Hostname: page-component-76dd75c94c-28gj6 Total loading time: 0 Render date: 2024-04-30T07:57:29.979Z Has data issue: false hasContentIssue false

Quantitative Metrics in Mass-Gathering Studies: A Comprehensive Systematic Review

Published online by Cambridge University Press:  05 April 2024

Cüneyt Çalışkan
Affiliation:
Department of Disaster Medicine, Hamidiye Institute of Health Sciences, University of Health Sciences, Istanbul, Türkiye Department of Emergency Aid and Disaster Management, Hamidiye Faculty of Health Sciences, University of Health Sciences, Istanbul, Türkiye
Ahmet Doğan Kuday*
Affiliation:
Department of Disaster Medicine, Hamidiye Institute of Health Sciences, University of Health Sciences, Istanbul, Türkiye
Tuğba Özcan
Affiliation:
Department of Disaster Medicine, Hamidiye Institute of Health Sciences, University of Health Sciences, Istanbul, Türkiye
Nihal Dağ
Affiliation:
Department of Disaster Medicine, Hamidiye Institute of Health Sciences, University of Health Sciences, Istanbul, Türkiye Department of Emergency Aid and Disaster Management, Hamidiye Faculty of Health Sciences, University of Health Sciences, Istanbul, Türkiye
Kerem Kınık
Affiliation:
Department of Disaster Medicine, Hamidiye Institute of Health Sciences, University of Health Sciences, Istanbul, Türkiye Department of Emergency Aid and Disaster Management, Hamidiye Faculty of Health Sciences, University of Health Sciences, Istanbul, Türkiye
*
Correspondence: Ahmet Doğan Kuday Department of Disaster Medicine Hamidiye Institute of Health Sciences University of Health Sciences Istanbul, Türkiye E-mail: dogankuday@gmail.com

Abstract

Introduction:

Mass gatherings are events where many people come together at a specific location for a specific purpose, such as concerts, sports events, or religious gatherings, within a certain period of time. In mass-gathering studies, many rates and ratios are used to assess the demand for medical resources. Understanding such metrics is crucial for effective planning and intervention efforts. Therefore, this systematic review aims to investigate the usage of rates and ratios reported in mass-gathering studies.

Methods:

In this systematic review, the PRISMA guidelines were followed. Articles published through December 2023 were searched on Web of Science, Scopus, Cochrane, and PubMed using the specified keywords. Subsequently, articles were screened based on titles, abstracts, and full texts to determine their eligibility for inclusion in the study. Finally, the articles that were related to the study’s aim were evaluated.

Results:

Out of 745 articles screened, 55 were deemed relevant for inclusion in the study. These included 45 original research articles, three special reports, three case presentations, two brief reports, one short paper, and one field report. A total of 15 metrics were identified, which were subsequently classified into three categories: assessment of population density, assessment of in-event health services, and assessment of out-of-event health services.

Conclusion:

The findings of this study revealed notable inconsistencies in the reporting of rates and ratios in mass-gathering studies. To address these inconsistencies and to standardize the information reported in mass-gathering studies, a Metrics and Essential Ratios for Gathering Events (MERGE) table was proposed. Future research should promote consistency in terminology and adopt standardized methods for presenting rates and ratios. This would not only enhance comparability but would also contribute to a more nuanced understanding of the dynamics associated with mass gatherings.

