Driver fatigue is a major contributor to road accidents. Therefore, driver assistance systems (DAS) that would monitor drivers' states may contribute to road safety. Such monitoring can potentially be achieved with input from ECG indices (e.g., heart rate). We reviewed the empirical literature on responses of cardiac measures to driver fatigue and on detecting fatigue with cardiac indices and classification algorithms. We used meta-analytical methods to explore the pooled effect sizes of different cardiac indices of fatigue, their heterogeneity, and the consistency of their responses across studies. Our large pool of studies (N = 39) allowed us to stratify the results across on-road and simulator studies. We found that despite the large heterogeneity of the effect sizes between the studies, many indices had significant pooled effect sizes across the studies, and more frequently across the on-road studies. We also found that most indices showed consistent responses across both on-road and simulator studies. Regarding the detection accuracy, we found that even on-road classification could have been as accurate as 70% with only 2-min of data. However, we could only find two on-road studies that employed fatigue classification algorithms. Overall, our findings are encouraging with respect to the prospect of using cardiac measures for detecting driver fatigue. Yet, to fully explore this possibility, there is a need for additional on-road studies that would employ a similar set of cardiac indices and detection algorithms, a unified definition of fatigue, and additional levels of fatigue than the two fatigue vs alert states.

疲劳驾驶是导致道路事故的主要原因。因此，监控驾驶员状态的驾驶员辅助系统（DAS）可能有助于道路安全。这种监测可以通过心电图指数（例如心率）的输入来实现。我们回顾了关于心脏测量对驾驶员疲劳的反应以及利用心脏指数和分类算法检测疲劳的实证文献。我们使用荟萃分析方法来探索不同心脏疲劳指数的汇总效应大小、它们的异质性以及它们在研究中反应的一致性。我们的大量研究（N = 39）使我们能够对道路和模拟器研究的结果进行分层。我们发现，尽管研究之间的效应大小存在很大的异质性，但许多指数在整个研究中具有显着的汇总效应大小，并且在道路研究中更常见。我们还发现，大多数指数在道路和模拟器研究中都显示出一致的反应。在检测精度方面，我们发现即使是在道路上分类，仅用 2 分钟的数据就可以达到 70% 的准确率。然而，我们只能找到两项采用疲劳分类算法的道路研究。总的来说，我们的研究结果对于使用心脏测量来检测驾驶员疲劳的前景是令人鼓舞的。然而，为了充分探索这种可能性，需要进行额外的道路研究，这些研究将采用一组类似的心脏指数和检测算法、统一的疲劳定义以及比两种疲劳与警戒状态不同的额外疲劳级别。