Fox G K, Bowden S C, Smith D S
Rehabilitation Studies Unit, University of Sydney and Royal Rehabilitation Centre Sydney, Australia.
Arch Phys Med Rehabil. 1998 Oct;79(10):1288-96. doi: 10.1016/s0003-9993(98)90277-5.
To examine the approaches to on-road assessment of driver competence in persons with brain impairment. Items examined were procedures, standardization, scoring methods, equipment requirements, and determination of fitness to drive.
All studies identified through citation or Medline search.
The studies reviewed were those published from 1971 to the present that examined driving competence after brain impairment, as measured by a driving test.
A qualitative review of published studies reporting methodologies and authors' conclusions abstracted from sourced publications.
Off-road driving assessments examine proficiency in operating a motor vehicle, but not ability to drive in traffic or accurate prediction of safe driving. On-road driving assessments have been used to examine the predictive validity of other driving assessment methods or the driving performance of subjects with brain impairment. Determining a subject's competence to drive is frequently a subjective evaluation. With a standardized driving test, a significant correlation between the objective driving score and the rater's global evaluation of fitness has been reported.
Closed-course, off-road driving tests are recommended for examining vehicle operation skills and readiness for in-traffic evaluation only. This allows practice with any vehicle adaptations before on-road evaluation and identification of clients who are unsafe to proceed on-road. A practical driving test in traffic, with standardized route and driving maneuvers, is recommended for determining driver competence. Scoring of driving performance should be standardized, reliable, and specific, to identify deficient driving skills that may be amenable to training. Driving performance should be evaluated according to predefined criteria, and the judgment regarding competence should be closely related to this objective measure.
探讨对脑损伤患者进行道路驾驶能力评估的方法。所考察的项目包括程序、标准化、评分方法、设备要求以及驾驶适宜性的判定。
通过文献引用或医学期刊数据库检索所识别出的所有研究。
所综述的研究为1971年至今发表的、通过驾驶测试来考察脑损伤后驾驶能力的研究。
对已发表研究进行定性综述，报告从原始出版物中提取的方法学和作者结论。
越野驾驶评估考察操作机动车的熟练程度，但不考察在交通环境中的驾驶能力或对安全驾驶的准确预测。道路驾驶评估已被用于检验其他驾驶评估方法的预测效度或脑损伤受试者的驾驶表现。确定受试者的驾驶能力往往是一种主观评估。据报道，采用标准化驾驶测试时，客观驾驶分数与评估者对驾驶适宜性的整体评价之间存在显著相关性。
建议采用封闭场地的越野驾驶测试，仅用于考察车辆操作技能以及是否准备好进行道路评估。这使得在进行道路评估之前可以对任何车辆改装进行练习，并识别出不适合上路的客户。建议采用具有标准化路线和驾驶动作的实际道路驾驶测试来确定驾驶能力。驾驶表现的评分应标准化、可靠且具体，以识别可能适合培训的欠缺驾驶技能。应根据预定义标准评估驾驶表现，关于驾驶能力的判断应与此客观指标密切相关。
