Alcohol and Driving- Related Performance – a Comprehensive Meta-Analysis Focusing the Significance of the Non-Significant
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Alcohol and driving- related performance – A comprehensive meta-analysis focusing the significance of the non-significant Inaugural-Dissertation zur Erlangung der Doktorwürde der Philosophischen Fakultät II der Julius-Maximilians-Universität Würzburg Vorgelegt von Dipl. Psych. Eva Schnabel aus Frankfurt/M. 2011 Erstgutachter: Prof. Dr. Hans-Peter Krüger Zweitgutachter: Prof. Dr. Mark Vollrath (TU Braunschweig) Tag des Kolloquiums: 07.03.2012 III ACKNOWLEDGEMENTS The present meta-analysis, which was conducted at the Center for Traffic Sciences (IZVW) in Würzburg, Germany, was produced under the project DRUID (“Driving under the Influence of Drugs, Alcohol and Medicines”) and was part of Work Package 1 (“Methodology & Research”). The project was financed by the European Community within the EU 6th Framework Program and coordinated by the Federal Highway Research Institute in Germany (“Bundesanstalt für Straßenwesen”, BASt). This work would not have been possible without the support of many people. First of all, I extend special thanks to my doctoral adviser Prof. Hans-Peter Krüger for all the productive discussions, the helpful comments and suggestions, and the time and interest he dedicated to this work. I would also like to thank Prof. Günter Berghaus for the extremely pleasant contact and the good cooperation within the project. In addition, I like to thank the whole project team of BASt, in particular Dr. Horst Schulze and Dr. Anja Knoche for the good cooperation and for being host of all the agreeable and fruitful project meetings. I thank all of my colleagues and friends at the IZVW, especially Dr. Volker Hargutt, for a lot of good advice (not only concerning this work, but also concerning survival), his assistance, useful comments and creative suggestions. Without his never-ending encouragement, this work would never have been successfully completed. Also very special thanks to Martina Walter for being my fellow sufferer, for the congenial atmosphere in our shared office, the constructive comments, the many needed distractions, for being there whenever I have needed her and for her valued friendship. Thanks to Marcus Schmitz for many cups of strong coffee, for advice and support, for simply being there. Thanks to all other colleagues for the very pleasant time at work and outside of work. Thanks to all my friends for making sure I found time to relax and to experience valuable moments during this work. Finally, I am particularly grateful to my parents for their ongoing support throughout my life and for encouraging me in everything I do. The present work is dedicated to my father, who taught me endurance and always serves as an example to me. IV TABLE OF CONTENTS I THEORETICAL PART ............................................................................ 17 1 INTRODUCTION ................................................................................... 17 1.1 Background .................................................................................................... 17 1.2 Objectives ...................................................................................................... 19 2 ALCOHOL AND THE HUMAN BODY ......................................................... 21 2.1 Pharmacokinetics of alcohol .......................................................................... 21 2.2 Pharmacodynamics of alcohol ....................................................................... 22 3 EFFECTS OF ALCOHOL ON PERFORMANCE ............................................ 24 3.1 The results of relevant reviews....................................................................... 24 3.1.1 Carpenter, 1962 ................................................................................................. 24 3.1.2 Wallgren & Barry, 1970 ...................................................................................... 25 3.1.3 Perrine, 1973 ...................................................................................................... 26 3.1.4 Moskowitz, 1973 ................................................................................................. 27 3.1.5 Levine, Kramer & Levine, 1975 .......................................................................... 27 3.1.6 Jones & Joscelyn, 1978 ..................................................................................... 28 3.1.7 Mitchell, 1985 ..................................................................................................... 29 3.1.8 Moskowitz & Robinson, 1988 ............................................................................. 29 3.1.9 Krüger, Kohnen, Diehl & Hüppe, 1990 ............................................................... 30 3.1.10 Finnigan & Hammersley, 1992 ........................................................................... 31 3.1.11 Ferrara, Zancaner & Giorgetti, 1994 .................................................................. 31 3.1.12 Holloway, 1995 ................................................................................................... 32 3.1.13 Koelega, 1995 .................................................................................................... 32 3.1.14 Kerr & Hindmarch, 1998 ..................................................................................... 33 3.1.15 Moskowitz & Fiorentino, 2000 ............................................................................ 33 V 3.1.16 Jones & Lacey, 2001 .......................................................................................... 35 3.1.17 Ogden & Moskowitz, 2004 ................................................................................. 35 3.2 Summary ........................................................................................................ 35 4 THE METHODOLOGY OF META-ANALYSIS .............................................. 39 II META-ANALYSIS ................................................................................ 41 5 LITERATURE SELECTION ..................................................................... 41 5.1 Selection criteria ............................................................................................. 41 5.1.1 Exclusion criteria ................................................................................................ 41 5.1.2 Inclusion criteria ................................................................................................. 42 5.2 Literature search ............................................................................................. 43 5.2.1 Overview ............................................................................................................ 43 5.2.2 Sources of literature ........................................................................................... 43 5.2.2.1 Bibliographical databases ....................................................................................... 43 5.2.2.2 Relevant scientific journals ..................................................................................... 44 5.2.2.3 Papers of relevant authors ...................................................................................... 44 5.2.2.4 Reviews and bibliographical references ................................................................. 44 5.2.2.5 Unspecific search .................................................................................................... 44 5.3 Results of the literature search ....................................................................... 45 5.4 Publication bias .............................................................................................. 46 6 PROCESSING OF THE RELEVANT LITERATURE – THE DATABASE ............. 48 6.1 Basic structure of the database ...................................................................... 48 6.1.1 The publications ................................................................................................. 48 6.1.2 The findings........................................................................................................ 49 6.2 Description of the BAC ................................................................................... 50 6.2.1 Definition of the absorptive vs. eliminative phase .............................................. 51 6.2.2 BAC calculation by using the empirically measured BAC .................................. 51 VI 6.2.3 BAC calculation by using the Widmark formula ................................................. 52 6.2.4 Calculation of the administered quantity of alcohol ............................................ 53 6.3 Classification of the tasks and parameters ..................................................... 54 6.3.1 The classification system ................................................................................... 54 6.3.2 Additional input fields ......................................................................................... 58 6.4 Classification of results .................................................................................. 58 6.4.1 Statistical significance ........................................................................................ 58 6.4.2 Effect sizes ......................................................................................................... 59 6.4.3 Consideration of multi-factorial designs ............................................................. 61 6.4.4 Confidence rating of effects ................................................................................ 61 7 RESULTS ..........................................................................................