Accident; analysis and prevention
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Review Meta Analysis
Analgesics and road traffic crashes in senior drivers: an epidemiological review and explorative meta-analysis on opioids.
To assess the epidemiological evidence associating the use of analgesics with the occurrence of road traffic crashes in senior drivers including a meta-analysis with specific focus on opioids. ⋯ The evidence is unconvincing in terms of number of studies, control of major confounders, and consistency of the results. The effect seen for opioids can be attributed to the lack of adjustment of key confounders such as concomitant illness or the consumption of alcohol or other psychoactive medications. There is a need for more efficient designs like larger population-based retrospective cohorts and nested case-control or case-crossover studies based on registers of high quality allowing adjustment for these factors and for the selection of unequivocal outcomes (e.g. drivers' responsibility) to produce more persuasive empirical evidence.
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The empirical basis for legislation to limit cell phones while driving is addressed. A comprehensive meta-analysis of the effects of cell phones on driving performance was performed. A total of 33 studies collected through 2007 that met inclusion criteria yielded 94 effect size estimates, with a total sample size of approximately 2000 participants. ⋯ In addition, drivers using either phone type do not appreciably compensate by giving greater headway or reducing speed. Tests for moderator effects on RT and speed found no statistically significant effect size differences across laboratory, driving simulation and on-road research settings. The implications of the results for legislation and future research are considered.
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Bicycle helmet efficacy was quantified using a formal meta-analytic approach based on peer-reviewed studies. Only those studies with individual injury and helmet use data were included. Based on studies from several countries published in the period 1987-1998, the summary odds ratio estimate for efficacy is 0.40 (95% confidence interval 0.29, 0.55) for head injury, 0.42 (0.26, 0.67) for brain injury, 0.53 (0.39, 0.73) for facial injury and 0.27 (0.10, 0.71) for fatal injury. ⋯ In conclusion, the evidence is clear that bicycle helmets prevent serious injury and even death. Despite this, the use of helmets is sub-optimal. Helmet use for all riders should be further encouraged to the extent that it is uniformly accepted and analogous to the use of seat belts by motor vehicle occupants.