I-Like-To-Bike

It is hard to imagine that there are many cyclists refusing treatment if they are in fact seriously injured in a bike-car accident.

Ambulances being dispatched to an accident scene is hardly indicitive of the severity of cyclist injuries, especially when, as you indicate, many cyclist "victims" don't need any emergency medical care.

Being the best available evidence does not add any credibility to conclusions drawn when the data is still lacking essential info.

invisiblehand

There are lots of anecdotes where people refuse treatment only to discover that they need medical attention later. I guess it depends on how you want to count something like a fractured arm or the sort. Would this be seriously injured? I can see people rejecting the ER to go to their personal doctor for "bad" things but not "bad" enough to be life threating.

Anyway, if anyone is interested, I wrote this quick summary.

JPprivate

Says the man from Lincoln Nebraska. If there is a place in this country that has a lot of space, it's Lincoln (and Omaha) Nebraska. Omaha, in particular, has been growing substaintially in the last 40 years. And people move further and further out west, in a city that already has a very low density. And that low density makes maintaining an infrastructure for motorists very expensive on a per capita basis.

No, except of a handful of high-density cities in the U.S. there is plenty of room. And cities appear to have plenty of money if they allow people (by means of providing infrastructure) to move further and further out of the city centers.

genec

I refused treatment after a car collision... I was in shock and had no idea how bad the injuries were... I actually drove the vehicle home, and then the next day could not believe I had driven the car. I also went to the hospital the next day after it was apparent I was quite hurt.

The problem is after a collision, with shock, you may not fully understand how injured you really are. I had no choice after my last car/bike collision... I was unconscious. I was taken to the hospital.

I do agree with you regarding the data collection issues... if police are called, a report should be written that includes at least some indicator of the severity of the injuries as observed. With computers and data pads, this should not be that big of a deal.

I-Like-To-Bike

If I was in charge of categozing severity of injuries. Serious injuries would require at least an overnight admission into hospital, permanent negative efffects, and/or an injury that requires a relatively long treatment prior to recovery. A broken arm is probably borderline IMO. Not serious are injuries to people who go to an emergency room or choose their own doctor to treat their boo-boos with a few stitches, bandages for their scratches or just in case MRI since the insurance company will pick up the tab.

Digital_Cowboy

Then I'm glad that you are not the one who is in charge of categorizing the severity of injuries. As, as it has been said in the past NOT all injuries present themselves immediately. Especially given the adrenaline that is pumping through one's system, as well as the state of shock that one also usually finds themselves in after being hit.

electrik

No need to stick your apparently uneducated nose in there, there are already well graduated trauma scoring guidelines for these studies.

genec

Well apparently they don't use "well graduated trauma scoring guidelines" for the studies done in the US... especially when reports are never written even documenting the collisions.

electrik

What is their tracking method, black and white? Any half decent study should adopt a trauma scoring standard, that way you don't get people throwing broken arms in with boo-boos. It is the cyclist's responsibly to report the accident if they're at all injured(even a boo boo) or damages exceed $100.

TheHen

Help me out here. Is that something unique to your country or is that commonly the law in the U.S.? I've never heard of such a requirement. That certainly doesn't mean it doesn't exist, but the only reporting requirement I've ever heard of is for motorists.

RobertHurst

Hardly ever.

For categorizing "serious injury," hospital admission is as good a parameter as any.

RobertHurst

This is all correct, but pretty much beside the point.

Hospital admissions may be one thing to look at, to gauge frequency of "serious injury." It is also fair to look at reported collisions or emergency response records. Even though many minor incidents will be counted and injurity severity will be ignored as a factor with that method, it is still a fair way to gauge frequency/likelihood of collisions. It is not clear how adding injury severity to the data would add much clarity when engaged in such a dubious venture as trying to determine the relative "safety" of different environments, facilities or streets.

Bekologist

I wonder if the missing hoardes of Montreal children also will toss any study of facilities there into the toilet.

The flat earth society could get a lot of new members from this crowd! Maybe some of you are already members.

The hypothesis of the survey of montreal data was that North American cycletrack installation may not be as dangerous as previously held, under suppositions about how cyclists 'fare best', that are in contrast to best practices in other parts of the world that allow much greater participation in bicycling and much more safely.



What was the figure quoted from John Pucher? Cyclists in the Netherlands are 26 times safer than american cyclists, and 27 percent of the entire country undertakes their daily trips by bike? Maybe its not the facilities, maybe its their land use planning, safety in numbers and strict liability. Transportation planners would point to all of them.

Cycletracks that intersect with the street grid are a integral element in enabling greater participation and safer ridership in Europe. Yes, some installations are safer than others, and European cycletrack architecture continues to advance in the progressive cities there.

But here, engage a forum about the possibility that cycletracks just might have some feasibility on this side of the atlantic, and out come the statisticians to dissect every weakness they find in the data.

The doubting thomases have lost the forest for the trees, and haplessly rally against the uptake and normalization of bicycling in North America.

In the recently released survey of Portland users of cycletracks and buffered bikelanes, the overwhelming majority were in favor of these facilities, would go out of their way to use them in a commute even if it were longer, and want more across Portland.

