Scheduling optimisation of alcohol test sites.

Drink driving is an infamous factor in road crashes and fatalities. Alcohol testing is a major countermeasure, and random breath tests (RBTs) deter tested drivers and passersby (observers who are not tested). We propose a genetic algorithm (GA)-based RBT scheduling optimisation method to achieve maximal deterrence of drink driving. The RBT schedule denotes the daily plan of where, when, and for how long tests should occur in the road network. The test results (positive and negative) and observing drivers are considered in the fitness function. The limited testing resource capacity is modeled by a number of constraints that consider the total duration of tests, the minimum and maximum duration of a single test site, and the total number of test sites during the day. Clustering of the alcohol-related crash data is used to estimate the matrix for drink driving on the scheduled day. The crash data and traffic flow data from Victoria, Australia are analysed and used to describe sober/drink driving. A detailed synthetic example is developed and a significant improvement with 150% more positive results and 59% more overall tests is observed using the proposed scheduling optimisation method.

Personal injury recovery cost of pedestrian-vehicle collisions in New South Wales, Australia.

BACKGROUND: There is a need for routine estimates of injury recovery costs from pedestrian collisions using hospital separation records for economic evaluations. OBJECTIVE: To estimate the cost of injury recovery following pedestrian-vehicle collisions using the personal injury recover cost (PIRC) equation using key demographic and injury characteristics. METHOD: An estimation of the costs of on-road pedestrian-vehicle collisions involving individuals who were injured and hospitalized in New South Wales (NSW), Australia, from 2002 to 2011 using the PIRC equation. The PIRC estimates individual injury recovery costs and does not include costs associated with property damage, vehicle repair, or rescue services. Individual recovery costs associated with severe traumatic brain injury (TBI) were estimated. The injured individual's mean, median, and total injury recovery costs are described for key demographic, injury, and crash characteristics. RESULTS: There were 9,781 pedestrians who were injured, costing an estimated total of $2.4 billion in personal injury recovery costs, an annual cost of $243 million. Males had a total injury recovery cost 1.7 times higher than females. The median injury recovery cost decreased with increasing age. TBI ($248,491) and spinal cord and vertebral column injuries ($264,103) had the highest median injury recovery costs for the body region of the most severe injury. TBI accounted for 22.6% of the total injury recovery costs for the most severe injury sustained. Just over one third of pedestrians sustained 4 or more injuries, with a median cost of $243,992, which was 1.6 times higher than the cost for a pedestrian who sustained a single injury ($153,682). CONCLUSIONS: Personal injury recovery costs following pedestrian-vehicle collisions where a pedestrian is injured are substantial in NSW. The PIRC equation enables the economic cost burden of road traffic injury to be calculated using hospital separation data. The PIRC enables comprehensive personal injury recovery costs to be estimated and would aid in economic evaluations of preventive strategies in road safety.

Examination of narratives from emergency department presentations to identify road trauma, crash and injury risk factors for different age groups.

BACKGROUND: Road trauma represents a high proportion of injury-related emergency department presentations. Narrative text recorded in the emergency department could provide useful information to monitor road trauma and to identify crash and injury risk factors by age group. OBJECTIVE: To examine the Public Health Real-time Emergency Department Surveillance System (PHREDSS) to identify road users (i.e. motor vehicle drivers, motor vehicle passengers, motorcyclists, pedal cyclists and pedestrians), and crash (e.g. vehicle speed) and injury risk factors (e.g. non-restraint use) by age group. METHOD: Narrative text from the PHREDSS in New South Wales, Australia, during 1 January 2006 to 31 December 2012 was reviewed. RESULTS: A keyword search of all emergency department presentations potentially identified 388,991 road trauma-related presentations and between 6,420 motorbike crashes to 138,889 motor vehicle accident emergency department presentations. Potential crash and injury risk factors were also identified. CONCLUSION: This exploratory study demonstrated the capability of information from PHREDSS to be used to support injury prevention efforts in road safety.

The role of evidence, standards and education in rock fishing safety in New South Wales, Australia.

OBJECTIVE: To examine rock fishing-related fatalities and hospitalisations, identify initiatives aimed at improving safety and survey key rock fishing stakeholders about the strengths and limitations of each initiative. METHOD: This research obtained information from mortality and hospitalisation statistics, the published literature and key stakeholders for opinions on the strengths, limitations and improvements for rock fishing safety initiatives. RESULTS: Injury patterns involving rock fishers have largely remained unchanged over time. The literature revealed that many rock fishing safety initiatives focused on awareness raising and engineering initiatives, but ignored the development of guidelines and the use of enforcement strategies. There had been limited evaluations conducted of any of the initiatives reviewed. CONCLUSIONS: It is likely that a combination of evidence-based, standard-focused and education initiatives would be useful in improving rock fishing safety in NSW, provided that the impact of these initiatives were routinely evaluated. IMPLICATIONS: Information from this research will be used to inform preventive strategies aimed at improving rock fishing safety through better coordination of the role of evidence in informing standards and practices and the continued evaluation of these initiatives.

Data linkage for injury surveillance and research in Australia: perils, pitfalls and potential.

OBJECTIVE: To outline some of the key issues for injury-related data linkage studies in Australia and describe potential applications of data linkage for injury surveillance and research. METHODS: Narrative review of data linkage capacity and injury-related data collection quality in Australia. RESULTS: The establishment of national and state-based data linkage centres in Australia has been a great leap forward for data linkage capacity for injury research. However, there are still limitations of using data linkage for injury surveillance and research. These are highlighted in the form of key perils and pitfalls, with examples provided. There is still much to be gained for injury research by using data linkage techniques to enhance the information available across the injury continuum, but data quality issues should always be acknowledged. CONCLUSIONS: Obtaining authorisation to link injury data collections for national research remains cumbersome. Streamlining of the application process is needed to ensure that injury research is able to be conducted in a timely fashion. Data quality and data linkage rates need to be considered when interpreting research findings. IMPLICATIONS: Streamlining of the application process for research that involves linking data collections would help ensure that research is conducted in a timely fashion.

Can SNOMED CT as implemented in New South Wales, Australia be used for road trauma injury surveillance in emergency departments?

The introduction of Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT) for diagnosis coding in emergency departments (EDs) in New South Wales (NSW) has implications for injury surveillance abilities. This study aimed to assess the consequences of its introduction, as implemented as part of the ED information system in NSW, for identifying road trauma-related injuries in EDs. It involved a retrospective analysis of road trauma-related injuries identified in linked police, ED and mortality records during March 2007 to December 2009. Of all SNOMED CT codes in the principal provisional diagnosis field, between 53.7% and 78.4% referred to the type of injury or symptom experienced by the individual. Of the road users identified by police, 3.2% of vehicle occupants, 6% of motorcyclists, 10.0% of pedal cyclists and 5.2% of pedestrians were identified using SNOMED CT codes in the principal provisional diagnosis field. The introduction of SNOMED CT may provide flexible terminologies for clinicians. However, unless carefully implemented in information systems, its flexibility can lead to mismatches between the intention and actual use of defined data fields. Choices available in SNOMED CT to indicate symptoms, diagnoses, or injury mechanisms need to be controlled and these three concepts need to be retained in separate data fields to ensure a clear distinction between their classifications in the ED.