BACKGROUND: Auto insurers use a variety of techniques to control theirlosses, and one that has been widely employed since the mid-1990's is the Minor Impact Soft Tissue (MIST)segmentation strategy. MIST protocol dictates that all injury claims resulting from collisions producingUS dollars 1000 or less in damage be "segmented", or adjusted for minimal compensation. MATERIAL/METHODS:Multiple databases were searched for studies comparing any of three dependent variables (injury risk,injury severity, or duration of symptoms) with structural damage in motor vehicle crashes of under 40km/h (25 mph). RESULTS: A limited correlation between crash severity and injury claims was found. Wecould not determine, however, whether this relationship held across all crash severities. Other studiesprovided conflicting results with regard to acute injury risk, but both found no statistically significantcorrelation between crash severity and long-term outcome. CONCLUSIONS: A substantial number of injuriesare reported in crashes of little or no property damage. Property damage is an unreliable predictor ofinjury risk or outcome in low velocity crashes. The MIST protocol for prediction of injury does not appearto be valid.

Keywords: Accidents, Traffic, Motor Vehicles, Risk Assessment, Severity of Illness Index, Wounds and Injuries - physiopathology