Road traffic crashes have far-reaching consequences that extend beyond immediate fatalities and severe injuries. While traditional road safety assessments focus on counting deaths and life-threatening injuries, they often overlook the prolonged impact on survivors. Long-term consequences (LTC) scales offer a more comprehensive approach by measuring the enduring physical, psychological, social, and economic effects of road crashes.

What are long-term consequences (LTC) scales?

Long-term consequences (LTC) scales are valuable tools for measuring the enduring effects of events such as road traffic crashes.

What are LTC scales for?

These scales are typically developed through statistical methods and surveys that use questionnaires to follow up with casualties over a defined period after the incident. They often encompass multiple dimensions—physical, psychological, social, and economic—evaluating the specific and general impacts of a crash on a casualty’s life.

LTC scales are frequently employed to monitor the long-term burden of road traffic casualties and to connect specific injuries to the functional losses they may cause.

Why are LTC scales crucial for road safety?

LTC scales provide a complementary metric for monitoring road safety at global, regional, and national levels. They also assess an individual’s health status after exposure to a traumatic event.

Traditionally, road safety has been assessed primarily by counting the number of deaths and severe injuries. In this framework, severity is considered as a threat to life.

However, LTC scales that account for multiple health dimensions, such as mobility, pain, and anxiety, allow for a more comprehensive evaluation by measuring the long-term burden of road traffic crashes at individual and injury-specific levels.

Even if a particular health condition is not life-threatening, it can have a long-lasting impact on an individual’s quality of life. Thus, LTC scales enable a deeper understanding of the impact of road safety strategies and countermeasures beyond simply tracking fatalities.

IMPROVA Project – Identify and review the LTC scales

For the IMPROVA project, we applied the PICO (Population, Intervention, Comparison, Outcome) framework to systematically review the LTC scales. In parallel, we also conducted separate reviews for physical and psychological LTCs.

Initial searches identified over 31,000 papers on physical LTCs and 14,000 on psychological LTCs. After rigorous screening, 769 papers on physical LTCs and 397 on psychological LTCs were selected for full-text review. A total of 76 scales and questionnaires for physical LTCs and 43 for psychological LTCs were identified. Examples include the Functional Capacity Index (FCI) for physical LTCs and the Posttraumatic Stress Disorder Checklist (PCL-5) for psychological LTCs.

Current challenges and next steps for LTC Scales

LTC scales are currently being thoroughly reviewed as part of the IMPROVA project to identify the most suitable and updatable scale.

Many existing scales were developed long ago using surveys conducted on populations that do not represent the current European demographic. This means they may not effectively capture the diverse physical, psychological, and socioeconomic consequences of modern road crashes. Therefore, the revised scale should encompass these varied impacts while also enabling the monitoring of road safety on a global scale and tracking progress in injury prevention at the body-region level.

The Role of the IMPROVA Project

As part of the IMPROVA project, researchers are working to refine and update LTC scales. The project aims to develop a more comprehensive and adaptable scale that can efficiently monitor road safety outcomes and guide policy decisions. By integrating LTC scales into road safety assessments, IMPROVA seeks to enhance injury prevention efforts and improve the quality of life for road traffic casualties.

The future of road safety research lies in a holistic approach that accounts for the long-term impacts of crashes. With continued advancements, LTC scales will play an increasingly vital role in shaping safer roads and more resilient communities.