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Comment & Response
June 2018

Questioning the Benefits of Private Vehicle Transportation vs Emergency Medical Services Transportation

Author Affiliations
  • 1Former Division of Prehospital Care and Prevention, Department of Trauma, John H. Stroger Jr Hospital of Cook County, Chicago, Illinois
JAMA Surg. 2018;153(6):595-596. doi:10.1001/jamasurg.2018.0096

To the Editor I read with great interest and applaud the efforts of Wandling et al1 in their trauma system–level analysis of the association of private vehicle transportation vs ground emergency medical services (EMS) transportation with mortality. Demetriades et al2 and Zafar et al3 published articles coming to similar conclusions. In studies comparing 2 groups for the effect of another variable, given the state of the art, injury severity analysis is always somewhat problematic. It is possible the private vehicle transportation group was in fact different from the EMS transportation group in this regard, but I think the number of patients across many urban areas lessens that possibility in the study by Wandling et al.1 Mean Injury Severity Score being significantly lower in the private vehicle transportation group is worrisome and may suggest there were differences.

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