EXPERT PANEL

An Expert Panel Meeting was held on November 2, 2000 at the National Highway Institute in Arlington, Virginia. Ten top experts in the field of at-risk driver and pedestrian research participated in the discussion:

The purpose of the panel was to discuss potential research projects, add projects if necessary, determine feasibility and practicality, and discuss importance. The ultimate goal was for the panelists to provide the input which would be used to prioritize the most important projects for NHTSA to fund.

Prior to the meeting the panelists were given the Literature Review and Potential Projects (see Appendices 2-6). Panel members discussed the list of potential projects and were asked to add ideas that were not in the list (see Appendix 7 for list of panelist additions).

Panelists were asked to consider the potential projects and, as a group, assign to each project a High, Medium, or Low Priority rating. The panelists discussed each potential research project in detail in order to determine priority levels. Panelists considered the history of each topic, including past research efforts’ results and implementation. Current related research was discussed, particularly with regard to overlap with the topic of interest. If a topic was at least partially covered by current or past work, the issue generally received a lower priority rating.

The discussion continued until the panelists reached a consensus regarding priority (driven by safety urgency, practicality and feasibility). Projects were assigned “High”, “Medium” or “Low” priority. When multiple studies addressed a common topic or issue, the panel often decided to “fold them together” as packages. A project package (with multiple studies) was then treated as a unit. Panelists suggested that these projects might be later “folded out” again.

After all potential projects were assigned “High, Medium” or “Low” priorities, panelists examined the nineteen “High” NHTSA priority projects. Panelists were asked to vote for the projects they felt should be given the highest priority, given the importance of safety urgency, practicality and feasibility. Each panel member could vote for as many as nine projects. The resulting vote totals are shown in Column 1 of Table 1, High-priority Research And Implementation Projects.

A few of the multi-study packages are very large and include many studies. These have been broken down into subpackages. Subpackages are typically groups of 2-4 studies which logically might be performed together. With this approach, the sometimes unwieldy multi-study packages can have smaller units “folded out” without breaking down into single studies.

In Table 1, multi-study packages are ordered by descending numbers of votes, as shown in Column 1. That is, the packages receiving the greatest numbers of votes appear first, and those receiving the fewest appear later. No package received zero votes.

One caveat should be made regarding the votes given to each package. On average, the largest packages (usually those including several studies) tended to receive the most votes for priority. This is perfectly logical, as larger packages will generate more information. However, it means that the votes may have become skewed toward the larger packages.

In Table 1, “High-priority Research and Implementation Projects”, “Votes” (Column 1) shows the number of priority votes a package received from the Expert Panel. “Level of Effort” (Column 2) shows the funding recommended by the Expert Panel for the package. “Package” (Column 3) shows the overall topic or title of a multi-study package. “Subpackage” (Column 4) shows the topic or title of the folded-out subpackage and the level of funding recommended for the subpackage if done independently from the rest of the multi-study package.

“Project Title”(Column 5) refers to the title of the potential project or concept from the Literature Review (or Expert Panel). The Expert Panel occasionally changed titles, but these are usually the same as those presented in the Literature Review. Although it is tempting to think of these as individual studies, many of the line items at this level would require multiple studies to fulfill the goals (for example, a project that calls for both the development and the validation of a screening instrument.)

“General Approach/Type of Study” (Column 6) shows the method recommended for the work. “Desired Outcomes” (Column 7) gives the goal, the question to be answered, or the desired product from the work.

In Table 2, the few Medium-priority Research and Implementation Projects are shown. Because the Medium-priority projects were not included in the vote and did not have a level of effort recommended by the Expert Panel, no votes or funding levels are shown. The Medium-priority projects were small efforts, so no multi-study titles or subpackages appear. Table 2 simply shows the Project Title, General Approach/Type of Study, and Desired Outcomes.

For both Tables 1 and 2, it is important to note that the descriptions are intended to serve only as summaries. Detailed Problem Statements follow and give a more complete description of each item.

Table 1
High-Priority Research and Implementation Projects

Votes Level of Effort Package Sub-Package, Where Applicable Project Title General Approach/Type of Study Desired Outcomes (Questions to be answered)
8 $500 K (without in-kind)  Maryland Model Follow-Up  N/A The Maryland Model: Further Testing  Pilot Test  Further pilot test MD at-risk program (test exportability)
7 $300 K Law Enforcement Training N/A Law Enforcement Program: Detecting Impaired Drivers Curriculum Development Develop and validate training programs for law enforcement to spot problem drivers - provide referral avenue (perhaps simplify procedural referral). Avoid age discrimination.
7 $4-500 K Driver Retraining Retraining Evaluation $400K Do Assessment-
and-Retraining Programs Improve Driving?
Evaluation Conduct follow-up of studies of outcomes of assessment and retraining programs, including investigation of remediation effectiveness
Evaluation of Older Driver Training Programs Evaluation Older driver training effectiveness
Retraining Standards $100K Standardization of Training and Standards of Driver Rehab/Assessment Professionals Expert Panel Identify research issues involved in potential standardization of training and standards of driver rehab/assessment professionals
7 $800 K Screening and Assessment Development, Eval and Validation of Tools $300K Screening Battery Development Development, Evaluation, Implementation Develop and evaluate, then implement, screening tests for visual, cognitive and/or physical problems related to crashes (and test training materials for administrators)
Screening for Higher-Order Cognitive Functions Evaluation Develop predictive models through the identification of assessment tools that take into account the role of higher order functions (e.g., judgment) and level of expertise
Screening Instruments and Crash Risk Evaluation/
Validation
Pilot test comprehensive screening and track crash experience of high risk vs. others
Types of Assessments $200K At-Risk Driver Assessment Tiers Screening/
Assessment Development
Develop multiple tiers of assessment (e.g., self assessment tools, education for medical/law personnel)
Tools for Self-Assessment Instrument Development Self assessment tools for different users
Screening: Routine or focused? $200K Evaluation of Routine Screening Evaluation Determine benefits/drawbacks of routine screening of older drivers (use randomized controlled trials)
Identifying At-Risk Populations for Screening Case Control On what basis should drivers be required to complete screening tests? Age? Medical referral? Insurance company referral? Crash status? Other criteria?
Referral Programs $100K Insurance Companies as Partners: Referring At-Risk Drivers for Screening Liaison Explore cooperation with insurance companies.
Referring At-Risk Older Drivers Expert Panel Develop referral system for at-risk drivers
7 $500 K PI&E Overall Awareness Level $300K  Educational Efforts “Demo Project”  PI&E  Development of overall public information strategy or social marketing plan

