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NCT04141891: AUTO

Advancing Understanding of Transportation Options

Completed NA Results posted Last updated 21 February 2025
What this trial tests

NA trial testing Driving Decision Aid in Diabetic Retinopathy in 529 participants. Completed in 21 December 2023.

Timeline
12 December 2019
Primary endpoint
23 June 2023
21 December 2023

Quick facts

Lead sponsorUniversity of Colorado, Denver
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingsingle
Primary purposehealth services research
Enrollment529
Start date12 December 2019
Primary completion23 June 2023
Estimated completion21 December 2023
Sites3 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

University of Colorado, Denver

Who can join

18 and older, any sex, with Diabetic Retinopathy or Macular Degeneration. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Decisional Conflict Scale (DCS) Scores at Day 0 (Post-intervention) Primary · Day 0 (Post-intervention)

Decision conflict scale (DCS) is calculated from 16 items, with each item ranging from 0 (strongly agree) to 4 (strongly disagree). The total score is reported on a 0-100 scale by summing all responses, dividing by 16 and multiplying by 25. Higher scores represent greater levels of uncertainty in decision-making (higher decision conflict = worse outcome), and interventions often aim to reduce decision conflict (lower decision conflict = greater likelihood of implementing a decision = better outcome).

GroupValue95% CI
Older Drivers Website15.2± 13.3
Driving Decision Aid12.3± 12.9
Values Clarity Subscale Score at Day 0 (Post-intervention) Secondary · Day 0 (Post-intervention)

For the values clarity subscale, three decision conflict scale (DCS) items (Likert scale responses from 0 \['strongly agree'\] to 4 \['strongly disagree'\]) are summed, divided by 3 and multiplied by 25; scores range from 0 (extremely clear) to 100 (extremely unclear about personal values); lower scores represent higher values clarity, which is a better outcome. Lower values clarity subscale scores are associated with positive outcomes. The measure will be assessed in drivers immediately following administration of control condition or intervention.

GroupValue95% CI
Older Drivers Website13.8± 15.3
Driving Decision Aid12.8± 15.4
Older Adult Driving Safety Knowledge Scores as Assessed by True/False Questions at Day 0 (Post-intervention) Secondary · Day 0 (Post-intervention)

The following true/false questions will be used to examine participants' safe driving knowledge: 1) Older drivers pose a bigger risk to other drivers and pedestrians than younger drivers do; 2) Drivers aged 70 years and older are more likely to be hurt or killed if they are in a crash; 3) There is a milestone age when everyone should stop driving; 4) With age, a person needs more light to see well; 5) Getting lost on familiar roads is a sign that it might be time to stop driving. A higher number of correctly answered questions indicate better outcomes. Knowledge will be defined as the percenta

GroupValue95% CI
Older Drivers Website79.9± 18.4
Driving Decision Aid88.9± 16.4
Decision Self Efficacy Score at Day 0 (Post-intervention) Secondary · Day 0 (Post-intervention)

The Decision Self-Efficacy Scale will be used to assess decision self efficacy. Scores range from 0 (extremely low self-efficacy; worst outcome) to 100 (extremely high self-efficacy; best outcome). Higher scores indicate better outcomes. The measure will be assessed in drivers immediately following administration of control condition or intervention

GroupValue95% CI
Older Drivers Website92.9± 10.3
Driving Decision Aid93.2± 9.4
Change in Patient-Reported Outcomes Measurement Information System (PROMIS) 4-item Depression Score Secondary · 6 months, 12 months, 18 months, 24 months

Depression will be measured using the PROMIS Short Form 4-item scale (4a Adult v1.0), with higher PROMIS scores indicating higher depression. PROMIS scores are presented as standardized T-scores (mean=50, standard deviation=10). Lower PROMIS depression scores indicate better outcomes (lower depression). Change in depression is calculated as the PROMIS depression score at each time point (6, 12, 18, or 24 months) minus the score at baseline (pre-randomization). Since PROMIS scores at each time point can range from 41.0 to 79.4, change in depression PROMIS scores can range from -38.4 to +38.4.

