Traffic Injury Research Foundation (TIRF), Ottawa, ON K2P 0B4, Canada.
Accid Anal Prev. 2009 Sep;41(5):1104-11. doi: 10.1016/j.aap.2009.06.024. Epub 2009 Jul 15.
Most jurisdictions in North America have some version of graduated driver licensing (GDL). A sound body of evidence documenting the effectiveness of GDL programs in reducing collisions, fatalities and injuries among novice drivers is available. However, information about the relative importance of individual components of GDL is lacking. The objectives of this study are to calculate a summary statistic of GDL effectiveness and to identify the most effective components of GDL programs using a meta-analytic approach. Data from 46 American States, the District of Columbia and 11 Canadian jurisdictions are used and were obtained from the Fatality Analysis Reporting System (FARS) for the U.S. and from Transport Canada's Traffic Accident Information Database (TRAID) for Canada. The timeframe of this evaluation is 1992 through 2006, inclusive. Relative fatality risks and their 95% confidence intervals were calculated using fatality counts and population data for target and comparison groups, both in a pre-implementation and post-implementation period in each jurisdiction. The target groups were 16-, 17-, 18- and 19-year-old drivers. The comparison group was 25-54-year-old drivers. The relative fatality risks of all jurisdictions were summarized using the random effects DerSimonian and Laird model. Meta-regression using Restricted Maximum Likelihood (REML) and Markov Chain Monte Carlo (MCMC) Gibbs sampling was also conducted. Strong evidence in support of GDL was found. GDL had a positive and significant impact on the relative fatality risk of 16-year-old drivers (reduction of 19.1%). Significant effects were found for meta-regression models with 16-, 18- and 19-year-old drivers. These effects include length of night restriction in the learner stage, country, driver education in the learner stage and in the intermediate stage, whether night restrictions are lifted in the intermediate stage for work purposes, passenger restriction in the intermediate stage, whether passenger restrictions in the intermediate stage are lifted if passengers are family members, and whether there is an exit test in the intermediate stage. In conclusion, several GDL program components have an important effect on the relative fatality risk of novice drivers. These results help understand how such effects are achieved.
北美大多数司法管辖区都有某种形式的分级驾照制度（GDL）。有大量证据证明 GDL 计划在减少新手驾驶员的碰撞、死亡和受伤方面的有效性。然而，关于 GDL 各个组成部分的相对重要性的信息却很缺乏。本研究的目的是计算 GDL 有效性的综合统计数据，并使用荟萃分析方法确定 GDL 计划中最有效的组成部分。使用的数据来自美国的伤亡分析报告系统（FARS）和加拿大的交通事故信息数据库（TRAID），来自 46 个美国州、哥伦比亚特区和 11 个加拿大司法管辖区。本评估的时间范围是 1992 年至 2006 年。使用死亡率计数和目标群体及比较群体的人口数据，计算了每个司法管辖区在实施前和实施后的相对死亡率风险及其 95%置信区间。目标群体是 16、17、18 和 19 岁的驾驶员。比较群体是 25-54 岁的驾驶员。使用随机效应 DerSimonian 和 Laird 模型总结了所有司法管辖区的相对死亡率风险。还使用受限最大似然（REML）和马尔可夫链蒙特卡罗（MCMC）吉布斯抽样进行了元回归。发现了支持 GDL 的有力证据。GDL 对 16 岁驾驶员的相对死亡率风险产生了积极而显著的影响（降低了 19.1%）。在针对 16、18 和 19 岁驾驶员的元回归模型中发现了显著的效果。这些效果包括学习阶段的夜间限制时长、国家、学习阶段和中级阶段的驾驶员教育、中级阶段是否因工作目的取消夜间限制、中级阶段的乘客限制、中级阶段是否取消如果乘客是家庭成员的乘客限制，以及中级阶段是否有出口考试。总之，GDL 计划的几个组成部分对新手驾驶员的相对死亡率风险有重要影响。这些结果有助于了解这些效果是如何实现的。
