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Normwerte und Gütekriterien eines interaktiven Fahrsimulators (“carsim”)

Reference values and quality criteria of “carsim”, an interactive driving simulation

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Zusammenfassung

Hauptziel der Studie war die Standardisierung und Optimierung sowie Normwerterstellung eines von uns neu entwickelten Computer-Programms “carsim”. Dieses simuliert mittels Bildschirm eine Straße mit Kurven, wobei das Fahrzeug durch Lenkradbewegungen auf der rechten Spur gehalten werden muss. Durch die Normierung und Optimierung von “carsim” sollte ein Instrument zur Charakterisierung der Dauerauf-merksamkeit für die obstruktive Schlafapnoe (OSAS) geschaffen werden. Dieses gestattet auch eine Kontrollmöglichkeit, um den Therapieerfolg bezüglich der Daueraufmerksamkeit nachzuweisen. Untersucht wurden 100 gesunde Probanden, insbesondere ohne Schlafstörung sowie 90 Patienten mit OSAS (AHI: 34,3/h±21,8 h; tiefste SaO2: 81,4%±9,0%). Während Gesunde nur 22,9±44,6 Spurabweichungen aufwiesen, ergaben sich bei unbehandelten OSAS-Patienten 3830±8753 (p<0,001). Die drei zur Güte eines Tests notwendigen Kriterien (Objektivität, Reliabilität, Validität) wurden überprüft. Sowohl bei der Überprüfung der internen Konsistenz als auch bei der Retest-Reliabität fanden sich sehr hohe Reliabilitätswerte. Der Test ergab beim tracking, der visual search und der Reaktionszeit bei bei-den Zuverlässigkeitsüberprüfungen Werte von über 0,9 (Ausnahme: Interne Konsistenz der Reaktionszeit r=0,8943). Ähnlich fielen auch die Validitätswerte (Interne; Externe; Konstruktvalidität: R=0,125; p=0,026) aus.

Der Fahrsimulatortest “carsim” erfüllt alle Gütekriterien, die notwendig sind, um ihn als objektives Testverfahren zur Erfassung der Daueraufmerksamkeit einzusetzen. Aufgrund seiner hoch signifikanten Unterschiede zwischen Gesunden und unbehandelten OSAS-Patienten sowie aufgrund seiner Testkonstruktion ist er als Instrument zur Erfassung der Daueraufmerksamkeitsminderung im klinischen Bereich sowie für spezielle gutachterliche Fragestellungen geeignet.

Summary

The main objective of the study was standardization, optimization and establishment of reference values of “carsim”, a computer program newly developed by us. Via a screen this program simulates a curved road on which a car is supposed to be kept on the right lane by operating a steering wheel. The intention of standardizing and optimizing “carsim” was to create a tool for characterization of sustained attention for obstructive sleep apnea (OSAS). This also allows for checkups to prove the success of therapy concerning sustained attention. The examination was carried out involving 100 healthy controls, with-out sleep disorders in particular, and 90 OSAS patients (AHI: 34,3/h±21,8/h; lowest SaO2: 81,4%±9,0%).

While among healthy persons, track deviations amounted to a mere 22,9±44,6, the result for untreated OSAS patients was 3830±8753 (p<0,001). The three criteria required for the quality of a test (objectivity, reliability, validity) have been verified. Verification of internal consistency as well as retest reliability resulted in very high reliability figures. For Tracking, visual search and reaction time, the test showed values of above 0,9 in both reliability checks (exception: internal consistency of reaction time r=0,8943), Similar results were achieved for validity figures (internal; external; construct validity: R=0,125; p=0,026).

The driving simulator “carsim” fulfills all quality criteria required for its being employed as an objective testing method to register sustained attention. Due to the highly significant differences shown between healthy persons and untreated OSAS patients as well as due to its test construction, it is a tool suitable for registration of diminished sustained attention in the clinical field and for problems concerning expert reports.

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Authors and Affiliations

  1. Klink Ambrock, Klinik für Pneumologie, Allergologie und Schlafmedizin, Universität Witten-Herdecke, Ambrocker Weg 60, D-58091, Hagen

    Antje Büttner, Karsten Siller, Winfried Randerath &  Karl-Heinz Rühle

  2. Betriebsarztzentrum der Dortmunder Stadtwerke, Dortmunder Stadtwerke

    Adelheid Kraft-Malycha

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  1. Antje Büttner
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  2. Karsten Siller
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Büttner, A., Siller, K., Kraft-Malycha, A. et al. Normwerte und Gütekriterien eines interaktiven Fahrsimulators (“carsim”). Somnologie 4, 129–136 (2000). https://doi.org/10.1007/s11818-000-0005-1

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