Objective: The odds of death for a seriously injured crash victim are drastically reduced if he or she received care at a trauma center. Advanced automated crash notification (AACN) algorithms are postcrash safety systems that use data measured by the vehicles during the crash to predict the likelihood of occupants being seriously injured. The accuracy of these models are crucial to the success of an AACN. The objective of this study was to compare the predictive performance of competing injury risk models and algorithms: logistic regression, random forest, AdaBoost, naive Bayes, support vector machine, and classification k-nearest neighbors. Methods: This study compared machine learning algorithms to the widely adopted logistic regression modeling approach. Machine learning algorithms have not been commonly studied in the motor vehicle injury literature. Machine learning algorithms may have higher predictive power than logistic regression, despite the drawback of lacking the ability to perform statistical inference. To evaluate the performance of these algorithms, data on 16,398 vehicles involved in non-rollover collisions were extracted from the NASS-CDS. Vehicles with any occupants having an Injury Severity Score (ISS) of 15 or greater were defined as those requiring victims to be treated at a trauma center. The performance of each model was evaluated using cross-validation. Cross-validation assesses how a model will perform in the future given new data not used for model training. The crash Delta V (change in velocity during the crash), damage side (struck side of the vehicle), seat belt use, vehicle body type, number of events, occupant age, and occupant sex were used as predictors in each model. Results and Conclusions: Logistic regression slightly outperformed the machine learning algorithms based on sensitivity and specificity of the models. Previous studies on AACN risk curves used the same data to train and test the power of the models and as a result had higher sensitivity compared to the cross-validated results from this study. Future studies should account for future data; for example, by using cross-validation or risk presenting optimistic predictions of field performance. Past algorithms have been criticized for relying on age and sex, being difficult to measure by vehicle sensors, and inaccuracies in classifying damage side. The models with accurate damage side and including age/sex did outperform models with less accurate damage side and without age/sex, but the differences were small, suggesting that the success of AACN is not reliant on these predictors.
