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45th Annual Proceedings.
  1. F A Haight

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    Association for the Advancement of Automotive Medicine. (Pp x + 431; unpriced.) PO Box 4176, Barrington, IL 60011-4176, USA. ISSN 0892-6484.

    Professional conferences, whether national or international, serve a variety of purposes: social, recreational, fulfilling an obligation to sponsoring organizations, seeking employers or employees, awarding prizes, medals or honors and, in general terms, seeing and being seen. One of the most important purposes is presenting and critiquing the professional work that serves as the reason for the conference. On the first page of the book in review the AAAM expresses this last purpose in the following terms: “ . . . a forum for the presentation and discussion of research and issues on crash injury control”.

    To the best of my knowledge, our colleagues in sociology have not yet had the opportunity to evaluate the importance of this last (professional) purpose as against the other social and recreational opportunities mentioned above.

    Now there is a golden opportunity for such social research: a conference proceedings for a conference that was never held. It should be possible—although perhaps not easy—for an industrious student of evaluation procedures to compare the 45th Annual Proceedings with the 44th, perhaps even the 43rd, etc to test the professional advantage of actually sitting down together.

    Leaving that task to younger and wiser heads, I will do no more than to comment on a few aspects of the 45th. There are 36 papers including 10 designated as “scientific posters”. They were chosen by a distinguished Scientific Program Committee and divided into the following categories: restraint systems, injury risk studies, analyses of fatal injury, injury cost and scaling, rear impact, outcome and triage, driving behavior, crash analysis, and driver licensing. The categories, like the papers themselves deal chiefly with well known subjects. They find once again that “seat belt usage in Sweden is high”, that “ . . .risky behavior in adolescents is associated with non-use of safety devices”, that “women drive smaller, lighter cars compared to men”, that “during a rear end impact, the torso is thrust forward by the seat before the head begins to move”, that “binge drinking is problematic behavior with respect to injury”.

    Special mention must be made of a paper by Ted Miller and colleagues. In it, the exact dollar cost “per highway crash survivor” is provided, classified by 30 body parts and by 10 sources of cost. With allowances for each MAIS score, this means about 3750 tabular entries. One must admire the industry and patience that would surely have gone into this massive tabulation. One must also wonder “what exactly does it all mean?”. A MAIS 4 skull fracture costs US (1999) $336 221 in monetary costs and $609 696 in quality of life (QALY) loss, for a total cost of a bit under a million dollars.

    However straightforward some of the calculations, such as lost wages, may be it is understood that they are only averages. It is the QALY estimate that has often confused people. The explanation given in these proceedings only pushes the QALY matter back to two earlier papers (1993 and 1989) by the same author. I acknowledge that Miller may have done the best humanly possible, but I also hope his team will try to answer the question that so many have asked: “Who would have the QALY money if the injury had not occurred?”. Perhaps the 2002 AAAM Conference would be a good place to discuss the matter.

    Two cheers for this paper!

    A conference is often a byproduct of its sponsors. In the present case, we have “the usual suspects”: NHTSA, CDC, State Farm, but also some less well known sources of funding: Albert Einstein Medical Center, the Riley Memorial Foundation, Société d'assurance automobile du Québec.

    With a disk version and ample time, it would be interesting to search out the words “must” and “should”, to see what new initiatives are being proposed by experts.

    The 45th Annual Proceedings will also be valuable for the lists of publications given in several papers. Many of these are government reports and ephemeral matter. Among the archival journals, it is gratifying to me to see Accident Analysis and Prevention referenced 43 times.

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