Vanasse Hangen Brustlin, Inc., 333 Fayetteville St, Suite 1450, Raleigh, NC 27601, United States.
Accid Anal Prev. 2013 Dec;61:87-96. doi: 10.1016/j.aap.2012.05.013. Epub 2012 Jun 8.
There is an increased interest in the use of epidemiological methods in highway safety analysis. The case-control and cohort methods are commonly used in the epidemiological field to identify risk factors and quantify the risk or odds of disease given certain characteristics and factors related to an individual. This same concept can be applied to highway safety where the entity of interest is a roadway segment or intersection (rather than a person) and the risk factors of interest are the operational and geometric characteristics of a given roadway. One criticism of the use of these methods in highway safety is that they have not accounted for the difference between sites with single and multiple crashes. In the medical field, a disease either occurs or it does not; multiple occurrences are generally not an issue. In the highway safety field, it is necessary to evaluate the safety of a given site while accounting for multiple crashes. Otherwise, the analysis may underestimate the safety effects of a given factor. This paper explores the use of the case-control method in highway safety and two variations to account for sites with multiple crashes. Specifically, the paper presents two alternative methods for defining cases in a case-control study and compares the results in a case study. The first alternative defines a separate case for each crash in a given study period, thereby increasing the weight of the associated roadway characteristics in the analysis. The second alternative defines entire crash categories as cases (sites with one crash, sites with two crashes, etc.) and analyzes each group separately in comparison to sites with no crashes. The results are also compared to a "typical" case-control application, where the cases are simply defined as any entity that experiences at least one crash and controls are those entities without a crash in a given period. In a "typical" case-control design, the attributes associated with single-crash segments are weighted the same as the attributes of segments with multiple crashes. The results support the hypothesis that the "typical" case-control design may underestimate the safety effects of a given factor compared to methods that account for sites with multiple crashes. Compared to the first alternative case definition (where multiple crash segments represent multiple cases) the results from the "typical" case-control design are less pronounced (i.e., closer to unity). The second alternative (where case definitions are constructed for various crash categories and analyzed separately) provides further evidence that sites with single and multiple crashes should not be grouped together in a case-control analysis. This paper indicates a clear need to differentiate sites with single and multiple crashes in a case-control analysis. While the results suggest that sites with multiple crashes can be accounted for using a case-control design, further research is needed to determine the optimal method for addressing this issue. This paper provides a starting point for that research.
人们越来越感兴趣地将流行病学方法应用于公路安全分析。病例对照和队列方法通常用于流行病学领域,以确定危险因素,并量化给定特征和个体相关因素下疾病的风险或几率。这一概念同样适用于公路安全,其中感兴趣的实体是道路路段或交叉口(而不是人),而感兴趣的危险因素是特定道路的运营和几何特征。这些方法在公路安全中的应用存在一个批评,即它们没有考虑到具有单个和多个碰撞的地点之间的差异。在医学领域,疾病要么发生,要么不发生;多次发生一般不是问题。在公路安全领域,在考虑到多个碰撞的情况下,有必要评估给定地点的安全性。否则,分析可能会低估给定因素的安全效果。本文探讨了病例对照法在公路安全中的应用以及两种变体,以考虑具有多个碰撞的地点。具体来说,本文提出了两种在病例对照研究中定义病例的替代方法,并在案例研究中比较了结果。第一种替代方法为给定研究期内的每次碰撞定义一个单独的病例,从而增加了分析中相关道路特征的权重。第二种替代方法将整个碰撞类别定义为病例(一次碰撞的地点、两次碰撞的地点等),并分别对每个组进行分析,与无碰撞的地点进行比较。结果还与“典型”病例对照应用进行了比较,其中病例仅定义为在给定时间段内经历至少一次碰撞的任何实体,而对照则是在给定时间段内没有碰撞的实体。在“典型”病例对照设计中,与单碰撞路段相关的属性与具有多个碰撞的路段的属性加权相同。结果支持这样一种假设,即与考虑具有多个碰撞的地点的方法相比,“典型”病例对照设计可能会低估给定因素的安全效果。与第一种替代病例定义(其中多个碰撞路段代表多个病例)相比,“典型”病例对照设计的结果不太明显(即更接近单位)。第二种替代方法(其中为各种碰撞类别构建病例定义并分别进行分析)进一步证明,在病例对照分析中,不应将具有单个和多个碰撞的地点归为一组。本文表明,在病例对照分析中需要明确区分具有单个和多个碰撞的地点。虽然结果表明可以使用病例对照设计来考虑具有多个碰撞的地点,但需要进一步研究来确定解决此问题的最佳方法。本文为该研究提供了一个起点。