Authors: Lew, Henry L.¹; Poole, John H.¹; Lee, Eun Ha¹; Jaffe, David L.¹; Huang, Hsiu-Chen¹; Brodd, Edward²

Source: Brain Injury, Volume 19, Number 3, March 2005 , pp. 177-188(12)

Publisher: Informa Healthcare

Abstract:

Objective: To evaluate whether driving simulator and road test evaluations can predict long-term driving performance, we conducted a prospective study on 11 patients with moderate to severe traumatic brain injury. Sixteen healthy subjects were also tested to provide normative values on the simulator at baseline.Method: At their initial evaluation (time-1), subjects' driving skills were measured during a 30-minute simulator trial using an automated 12-measure Simulator Performance Index (SPI), while a trained observer also rated their performance using a Driving Performance Inventory (DPI). In addition, patients were evaluated on the road by a certified driving evaluator. Ten months later (time-2), family members observed patients driving for at least 3?hours over 4 weeks and rated their driving performance using the DPI.Results: At time-1, patients were significantly impaired on automated SPI measures of driving skill, including: speed and steering control, accidents, and vigilance to a divided-attention task. These simulator indices significantly predicted the following aspects of observed driving performance at time-2: handling of automobile controls, regulation of vehicle speed and direction, higher-order judgment and self-control, as well as a trend-level association with car accidents. Automated measures of simulator skill (SPI) were more sensitive and accurate than observational measures of simulator skill (DPI) in predicting actual driving performance. To our surprise, the road test results at time-1 showed no significant relation to driving performance at time-2.Conclusion: Simulator-based assessment of patients with brain injuries can provide ecologically valid measures that, in some cases, may be more sensitive than a traditional road test as predictors of long-term driving performance in the community.

Keywords: Closed head injuries; cognition; computer simulation; driving behavior; ecological validity; predictive value of tests; risk assessment; safety standards; virtual reality systems

Document Type: Research article

DOI: http://dx.doi.org/10.1080/02699050400017171

Affiliations: 1: Rehabilitation Research and Development Center VA Palo Alto Health Care System Palo Alto CA USA 2: Physical Medicine & Rehabilitation Service VA Palo Alto Health Care System Palo Alto CA 94304 USA

Publication date: 2005-03-01

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