| 1. |
- Andersson, Jan, 1965-
(author)
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Kan individer med synfältsbortfall köra säkert?
- 2024
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In: Sammanställning av referat från Transportforum 2024. - Linköping : Statens väg- och transportforskningsinstitut. ; , s. 279-279
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Conference paper (other academic/artistic)abstract
- Synfältsbortfall (SFB) kan leda till indragning av körkort. EU-direktivet kräver ett synfält på 120 grader horisontellt och 40 grader vertikalt (enkelt uttryckt). Om detta synfältsbortfall upptäcks av ansvarig läkare är han/hon skyldig (i Sverige) att anmäla detta till Transportstyrelsen. TS drar in körkortet och även körkortstillståndet. Därmed förlorar individen också sin möjlighet att bevisa sin förmåga att köra säkert, genom t.ex. en uppkörning. Cirka 1 000 personer förlorar årligen sitt körkort på grund av synfältsbortfall i Sverige. Individer med synfältsbortfall (SFB) testades i en simulator. De körde i cirka 55 minuter. Scenariot skapades för att efterlikna ett vanligt körprov på väg. 350 deltagare testades och 216 godkändes och fick tillbaka körkortet. Andelen godkända var 69 %. När simulatorstudien var klar och deltagarna med synfältsbortfall hade kört bil i 2 –4 år hade ca 150 av dem fortfarande ett giltigt körkort. Alla dessa kontaktades igen och tillfrågades om att delta i en uppföljningsstudie på väg. Sjuttio-två deltagare med synfältsbortfall (och körkortsdispens) deltog och 70 äldre och 70 unga, matchade kontroller (de unga kontrollerna har haft sitt körkort i minst 4–5 år). Kontrolldeltagarna var matchade i) på bostadsområde, ii) årliga körda körsträcka och iii) ålder för kontrollgruppen äldre. Varje SFB-deltagare hade således två individmatchade kontroller. Uppgiften var att genomföra ett ordinarie körprov på väg med en "blind" förarprövare. All logistik utfördes av VTI och förarprövare och alla deltagare fick i uppdrag att inte diskutera något med avseende på synförmågor. Förarprövaren förstod givetvis att en del var äldre och att en del var yngre, men de var blinda utifrån ett forskningsfråga perspektiv. När uppkörningen var klar skickade förarprövaren resultatet till VTI. SFB-gruppen och den äldre matchade kontrollgruppen presterade lika bra (68,1 % respektive 65,7 % godkända prov). Även om SFB-deltagarna var något bättre var skillnaden inte signifikant. Den yngre kontrollgruppen var godkända i 81,4 % av fallen. Skillnaden mellan den yngre kontrollgruppen och SFB individer var inte heller signifikant (Fischers exakta test användes för analys).
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| 2. |
- Andersson, Jan, 1965-, et al.
(author)
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The importance of reaction time, cognition, and meta-cognition abilities for drivers with visual deficits
- 2019
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In: Cognition, Technology & Work. - : Springer. - 1435-5558 .- 1435-5566.
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Journal article (peer-reviewed)abstract
- Individuals who do not fulfill required visual field standards have their driving license withdrawn in Sweden. However, understanding of the ability to compensate for this loss is limited. This study aimed to determine if reaction time and cognitive performance are important for safe driving in visual field loss (VFL) individuals. Visually demanding reaction time tasks of different complexity, for example, can help one understand why some VFL individuals drive as safely as normally sighted individuals. Twenty VFL individuals and 83 normally sighted individuals participated in a driving simulator experiment and an additional test battery. The driving task categorized VFL participants into two subgroups: passed or failed. Three reaction time tasks, four cognitive tests, and two meta-cognitive scales were completed. The passed VFL subgroup was faster than the failed subgroup in the context-dependent reaction time task and slower in the context-independent reaction time task. The passed subgroup performed equally well, or less well, on the cognitive tasks compared to the failed subgroup. The VFL participants performed less well than the normally sighted individuals on most cognitive tasks. However, VFL participants did not reflect on their driving ability (in meta-cognitive scales) in the same way as normally sighted individuals. There appear to be VFL subgroups in terms of ability to drive safely. Reaction time is important, but context dependent. Cognitive context-independent tests appear unrelated to driving test outcome for VFL individuals. The problems with context-independent testing of perceptual, cognitive, and meta-cognitive abilities when predicting safe driving capabilities are discussed. © 2019, The Author(s).
