Thursday, January 2, 2014

Correlating Crash Severity with Injury Risk, Injury Severity, and Long-term Symptoms in Low Velocity Motor Vehicle Collisions

Medical Science Monitor
October 2005; 11(10): RA316-321
Arthur C. Croft and Michael D. Freeman

These authors note: In the mid-1990s, a set of guidelines was published by a leading U.S. auto insurer instructing claims adjusters that injury claims resulting from motor vehicle crashes with less that $1,000 US in claimant's vehicle property are "unlikely to — or cannot cause significant or permanent injury" and should "be handled as a fraudulent claim," regardless of medical evidence of injury. The "claim goal was to close without payment."

The MIST (minor impact soft tissue) protocol uses vehicle property damage as a construct for injury, and all injury claims less than $1,000 US of vehicle property damage are considered to be false.
  
These authors "conducted a comprehensive best evidence synthesis of the existing medical and engineering literature to investigate the relationship between vehicular structural damage and occupant injury in motor vehicle crashes."
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The key points noted in this article include:
  • A substantial number of injuries are reported in crashes of little or no property damage.
  • Property damage is an unreliable predictor of injury risk or outcome in low velocity crashes!
  • 95% of rear impact injury crashes occur below 25 mph.
  • Rear-end collision injury severity and duration can be reduced with a head restraint closer to the occupant's head.
  • Well-done studies documented cases of injury with "almost no vehicle damage."
  • There is "no statistically significant associations between crash severity and the 6-month injury status."!
  •  "Persons who were unaware of the impending crash were significantly more likely to have persistent symptoms."
  • "No statistically significant relationships existed between measures of crash severity in terms of calculated velocity change or maximum deformation and long-term symptoms."
  • There are no significant correlations between crash severity and long-term symptoms.
  • There is a substantial injury risk in frontal and rear impact low speed crashes without sustaining appreciable vehicle damage.
  • "It seems clear that property damage in low velocity motor vehicle crashes does not provide a reliable means of assessing the validity of injury claims and, provides no reliable means of prognosticating long term outcome."
  • "A substantial number of injuries are reported in crashes of severities that are unlikely to result in significant property damage."
  • "Property damage is neither a valid predictor of acute injury risk nor of symptom duration."
  • "Based upon our best evidence synthesis, the level of vehicle property damage appears to be an invalid construct for injury presence, severity, or duration."
  •  "The MIST protocol for prediction of injury does not appear to be valid."    
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