In @entity1 With XXXX , Driving Simulator Performance Is  Associated With Real-life Driving.

@entity1 @entity82 @entity3851 @entity285 @entity99
BACKGROUND _ AIMS: @entity99 ( @entity99 ) has been linked to higher real-life rates of automobile crashes and poor performance in driving simulation studies, but the link between driving simulator performance and real-life automobile crashes has not been clearly established. Furthermore, not all @entity1 with @entity99 are unsafe drivers, but it is unclear how to distinguish them from unsafe drivers. We investigated the link between performance on driving simulators and real-life automobile accidents and traffic violations. We also aimed to identify features of unsafe drivers with @entity82 and evaluated changes in simulated driving skills and @entity99 status after 1 year. METHODS: We performed a study of outpatients with @entity82 (n  = 205; median 55 years old; median model for @entity3851 score, 9.5; none with overt @entity99 or @entity285 or illicit drug use within previous 6 months) seen at the Virginia Commonwealth University and McGuire Veterans Administration Medical Center, from November 2008 through April 2014. All @entity1 were given paper-pencil tests to diagnose @entity99 (98 had @entity99 ; 48%), and 163 @entity1 completed a standardized driving simulation. Data were collected on traffic violations and automobile accidents from the Virginia Department of Motor Vehicles and from @entity1 ' self-assessments when they entered the study, and from 73 @entity1 1 year later. @entity1 also completed a questionnaire about @entity285 use and cessation patterns. The driving simulator measured crashes, run-time, road center and edge excursions, and illegal turns during navigation; before and after each driving simulation session, @entity1 were asked to rate their overall driving skills. Drivers were classified as safe or unsafe based on crashes and violations reported on official driving records; simulation results were compared with real-life driving records. Multivariable regression analyses of real-life crashes and violations was performed using data on demographics, @entity82 details, @entity99 status, and @entity285 cessation patterns, at baseline and at 1 year. RESULTS: Drivers categorized as unsafe had more crashes and made more illegal turns on the driving simulator than drivers categorized as safe; a higher proportion of subjects with @entity99 were categorized as unsafe drivers at baseline (16%) than subjects without @entity99 (7%; P  = .02), and at 1-year follow-up (18% vs 0%; P  = .02). @entity285 cessation within <1 year and illegal turns during simulator navigation tasks were associated with real-life automobile crashes and @entity99 in regression analysis; road edge excursions in the simulator were associated with real-life traffic violations. Personal assessment of driving skills improved after each simulation episode. CONCLUSIONS: In a study of 205 @entity1 with @entity82 , we associated results from driving simulation tests with real-life driving records and @entity99 . Traffic safety counseling should focus on @entity1 with @entity82 who recently quit consuming @entity285 and perform poorly on driving simulation.
