Driving errors that predict simulated rear-end collisions in drivers with multiple sclerosis.

OBJECTIVE

Drivers with Multiple Sclerosis (MS) may have an increased crash risk. However, the driving performance deficits that contribute to crashes are not fully understood. Based on the extant literature, adjustment to stimuli errors indicate failing an on-road assessment. This study examines whether adjustment to stimuli errors can detect the occurrence of collisions in a driving simulator in drivers with MS.

METHODS

As part of a quasi-experiment, 38 participants with MS and 21 participants without MS completed visual-cognitive and driving simulator assessments, which also recorded their adjustment to stimuli maneuvers. We quantified participants' adjustment to stimuli maneuvers via initial pedal reaction time (seconds), time to collision (seconds), mean speed (meters per second), and the occurrence of rear-end collisions (collide vs. did not collide) when a simulated vehicle cut across the lane in front of them.

RESULTS

Logistic regression analyses indicated that, compared to drivers without MS, those with MS had a shorter time to collision (OR= .04, = .001, 95% CI= [.006, .27]) and a faster mean speed (OR= 1.32, = .04, 95% CI= [1.01, 1.74]) which increased the odds of experiencing a rear-end collision. Receiver operating characteristic curve analyses indicated that, for MS and control groups, time to collision (MS group = AUC= .94, <.0001, Control group = AUC= .86, <.0001) and mean speed (MS group = AUC= .76, =.005, Control group = AUC = .78, = .005) differentiated between participants who collided vs. did not collide. For drivers with MS, a time to collision of 1.81 seconds (85% sensitivity, 100% specificity, 15% error rate), and a mean speed of 7.83 meters per second (77% sensitivity, 76% specificity, 47% error rate) predicted the occurrence of collisions with the lowest error rate.

CONCLUSIONS

During a driving simulator assessment, adjustment to stimuli errors predicted the occurrence of rear-end collisions in drivers with MS (vs. without MS). Driving assessors may target scenarios that measure participants' adjustment to stimuli, via time to collision and mean speed, to make decisions about their visual-cognitive deficits and driving performance.