6 month follow-up (change from baseline)
GroupValue95% CI
Older Drivers Website0.56± 5.50
Driving Decision Aid0.04± 5.42
12 month follow-up (change from baseline)
GroupValue95% CI
Older Drivers Website1.32± 4.58
Driving Decision Aid0.26± 5.91
18 month follow-up (change from baseline)
GroupValue95% CI
Older Drivers Website1.46± 5.05
Driving Decision Aid-1.10± 5.49
24 month follow-up (change from baseline)
GroupValue95% CI
Older Drivers Website1.20± 5.31
Driving Decision Aid0.65± 5.81
Change in Ottawa Decision Regret Score Secondary · 12 months, 18 months, 24 months

Change in decision regret will be measured by the Ottawa Decision Regret Scale. This validated measure correlates with decision satisfaction and conflict, and overall quality of life. Scored from 0-100, high scores represent higher regret. Lower scores indicate better outcomes. Decision regret was measured at 6, 12, 18, and 24 months, so change in decision regret can be calculated from 12 months (vs. 6 months), 18 months (vs. 6 months), and 24 months (vs 6 months). Since decision regret scores range from 0-100, change in decision regret scores range from -100 to + 100, with change-scores \<=

12 month change-score (12 month - 6 month)
GroupValue95% CI
Older Drivers Website3.24± 15.61
Driving Decision Aid-1.98± 9.57
18 month change-score (18 month - 6 month)
GroupValue95% CI
Older Drivers Website2.39± 15.55
Driving Decision Aid-1.57± 10.59
24 month change-score (24 month - 6 month)
GroupValue95% CI
Older Drivers Website1.71± 15.13
Driving Decision Aid0.37± 12.47
Change in Life Space Score Secondary · 6 months, 12 months, 18 months, 24 months

Life space is a global measure of mobility and community engagement. The Life-Space Assessment instrument (UAB Study of Aging) is a validated tool assessing recent mobility and function. Composite scores range from 0 (bedbound) to 120 (travel out of town every day without assistance); scores of ≤60 are correlated with lower levels of social participation and higher mortality. Higher scores indicate better outcomes. Change in life space can be calculated at 6 months (vs baseline), 12 months (vs baseline), 18 months (vs baseline), and 24 months (vs baseline). Since life space scores range from

6 month change-score (6 month - baseline)
GroupValue95% CI
Older Drivers Website-1.97± 20.77
Driving Decision Aid-3.10± 20.09
12 month change-score (12 month - baseline)
GroupValue95% CI
Older Drivers Website2.68± 19.12
Driving Decision Aid-2.44± 19.15
18 month change-score (18 month - baseline)
GroupValue95% CI
Older Drivers Website1.93± 21.08
Driving Decision Aid-0.16± 20.23
24 month change-score (24 month - baseline)
GroupValue95% CI
Older Drivers Website1.61± 21.95
Driving Decision Aid-1.91± 19.93
Change in Self-reported Driving Frequency Secondary · 6 months, 12 months, 18 months, 24 months

Self-reported driving frequency will be measured by number of days per week participants drive, with consideration of higher or lower frequency as a positive or negative outcome in the context of participant's intent to drive with lower or higher frequency. In the final study survey, this question was reworded, so participants were asked "during the past 6 months, have you reduced the number of days per week you normally drive?" with response options of "yes", "no", "I don't know". Percentage of those who answered "yes" at each time point are reported.

Have reduced days/week driving at 6 months
GroupValue95% CI
Older Drivers Website64
Driving Decision Aid70
days/week driving at 12 months
GroupValue95% CI
Older Drivers Website44
Driving Decision Aid45
days/week driving at 18 months
GroupValue95% CI
Older Drivers Website32
Driving Decision Aid43
days/week driving at 24 months
GroupValue95% CI
Older Drivers Website23
Driving Decision Aid29
Change in Self-reported Situational Driving Avoidance Secondary · 6 months, 12 months, 18 months, 24 months

Driving avoidance in certain situations will be measured by asking participants about their avoidance of riskier driving situations, e.g., nighttime driving, with consideration of avoidance in certain situations as a positive or negative outcome in the context of participant's intent to avoid these situations. Avoidance of night driving was worded as: "Using a scale from 1 to 7 where 1 is Not At All Comfortable and 7 is Completely Comfortable, how comfortable do you feel in the following situation?", and the situation presented was "Driving at night?". Higher scores indicate greater comfort w

6 month change-score (6 month - baseline)
GroupValue95% CI
Older Drivers Website-0.10± 1.23
Driving Decision Aid-0.40± 1.15
12 month change-score (12 month - baseline)
GroupValue95% CI
Older Drivers Website-0.38± 1.06
Driving Decision Aid-0.42± 1.16
18 month change-score (18 month - baseline)
GroupValue95% CI
Older Drivers Website-0.42± 1.19
Driving Decision Aid-0.53± 1.27
24 month change-score (24 month - baseline)
GroupValue95% CI
Older Drivers Website-0.69± 1.19
Driving Decision Aid-0.67± 1.16
Occurrence of Driving Cessation Secondary · 6 months, 12 months, 18 months, 24 months

Driving cessation will be measured by asking participants whether they are currently driving; all participants were currently driving at study baseline. Consideration of driving cessation as a positive or negative outcome will be determined in the context of participant's intent to engage in driving cessation. This question was worded as "Do you currently drive?" with response options of "yes" and "no". The numbers reported are those who said "no", which represents driving cessation. The wording of this question was added to the study after an early DSMB meeting, so less data are available fo

