Injury risk curves (IRCs) represent the quantification of risk of adverse outcomes, such as a bone fracture, quantified by a biomechanical metric such as force or deflection. From a biomechanical perspective, they are crucial in crashworthiness studies to advance human safety. In clinical settings, they can be used as an assistive tool to aid in the decision-making process for surgical or conservative treatment. The estimation of risk corresponding to a level of biomechanical metric is done using a regression technique, such as a parametric survival regression model. As with any statistical procedure, error measures are computed for the IRC, representing the quality of the estimated risk. For example, confidence intervals (CIs) are recommended by the International Standards Organization, and the normalized confidence interval width (NCIW) is computed based on the width of the CI. This is a surrogate for the quality of the risk curve. A 95% CI means that if the same experiment were hypothetically repeated 100 times, at least 95 of the computed CIs should contain the true risk curve. Such an interpretation is problematic in most biomechanical contexts as rarely the same experiment is repeated. The notion that a wider confidence interval implies a poorer quality risk curve can be misleading. This article considers the evaluation of CIs and its implications in biomechanical settings for safety engineering and clinical practice. Alternatives are suggested for future studies.

中文翻译：

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冲击损伤风险评估的不确定性评估及其对临床实践的影响


伤害风险曲线 (IRC) 表示不良后果风险的量化，例如骨折，通过力或变形等生物力学指标进行量化。从生物力学的角度来看，它们对于提高人类安全的耐撞性研究至关重要。在临床环境中，它们可以用作辅助工具，帮助做出手术或保守治疗的决策过程。使用诸如参数生存回归模型之类的回归技术来完成与生物力学度量水平相对应的风险的估计。与任何统计程序一样，IRC 会计算误差度量，代表估计风险的质量。例如，国际标准组织推荐的置信区间(CI)，以及根据CI的宽度计算归一化置信区间宽度(NCIW)。这是风险曲线质量的替代指标。 95% CI 意味着如果假设重复相同的实验 100 次，则计算出的 CI 中至少有 95 个应包含真实风险曲线。这种解释在大多数生物力学背景下都是有问题的，因为很少重复相同的实验。置信区间越宽意味着风险曲线质量越差的观点可能会产生误导。本文探讨了 CI 的评估及其对安全工程和临床实践的生物力学环境的影响。为未来的研究提出了替代方案。