title: The effect of earlier or automatic collision notification on traffic mortality by survival analysis.
abstract: OBJECTIVE
  This article explores the effects of earlier emergency medical services (EMS) or automatic collision notification (ACN) and EMS arrival on passenger/driver survivability within the short time frame following traffic crashes.
  
  
  METHODS
  Survival analysis techniques are used extensively in this study, because traffic crash and EMS data are closely associated with time. The Kaplan-Meier estimator and life curves are applied to compare the survival rates between 2 or more conditions (e.g., earlier verus late EMS notification); The Weibull model with 3 parameters is used to predict mortality over time; furthermore, the Cox proportional hazard model explores multiple risk factors related to traffic mortality.
  
  
  RESULTS
  Based on Fatality Analysis Reporting System (FARS) data from 2005 to 2009, Kaplan-Meier life curves clearly showed the benefits associated with earlier notifications (approximately 1.84% fatality reduction within a time frame of 6 h after a crash) and earlier arrivals, and the Weibull model with 3 parameters reasonably predicted the fatality trends. The relative risks (RRs) associated with collision notification, arrival, location, and age were obtained from a multiple Cox regression model, and the relatively higher fatality hazard (2.4% higher) associated with the later notification of more than 1 min was studied in detail.
  
  
  CONCLUSIONS
  This article obtains the driver/passenger survival probability differences over time under different conditions of collision notifications, EMS arrivals, and crash locations; furthermore, this analysis provides an estimation of the lives that could potentially be saved (approximately 154 to 290 per year) due to earlier ACN.
authors.affiliation: National Highway Traffic Safety Administration, U.S. Department of Transportation, Washington, DC, USA. jingshu.wu@dot.gov
authors.forename: Jingshu
authors.initials: J
authors.lastname: Wu
authors.forename: Rajesh
authors.initials: R
authors.lastname: Subramanian
authors.forename: Matthew
authors.initials: M
authors.lastname: Craig
authors.forename: Marc
authors.initials: M
authors.lastname: Starnes
authors.forename: Anders
authors.initials: A
authors.lastname: Longthorne
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality* / Q000706:statistics & numerical data; D015331:Cohort Studies; D004631:Emergency Medical Service Communication Systems; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D006801:Humans; D019035:Rural Health Services; D016019:Survival Analysis; D013997:Time Factors; D019037:Urban Health Services