title: Expert Perspectives on Time Sensitivity and a Related Metric for Children Involved in Motor Vehicle Crashes.
abstract: Advanced Automatic Crash Notification (AACN) uses vehicle telemetry data to predict risk of serious injury among motor vehicle crash occupants and can thus improve the accuracy with which injured children are triaged by first responders. To better define serious injury for AACN systems (which typically use Abbreviated Injury Scale [AIS] metrics), an age-specific approach evaluating severity, time sensitivity (TS), and predictability of injury has been developed. This study outlines the development of the TS score.
  
  
  
  The 95% most frequent AIS 2+ injuries in a national motor vehicle crash data set spanning 2000 to 2011 were determined for the following age groups: 0 to 4, 5 to 9, 10 to 14, and 15 to 18 years. For each age-specific injury, clinicians with pediatric trauma expertise were asked if treatment at a trauma center was required and were asked about the urgency of treatment. A TS score (range 0-1) was calculated by combining the mean trauma center decision and urgency scores.
  
  
  
  A total of 30 to 32 responses were obtained for each age-specific injury. The most frequent motor vehicle crash-induced injuries in the younger groups received significantly higher scores than those in the older groups (median TS score 0 to 4 years: 0.89, 5-9 years: 0.87, 10-14 years: 0.82, 15-18 years: 0.72, P < .001). Large variations in TS existed within each AIS severity level; for example, scores among AIS 2 injuries in 0- to 4-year-olds ranged from 0.12 to 0.98.
  
  
  
  The TS of common pediatric injuries varies on the basis of age and may not be accurately reflected by AIS metrics. AIS may not capture all aspects of injury that should be considered by AACN systems.
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, NC; Childress Institute for Pediatric Trauma, Winston-Salem, NC.
authors.forename: Andrea N
authors.initials: AN
authors.lastname: Doud
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, NC; Virginia Tech-Wake Forest University Center for Injury Biomechanics, Winston-Salem, NC.
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Schoell
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, NC; Virginia Tech-Wake Forest University Center for Injury Biomechanics, Winston-Salem, NC. Electronic address: asweaver@wakehealth.edu.
authors.forename: Ashley A
authors.initials: AA
authors.lastname: Weaver
authors.affiliation: Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Jennifer W
authors.initials: JW
authors.lastname: Talton
authors.affiliation: Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Ryan T
authors.initials: RT
authors.lastname: Barnard
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, NC; Childress Institute for Pediatric Trauma, Winston-Salem, NC.
authors.forename: John K
authors.initials: JK
authors.lastname: Petty
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, NC; Childress Institute for Pediatric Trauma, Winston-Salem, NC.
authors.forename: J Wayne
authors.initials: JW
authors.lastname: Meredith
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, NC; Virginia Tech-Wake Forest University Center for Injury Biomechanics, Winston-Salem, NC; Childress Institute for Pediatric Trauma, Winston-Salem, NC.
authors.forename: Joel D
authors.initials: JD
authors.lastname: Stitzel
mesh_terms: D015998:Abbreviated Injury Scale; D000063:Accidents, Traffic; D000293:Adolescent; D000367:Age Factors; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D060731:Emergency Responders; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018570:Risk Assessment; D013997:Time Factors; D061665:Time-to-Treatment; D014218:Triage; D014947:Wounds and Injuries / Q000453:epidemiology / Q000503:physiopathology*
keywords: Advanced Automatic Crash Notification (AACN); injury; pediatric trauma; time sensitivity; triage