The term 'silent epidemic' is used to characterize the incidence of traumatic brain injury (TBI) worldwide, in part because many cases are not recognized and are, therefore, excluded from official statistics. A recently published study conducted in New Zealand has provided an example of how scrupulous epidemiological research can elucidate the incidence of TBI. For this research, Feigin and colleagues combined data from prospective and retrospective surveillance systems to ensure registration of all TBI events in residents of all ages within a 1-year period. The results of the Brain Injury Outcomes New Zealand In the Community (BIONIC) study suggest that the incidence of TBI, especially mild TBI, is far greater than would be estimated from the findings of previous studies conducted in other high-income countries.
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