Health and Rehabilitation Sciences, University of Western Ontario, London, Ontario, Canada.
Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA.
Traffic Inj Prev. 2021;22(3):212-217. doi: 10.1080/15389588.2021.1883008. Epub 2021 Mar 10.
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.
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.
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.
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.
多发性硬化症（MS）患者可能存在更高的撞车风险。然而，导致撞车的驾驶表现缺陷尚未完全了解。根据现有文献，对刺激的调整错误表明在路考中失败。本研究旨在探讨调整刺激错误是否可以在驾驶模拟器中检测到 MS 患者的碰撞发生。
作为准实验的一部分，38 名 MS 患者和 21 名无 MS 患者完成了视觉认知和驾驶模拟器评估，同时记录了他们对刺激的调整操作。我们通过初始脚踏反应时间（秒）、碰撞时间（秒）、平均速度（米/秒）和模拟车辆切入他们前方车道时发生追尾碰撞（碰撞与未碰撞）的情况，来量化参与者对刺激操作的调整。
逻辑回归分析表明，与无 MS 患者相比，MS 患者的碰撞时间更短（OR=.04，=.001，95%CI= [.006，.27]），平均速度更快（OR= 1.32，=.04，95%CI= [1.01，1.74]），这增加了发生追尾碰撞的可能性。受试者工作特征曲线分析表明，对于 MS 组和对照组，碰撞时间（MS 组 AUC=.94，<.0001，对照组 AUC=.86，<.0001）和平均速度（MS 组 AUC=.76，=.005，对照组 AUC=.78，=.005）区分了发生碰撞与未发生碰撞的参与者。对于 MS 患者，碰撞时间为 1.81 秒（85%灵敏度，100%特异性，15%误差率），平均速度为 7.83 米/秒（77%灵敏度，76%特异性，47%误差率）可以预测碰撞的发生，误差率最低。
在驾驶模拟器评估中，对刺激的调整错误预测了 MS 患者（与无 MS 患者相比）发生追尾碰撞的情况。驾驶评估员可以通过碰撞时间和平均速度等方式针对测量参与者对刺激的调整的场景做出决策，以了解他们的视觉认知缺陷和驾驶表现。
