Methods to evaluate driving competence for people with acquired brain injury (ABI): A systematic review.
Doha Alhashmi, Aislinn Lalor, Ellie Fossey
PMID 36684687WHAT IT FOUND
No single clinical test predicts safe driving after brain injury.
Cognitive screens help decide who needs an on-road test, but cannot replace it. On-road assessment remains the standard, though scoring varies and simulator evidence is weak.
Key findings
01There is no consensus on assessment methods for driving competence after acquired brain injury, and most included studies were of low quality (level 4 evidence).
02Clinical cognitive assessments may assist in referral decisions but cannot replace on-road driving performance testing.
03There is insufficient evidence to support the use of driving simulators as a primary assessment method following acquired brain injury.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The review could not perform a meta-analysis because the included studies were too different in design, population, and outcome measures. Only studies published in English were included, which may limit global applicability. Most included studies were of low methodological quality (level 4 evidence), with small sample sizes and lack of blinding being common issues. Time since injury varied widely (from 24 hours to 7 years), making it difficult to apply findings to specific stages of recovery. The protocol for this systematic review was not registered.
Declared interests
The text does not report any conflicts of interest or funding sources.
The easy way to misread this
Do not assume a high score on a cognitive test like the UFOV or SDSA means a patient is safe to drive. These tests only help decide who needs an on-road evaluation; they do not replace it. Similarly, do not rely on driving simulators to make competence decisions, as the evidence base for them is currently insufficient.