What a bunch of i-----! the public, it's just the elite cyclists that knows what everyone needs!

electrik

Not really, serious enough to seek treatment or report to police is not always serious in the clinical sense. Injuries may be tracked according to CTAS(Canadian Trauma Acuity score) and length of hospitalization. Anyways, the point is... no "boo boo" should be lumped in and inflating the broken arm numbers in any properly controlled study.

Both parties are required to report any traffic accident to police if there is an injury or damages to property over a certain dollar amount. This pretty much means every cycling accident should be reported, since we tend to get injured.

RobertHurst

"Hospital admission" does not equal a visit to the hospital or ER. It means someone had an injury serious enough that they have been admitted to the hospital with a bed upstairs. It is a fine way to count serious injuries. No boo boos.

This gets into the definition of "serious injury," which is different for every layman, and even in the research community there is little standardization of terms.

Whether you want to use them as a way to count "serious injuries" or not, counting hospital admissions is a good way to count hospital admissions. We have decent numbers on ER visits, hospital admissions and fatalities.

I-Like-To-Bike

Comparing the risk of various activities or measuring the effects of various countermeasures to reduce risk can NOT be credibly evaluated without considering the relative severity of the injuries involved. Otherwise all you have is the probability of accidents of equal and unknown value.

Without any recording of severity, the safety/risk of an activity that produced 50 scratched knees would be considered the same as an activity that produced 50 fractured skulls; no difference when all the data is related to counting number of accidents with no regards for injury severity.

Bekologist

Ambulance chasers that have lost the forest for the trees.

"that's not a grove, that's a tamarack!"

ALL that hair parsing you statisticians are doing is pretty much beside the point. -Not to mention all the phantom children of montreal, throwing any data collected by cycling counts in Montreal into "fundamental bankruptcy"

the gas, it addles, man.

sggoodri

Police reports of car-bike collisions include reporting of injury severity as standard practice. 779 car-bike crashes in the city of Raleigh from 1997-2008 had the following injury classifications per the police reports:

No Injury: 15%
Possible Injury: 38%
Evident injury: 41%
Disabling Injury: 5%
Fatality: 1%

I don't have the NC definition of Disabling Injury, but here is the definition from the State of Washington collision reporting instruction manual:
https://www.wsp.wa.gov/publications/forms/pctrmanl.pdf
(Emphasis mine.)

In Raleigh, which is urban, intersection collision injury severities appear similar in distribution to non-intersection and same-direction injury severities. Outside of Raleigh, in more rural areas, where there is less exposure time at intersections as a percentage of travel time, and vehicle speeds are higher, and drivers often less attentive, same direction collision injury severity appears to be higher in general than intersection related collision severity, and a higher percentage of the severe injuries are related to same-direction collisions.

electrik

Well, i never said different Robert... hospital admission is important to determine length of care required. Simply counting those admissions as serious injuries is not a good metric. All injuries in a study should be classified by trauma scale. I see no reason to lump it all under "visited hospital." In fact one doesn't need to visit the ER, information can be taken from the police report on file.

You seem to be obsessed with the counting those injuries which people seem themselves to think not worth mentioning. Why?

RobertHurst

Eh?? I'll say it again. "Hospital admission" occurs for _serious injuries_, or injuries which have the doctors so freaked out that they want to keep the victim overnight for observation. Not the same as ER visits, which include a large number of superficial injuries and which result in almost everybody being treated and released.

For example, in the US there are approx. 25,000 hospital admissions of cyclists each year. But there are approximately 500,000 ER visits. (And several million minor injuries that go untreated, no doubt.) The portion of serious injuries among all ER visits is about 5%.

You're all mixed up. I like counting "hospital admissions" precisely because they don't include all those superficial injuries.

RobertHurst

Did the authors of this study include the wrecks of children, either on purpose or inadvertently?

Did you even read it?

ItsJustMe

It took me a bit of reading to figure out what a cycle track was.

RobertHurst

True. It is possible that one street is more likely to produce a more devastating sort of reported collision than another. For instance, streets with high speeds and opportunities for drivers to turn left into oncoming cyclists would show relatively high injury _severity_ compared to a low-speed street that did not possess these features, even if the frequency of car-bike collision were the same. In a study that counted only frequency of car-bike collision (which is basically what this study in question does), these two streets would appear to be equal in "safety."

OTOH, the same exact collision could produce a wide range of injury depending on the cyclist and his/her ability to absorb or deal with the collision, or depending on luck, and we wouldn't want to gauge relative safety based on that. If one speeding left-turner bashes a cyclist on street A and the cyclist is seriously injured, while a speeding left-turner bashes a cyclist on street B and the cyclist luckily flies over the car and lands relatively uninjured in the street, does that mean street B is safer?

I like counting reported collisions as a baseline. There is no perfect method of parsing bicycle accident/injury stats. It might be true that there is no good way.

invisiblehand

There is nothing wrong with having several metrics. What is wrong is naively interpreting the statistic that best matches a personal set of biases.

Bekologist

oh absolutely. I just put my plea out for the missing children of Montreal out of solidarity to one of your pet peeves of crash reporting you find endemic.