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Prediction of Driving Capacity After Traumatic Brain Injury: A Systematic Review

Ortoleva, Claudia MSc; Brugger, Camille MSc; Van der Linden, Martial PhD; Walder, Bernhard MD

Section Editor(s): Caplan, Bruce PhD, ABPP; (Senior Editor); Bogner, Jennifer PhD ABPP; (Associate Editor)

The Journal of Head Trauma Rehabilitation: July/August 2012 - Volume 27 - Issue 4 - p 302–313
doi: 10.1097/HTR.0b013e3182236299
Focus on Clinical Research and Practice

Objective: To review the current evidence on predictors for the ability to return to driving after traumatic brain injury.

Methods: Systematic searches were conducted in MEDLINE, PsycINFO, EMBASE, and CINAHL up to March 1, 2010. Studies were rigorously rated for their methodological content and quality and standardized data were extracted from eligible studies.

Results: We screened 2341 articles, of which 7 satisfied our inclusion criteria. Five studies were of limited quality because of undefined, unrepresentative samples and/or absence of blinding. Studies mentioned 38 candidate predictors and tested 37. The candidate predictors most frequently mentioned were “selective attention” and “divided attention” in 4/7 studies, and “executive functions” and “processing speed,” both in 3/7 studies. No association with driving was observed for 19 candidate predictors. Eighteen candidate predictors from 3 domains were associated with driving capacity: patient and trauma characteristics, neuropsychological assessments, and general assessments; 10 candidate predictors were tested in only one study and 8 in more than one study. The results of associations were contradictory for all but one: time between trauma and driving evaluation.

Conclusions: There is no sound basis at present for predicting driving capacity after traumatic brain injury because most studies have methodological limitations.

Cognitive Psychopathology and Neuropsychological Unit, University of Geneva, Switzerland (Ms Ortoleva and Prof Van der Linden); and Division of Anesthesiology, Department of Anesthesiology, Pharmacology and Intensive Care, University Hospitals of Geneva and University of Geneva, Switzerland (Ms Brugger and Dr Walder).

Corresponding Author: Camille Brugger, MSc, Division of Anesthesiology, Department of Anesthesiology, Pharmacology and Intensive Care University Hospitals of Geneva, 4, rue Gabreille-Perret-Gentil, 1211 Geneva 14, Switzerland (

The authors declare no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.