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| 3. |
- Andersérs, Caroline, et al.
(author)
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The importance of individual characteristics on bicycle performance during alcohol intoxication
- 2024
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In: Traffic Safety Research. - Lund : Faculty of Engineering, Lund University. - 2004-3082. ; 6
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Journal article (peer-reviewed)abstract
- Bicycling accidents are a well-known problem for traffic safety globally. Alcohol intoxication is one possible factor, although the exact number of accidents due to intoxication is difficult to establish. Not all bicyclists act in the same way, particularly when under the influence of alcohol, i.e., bicycling performance might be related to a bicyclist's personal characteristics. This study aimed to investigate if the bicyclist's characteristics (bicycling experience, physical fitness, or sensation seeking scores) influence bicycling stability, cognitive performance, or self-rated bicycling ability ratings at different levels of alcohol intoxication. The experiment was completed on a wide treadmill, which allowed control of several influencing factors such as speed and physical effort. Intoxicated and sober participants bicycled on the treadmill five times for 10 minutes each time, and breath alcohol concentration (BrAC) levels were measured five times. Participants were given doses of alcohol up to a BrAC level of 0.8%.
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| 4. |
- Andersson, Jan, 1965-, et al.
(author)
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Bicycling during alcohol intoxication
- 2023
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In: Traffic Safety Research. - : Lund University Faculty of Engineering. - 2004-3082. ; 4
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Journal article (peer-reviewed)abstract
- The number of bicycling fatalities was 19 450 between 2010 and 2018 in Europe. The number of bicyclists killed when intoxicated by alcohol is harder to establish given the lack of reliable data. In Sweden, drunk bicycling is socially acceptable and legal (unless reckless). This experiment aimed to investigate how alcohol intoxication affect bicycling stability performance, executive functions, and self-rated ability. The experiment was completed on a wide treadmill that allowed control of several influencing factors such as speed and physical effort. Intoxicated and sober participants bicycled on the treadmill for five 10 minute sessions. Alcohol as administered incrementally to reach a target breath alcohol concentration level of 0.8‰. Stability decreased with intoxication; especially roll rate measurements were identified as being adequate indicators of bicycling instability. Executive function was negatively affected, and ability ratings decreased due to intoxication. The intoxicated participants were aware of their reduced ability to bicycle in a safe manner on a group level but not on an individual level. However, this insight does not affect their intention to bicycle intoxicated.
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| 5. |
- Nyberg, Jonna, 1967-, et al.
(author)
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Experienced processes and outcomes of driving license withdrawal due to visual field loss : A Swedish survey study of trust in authorities
- 2023
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In: Transportation Research Interdisciplinary Perspectives. - : Elsevier. - 2590-1982. ; 17
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Journal article (peer-reviewed)abstract
- Citizen perceptions of justice, regarding both processes and outcomes, are closely related to the perceived legitimacy of the authorities involved and are thus significant for trust. This study investigates how a withdrawn driving license due to visual field loss might affect trust in the authorities involved in withdrawal processes and outcomes: the health-care system, the Swedish Transport Agency, and the judicial system. The factors influencing trust were investigated as was whether the withdrawal experience had changed the trust in other authorities not involved in the withdrawal process. Also, the aetiology of the visual field loss and gender were investigated.A survey study was conducted in which 402 Swedish respondents with visual field loss and a withdrawal experience participated. Variance, regression, and content analyses were conducted. The following conceptual factors were used in understanding trust: Benevolence, Openness, Integrity, Ability, and Value Congruence.The results revealed that processes and outcomes affected the overall trust in all three authorities, although the highest trust was in the health-care system (but still low). Diagnosis, but not gender, was important for the experienced trust. Differences in levels of trust in each authority were related to the aetiology of the diagnosis. Benevolence and Ability were the trust factors most important for overall trust in the health-care system and the Swedish Transport Agency. For some respondents (46%), the negative experiences of the withdrawal had worsened their trust in other, not involved authorities, as well.