Type
Systematic Review
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Koçak, H, Tuncay, İ. Evaluation of trauma cases in different types of mass gathering events. Ulus Travma Acil Cerrahi Derg. 2022;28(6):781789.Google ScholarPubMed
World Health Organization. Public health for mass gatherings: key considerations. 2015. https://www.who.int/publications-detail-redirect/public-health-for-mass-gatherings-key-considerations. Accessed November 22, 2023.Google Scholar
Yezli, S, Alotaibi, B. Mass gatherings and mass gatherings health. Saudi Med J. 2016;37(7):729730.CrossRefGoogle ScholarPubMed
Memish, ZA, Steffen, R, White, P, et al. Mass gatherings medicine: public health issues arising from mass gathering religious and sporting events. Lancet. 2019;393(10185):20732084.CrossRefGoogle ScholarPubMed
Aitsi-Selmi, A, Murray, V, Heymann, D, et al. Reducing risks to health and wellbeing at mass gatherings: the role of the Sendai Framework for Disaster Risk Reduction. Int J Infect Dis. 2016;47:101104.CrossRefGoogle ScholarPubMed
Sharma, U, Desikachari, BR, Sarma, S. Protocol for development of a risk assessment tool for planning and management of religious mass-gathering events of India—a health system-strengthening initiative. Pilot Feasibility Stud. 2019;5(1):83.CrossRefGoogle ScholarPubMed
Milsten, AM, Maguire, BJ, Bissell, RA, et al. Mass-gathering medical care: a review of the literature. Prehosp Disaster Med. 2002;17(3):151162.CrossRefGoogle ScholarPubMed
De Lorenzo, RA. Mass gathering medicine: a review. Prehosp Disaster Med. 1997;12(1):6872.CrossRefGoogle ScholarPubMed
Van Remoortel, H, Scheers, H, De Buck, E, et al. Prediction modelling studies for medical usage rates in mass gatherings: a systematic review. PLoS One. 2020;15(6):e0234977.CrossRefGoogle ScholarPubMed
Whittemore, R, Knafl, K. The integrative review: updated methodology. J Adv Nurs. 2005;52(5):546553.CrossRefGoogle ScholarPubMed
Hong, QN, Fàbregues, S, Bartlett, G, et al. The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Education for Information. 2018;34(4):285291.CrossRefGoogle Scholar
Kuday, AD, Özcan, T, Çalışkan, C, et al. Challenges faced by medical rescue teams during disaster response: a systematic review study. Disaster Med Public Health Prep. 2023;17:e548.CrossRefGoogle ScholarPubMed
Alassaf, WI. EMS Coverage of a female-only event with 10,000 attendees: preparation and implementation in one week. Prehosp Disaster Med. 2017;32(6):694698.CrossRefGoogle ScholarPubMed
Allen, TL, Jolley, SJ, Cooley, VJ, et al. The epidemiology of illness and injury at the alpine venues during the Salt Lake City 2002 Winter Olympic Games. J Emerg Med. 2006;30(2):197202.CrossRefGoogle Scholar
Allgaier, RL, Shaafi-Kabiri, N, Romney, CA, et al. Use of predictive modeling to plan for special event medical care during mass gathering events. Disaster Med Public Health Prep. 2019;13(5-6):874879.CrossRefGoogle ScholarPubMed
Anikeeva, O, Arbon, P, Zeitz, K, et al. Patient presentation trends at 15 mass-gathering events in South Australia. Prehosp Disaster Med. 2018;33(4):368374.CrossRefGoogle ScholarPubMed
Arbon, P, Bridgewater, FH, Smith, C. Mass gathering medicine: a predictive model for patient presentation and transport rates. Prehosp Disaster Med. 2001;16(3):150158.CrossRefGoogle ScholarPubMed
Bock, HC, Cordell, WH, Hawk, AC, et al. Demographics of emergency medical care at the Indianapolis 500-mile race (1983-1990). Ann Emerg Med. 1992;21(10):12041207.CrossRefGoogle ScholarPubMed
Bortolin, M, Ulla, M, Bono, A, et al. Holy shroud exhibition 2010: health services during a 40-day mass-gathering event. Prehosp Disaster Med. 2013;28(3):239244.CrossRefGoogle ScholarPubMed
Burton, JO, Corry, SJ, Lewis, G, et al. Differences in medical care usage between two mass-gathering sporting events. Prehosp Disaster Med. 2012;27(5):458462.CrossRefGoogle ScholarPubMed
