Short abstract
This article documents the update of an online tool to help assess costs and effectiveness of implementing up to 14 interventions and select those most effective in reducing death and injury from motor vehicle crashes for a given budget.
Keywords: Health Interventions, Public Safety Legislation, Traffic Accidents, Transportation Safety
Abstract
Motor vehicle crashes account for a large number of deaths and injuries. In the United States, in 2015, more than 35,000 people were killed and approximately 2.44 million were injured in motor vehicle crashes. In 2010, the economic costs associated with motor vehicle crashes in the United States were substantial, estimated to be $242 billion. Fortunately, a wide range of evidence-based interventions, including both policies and programs, can help prevent motor vehicle–related injuries and deaths.
In 2014, RAND researchers developed an online tool, the Motor Vehicle Prioritizing Interventions and Cost Calculator for States (MV PICCS), to help determine the costs and effectiveness of various interventions to reduce injuries and deaths from motor vehicle crashes and what interventions together generate the largest reductions in injuries and deaths for a given implementation budget.
A 2015 update added two new interventions and produced a series of reports about allocating traffic safety funds. The 2017 update, MV PICCS 3.0, determined whether to add new interventions, updated information on the interventions' effectiveness and costs, and redesigned the tool's user interface to be more user-friendly.
Motor vehicle crashes account for a large number of deaths and injuries. In the United States, in 2015, more than 35,000 people were killed and approximately 2.44 million were injured in motor vehicle crashes (National Center for Statistics and Analysis, 2016). Crash deaths rose yet again in 2016, to more than 37,000 (National Center for Statistics and Analysis, 2017). In 2010, the economic costs associated with motor vehicle crashes in the United States were substantial, estimated to be $242 billion (Blincoe et al., 2015). Fortunately, a wide range of evidence-based interventions, including both policies and programs, can help prevent motor vehicle–related injuries and deaths.
In 2014, RAND researchers developed, for the Centers for Disease Control and Prevention (CDC), an online tool for decisionmakers—primarily state health, transportation, and safety officials—to use in determining the costs and effectiveness of various interventions to reduce injuries and deaths from motor vehicle crashes and in determining what interventions together generate the largest reductions in the numbers of injuries and deaths for a given implementation budget. The tool is called Motor Vehicle Prioritizing Interventions and Cost Calculator for States (MV PICCS) and is available at www.cdc.gov/motorvehiclesafety/calculator/ (CDC, 2015).
Developing MV PICCS required collecting and analyzing data related to the selection of interventions, their effectiveness, and their cost (specific to each state), as well as programming the tool to select interventions based on a specified budget and the cost-effectiveness of interventions in a specific state.
Since 2014, we have updated the tool twice. The first update was released in 2015; it added two new interventions and produced a series of reports about allocating traffic safety funds (listed in the preface). In this article, we refer to this update (the interventions and reports together) as MV PICCS 2.0.
In 2017, we conducted the second update, described in this article, for the National Governors Association (NGA), working with the National Center for Injury Prevention and Control at CDC. NGA commissioned RAND to update the MV PICCS tool, with the following goals:
Determine whether new interventions should be added, based on the most-recent evidence available.
Update information on the effectiveness of interventions.
Update cost data.
Redesign the tool's user interface to be more user-friendly.
This documentation summarizes the changes made to MV PICCS in these four areas. We refer to this most recent update as MV PICCS 3.0.
New Interventions
We reviewed seven interventions for potential addition to the tool. We considered adding one new intervention out of those: lowering the legal limit for a driving-while-intoxicated (DWI) charge from a blood alcohol concentration of 0.08 to 0.05 g per deciliter. However, following discussions with NGA and CDC, we opted not to include it, for two main reasons: It would be difficult to (1) develop a specific estimate of how many lives could be saved and (2) incorporate it with similar drunk-driving interventions (sobriety checkpoints and saturation patrols).
During the research for the 2015 update, we reviewed the literature on cell phone and texting bans to prevent distracted driving. At the time, we determined that the evidence was not strong enough to include these interventions in the tool. We also scanned the literature in 2017 to determine whether the research findings suggested any new understanding of their effectiveness, and we found that the research was still mixed.
Effectiveness Data Updates
Given the extensive review we conducted during the original research and the 2015 update, we did not update any of the effectiveness data (the percentage by which the number of deaths due to specific crash causes would decline if the intervention were implemented). We did update the state-specific data on the number of deaths in different crash categories by state, as well as our estimates of injuries by state, with the most-recent data available, 2015. These updates provide more-realistic estimates because most states have experienced an increase in traffic crash deaths from 2010 to 2015. We also believe that our current method for estimating injuries provides a more accurate number of injuries per state.
