title: Using cognitive status to predict crash risk: blazing new trails?
abstract: BACKGROUND
  A computer-based version of an established neuropsychological paper-and-pencil assessment tool, the Trail-Making Test, was applied with approximately 700 drivers aged 70 years and older in offices of the Maryland Motor Vehicle Administration.
  
  
  METHODS
  This was a volunteer sample that received a small compensation for study participation, with an assurance that their license status would not be affected by the results. Analyses revealed that the study sample was representative of Maryland older drivers with respect to age and indices of prior driving safety. The relationship between drivers' scores on the Trail-Making Test and prospective crash experience was analyzed using a new outcome measure that explicitly takes into account error responses as well as correct responses, the error-compensated completion time.
  
  
  RESULTS
  For the only reliable predictor of crash risk, Trail-Making Test Part B, this measure demonstrated a modest gain in specificity and was a more significant predictor of future safety risk than the simple time-to-completion measure.
  
  
  CONCLUSIONS
  Improved specificity and the potential for autonomous test administration are particular advantages of this measure for use with large populations, in settings such as health care or driver licensing.
authors: TransAnalytics, LLC; 336 West Broad Street, Quakertown, PA 18951, USA. Electronic address: lstaplin@transanalytics.com.
authors: Loren
authors: L
authors: Staplin
authors: TransAnalytics, LLC; 336 West Broad Street, Quakertown, PA 18951, USA.
authors: Kenneth W
authors: KW
authors: Gish
authors: National Highway Traffic Safety Administration; 1200 New Jersey Ave., SE, Washington, DC 20590, USA.
authors: Kathy J
authors: KJ
authors: Sifrit
mesh_terms: D000063:Accidents, Traffic / Q000523:psychology*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology; D001333:Automobile Driver Examination / Q000523:psychology; D001334:Automobile Driving / Q000523:psychology* / Q000706:statistics & numerical data; D003072:Cognition Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008004:Licensure / Q000145:classification; D008297:Male; D008396:Maryland; D018986:Motor Vehicles / Q000331:legislation & jurisprudence; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D013997:Time Factors; D014145:Trail Making Test / Q000592:standards*
keywords: Aging; Cognitive impairment; Crash risk prediction; Driver; Trail making Test