Ceyhan, MA, Demir, GG, Güler, GB. Evaluation of health care services provided in political public meetings in Turkey: a forgotten detail in politics. Prehosp Disaster Med. 2018;33(6):607613.CrossRefGoogle Scholar
Ceyhan, MA, Demir, GG. Health care services in shopping centers: a routine mass-gathering event. Prehosp Disaster Med. 2020;35(6):669675.CrossRefGoogle Scholar
Chang, WH, Chang, KS, Huang, CS, et al. Mass gathering emergency medicine: a review of the Taiwan experience of long-distance swimming across Sun-Moon Lake. Int J Gerontol. 2010;4(2):5368.CrossRefGoogle Scholar
Crabtree, N, Mo, S, Ong, L, et al. Retrospective analysis of patient presentations at the Sydney (Australia) Royal Easter Show from 2012 to 2014. Prehosp Disaster Med. 2017;32(2):187194.CrossRefGoogle ScholarPubMed
Dutch, MJ, Senini, LM, Taylor, DJ. Mass gathering medicine: the Melbourne 2006 Commonwealth Games experience. Emerg Med Australas. 2008;20(3):228233.CrossRefGoogle ScholarPubMed
Friedman, MS, Plocki, A, Likourezos, A, et al. A prospective analysis of patients presenting for medical attention at a large electronic dance music festival. Prehosp Disaster Med. 2017;32(1):7882.CrossRefGoogle Scholar
Friedman, NMG, O’Connor, EK, Munro, T, et al. Mass-gathering medical care provided by a collegiate-based first response service at an annual college music festival and campus-wide celebration. Prehosp Disaster Med. 2019;34(1):2529.CrossRefGoogle ScholarPubMed
Goldberg, SA, Maggin, J, Molloy, MS, et al. The Gillette Stadium experience: a retrospective review of mass gathering events from 2010 to 2015. Disaster Med Public Health Prep. 2018;12(6):752758.CrossRefGoogle ScholarPubMed
Goldberg, SA, Battistini, V, Cash, RE, et al. A retrospective review of out of hospital cardiac arrest at Gillette Stadium: 10 years of experience at a large sports venue. Resusc Plus. 2023;14.Google Scholar
Grant, WD, Nacca, NE, Prince, LA, et al. Mass-gathering medical care: retrospective analysis of patient presentations over five years at a multi-day mass gathering. Prehosp Disaster Med. 2010;25(2):183187.CrossRefGoogle Scholar
Gutman, SJ, Lund, A, Turris, SA. Medical support for the 2009 world police and fire games: a descriptive analysis of a large-scale participation event and its impact. Prehosp Disaster Med. 2011;26(1):3339.CrossRefGoogle Scholar
Hardcastle, TC, Samlal, S, Naidoo, R, et al. A redundant resource: a pre-planned casualty clearing station for a FIFA 2010 stadium in Durban. Prehosp Disaster Med. 2012;27(5):409415.CrossRefGoogle ScholarPubMed
Ho, WH, Koenig, KL, Quek, LS. Formula one night race in Singapore: a 4-year analysis of a planned mass gathering. Prehosp Disaster Med. 2014;29(5):489493.CrossRefGoogle Scholar
Hostettler-Blunier, S, Müller, N, Haltmeier, T, et al. Public medical preparedness at the “Swiss Wrestling and Alpine Games 2013”: descriptive analysis of 1,533 patients treated at the largest 3-day sporting event in Switzerland. Emerg Med Int. 2017;2017:9162095.CrossRefGoogle ScholarPubMed
Imbriaco, G, Flauto, A, Bussolari, T, et al. Mass gathering emergency medicine organization for the Union of European Football Associations’ under-21 championship 2019 in Bologna, Italy. Disaster Med Public Health Prep. 2022;16(1):405408.CrossRefGoogle ScholarPubMed
Johnsson, KMC, Örtenwall, PA, Kivi, ALH, et al. Medical support during the European Union Summit in Gothenburg, Sweden, June 2001. Prehosp Disaster Med. 2006;21(4):282285.CrossRefGoogle ScholarPubMed
Koçak, H, Çalışkan, C, Sönmezler, , et al. Analysis of medical responses in mass gatherings: the commemoration ceremonies for the 100th anniversary of the Battle of Gallipoli. Prehosp Disaster Med. 2018;33(3):288292.CrossRefGoogle ScholarPubMed
