Predicting Fitness to Drive in People With Cognitive Impairments by Using DriveSafe and DriveAware
Abstract
Kay LG, Bundy AC, Clemson LM. Predicting fitness to drive in people with cognitive impairments by using DriveSafe and DriveAware.
Objectives
To examine the psychometric properties of DriveSafe and DriveAware and their predictive validity.
Design
Prospective study compared screening tests with criterion standard.
Setting
Two driving rehabilitation centers affiliated with a university and a geriatric rehabilitation facility.
Participants
Consecutive sample of drivers with functional impairments (n=115) and subgroup of drivers with cognitive impairments (n=96) referred for a driving assessment.
Interventions
Not applicable.
Main Outcome Measure
Driving performance was measured by a standardized assessment in real traffic.
Results
Rasch analysis provided evidence for construct validity and internal reliability of both tests. Tests trichotomized drivers into unsafe, safe, and further testing categories. The optimal lower cutoff identified unsafe drivers with a specificity of 97% (95% confidence interval [CI], 83–100) in the test sample and 96% (95% CI, 80–100) in the validation sample. The optimal upper cutoff identified safe drivers with a sensitivity of 93% (95% CI, 77–99) and 95% (95% CI, 76–100), respectively.
Conclusions
By using DriveSafe and DriveAware, drivers with cognitive impairments referred for a driving assessment can be categorized as unsafe, safe, or requiring further testing, with only 50% needing an on-road assessment. Before clinical practice is changed, these findings should be replicated.
Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, Australia
Reprint requests to Lynnette Kay, BOccThy, PO Box 170, Lidcombe, NSW, 1825 Australia
This research was a partial fulfillment of the PhD requirements for Lynnete Kay at University of Sydney. This was unfunded doctoral research. Lynnette Kay was in receipt of an Australian Post-Graduate Award Scholarship during the completion of the project.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
ABSTRACT