ArticleCanadian geriatrics journal : CGJ2013
Systematic review of the evidence for Trails B cut-off scores in assessing fitness-to-drive.
Article in Canadian geriatrics journal : CGJ, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed.
- Computer-Based Driving in Dementia Decision Tool With Mail Support: Cluster Randomized Controlled Trial.Journal of medical Internet research · 2018Trial
- Trial
- Neuropsychological Assessment Using Portable Automated Rapid Testing in Cognitively Healthy Older Adults: Test-Retest Reliability Study.JMIR formative research · 2026Article
- Association Between the Japanese Version of Montreal Cognitive Assessment Tasks and Driving as the Primary Mode of Transport Among Community-Dwelling Older Adults.Canadian geriatrics journal : CGJ · 2026Article
- Medical Marijuana Initiation and Simulated Driving Performance Among Mid-to-Late-Life Adults With Chronic Pain: Prospective Observational Feasibility Cohort Study With Matched Controls.JMIR formative research · 2026Observational
- Recent drinking in alcohol use disorder as a modifiable risk factor of postural tremor and instability in mild cognitive impairment: An initial study.Alcohol, clinical & experimental research · 2025Article
- Identification of novel protective loci for executive function using the trail making test part B in the Long Life Family Study.bioRxiv : the preprint server for biology · 2025Article
- Home-based telemonitoring care and executive function in patients with heart failure.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Alcohol use disorder and fitness to drive: Discrepancies between health professionals' evaluations and objective measures of alcohol use and cognitive functioning.Nordisk alkohol- & narkotikatidskrift : NAT · 2024Article
- The Impact of Spatial Orientation Changes on Driving Behavior in Healthy Aging.The journals of gerontology. Series B, Psychological sciences and social sciences · 2024Article
- Cognitive function and impact on driving after SARS-COV-2 infection in a man with long-standing HIV infection: a case report.Journal of neurovirology · 2023Article
- Clinical Tests Predicting On-Road Performance in Older Drivers with Cognitive Impairment.Canadian journal of occupational therapy. Revue canadienne d'ergotherapie · 2023Article
- Decline in Other Instrumental Activities of Daily Living as Indicators of Driving Risk in Older Adults at an Academic Memory Clinic.Geriatrics (Basel, Switzerland) · 2023Article
- Validation of a computerized driving simulator test of cognitive abilities for fitness-to-drive assessments.Frontiers in psychology · 2023Article
- Driving Errors Predicting Pass/Fail On-Road Assessment Outcomes Among Cognitively Impaired Older Drivers.OTJR : occupation, participation and health · 2023Article
- Are the Physical and Cognitive Functions of Older Adults Affected by Having a Driver's License?-A Pilot Study of Suburban Dwellers.International journal of environmental research and public health · 2022Article
- Clinical Trial Endpoints and Their Clinical Meaningfulness in Early Stages of Alzheimer's Disease.The journal of prevention of Alzheimer's disease · 2022Review
- Neuropsychological Assessments of Patients With Acquired Brain Injury: A Cluster Analysis Approach to Address Heterogeneity in Web-Based Cognitive Rehabilitation.Frontiers in neurology · 2021Article
- Associations between small and middle molecules clearance and the change of cognitive function in peritoneal dialysis.Journal of nephrology · 2020Article
- Screening tools for virtual assessment of cognition.Canadian family physician Medecin de famille canadien · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFitness-to-drive guidelines recommend employing the Trail Making B Test (a.k.a. Trails B), but do not provide guidance regarding cut-off scores. There is ongoing debate regarding the optimal cut-off score on the Trails B test. The objective of this study was to address this controversy by systematically reviewing the evidence for specific Trails B cut-off scores (e.g., cut-offs in both time to completion and number of errors) with respect to fitness-to-drive.
methodsSystematic review of all prospective cohort, retrospective cohort, case-control, correlation, and cross-sectional studies reporting the ability of the Trails B to predict driving safety that were published in English-language, peer-reviewed journals.
resultsForty-seven articles were reviewed. None of the articles justified sample sizes via formal calculations. Cut-off scores reported based on research include: 90 seconds, 133 seconds, 147 seconds, 180 seconds, and < 3 errors.
conclusionsThere is support for the previously published Trails B cut-offs of 3 minutes or 3 errors (the '3 or 3 rule'). Major methodological limitations of this body of research were uncovered including (1) lack of justification of sample size leaving studies open to Type II error (i.e., false negative findings), and (2) excessive focus on associations rather than clinically useful cut-off scores.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.