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| 6. |
- Andersson, Jan, 1965-, et al.
(author)
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Self-Perception and the Relation to Actual Driving Abilities for Individuals With Visual Field Loss
- 2022
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In: Frontiers in Human Neuroscience. - : Frontiers Media SA. - 1662-5161. ; 16
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Journal article (peer-reviewed)abstract
- BackgroundIn Sweden, individuals with visual field loss (VFL) have their driving license withdrawn. The literature clearly indicates that individuals with VFL are unsafe drivers on a group level. However, many drivers with VFL can be safe on an individual level. The literature also suggests that self-perception, beliefs, and insights of one's own capabilities are related to driving performance. This study had three aims: (1) To investigate self-perceived driving capability ratings for individuals with VFL; (2) to compare these ratings between groups with different medical conditions associated with VFL (stroke, glaucoma, and diabetes); and (3) to relate the self-perception ratings to actual driving performance in an advanced driving simulator. MethodsParticipants comprised 723 individuals whose driver's license had been withdrawn because of VFL and 92 normally sighted elderly individuals. All participants completed a background survey, rated difficulties with different traffic situations, rated their strengths and weaknesses as drivers, and rated aspects that were important for causing traffic accidents. Of the VFL group participants, 264 also completed a simulator-based driving test that they knew could lead to renewal of their driving license. VFL participants and normally sighted was at the same age when they completed the simulator driving test. ResultsOverall, individuals with VFL rated their capabilities as high on all instruments and scales used, even higher than the elderly normally sighted control group. The only VFL etiology group that rated lower than other groups was the diabetes group. Safety orientation and internal control orientation values were best at discriminating between VFL participants in terms of self-perception of driving performance. Participants categorized as "high" in terms of safety skills and internal control were more modest in their ratings. Finally, participants who passed the simulated driving test did not differ from those who failed, in any of the self-perception measures. ConclusionSelf-perception ratings among individuals with VFL were higher than those of normally sighted elderly individuals. Self-assessed skills did not predict driving performance. Groups with different VFL etiologies rated similarly. Self-ratings of driving abilities cannot be used to assess actual driving performance. Actual driving tests (on road or in the simulator) are necessary to discriminate between safe and unsafe drivers with VFL.
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| 7. |
- Bro, Tomas, et al.
(author)
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The effects of visual field loss from glaucoma on performance in a driving simulator
- 2022
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In: Acta Ophthalmologica. - : WILEY. - 1755-375X .- 1755-3768. ; 100:2, s. 218-224
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Journal article (peer-reviewed)abstract
- Background To examine the effects of different stages of visual field loss (VFL) from advanced glaucoma on performance in a driving simulator. Methods Data on performance and safety from a traffic simulator test for 104 participants with withdrawn drivers licences due to visual field loss from advanced glaucoma were compared with data from 83 individuals without visual deficits in a cross-sectional study. Individuals with glaucoma that regained their driving licences after a successful simulator test were then followed in a national accident database. Results Glaucoma participants passed the test in 71% (95% confidence interval 61-79%) of the cases. Younger participants were more successful than older. No significant differences on safety or performance measures were detected between glaucoma- and normally sighted participants. Compared with passed glaucoma participants, failed glaucoma participants had more collisions, more critical failed to give way events, longer time headways, and longer reaction times. This group had also a higher extent of central visual field loss. None of the participants with a regained licence were involved in a motor vehicle accident during the 2 to 4 year follow-up after the simulator test. Conclusion Severity of glaucoma predicts driver safety on a group level. However, even individuals with severe visual field loss from glaucoma might drive safely, which highlights the need for individual assessments for licencing purposes.
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| 8. |
- Bro, Tomas, et al.
(author)
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The Effects of Visual Field Loss from Optic Disc Drusen on Performance in a Driving Simulator
- 2022
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In: Neuro-ophthalmology (Aeolus Press. 1980). - : TAYLOR & FRANCIS AS. - 0165-8107 .- 1744-506X.
