Can a novel web-based computer test predict poor simulated driving performance? A pilot study with healthy and cognitive-impaired participants

BACKGROUND Driving a car is a complex instrumental activity of daily living and driving performance is very sensitive to cognitive impairment. The assessment of driving-relevant cognition in older drivers is challenging and requires reliable and valid tests with good sensitivity and specificity to predict safe driving. Driving simulators can be used to test fitness to drive. Several studies have found strong correlation between driving simulator performance and on-the-road driving. However, access to driving simulators is restricted to specialists and simulators are too expensive, large, and complex to allow easy access to older drivers or physicians advising them. An easily accessible, Web-based, cognitive screening test could offer a solution to this problem. The World Wide Web allows easy dissemination of the test software and implementation of the scoring algorithm on a central server, allowing generation of a dynamically growing database with normative values and ensures that all users have access to the same up-to-date normative values. OBJECTIVE In this pilot study, we present the novel Web-based Bern Cognitive Screening Test (wBCST) and investigate whether it can predict poor simulated driving performance in healthy and cognitive-impaired participants. METHODS The wBCST performance and simulated driving performance have been analyzed in 26 healthy younger and 44 healthy older participants as well as in 10 older participants with cognitive impairment. Correlations between the two tests were calculated. Also, simulated driving performance was used to group the participants into good performers (n=70) and poor performers (n=10). A receiver-operating characteristic analysis was calculated to determine sensitivity and specificity of the wBCST in predicting simulated driving performance. RESULTS The mean wBCST score of the participants with poor simulated driving performance was reduced by 52%, compared to participants with good simulated driving performance (P<.001). The area under the receiver-operating characteristic curve was 0.80 with a 95% confidence interval 0.68-0.92. CONCLUSIONS When selecting a 75% test score as the cutoff, the novel test has 83% sensitivity, 70% specificity, and 81% efficiency, which are good values for a screening test. Overall, in this pilot study, the novel Web-based computer test appears to be a promising tool for supporting clinicians in fitness-to-drive assessments of older drivers. The Web-based distribution and scoring on a central computer will facilitate further evaluation of the novel test setup. We expect that in the near future, Web-based computer tests will become a valid and reliable tool for clinicians, for example, when assessing fitness to drive in older drivers.

Keeping citizens, companies, and organizations informed by Web KnowARR

For the main part, electronic government (or e-government for short) aims to put digital public services at disposal for citizens, companies, and organizations. To that end, in particular, e-government comprises the application of Information and Communications Technology (ICT) to support government operations and provide better governmental services (Fraga, 2002) as possible with traditional means. Accordingly, e-government services go further as traditional governmental services and aim to fundamentally alter the processes in which public services are generated and delivered, after this manner transforming the entire spectrum of relationships of public bodies with its citizens, businesses and other government agencies (Leitner, 2003). To implement this transformation, one of the most important points is to inform the citizen, business, and/or other government agencies faithfully and in an accessible way. This allows all the partaking participants of governmental affairs for a transition from passive information access to active participation (Palvia and Sharma, 2007). In addition, by a corresponding handling of the participants' data, a personalization towards these participants may even be accomplished. For instance, by creating significant user profiles as a kind of participants' tailored knowledge structures, a better-quality governmental service may be provided (i.e., expressed by individualized governmental services). To create such knowledge structures, thus known information (e.g., a social security number) can be enriched by vague information that may be accurate to a certain degree only. Hence, fuzzy knowledge structures can be generated, which help improve governmental-participants relationship. The Web KnowARR framework (Portmann and Thiessen, 2013; Portmann and Pedrycz, 2014; Portmann and Kaltenrieder, 2014), which I introduce in my presentation, allows just all these participants to be automatically informed about changes of Web content regarding a- respective governmental action. The name Web KnowARR thereby stands for a self-acting entity (i.e. instantiated form the conceptual framework) that knows or apprehends the Web. In this talk, the frameworks respective three main components from artificial intelligence research (i.e. knowledge aggregation, representation, and reasoning), as well as its specific use in electronic government will be briefly introduced and discussed.