Predicting Older Driver On-Road Performance by Means of the Useful Field of View and Trail Making Test Part B

Classen, Sherrilene; Wang, Yanning; Crizzle, Alexander M.; Winter, Sandra; Lanford, Desiree N.

doi:10.5014/ajot.2013.008136

Cited by 65 publications

(47 citation statements)

References 29 publications

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“…This has strong potential for introducing bias into their ratings, which could be exacerbated in studies that include assessments performed by several different CDRS evaluators. 24, 104 …”

Section: Performancementioning

confidence: 99%

A roadmap for interpreting the literature on vision and driving

Owsley

Wood

McGwin

2015

Survey of Ophthalmology

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Over the past several decades there has been a sharp increase in the number of studies focused on the relationship between vision and driving. The intensified scientific attention to this topic has most likely been stimulated by the lack of an evidence-basis for determining vision standards for driving licensure and a poor understanding about how vision impairment impacts driver safety and performance. Clinicians depend on the scientific literature on vision and driving as a resource to appropriately advise visually impaired patients about driving fitness. Policy makers also depend on the scientific literature in order to develop guidelines that are evidence-based and are thus fair to persons who are visually impaired. Thus it is important for clinicians and policy makers alike to understand how various study designs and measurement methods should be appropriately interpreted so that the conclusions and recommendations they make based on this literature are not overly broad, too narrowly constrained, or even misguided. In this overview, based on our 25 years of experience in this field, we offer a methodological framework to guide interpretations of studies on vision and driving, which can also serve as a heuristic for researchers in the area. Here we discuss research designs and general measurement methods for the study of vision as they relate to driver safety, driver performance, and driver-centered (self-reported) outcomes.

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“…This has strong potential for introducing bias into their ratings, which could be exacerbated in studies that include assessments performed by several different CDRS evaluators. 24, 104 …”

Section: Performancementioning

confidence: 99%

A roadmap for interpreting the literature on vision and driving

Owsley

Wood

McGwin

2015

Survey of Ophthalmology

View full text Add to dashboard Cite

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“…Some consider UFOV to be a gold standard of cognitive driving tests (e.g., Classen, Wang, Crizzle, Winter, & Lanford, 2013; Weaver, Bédard, McAuliffe, & Parkkari, 2009). Thus, UFOV commonly serves as a proxy for driving ability among older adults and in clinical populations such as Parkinson's disease, multiple sclerosis, Alzheimer's disease, and HIV (Classen et al, 2009, 2013; Crizzle, Classen, & Uc, 2012; Duchek, Hunt, Ball, Buckles, & Morris, 1998; Fisk, Novack, Mennemeier, & Roenker, 2002; Goode et al, 1998; Weaver et al, 2009; Wood et al, 2012). …”

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confidence: 99%

Incremental validity of Useful Field of View subtests for the prediction of instrumental activities of daily living

Aust

Edwards

2016

Journal of Clinical and Experimental Neuropsychology

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Introduction The Useful Field of View Test (UFOV®) is a cognitive measure that predicts older adults’ ability to perform a range of everyday activities. However, little is known about the individual contribution of each subtest to these predictions and the underlying constructs of UFOV performance remain a topic of debate. Method We investigated the incremental validity of UFOV subtests for the prediction of Instrumental Activities of Daily Living (IADL) performance in two independent datasets, the SKILL (n = 828) and ACTIVE (n = 2426) studies. We, then, explored the cognitive and visual abilities assessed by UFOV using a range of neuropsychological and vision tests administered in the SKILL study. Results In the four subtest variant of UFOV, only subtests 2 and 3 consistently made independent contributions to the prediction of IADL performance across three different behavioral measures. In all cases, the incremental validity of UFOV subtests 1 and 4 was negligible. Furthermore, we found that UFOV was related to processing speed, general non-speeded cognition, and visual function; the omission of subtests 1 and 4 from the test score did not affect these associations. Conclusions UFOV subtests 1 and 4 appear to be of limited use to predict IADL and possibly other everyday activities. Future experimental research should investigate if shortening the UFOV by omitting these subtests is a reliable and valid assessment approach.

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“…The TMTs have been shown to be significantly correlated with impaired driving on road tests by older drivers. [4][5][6][7][8][9][10][11][12][13][14][15][16] They are also widely used in clinical settings as screening measures for driving impairment in older drivers with and without cognitive impairment, 17,18 having been recommended for this purpose in the past by the American Medical Association. 19 The TMTs have other attractive features as potential screening tests, including their brevity (each test part taking <5 minutes), ease of administration (as pencil-and-paper tasks), low cost, and availability in the public domain.…”

mentioning

confidence: 99%

Clinical Utility of the Trail‐Making Test as a Predictor of Driving Performance in Older Adults

Papandonatos

Ott

Davis

et al. 2015

J American Geriatrics Society

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OBJECTIVES To assess the clinical utility of trail making tests as screens for impaired road-test performance. DESIGN We performed secondary analyses on three separate data sets from previously published studies of impaired driving in older adults using comparable road test designs and outcome measures. SETTING Two academic driving specialty clinics. PARTICIPANTS A total of 392 older drivers (303 with cognitive impairment and 89 controls) from Rhode Island and Missouri. MEASUREMENTS Standard operating characteristics were evaluated for Trail Making Test Part A (TMT-A), and Part B (TMT-B), as well as optimal upper and lower test cut points that could be useful in defining groups of drivers with indeterminate likelihood of impaired driving, who would most benefit from further screening or on-road testing. RESULTS Discrimination remained relatively high (>70%), when cut points for trail making tests derived from Rhode Island data were applied to Missouri data, but calibration was poor (p<.01). TMT-A provided the best utility for determining a range of scores (68–90 sec) for which additional road testing would be indicated in general practice settings. TMT-B was limited by a high frequency of cognitively-impaired participants unable to perform the test within the allotted time (>25%). Mere inability to complete the test in a reasonable time frame, e.g., TMT-A>48 sec or TMT-B>108 sec, may still be a useful tool in separating Unsafe from Safe/Marginal drivers in such samples. CONCLUSION Trail making tests (particularly TMT-A) may be useful as screens for driving impairment in older drivers in general practice settings, where most people are still safe drivers, but more precise screening measures need to be analyzed critically in a variety of clinical settings for testing cognitively-impaired older drivers.

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Predicting Older Driver On-Road Performance by Means of the Useful Field of View and Trail Making Test Part B

Cited by 65 publications

References 29 publications

A roadmap for interpreting the literature on vision and driving

A roadmap for interpreting the literature on vision and driving

Incremental validity of Useful Field of View subtests for the prediction of instrumental activities of daily living

Clinical Utility of the Trail‐Making Test as a Predictor of Driving Performance in Older Adults

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