Driving Evaluation After Traumatic Brain Injury

Neurologic Conditions: Assessing Medical Fitness to Drive

“…The data must be interpreted with skepticism because of the potential for selection biases and lack of comparable control group. 18,28,29 Patients with traumatic brain injury typically require more time to complete certain tasks because of delays in information processing, impairment in the perception of spatial relationships and inattentiveness to a series of multiple simultaneous events. 3,30 The extent of slowing is dependent upon the severity of injury, duration since the injury and complexity of the task.…”

Role of premorbid factors in predicting safe return to driving after severe TBI

“…Other authors considered the time taken for various actions [30] or used a pass-fail rating for each manoeuvre [11,16,24,25,65,66] or even adopted a qualitative description of driving skills [9,67,68]. Many studies used one rater in the car during on-road assessment (a driving instructor or an occupational therapist) [24,31,67,68] whilst others used two or more raters [9,25,64,66].…”

“…Jones [62] administered his highly standardized test to 194 high-school driving students and then re-tested 67 of them 2 weeks later: test-retest correlation was only 0.40. Van Zomeren et al [69] and Galski et al [16] found that the overall rating of driving outcome did not relate to single items calculated in terms of driving error score, whilst Brooke et al [30] reported a higher correlation between global rating and single manoeuvre score (r ¼ 0.58).…”

“…Various researchers examined fitness to drive in persons with Alzheimer's disease [27,71,72], in subjects with different types of dementia [25,66], in patients with brain damage with or without aphasia [63], in TBI subjects [7,18,20,21,30], in mixed clinical population (typically TBI and cerebrovascular patients together) [11,16,28,29], or in normal subjects [60,73]. Obviously, findings in one population do not necessarily generalize to another.…”

“…3 months to 1 year [22,23,30,74]. The variability of the period taken into consideration could perhaps explain why some authors reported time since injury as an important predictor [21] and other authors did not [17,19].…”