Traffic injury prevention
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Traffic injury prevention · Sep 2016
Prehospital transportation decisions for patients sustaining major trauma in road traffic crashes in Sweden.
The objective of this study was to evaluate the proportion and characteristics of patients sustaining major trauma in road traffic crashes (RTCs) who could benefit from direct transportation to a trauma center (TC). ⋯ Our results show that the majority of RTC major trauma patients are transported to a non-TC. This may cause unnecessary morbidity and mortality. These findings can guide the development of improved prehospital treatment guidelines, protocols and decision support systems.
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Traffic injury prevention · Sep 2016
Development of an expert based ICD-9-CM and ICD-10-CM map to AIS 2005 update 2008.
This article describes how maps were developed from the clinical modifications of the 9th and 10th revisions of the International Classification of Diseases (ICD) to the Abbreviated Injury Scale 2005 Update 2008 (AIS08). The development of the mapping methodology is described, with discussion of the major assumptions used in the process to map ICD codes to AIS severities. There were many intricacies to developing the maps, because the 2 coding systems, ICD and AIS, were developed for different purposes and contain unique classification structures to meet these purposes. ⋯ This mapping between ICD and AIS provides a comprehensive, expert-designed solution for analysts to bridge the data gap between the injury descriptions provided in hospital codes (ICD-9-CM, ICD-10-CM) and injury severity codes (AIS08). By applying consistent rules from both the ICD and AIS taxonomies, the expert panel created these definitive maps, which are the only ones endorsed by the Association for the Advancement of Automotive Medicine (AAAM). Initial validation upheld the quality of these maps for the estimation of AIS severity, but future work should include verification of these maps for MAIS and ISS estimations with large data sets. These ICD-AIS maps will support data analysis from databases with injury information classified in these 2 different systems and open new doors for the investigation of injury from traumatic events using large injury data sets.
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Traffic injury prevention · Jul 2016
A virtual test system representing the distribution of pedestrian impact configurations for future vehicle front-end optimization.
The purpose of this study is to define a computationally efficient virtual test system (VTS) to assess the aggressivity of vehicle front-end designs to pedestrians considering the distribution of pedestrian impact configurations for future vehicle front-end optimization. The VTS should represent real-world impact configurations in terms of the distribution of vehicle impact speeds, pedestrian walking speeds, pedestrian gait, and pedestrian height. The distribution of injuries as a function of body region, vehicle impact speed, and pedestrian size produced using this VTS should match the distribution of injuries observed in the accident data. The VTS should have the predictive ability to distinguish the aggressivity of different vehicle front-end designs to pedestrians. ⋯ Injury predictions derived from the VTS give a good representation of the distribution of injuries observed in the PCDS and distinguishing ability on the aggressivity of vehicle front-end designs to pedestrians. The VTS can be considered as an effective approach for assessing pedestrian safety performance of vehicle front-end designs at the generalized level. However, the absolute injury number is substantially underpredicted by the VTS, and this needs further development.
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Traffic injury prevention · May 2016
All-terrain vehicle fatalities on paved roads, unpaved roads, and off-road: Evidence for informed roadway safety warnings and legislation.
All-terrain vehicles (ATVs) are designed for off-highway use only, and many of their features create increased risk with roadway travel. Over half of all ATV-related fatalities occur on roadways, and nonfatal roadway crashes result in more serious injuries than those off the road. A number of jurisdictions have passed or have considered legislation allowing ATVs on public roadways, sometimes limiting them to those unpaved, arguing that they are safe for ATVs. However, no studies have determined the epidemiology of ATV-related fatalities on different road surface types. The objective of the study was to compare ATV-related deaths on paved versus unpaved roads and to contrast them with off-road fatalities. ⋯ Although differences were observed between paved and unpaved roads, our results show that riding on either represented significantly greater dangers than riding off the road. Many vehicle warnings specifically mention the risks of paved but not unpaved roads, yet we found 23 states with half or more of their roadway deaths on unpaved surfaces. Safety warnings should explicitly state the dangers of roadway riding regardless of surface type. These data further support laws/ordinances greatly restricting ATV riding on all types of public roadways.
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Traffic injury prevention · May 2016
Validation of quasi-induced exposure representativeness assumption among young drivers.
Young driver studies have applied quasi-induced exposure (QIE) methods to assess relationships between demographic and behavioral factors and at-fault crash involvement, but QIE's primary assumption of representativeness has not yet been validated among young drivers. Determining whether nonresponsible young drivers in clean (i.e., only one driver is responsible) 2-vehicle crashes are reasonably representative of the general young driving population is an important step toward ensuring valid QIE use in young driver studies. We applied previously established validation methods to conduct the first study, to our knowledge, focused on validating the QIE representativeness assumption in a young driver population. ⋯ It appears that the representativeness assumption holds among the population of young NJ drivers. We encourage young driver studies utilizing QIE methods to conduct internal validation studies to ensure appropriate application of these methods and we propose utilization of QIE methods to address broader foundational and applied questions in young driver safety.