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Thursday, November 4, 2010

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."
The key points noted in this article include:
  1. A substantial number of injuries are reported in crashes of little or no property damage.
  2. Property damage is an unreliable predictor of injury risk or outcome in low velocity crashes!
  3. 95% of rear impact injury crashes occur below 25 mph.
  4. Rear-end collision injury severity and duration can be reduced with a head restraint closer to the occupant's head.
  5. Well-done studies documented cases of injury with "almost no vehicle damage."
  6. There is "no statistically significant associations between crash severity and the 6-month injury status."!
  7.  "Persons who were unaware of the impending crash were significantly more likely to have persistent symptoms."
  8. "No statistically significant relationships existed between measures of crash severity in terms of calculated velocity change or maximum deformation and long-term symptoms."
  9. There are no significant correlations between crash severity and long-term symptoms.
  10. There is a substantial injury risk in frontal and rear impact low speed crashes without sustaining appreciable vehicle damage.
  11. "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."
  12. "A substantial number of injuries are reported in crashes of severities that are unlikely to result in significant property damage."
  13. "Property damage is neither a valid predictor of acute injury risk nor of symptom duration."
  14. "Based upon our best evidence synthesis, the level of vehicle property damage appears to be an invalid construct for injury presence, severity, or duration."
  15.  "The MIST protocol for prediction of injury does not appear to be valid."    
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