The epidemiologic principles underlying traffic safety study designs

This article describes the epidemiological principles underlying four observational study designs commonly used to assess traffic safety: the case-control, case-crossover, culpability and quasi-induced exposure designs. We focus in particular on the specific challenges for preventing bias using each design. Whereas recruiting controls representative of the source population poses a special challenge in case-control traffic safety studies, case-crossover designs are prone to recall bias, and culpability and quasi-induced exposure studies can be undermined by difficulties assigning crash responsibility. Using causal diagrams and worked examples, we provide a simple way to teach traffic safety designs to epidemiologists and to encourage proper application of epidemiological principles among researchers designing traffic safety studies.