Cost Data Updates
We made some changes to the data that determine the cost per intervention. These include adjusting all dollar figures to 2017 dollars and using more-recent data for cost elements, such as state employee wages, number of drivers by state, and the value of saving one life. We also made two more-significant changes. First, because of known undercounting in the data, we adjusted figures for the number of people arrested for DWI. The new figures should provide a more realistic estimate of the number of arrests, which leads to more-realistic implementation costs, especially in those states where undercounts were very pronounced. Second, we updated our method for estimating the number of red-light and speed cameras assumed to be deployed in each state. This resulted in reductions in the estimated number of cameras, which translates into lower costs for these two interventions in all states. Both of these updates should lead to more-realistic estimates.
User Interface Redesign
Finally, we completely redesigned the user interface to streamline it and make it more intuitive to use. This includes the way in which users enter information and the way the tool displays the results. We have also created links within the tool to fact sheets about each intervention and a new feature that allows the user to generate a Portable Document Format version of the MV PICCS results. We believe that the user interface is now more intuitive in terms of inputting data, as well as in providing outputs that are easier to interpret and share.
Table 1 summarizes the changes made to MV PICCS.
Table 1.
Summary of Changes to MV PICCS
| Methods and Data from MV PICCS 2.0 | MV PICCS 3.0 Revisions to Methods and Data |
|---|---|
| Interventions | |
| Identified 14 interventions | No change to the list of interventions |
| Updated information on which interventions are currently implemented for each state | |
| Effectiveness | |
| Informed by the literature, developed an estimate of the percentage of lives saved by each intervention | No change to these estimates |
| Identified the number of people killed in each state, by crash type, using 2010 FARS data | Updated FARS data from 2010 to 2015 |
| Estimated the number of people injured in each state, by crash type | Used a different method to develop injury estimates and applied it using FARS and General Estimates System data from 2015 |
| Estimated the monetary value of lives saved and injuries prevented, by state | Updated state-specific adjustment factors and updated costs to 2017 dollars; no change to underlying injury and fatality dollar estimates |
| Costs | |
| Developed ten cost components | No change to the list of cost components |
| Defined cost components for each intervention | No change to cost components per intervention |
| Developed cost estimates for each intervention | Updated all costs to 2017 dollars |
| Updated state-specific cost elements (wage rates, population, number of licensed drivers, and number of registered motorcycles) to the most recent year available | |
| Developed a new method to estimate the number of DWI arrests per state, which affects the costs of four DWI-related interventions | |
| Revised the method of estimating the number of red-light and speed cameras per state, resulting in lower costs | |
| Online tool | |
| Created a user interface with two types of analysis (cost-effectiveness analysis and portfolio analysis) | Combined both forms of analysis into one model run with one complete set of cost-effectiveness outputs that provides a summary of the portfolio analysis results |
| Updated ways for users to supply data inputs | Streamlined data inputs and changed the order so that users input the desired parameters before model runs; changed defaults to unimplemented interventions and excluded fines and fees; provided a state map |
| Streamlined the sensitivity analysis, allowing users to change some default inputs | Streamlined sensitivity analysis such that users can change only two types of inputs and allowed users to access sensitivity inputs on any model run |
| Created additional graphics to display information, and provided links to information on each intervention | |
| NOTE: FARS = Fatality Analysis Reporting System. | |
Notes
This work was sponsored by the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention and conducted jointly in RAND Health and the Infrastructure Resilience and Environmental Policy Program, a part of RAND Justice, Infrastructure, and Environment.
References
- Blincoe Lawrence, Miller Ted R., Zaloshnja Eduard, Lawrence Bruce A. The Economic and Societal Impact of Motor Vehicle Crashes, 2010 (Revised) Washington, D.C.: National Highway Traffic Safety Administration; May 2015. DOT HS 812 013. As of July 9, 2015: http://www-nrd.nhtsa.dot.gov/Pubs/812013.pdf. [Google Scholar]
- Centers for Disease Control and Prevention. Motor Vehicle Prioritizing Interventions and Cost Calculator for States (MV PICCS) 2017. last updated December 14, 2015. As of November 13.
- https://www.cdc.gov/motorvehiclesafety/calculator/
- National Center for Statistics and Analysis, National Highway Traffic Safety Administration. 2015 Motor Vehicle Crashes: Overview. 2017. Traffic Safety Facts Research Note, DOT HS 812 318, August 2016. As of November 11. https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/812318.
- National Center for Statistics and Analysis, National Highway Traffic Safety Administration. 2016 Fatal Motor Vehicle Crashes: Overview. 2017. Traffic Safety Facts Research Note, DOT HS 812 456, October 2017. As of December 5. https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/812456.