Quantitative Crash Injury Risk Predictions by Body Region: Is Risk Sensitive to New Vehicle Safety Features?

Author(s):  
Kristofer D. Kusano ◽  
Hampton C. Gabler

Retrospective examinations of real-world injury data is often used to evaluate injury risk for exposure to hazards, e.g. car crashes. In studying injury resulting from passenger vehicle crashes, there are several sources of real-world data that contain information about the crashes (e.g. vehicle damage, impact speeds) as well as occupant injury outcome. These real-world crash databases are used, for example, to study risk of traumatic brain injury, countermeasure opportunities for far-side occupants in side impact, and spleen injury for different restraint types [1–3].

2005 ◽  
Author(s):  
Hampton C. Gabler ◽  
Kennerly Digges ◽  
Brian N. Fildes ◽  
Laurie Sparke

1994 ◽  
Vol 116 (3) ◽  
pp. 270-277 ◽  
Author(s):  
David C. Viano

BioSID dummy tests were run with the arm down at the side during loading of different armrests in simulated side impact crashes. The Hyge sled tests duplicated previous studies of BioSID with the arm up, SID, and animals. When the BioSID arm is against the side, the arm extends from the shoulder to the bottom of the third rib and has a steel shank covered by foam and vinyl. Loading through the arm transfers force to the three chest ribs and shoulder. In comparison, direct armrest loading of the chest or abdomen primarily involves a single rib and substantial rib deflection, when the armrest crush-force exceeds the strength of the rib. The Viscous response in BioSID showed the greatest difference of all criteria for the arm up or down. The response of the third rib correlated with injury risks determined from animal tests using the different armrest designs in a simulated high position. While injury data are not available for the arm at the side or for the armrest in the low position, the STIFF armrest may cause injury when the arm is not at the side and the armrest loads the liver and spleen. Rib deflection in BioSID showed the protrusion of the STIFF armrest into the abdominal region in both arm positions, because the loading was below the arm even in the down position. However, the arm extends laterally so it involves the upper ribs earlier than in the arm-up condition where more space is available. Torso deflection showed similar maxima with the arm down and a high armrest position, because the bridging action of the arm and shoulder increases the stiffness of the dummy. The armrest designs cover a range in crush characteristics for occupant protection systems based on experience with other interior safety features, knowledge of human tolerance, and results of injury in animal tests. The SOFT design was most appropriate for interior use. The STIFF design produced serious injury in companion tests with animals, and the BioSID correctly assessed injury risk by peak rib deflection or Viscous response when tested similarly. In contrast, SID and TTI(d) did not indicate injury risks or safety performance. The current study indicates that response differences can be expected with arm placement, and BioSID can assess safety implications of different armrest types and arm placement.


2016 ◽  
Vol 22 ◽  
pp. 219
Author(s):  
Roberto Salvatori ◽  
Olga Gambetti ◽  
Whitney Woodmansee ◽  
David Cox ◽  
Beloo Mirakhur ◽  
...  

VASA ◽  
2019 ◽  
Vol 48 (2) ◽  
pp. 134-147 ◽  
Author(s):  
Mirko Hirschl ◽  
Michael Kundi

Abstract. Background: In randomized controlled trials (RCTs) direct acting oral anticoagulants (DOACs) showed a superior risk-benefit profile in comparison to vitamin K antagonists (VKAs) for patients with nonvalvular atrial fibrillation. Patients enrolled in such studies do not necessarily reflect the whole target population treated in real-world practice. Materials and methods: By a systematic literature search, 88 studies including 3,351,628 patients providing over 2.9 million patient-years of follow-up were identified. Hazard ratios and event-rates for the main efficacy and safety outcomes were extracted and the results for DOACs and VKAs combined by network meta-analysis. In addition, meta-regression was performed to identify factors responsible for heterogeneity across studies. Results: For stroke and systemic embolism as well as for major bleeding and intracranial bleeding real-world studies gave virtually the same result as RCTs with higher efficacy and lower major bleeding risk (for dabigatran and apixaban) and lower risk of intracranial bleeding (all DOACs) compared to VKAs. Results for gastrointestinal bleeding were consistently better for DOACs and hazard ratios of myocardial infarction were significantly lower in real-world for dabigatran and apixaban compared to RCTs. By a ranking analysis we found that apixaban is the safest anticoagulant drug, while rivaroxaban closely followed by dabigatran are the most efficacious. Risk of bias and heterogeneity was assessed and had little impact on the overall results. Analysis of effect modification could guide the clinical decision as no single DOAC was superior/inferior to the others under all conditions. Conclusions: DOACs were at least as efficacious as VKAs. In terms of safety endpoints, DOACs performed better under real-world conditions than in RCTs. The current real-world data showed that differences in efficacy and safety, despite generally low event rates, exist between DOACs. Knowledge about these differences in performance can contribute to a more personalized medicine.


2020 ◽  
Author(s):  
Jersy Cardenas ◽  
Gomez Nancy Sanchez ◽  
Sierra Poyatos Roberto Miguel ◽  
Luca Bogdana Luiza ◽  
Mostoles Naiara Modroño ◽  
...  

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