Kocak, H, Tuncay, I. Comparison of emergency medical services cases in different types of mass gathering events held between 2015-2018 in Turkey. Eurasian J Emerg Med. 2022;21(2):9399.CrossRefGoogle Scholar
Locoh-Donou, S, Yan, G, Berry, T, et al. Mass gathering medicine: event factors predicting patient presentation rates. Intern Emerg Med. 2016;11(5):745752.CrossRefGoogle ScholarPubMed
Lonnee, M, Andersen, KG, Stagelund, S, et al. Use of medical supplies at the Roskilde Festival 2016: a prospective observational study. Prehosp Disaster Med. 2021;36(3):306312.CrossRefGoogle ScholarPubMed
Lund, A, Turris, SA. Mass-gathering medicine: risks and patient presentations at a 2-day electronic dance music event. Prehosp Disaster Med. 2015;30(3):271278.CrossRefGoogle Scholar
Maleczek, M, Rubi, S, Fohringer, C, et al. Medical care at a mass gathering music festival: retrospective study over 7 years (2011-2017). Wien Klin Wochenschr. 2022;134(7-8):324331.CrossRefGoogle Scholar
Milsten, AM, Seaman, KG, Liu, P, et al. Variables influencing medical usage rates, injury patterns, and levels of care for mass gatherings. Prehosp Disaster Med. 2003;18(4):334346.CrossRefGoogle ScholarPubMed
Milsten, AM, Tennyson, J, Weisberg, S. Retrospective analysis of mosh-pit-related injuries. Prehosp Disaster Med. 2017;32(6):636641.CrossRefGoogle ScholarPubMed
Milsten, A, Bradley, WF, Hill, M, et al. Foul ball rates and injuries at Major League Baseball games: a retrospective analysis of data from three stadiums. Prehosp Disaster Med. 2022;37(2):277283.CrossRefGoogle Scholar
Milsten, A, Ness, J. Hockey puck strike rates and injuries at National Hockey League games: a retrospective analysis of data from six seasons. Prehosp Disaster Med. 2022;37(3):397400.CrossRefGoogle Scholar
Morimura, N, Katsumi, A, Koido, Y, et al. Analysis of patient load data from the 2002 FIFA World Cup Korea/Japan. Prehosp Disaster Med. 2004;19(3):278284.CrossRefGoogle ScholarPubMed
Munn, MB, Lund, A, Golby, R, et al. Observed benefits to on-site medical services during an annual 5-day electronic dance music event with harm reduction services. Prehosp Disaster Med. 2016;31(2):228234.CrossRefGoogle ScholarPubMed
Pakravan, AH, West, RJ, Hodgkinson, DW. Suffolk Show 2011: prehospital medical coverage in a mass-gathering event. Prehosp Disaster Med. 2013;28(5):529532.CrossRefGoogle Scholar
Piat, SC, Minniti, D, Traversi, D, et al. Torino 2006 Winter Olympic Games: highlight on health services organization. J Emerg Med. 2010;39(4):454461.CrossRefGoogle ScholarPubMed
Rabb, H, Coleby, J. Hurt on the hill: a longitudinal analysis of obstacle course racing injuries. Orthop J Sports Med. 2018;6(6):2325967118779854.CrossRefGoogle Scholar
Rajakrishnan, S, Hafiz Ismail, MZ, Jamalulail, SH, et al. Investigation of a foodborne outbreak at a mass gathering in Petaling District, Selangor, Malaysia. Western Pac Surveill Response J. 2022;13(1):15.CrossRefGoogle Scholar
Sabra, JP, Cabañas, JG, Bedolla, J, et al. Medical support at a large-scale motorsports mass-gathering event: the inaugural formula one united states grand prix in Austin, Texas. Prehosp Disaster Med. 2014;29(4):392398.CrossRefGoogle Scholar
Spaepen, K, Haenen, WAP, Kaufman, L, et al. Validation of a Belgian prediction model for patient encounters at music mass gatherings. Prehosp Disaster Med. 2020;35(5):561566.CrossRefGoogle ScholarPubMed
Spaepen, K, Arno, G, Kaufman, L, et al. Validation of a Belgian prediction model for patient encounters at Belgium’s largest public cultural mass gathering. Disaster Med Public Health Prep. 2022;16(3):11281133.CrossRefGoogle ScholarPubMed
Spaepen, K, Lauwaert, D, Kaufman, L, et al. Validation of a Belgian prediction model for patient encounters at football mass gatherings. Prehosp Disaster Med. 2021;36(6):724729.CrossRefGoogle ScholarPubMed
