Kardamanidis Katina, Martiniuk Alexandra, Ivers Rebecca Q, Stevenson Mark R, Thistlethwaite Katrina
The George Institute for Global Health, PO Box M201 Missenden Road, Sydney, NSW, Australia, 2050.
Cochrane Database Syst Rev. 2010 Oct 6(10):CD005240. doi: 10.1002/14651858.CD005240.pub2.
Riding a motorcycle (a two-wheeled vehicle that is powered by a motor and has no pedals) is associated with a high risk of fatal crashes, particularly in new riders. Motorcycle rider training has therefore been suggested as an important means of reducing the number of crashes, and the severity of injuries.
To quantify the effectiveness of pre- and post-licence motorcycle rider training on the reduction of traffic offences, traffic crash involvement, injuries and deaths of motorcycle riders.
We searched the Cochrane Injuries Group Specialised Register, CENTRAL (The Cochrane Library 2008, Issue 3), TRANSPORT, MEDLINE, EMBASE, CINAHL, WHOLIS (World Health Organization Library Information System), PsycInfo, LILACS (Latin American and Caribbean Health Sciences), ISI Web of Science: Social Sciences Citation Index (SSCI), ERIC, ZETOC and SIGLE. Database searches covered all available dates up to October 2008. We also checked reference lists of relevant papers and contacted study authors in an effort to identify published, unpublished and ongoing trials related to motorcycle rider training.
We included all relevant intervention studies such as randomised and non-randomised controlled trials, interrupted time-series and observational studies such as cohort and case-control studies.
Two review authors independently analysed data about the study population, study design and methods, interventions and outcome measures as well as data quality from each included study, and compared the findings. We resolved differences by discussion with a third review author.
We reviewed 23 studies: three randomised trials, two non-randomised trials, 14 cohort studies and four case-control studies. Five examined mandatory pre-licence training, 14 assessed non-mandatory training, three of the case-control studies assessed 'any' type of rider training, and one case-control study assessed mandatory pre-licence training and non-mandatory training. The types of assessed rider training varied in duration and content.Most studies suffered from serious methodological weaknesses. Most studies were non-randomised and controlled poorly for confounders. Most studies also suffered from detection bias due to the poor use of outcome measurement tools such as the sole reliance upon police records or self-reported data. Small sample sizes and short follow-up time after training were also common.
AUTHORS' CONCLUSIONS: Due to the poor quality of studies identified, we were unable to draw any conclusions about the effectiveness of rider training on crash, injury, or offence rates. The findings suggest that mandatory pre-licence training may be an impediment to completing a motorcycle licensing process, possibly indirectly reducing crashes through a reduction in exposure. It is not clear if training (or what type) reduces the risk of crashes, injuries or offences in motorcyclists, and a best rider training practice can therefore not be recommended. As some type of rider training is likely to be necessary to teach motorcyclists to ride a motorcycle safely, rigorous research is needed.
骑乘摩托车（一种由发动机驱动且无踏板的两轮车辆）与致命撞车的高风险相关，尤其是在新骑手当中。因此，摩托车骑手培训被视为减少撞车事故数量及降低受伤严重程度的一项重要手段。
量化执照颁发前和颁发后的摩托车骑手培训在减少交通违规行为、交通撞车事故参与度、摩托车骑手受伤及死亡方面的效果。
我们检索了考科蓝伤害小组专业注册库、CENTRAL（考科蓝图书馆2008年第3期）、交通运输领域数据库、医学期刊数据库、荷兰医学文摘数据库、护理学与健康领域数据库、世界卫生组织图书馆信息系统、心理学文摘数据库、拉丁美洲和加勒比地区健康科学文献数据库、科学引文索引（社会科学版）、教育资源信息中心数据库、英国国家学术会议录数据库及灰色文献数据库。数据库检索涵盖截至2008年10月的所有可用日期。我们还查阅了相关论文的参考文献列表，并与研究作者联系，以识别已发表、未发表及正在进行的与摩托车骑手培训相关的试验。
我们纳入了所有相关的干预性研究，如随机对照试验和非随机对照试验、中断时间序列研究以及观察性研究，如同队列研究和病例对照研究。
两位综述作者独立分析了每项纳入研究中有关研究人群、研究设计与方法、干预措施及结果测量的数据以及数据质量，并比较了研究结果。我们通过与第三位综述作者讨论来解决分歧。
我们综述了23项研究：三项随机试验、两项非随机试验、14项队列研究和四项病例对照研究。五项研究考察了强制性执照颁发前培训，14项评估了非强制性培训，三项病例对照研究评估了“任何”类型的骑手培训，一项病例对照研究评估了强制性执照颁发前培训和非强制性培训。所评估的骑手培训类型在持续时间和内容上各不相同。大多数研究存在严重的方法学缺陷。大多数研究是非随机的，且对混杂因素控制不佳。由于结果测量工具使用不当，如仅依赖警方记录或自我报告数据，大多数研究还存在检测偏倚。样本量小以及培训后随访时间短也很常见。
由于所识别研究的质量较差，我们无法就骑手培训对撞车事故、受伤或违规率的有效性得出任何结论。研究结果表明，强制性执照颁发前培训可能会阻碍摩托车执照获取流程的完成，可能通过减少接触间接降低撞车事故。目前尚不清楚培训（或何种类型的培训）是否能降低摩托车骑手的撞车事故风险、受伤风险或违规风险，因此无法推荐最佳的骑手培训实践。鉴于某种类型的骑手培训对于教导摩托车骑手安全骑行可能是必要的，所以需要进行严格的研究。