6 month
GroupValue95% CI
Older Drivers Website4
Driving Decision Aid1
12 month
GroupValue95% CI
Older Drivers Website2
Driving Decision Aid2
18 month
GroupValue95% CI
Older Drivers Website6
Driving Decision Aid5
24 month
GroupValue95% CI
Older Drivers Website11
Driving Decision Aid3
Occurrence of Self-reported Crashes Secondary · 6 months, 12 months, 18 months, 24 months

Occurrence of self-reported crashes will be measured by ≥1 crash versus no crashes, where ≥1 crash is a negative outcome.

6 month
GroupValue95% CI
Older Drivers Website15
Driving Decision Aid9
12 month
GroupValue95% CI
Older Drivers Website10
Driving Decision Aid10
18 month
GroupValue95% CI
Older Drivers Website10
Driving Decision Aid12
24 month
GroupValue95% CI
Older Drivers Website12
Driving Decision Aid13

Adverse events — posted to ClinicalTrials.gov

Time frame: 2 years of study from enrollment to follow-up (baseline, 6 month, 12 month, 18 month, 24 month visits). Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Older Drivers Website
Serious: 3/267 (1%)
Deaths: 4/267
Driving Decision Aid
Serious: 4/262 (2%)
Deaths: 5/262

Serious adverse events (3 terms)

ReactionSystemOlder Drivers WebsiteDriving Decision Aid
Inpatient hospitalizationInjury, poisoning and procedural complications
Motor vehicle accident as driverInjury, poisoning and procedural complications
Emergency department (ED) visitInjury, poisoning and procedural complications
Other adverse events (2 terms — click to expand)

ReactionSystemOlder Drivers WebsiteDriving Decision Aid
Motor vehicle accident as driverInjury, poisoning and procedural complications
Distress during any assessmentSocial circumstances

Most-reported serious reactions: Inpatient hospitalization, Motor vehicle accident as driver, Emergency department (ED) visit.

Data from ClinicalTrials.gov NCT04141891 adverse events section.

Sponsor's own description

This Stage II randomized, controlled, longitudinal trial seeks to assess the acceptability, feasibility, and effects of a driving decision aid use among geriatric patients and providers. This multi-site trial will (1) test the driving decision aid (DDA) in improving decision making and quality (knowledge, decision conflict, values concordance and behavior intent); and (2) determine its effects on specific subpopulations of older drivers (stratified for cognitive function, decisional capacity, and attitudinally readiness for a mobility transition). The overarching hypotheses are that the DDA will help older adults make high-quality decisions, which will mitigate the negative psychosocial impacts of driving reduction, and that optimal DDA use will target certain populations and settings.

Publications & conference data

6 peer-reviewed publications reference this trial (live from Europe PMC):

  1. The Advancing Understanding of Transportation Options (AUTO) study: design and methods of a multi-center study of decision aid for older drivers.
    Betz ME, Omeragic F, Meador L, DiGuiseppi CG, et al · · 2021 · cited 7× · PMID 33934709 · DOI 10.1186/s40621-021-00310-4
  2. "Is it time to stop driving?": A randomized clinical trial of an online decision aid for older drivers.
    Betz ME, Hill LL, Fowler NR, DiGuiseppi C, et al · · 2022 · cited 6× · PMID 35441700 · DOI 10.1111/jgs.17791
  3. Impact of the COVID-19 Pandemic on Older Adult Driving in the United States.
    Betz ME, Fowler NR, Han SD, Hill LL, et al · · 2022 · cited 3× · PMID 35583182 · DOI 10.1177/07334648221091556
  4. Internal Factors that Influence Coping in Older Drivers' Transition to Non-Driving.
    Hansmann KJ, Meuser T, Johnson RL, Peterson RA, et al · · 2025 · cited 2× · PMID 39626218 · DOI 10.1177/07334648241298670
  5. Relationship of Decisional Conflict About Driving Habits Between Older Adult Drivers and Their Family Members and Close Friends.
    Fowler NR, Johnson RL, Peterson R, Schroeder MW, et al · · 2024 · cited 1× · PMID 38087851 · DOI 10.1177/07334648231211742
  6. An online driving decision aid for older drivers reduces ambivalence and regret about driving decisions: Randomized trial.
    DiGuiseppi CG, Hill LL, Fowler NR, Johnson RL, et al · · 2025 · PMID 39630631 · DOI 10.1111/jgs.19293

Verify or expand the search:

Other recruiting trials for Diabetic Retinopathy

Currently open trials in the same condition.

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Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT04141891.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing