locations during the explosion were determined for all cases. No association was noted between admission and location in the building.
Conclusions: This study demonstrates the availability and usefulness of data in the public domain. Using FOIA requests or partnerships with public or private agencies may more clearly define denominator data in epidemiologic evaluations of disasters.

Author Biographies

Stephanie Barnhart, DO

Emergency Medicine Resident, Department of Emergency Medicine, Integris Southwest Medical Center, Emergency Medicine Residency Program, Oklahoma City, Oklahoma.

Patrick M. Cody, DO

Prehospital and Disaster Medicine Fellow, Department of Emergency Medicine, Integris Southwest Medical Center, Emergency Medicine Residency Program, Oklahoma City, Oklahoma.

David E. Hogan, DO, MPH, FACEP

Adjunct Professor, Oklahoma State University, Director of Prehospital and Disaster Medicine Fellowship Program, Department of Emergency Medicine, Integris Southwest Medical Center, Emergency Medicine Residency Program, Oklahoma City, Oklahoma.


Logue JN, Melick ME, Hansen H: Research issues and directions in the epidemiology of health effects of disasters. Epidemiol Rev. 1981; 3: 140-162.

Greenough PG, Burkle FM: Practical applications of disaster epidemiology. In Ciottone GR, Anderson PD, Auf Der Heidi E, et al. (eds.): Disaster Medicine. Philadelphia, PA: Elsevier Mosby, 2006: 327-334.

Dominici F, Levy JI, Louis TA: Methodological challenges and contributions in disaster epidemiology. Epidemiol Rev. 2005; 27: 9-12.

Hogan DE: The Oklahoma City terrorist blast: A case study in disaster. In Landesman LY (ed.): Emergency Preparedness in Health Care Organizations. Chicago: Joint Commission on Accreditation of Healthcare Organizations Publications, 1996: 1-16.

Binder LS, Chapman DM: Qualitative research methodologies in emergency medicine. Acad Emerg Med. 1995; 2(12): 1098-1102.

Nelson BD, Dierberg K,Sˇ c´epanovic´ M, et al.: Integrating quantitative and qualitative methodologies for the assessment of health care systems: Emergency medicine in post-conflict Serbia. BMJ. 2005; 5(14): 14-25.

Gorelick MH, Alpern ER, Singh T, et al.: Availability of pediatric emergency visit data from existing data sources. Acad Emerg Med. 2007; 12(12): 1195-1200.

Gorelick MH, Knight S, Alessandrin EA, et al.: Lack of agreement in pediatric emergency department discharge diagnosis from clinical and administrative data sources. Acad Emerg Med. 2007; 14(7): 646-652.

Hogan DE, Lillibridge SR, Waeckerle J, et al.: Emergency Department impact of the Oklahoma City terrorist bombing. Ann Emerg Med. 1999; 34: 160-167.

Mallonee S, Shariat S, Stennies G, et al.: The epidemiology of physical injuries associated with the Oklahoma City bombing. JAMA. 1996; 276: 382-387.

May BM, Hogan DE, Feighner K: Impact of a tornado on a community hospital. JAOA. 2002; 102: 225-228.

Brismar B, Bergenwald L: The terrorist bomb explosion in Bologna, Italy, 1980: An analysis of the effects and injuries sustained. J Trauma. 1982; 22: 216-220.

Rignault DP, Deligny MC: The 1986 terrorist bombing experience in Paris. Ann Surg. 1989; 3: 368-373.

Johnston DJ, Evans SC, Field RE, et al.: The Victoria bomb: A report from the Westminster Hospital. Injury. 1993; 24: 5-9.

FOIA: The Freedom of Information Act 5 U.S.C. §552, As Amended by Public Law No. 104-231, 110 Stat. 3048.

Bingham CM, Van Der Weyden MB: Freedom of information? Med J Aust. 2002; 177(11-12): 581.

Montgomery BJ: Abuses of freedom of information act. JAMA. 1979; 242: 1007-1009.

Wade N: Freedom of Information NSF accused of infringing act. Science. 1976; 192: 872-873

Gostin LO: Public Health Law and Ethics. Berkley, CA: University of California Press, 2002: 161-193.

Richards EP, Rathbun KC: The legal basis for public health. In Keck WC, Sutchfield DF (eds.): Principles of Public Health Practice, 2nd ed. Clifton Park, NJ: Delmar Learning Inc., 2003.



How to Cite

Barnhart, DO, S., P. M. Cody, DO, and D. E. Hogan, DO, MPH, FACEP. “Multiple Information Sources in the Analysis of a Disaster”. American Journal of Disaster Medicine, vol. 4, no. 1, Jan. 2009, pp. 41-47, doi:10.5055/ajdm.2009.0006.

Most read articles by the same author(s)