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Analysis of Alabama ACN Data

The CenTIR currently has access to a unique OnStar dataset from the Alabama ACN Project.  As part of our CenTIR research to evaluate use of crash telemetry data to support emergency medical response, several activities are underway.

• Creation of an Alabama ACN SQL server database.  This database contains and correlates all available information on the OnStar reported Alabama ACN and AACN crashes.  This information includes available police accident report data, OnStar message data on the vehicle and the crash, and for the crashes that occur in the Birmingham Alabama region, information on the vehicle occupant injury severity.  When completed, the database will be used to support crash analyses.
• Analyses of existing AACN crash data.  The ability to accurately triage trauma patients can be difficult in the prehospital environment. Prehospital trauma scoring systems (e.g., Glascow Coma Score) have been developed with a goal of determining which patients should be transported immediately to a trauma center, where a patient can have access to the highest medical expertise and resource-intensive lifesaving interventions (LSI).  Much of the available research indicates that the optimal discrimination of this group of patients will require new analytic approaches [1, 2, 3, 4].

Crash severity information, provided in OnStar AACN crash messages provides a new source of data for real-time prediction of injury severity.  With this in mind, we calculated the sensitivity, specificity and positive predictive values associated with the use of the OnStar reported crash delta velocity to predict crash victim need for LSI.  (‘Truth’ used in our calculations was the field triage decisions made by ‘expert’ paramedic/EMTs at the Birmingham region Trauma Communications Center.)  Initial results show that although the sample size is small, the values compare favorably with the performance of other commonly used metrics and illustrate the potential value of using vehicle supplied crash severity data to improve pre-hospital triage processes.

1. Holcomb J,  Niles S,   Miller CC,   Hinds D,   Duke JH,  Moore FA: Prehospital Physiologic Data and Lifesaving Interventions in Trauma Patients Military Medicine, Volume 170, Number 1, January 2005 , pp. 7-13(7)
2. Zimmer-Gembeck MJ, Southard PA, Hedges JR, et al: Triage in an established trauma system. J Trauma 1995; 39: 922-8.
3. Garner A, Lee A, Harrison K, Schullz CH: Comparative analysis of multiple-casualty incident triage algorithms. Ann Emerg Med 2001; 38: 541-8.
4. Kane G, Engelhardt R, Celentano J, et al: Empirical development and evaluation of prehospital trauma triage instruments. J Trauma 1986; 25: 482-89.