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METHODOLOGIC ISSUES |
Harborview Injury Prevention and Research Center and the Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
Correspondence and reprint requests to:
Dr Peter Cummings, Harborview Injury Prevention and Research Center, 325 Ninth Avenue, Box 359960, Seattle, WA 98104–2499, USA;
peterc{at}u.washington.edu
Objective: Estimates of any protective effect of seat belts could be exaggerated if some crash survivors falsely claimed to police that they were belted in order to avoid a fine. The aim of this study was to determine whether estimates of seat belt effectiveness differed when based on belt use as recorded by the police and belt use determined by trained crash investigators.
Design: Matched cohort study.
Setting: United States.
Subjects: Adult driver-passenger pairs in the same vehicle with at least one death (n=1689) sampled from crashes during 1988–2000; data from the National Accident Sampling System Crashworthiness Data System.
Main outcome measure: Risk ratio for death among belted occupants compared with those not belted.
Results: Trained investigators determined post-crash seat belt use by vehicle inspections for 92% of the occupants, confidential interviews with survivors for 5%, and medical or autopsy reports for 3%. Using this information, the adjusted risk ratio for belted persons was 0.36 (95% confidence interval 0.29 to 0.46). The risk ratio was also 0.36 using police reported belt use for the same crashes.
Conclusions: Estimates of seat belt effects based upon police data were not substantially different from estimates which used data obtained by trained crash investigators who were not police officers. These results were from vehicles in which at least one front seat occupant died; these findings may not apply to estimates which use data from crashes without a death.
Keywords: accidents, traffic; cohort studies; conditional Poisson regression; epidemiologic methods; seat belts
Abbreviations: CDS, Crashworthiness Data System; CI, confidence interval; FARS, Fatality Analysis Reporting System
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P A MacLennan, G McGwin Jr, J Metzger, S G Moran, and L W Rue III Risk of injury for occupants of motor vehicle collisions from unbelted occupants Inj. Prev., December 1, 2004; 10(6): 363 - 367. [Abstract] [Full Text] [PDF]
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 P. Cummings and F. P. Rivara Car Occupant Death According to the Restraint Use of Other Occupants: A Matched Cohort Study JAMA, January 21, 2004; 291(3): 343 - 349. [Abstract] [Full Text] [PDF]
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 P. Cummings, B. McKnight, and S. Greenland Matched Cohort Methods for Injury Research Epidemiol. Rev., August 1, 2003; 25(1): 43 - 50. [Full Text] [PDF]
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P Cummings and F P Rivara Misclassification of seat belt use Inj. Prev., March 1, 2003; 9(1): 91 - 91. [Full Text] [PDF]
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