Today one of the most important health issues that threatens the lives of people in different countries is the increase in the rates of road traffic injuries [1]. Road traffic injuries are the main causes of death in most countries of the world [2].
According to the recent reports, every year global road traffic deaths are estimated to be 1.2 million and between 20 and 50 million suffer from non-fatal injuries [3]. In Iran, according to the latest statistics released by the Forensic Medicine Organization, traffic crashes cause nearly 17000 deaths each year and a permanent injury or disability for 300000 people [4]. Deaths from traffic accidents can happen immediately after the accident or during the transfer to the hospital or in the hospital [5]. 
According to the World Health Organization (WHO), in most countries, the shortage or lack of adequate information on prehospital services has been a major barrier to proper planning for reducing road traffic injuries [6]. According to the statistics, at least 39% of the deaths from traffic accidents in the world that occur before reaching the hospital are potentially preventable [7]. Based on a study on preventable trauma death conducted in teaching hospitals of Tehran, 26% of all trauma deaths are preventable. Of 31 Non-Central Nervous System (CNS)-related deaths, 17 cases were identified as surely preventable and 6 as probably preventable. In CNS-related deaths, 5% are surely preventable [8]. In fact, part of the deaths occurring at crash scene can be prevented if care and clinical interventions be provided in a timely manner.
In Iran, measures such as the development of emergency trauma care systems in hospitals and expeditious transfer of injured people with the aim of reducing the number of deaths from road traffic crashes have been carried out as prehospital activities. However, Based on a study report, it is necessary to focus on reducing preventable deaths in the prehospital phase [9]. 
The biggest limitation on investigating the preventable deaths from road traffic injuries in Iran is the lack of instrument tools and methods for preventable deaths. Measuring the effective components in preventable deaths in traffic crashes requires the use of appropriate detection tools [10]. In this regard, either new tools must be designed or, after verifying the psychometric properties (the validity and reliability), the existing tools should be employed. There are tools available for measuring preventable deaths caused by road traffic injures, but given that the health system and the terms of services are not the same in different countries, it is not possible to fully utilize them after translation. 
In Iran, however, the health system is blamed for not clarifying the increasing causes of deaths from road traffic injuries. Given the importance of saving lives as the most important goal of any health system, the treatment sector must be responsible for preventable deaths from traffic crashes. In literature, almost no comprehensive research was found on the definitions and factors affecting the reduction of preventable deaths, especially as a result of road traffic injuries. 
Health policymakers need accurate information for decision making and policy formulation on preventable deaths. This can be useful in identifying the causes of the road traffic injuries as well as determining the contribution of each one for future planning. For this reason, valid measurement of effective factors in detecting preventable deaths is beneficial and the design of a detection tool for factors affecting such deaths in road traffic injuries is one of the essential requirements of any health system. Therefore, the design and psychometric evaluation of a preventative death detection tool in the form of a research project is one of the major needs to provide more accurate information for health policy planners and future planners.

Adel Eftekhari1, Davoud Khorasani-Zavareh2*, Khadijeh Nasiriani3
1. Department of Health in Emergencies & Disasters, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
2. Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3. Department of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. 

* Corresponding author: 
Davoud Khorasani-Zavareh, PhD
Address: Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
E-mail: davoud.khorasani@gmail.com


References