Aging and Transportation Issues: Promoting Awareness 

PI&E  Promote awareness and education on aging and transportation issues and solutions - include policymakers, consumers, professionals, service providers, health and medical, public community organizations 

Evaluate PI&E Efforts - new and old $200K 

Evaluation of Mobility PI&E Resources 

Evaluate PI&E/Expert Panel 

Community-level evaluation of senior mobility examine materials/strategies for: 
- appropriateness of messages and delivery system 
- cultural and geographic appropriateness 
- financial realities 

Identification of New Messages 

PI&E 

Identification of new messages - identify successful models for other social issues that can be adapted and tested for senior market 

Before You Give Up Your Keys: A Handbook of Options 

PI&E 

Pilot test program to make older drivers and families aware of options prior to loss of driving privilege

6 $200K

Evaluate Mobility Alternatives 

N/A 

Evaluation of Transportation Solutions 

Evaluate existing programs 

Identify and evaluate successful transportation solutions developed in/by communities/local groups (mobility options). Measure effects on exposure. 

Alternative Transportation: What’s Working, What’s Not 

Literature Review/ Expert Panel 

Best practices report on establishing/ resolving policy issues and creating funding mechanisms for alternative transportation 

6 $2-300 K

Mobility Alt. PI&E 

N/A 

Information on Mobility Alternatives 

PI&E 

Strategies to communicate mobility alternatives 

Services For Those Who Stop Driving 

PI&E 

Social marketing to older people so they know that they are eligible for services (and to design services that match their needs) 

4 $200 K N/A N/A

Alternative Transportation User Needs And Capabilities 

Survey 

What are needs and capabilities of alternative transportation users, including pedestrians? 

4 $250 K N/A N/A Rate of Impaired Status Cohort study What % of Older Drivers are impaired?
3 $100 K Effects of Medication on Driving  N/A Assessment of Medication Effects on Older Drivers  Expert Panel  Medication (prescription and over the counter): What are the connections and implications for the older driver? Explore interactions and combination effects, where possible. 
Effects of Medication on Driving  PI&E  Effective dissemination of existing knowledge (e.g., medication effects) 
3 $200 K ITS N/A ITS and Implications for At-risk Drivers Exposure Study

ITS Displays - HUD’s, contrast, maps, character size. Consequences of use for exposure 

   

Highway-related ITS devices (highway) 

3 $100 K     Media Portrayal of Older Drivers PI&E Educate media so they frame problem correctly - most older drivers are safe.
2 $25 K     NPTS Survey - Analysis Expert Panel Identify data elements to add to NPTS survey for older population sample.
2 $100 K     Overcoming Barriers to Driver Assessment Survey, focus groups, expert panel Overcoming barriers to seeking driver assessment-both self referrals and other referrals (e.g., physician)
2 $400 K     Early-stage Dementia Driving Behavior Research Longitudinal observational study Early stage dementia driving behavior research: Do they keep driving? What are the consequences?
2 $1 M     Indiana Tri-Level, Update Analyze crashes Repeat Indiana Tri-Level study with all age groups, including at-risk drivers.
2 $400 K     Medical Conditions: Do They Impede Insight for Self-Regulation? Evaluate Ss, conduct survey Some medical conditions harm judgment and self-perception. Investigate such conditions as dementia, sleep apnea, hypoglycemic reactions (e.g., in diabetes), some medications.
1 $200 K     Rural Older Drivers, Crashes, and Exposure Survey, crash analysis Do rural ODs continue to drive for longer than urban or suburban drivers? Is it related to a lack of alternatives? If so, is this related to crashes?
1 $200 K     Crashes Involving Older Pedestrians Exposure study Are Older Pedestrians overrepresented in pedestrian crashes in the U. S.? Investigate exposure, looking at walking exposure rather than per capita rates.

 

Table 2
Medium-priority Research and Implementation Projects
Project Title General Approach/ 
Type of Study
Desired Outcomes 
(Question to be Answered)
Passengers of Older Drivers: Distraction or Assistant? Investigate performance of ODs with passengers, particularly spouses. Assess performance in simulator while unassisted/assisted by spouse. May compare to middle-age drivers and/or inexperienced drivers. Do older couples use each other as external working memory sources when driving? Unlike teens with passengers, ODs with spouse-passengers may have lower crash rate. What are the consequences? What are the limitations?
Crash rates of Older Females: Cohort Effect?   Examine higher crash rate for older females (Gender X Age interaction)
Medical Advisory Boards Expert Panel Examine role of medical advisory boards in relation to at-risk drivers. Develop series of standards to apply.