Spaepen, K, Cardinas, R, Haenen, WAP, et al. The impact of in-event health services at Europe’s largest electronic dance music festival on EMS and ED in the host community. Int J Environ Res Public Health. 2023;20(4):3207.CrossRefGoogle ScholarPubMed
Spaite, DW, Meislin, HW, Valenzuela, TD, et al. Banning alcohol in a major college stadium: impact on the incidence and patterns of injury and illness. J Am Coll Health Assoc. 1990;39(3):125128.CrossRefGoogle Scholar
Tajima, T, Takazawa, Y, Yamada, M, et al. Spectator medicine at an international mega sports event: Rugby World Cup 2019 in Japan. Environ Health Prev Med. 2020;25(1):72.CrossRefGoogle ScholarPubMed
Thierbach, AR, Wolcke, BB, Piepho, T, et al. Medical support for children’s mass gatherings. Prehosp Disaster Med. 2003;18(1):1419.CrossRefGoogle ScholarPubMed
Turris, SA, Callaghan, CW, Rabb, H, et al. On the way out: an analysis of patient transfers from four large-scale north American music festivals over two years. Prehosp Disaster Med. 2019;34(1):3845.CrossRefGoogle ScholarPubMed
Ussahgij, W, Kotruchin, P, Osotthanakorn, P, et al. Analysis of medical interventions at the Start-Finish Medical Post of an international running event in rural Thailand. Prehosp Disaster Med. 2022;37(1):8489.CrossRefGoogle ScholarPubMed
Westrol, MS, Koneru, S, Mcintyre, N, et al. Music genre as a predictor of resource utilization at outdoor music concerts. Prehosp Disaster Med. 2017;32(3):289296.CrossRefGoogle ScholarPubMed
Yazawa, K, Kamijo, Y, Sakai, R, et al. Medical care for a mass gathering: the Suwa Onbashira festival. Prehosp Disaster Med. 2007;22(5):431435.CrossRefGoogle ScholarPubMed
Zeitz, KM, Schneider, DPA, Jarrett, D, et al. Mass gathering events: retrospective analysis of patient presentations over seven years. Prehosp Disaster Med. 2002;17(3):147150.CrossRefGoogle ScholarPubMed
Zeitz, KM, Zeitz, CJ, Arbon, P. Forecasting medical work at mass-gathering events: predictive model versus retrospective review. Prehosp Disaster Med. 2005;20(3):164168.CrossRefGoogle ScholarPubMed
Zeitz, K, Haghighi, PD, Burstein, F, et al. Understanding the drivers on medical workloads: an analysis of spectators at the Australian Football League. Australian Health Review. 2013;37(3):402406.CrossRefGoogle ScholarPubMed
Arbon, P. The development of conceptual models for mass-gathering health. Prehosp Disaster Med. 2004;19(3):208212.CrossRefGoogle ScholarPubMed
Scheers, H, Van Remoortel, H, Lauwers, K, et al. Predicting medical usage rate at mass gathering events in Belgium: development and validation of a nonlinear multivariable regression model. BMC Public Health. 2022;22(1):173.CrossRefGoogle ScholarPubMed
Ranse, J, Hutton, A. Minimum data set for mass-gathering health research and evaluation: a discussion paper. Prehosp Disaster Med. 2012;27(6):543550.CrossRefGoogle ScholarPubMed
Agar, C, Pickard, L, Bhangu, A. The tough guy prehospital experience: patterns of injury at a major UK endurance event. Emerg Med J. 2009;26(11):826830.CrossRefGoogle Scholar
Wetterhall, SF, Coulombier, DM, Herndon, JM, et al. Medical care delivery at the 1996 Olympic games. JAMA. 1998;279(18):14631468.CrossRefGoogle ScholarPubMed
Chan, SB, Quinn, JE. Outcomes in EMS-transported attendees from events at a large indoor arena. Prehosp Emerg Care. 2003;7(3):332335.CrossRefGoogle Scholar
Supplementary material: File

Çalışkan et al. supplementary material 1

Çalışkan et al. supplementary material
Download Çalışkan et al. supplementary material 1(File)
File 20.4 KB
Supplementary material: File

Çalışkan et al. supplementary material 2

Çalışkan et al. supplementary material
Download Çalışkan et al. supplementary material 2(File)
File 28.3 KB