Driving Simulator Assessment of Fitness-to-Drive Following Traumatic Brain Injury
DOI: 10.17077/drivingassessment.1704
archive: archived pipeline: cataloged verified
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Summary
This pilot study investigates the utility of high-fidelity driving simulators in assessing fitness-to-drive for individuals recovering from moderate-to-severe traumatic brain injury (TBI). While on-road instrumented vehicle assessments are considered the gold standard for determining driving readiness, they are limited by ethical constraints regarding exposure to hazardous or unpredictable driving situations. The researchers aimed to determine if a driving simulator could differentiate between active drivers and non-drivers post-TBI and to identify cognitive correlates of driving performance in these populations. Fourteen participants (ages 20–50) recruited from a TBI clinic were divided into two groups of seven: active drivers who had been cleared to drive and non-drivers deemed unlikely to return to driving. Participants completed five driving simulator modules of increasing complexity: basic vehicle operation, secondary task engagement (coin-sorting or conversation), car following, divided attention (identifying mirrored billboards), and navigating left-hand turns across oncoming traffic. Driving outcomes included average speed, speed variability, and lane position variability. Cognitive performance was assessed using the Cogstate Brief Battery, measuring processing speed, attention, visual learning, and working memory. The study found no statistically significant differences in driving outcomes between active and non-driver groups across the modules, likely due to the small sample size. However, general trends indicated that non-drivers exhibited slower average speeds and increased lane position variation. Regression analysis revealed that time since injury significantly predicted speed variability in the most complex module, and non-drivers showed significantly greater lane variability during secondary task engagement compared to active drivers. Correlational analyses highlighted distinct cognitive patterns: in active drivers, higher-order processes like working memory were more strongly associated with driving outcomes, particularly under high cognitive load. In contrast, non-drivers showed stronger associations between driving outcomes and lower-level processes like processing speed and attention. The findings suggest that while the simulator modules did not yield statistically significant group differences, they provided valuable insights into the cognitive demands of driving post-TBI. The differential association of cognitive processes with driving performance indicates that simulators can capture nuances difficult to assess in on-road tests. The authors conclude that modules involving specific tasks beyond basic navigation, such as divided attention and gap judgment, hold the most potential for distinguishing between driving groups. These results support the continued development of simulator-based assessments to inform clinical decisions regarding return-to-driving for TBI patients.
Provenance
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| Stage | Outcome | Tool | Model | Prompt | Attempts | Completed |
|---|---|---|---|---|---|---|
| discover | success | Crossref | — | — | 1 | 2026-06-07 |
| archive | success | canonical_url | — | — | 1 | 2026-06-09 |
| extract | success | pdftotext | — | — | 2 | 2026-06-09 |
| clean | success | clean | — | — | 1 | 2026-06-09 |
| chunk | success | chunk | — | — | 1 | 2026-06-09 |
| embed | success | embed | Qwen/Qwen3-Embedding-8B | — | 1 | 2026-06-09 |
| enrich | success | semantic_scholar | — | — | 1 | 2026-06-09 |
| promote | success | — | — | — | 1 | 2026-06-07 |
| summarize | success | llm | qwen3.6-27b-prismaquant | summ-v5 | 1 | 2026-06-09 |
| tag | success | vector_similarity | — | — | 8 | 2026-06-11 |
| verify | success | — | — | — | 1 | 2026-06-09 |
Summary generated by qwen3.6-27b-prismaquant on 2026-06-09; verification: verified.
Topics
Ranked by relevance to this paper. Hover a topic for its definition.
- post concussion
- cognitive impairment
- cognitive capacity variation
- mci dementia driving
- fitness to drive assessment
- simulator validity fidelity
Information type
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- Methodological Resource: validation psychometrics, tool software
- Theoretical Contribution: computational model