Cognitive Psychopathology and Neuropsychological Unit, University of Geneva, Switzerland.
J Head Trauma Rehabil. 2012 Jul-Aug;27(4):302-13. doi: 10.1097/HTR.0b013e3182236299.
To review the current evidence on predictors for the ability to return to driving after traumatic brain injury.
Systematic searches were conducted in MEDLINE, PsycINFO, EMBASE, and CINAHL up to March 1, 2010. Studies were rigorously rated for their methodological content and quality and standardized data were extracted from eligible studies.
We screened 2341 articles, of which 7 satisfied our inclusion criteria. Five studies were of limited quality because of undefined, unrepresentative samples and/or absence of blinding. Studies mentioned 38 candidate predictors and tested 37. The candidate predictors most frequently mentioned were "selective attention" and "divided attention" in 4/7 studies, and "executive functions" and "processing speed," both in 3/7 studies. No association with driving was observed for 19 candidate predictors. Eighteen candidate predictors from 3 domains were associated with driving capacity: patient and trauma characteristics, neuropsychological assessments, and general assessments; 10 candidate predictors were tested in only one study and 8 in more than one study. The results of associations were contradictory for all but one: time between trauma and driving evaluation.
There is no sound basis at present for predicting driving capacity after traumatic brain injury because most studies have methodological limitations.
回顾目前关于创伤性脑损伤后恢复驾驶能力的预测因素的证据。
系统检索了 MEDLINE、PsycINFO、EMBASE 和 CINAHL，检索时间截至 2010 年 3 月 1 日。对研究的方法内容和质量进行了严格评估，并从合格研究中提取了标准化数据。
我们筛选了 2341 篇文章，其中 7 篇符合我们的纳入标准。由于样本定义不明确、无代表性以及缺乏盲法，有 5 项研究质量有限。研究中提到了 38 个候选预测因素，并对 37 个进行了测试。在 7 项研究中有 4 项研究频繁提到了候选预测因素“选择性注意”和“分散注意”，在 3 项研究中有 3 项研究提到了“执行功能”和“处理速度”。19 个候选预测因素与驾驶能力无关。来自 3 个领域的 18 个候选预测因素与驾驶能力有关：患者和创伤特征、神经心理学评估和一般评估；10 个候选预测因素仅在一项研究中进行了测试，8 个候选预测因素在多项研究中进行了测试。除了一个之外，所有候选预测因素的相关性结果都相互矛盾：创伤和驾驶评估之间的时间。
目前还没有可靠的依据来预测创伤性脑损伤后驾驶能力，因为大多数研究都存在方法学上的局限性。
