BioTab-A New Method for Analyzing and Documenting Injury Causation in Motor-Vehicle Crashes

摘要

Objective: To describe a new method for analyzing and documenting the causes of injuries in motor vehicle crashes that has been implemented since 2005 in cases investigated by the Crash Injury Research Engineering Network (CIREN). Methods: The new method, called BioTab, documents injury causation using evidence from in-depth crash investigations. BioTab focuses on developing injury causation scenarios (ICSs) that document all factors considered essential for an injury to have occurred as well as factors that contributed to the likelihood and/or severity of an injury. The elements of an injury causation scenario are (1) the source of the energy that caused the injury, (2) involved physical components (IPCs) contacted by the occupant that are considered necessary for the injury to have occurred, (3) the body region or regions contacted by each IPC, (4) the internal paths between body regions contacted by IPCs and the injured body region, (5) critical intrusions of vehicle components, and (6) factors that contributed to the likelihood and/or the severity of injury. Results: Advantages of the BioTab method are that it - attempts to identify all factors that cause or contribute to clinically significant injuries, - allows for coding of scenarios where one injury causes another injury, - associates injuries with a source of energy and allows injuries to be associated with sources of energy other than the crash, such as air bag deployment energy, - allows for documenting scenarios where an injury was caused by two different body regions contacting two different IPCs, - identifies and documents the evidence that supports ICSs and IPCs, - assigns confidence levels to ICSs and IPCs based on available evidence, and - documents body region and organ/component-level "injury mechanisms" and distinguishes these mechanisms from ICSs. Conclusion: The BioTab method provides for methodical and thorough evidenced-based analysis and documentation of injury causation in motor vehicle crashes.