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Journal article (peer-reviewed)abstract
- The purpose of this study was to compare the driving simulator performance of participants with visual field loss (VFL) from optic disc drusen (ODD) with a normally sighted control group and a group of individuals with glaucoma. Data on performance and safety from a traffic simulator test for five participants with VFL from ODD were retrospectively compared with data from 49 male individuals without visual deficits in a cross-sectional study. VFL of the ODD group was also compared with a group of 20 male glaucoma participants who had failed the same simulator test. Four individuals with ODD regained their driving licences after a successful simulator test and were then followed in a national accident database. All participants with ODD passed the test. No significant differences in safety or performance measures were detected between the normally sighted participants and the ODD group despite severe concentric visual field constrictions. Compared with failed glaucoma male participants, the ODD group had even lower mean sensitivity in the peripheral and peripheral inferior field of vision. None of the four participants with a regained licence were involved in a motor vehicle accident during a 3-year follow-up period after the simulator test. Despite having severe VFL, participants with ODD had no worse performance or safety than controls. As even individuals with severe VFL might drive safely, there is a need for individual practical assessments on licencing issues.
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| 9. |
- Bro, Tomas, et al.
(author)
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The effects of visual-field loss from panretinal photocoagulation of proliferative diabetic retinopathy on performance in a driving simulator
- 2023
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In: Eye (London. 1987). - : SPRINGERNATURE. - 0950-222X .- 1476-5454. ; 37, s. 103-108
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Journal article (peer-reviewed)abstract
- Background The purpose of this study was to compare driving-simulator performance of participants with visual-field loss (VFL) from panretinal photocoagulation (PRP) of proliferative diabetic retinopathy (PDR) with a normally sighted control group. Furthermore, we investigated the effects of VFL of different extent on driving. Methods Data on performance and safety from a traffic-simulator test for 27 participants with VFL from PRP of PDR were retrospectively compared with data from 83 individuals without visual deficits in a cross-sectional study. Individuals with diabetes that regained their driving licences after a successful simulator test were then followed in a national accident database. Results Diabetes participants passed the test in 56% of the cases. Compared with the control group, diabetes participants had more risky "failed to give way" events and longer reaction times. Failed diabetes participants had lower mean sensitivity in the superior visual field than those who passed. None of the participants with a regained licence were involved in a motor vehicle accident during the 3-6-year follow-up after the simulator test. Conclusions Diabetes participants had worse performance and safety than the controls. However, even individuals with VFL from PRP might drive safely, which highlights the need for individual assessments in licencing issues.
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| 10. |
- Bro, Tomas, et al.
(author)
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The Effects of Visual Field Loss from Stroke on Performance in a Driving Simulator
- 2022
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In: Optometry and Vision Science. - : LIPPINCOTT WILLIAMS & WILKINS. - 1040-5488 .- 1538-9235. ; 99:9, s. 679-686
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Journal article (peer-reviewed)abstract
- SIGNIFICANCE: Visual field loss is a common consequence of stroke and often precludes driving. However, legal visual requirements for drivers licenses are largely without scientific basis. PURPOSE: This study aimed to examine the effects of different types of homonymous visual field loss after stroke on simulated driving. METHODS: Data on performance and safety from a traffic simulator test for 153 participants with withdrawn drivers licenses due to visual field loss from stroke were retrospectively compared with data from 83 healthy individuals without visual deficits in a cross-sectional study. The 93 individuals in the stroke group who regained their driving licenses after a successful simulator test were then followed in a national accident database. RESULTS: Sixty-five percent of the stroke participants passed the simulator test (95% confidence interval, 57 to 72%). Younger patients were more successful than older. However, classification by neither type of homonymous visual field loss nor side of visual field loss was predictive of driver safety. Participants with hemianopia had their lateral lane position dislocated to the nonaffected side of the visual field. None of the participants with a regained license were involved in motor vehicle accidents 3 to 6 years after the test. CONCLUSIONS: In this large cohort, driver safety could not be predicted from the type of homonymous visual field loss. Even individuals with severe visual field loss might be safe drivers. Therefore, it seems reasonable to provide an opportunity for individualized assessments of practical fitness to drive in circumstances of licensing issues. This study demonstrates the potential of using a standardized driving simulator test for such assessments of fitness to drive.
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