title: Prediction of Driving Ability in Persons with Brain Disorders using Sensory-Motor and Cognitive Tests.
abstract: Brain lesions and degeneration can lead to a decreased ability to perform the physical and cognitive functions necessary for safe driving. A battery of computerized sensory-motor and cognitive tests (SMCTests&#8482;) has been developed to quantify sensory-motor and cognitive dysfunction, with particular application to the assessment of driving abilities in patients with neurological disorders. SMCTests and an on-road driving assessment were applied to 50 subjects with brain lesions referred to the Driving and Vehicle Assessment Service at Burwood Hospital, Christchurch (36 males, 14 females; age range 43-85 years, mean age 71.3 years; 35 stroke, 4 traumatic brain injury, 4 Alzheimer's disease, 7 with other diagnoses). Two techniques were used to build model equations for prediction of on-road driving ability based on SMCTests performance - binary logistic regression and nonlinear causal resource analysis (NCRA). Binary logistic regression correctly classified 94% of referrals as on-road pass or fail, while NCRA correctly classified 90% of referrals. Leave-one-out cross-validation analysis estimated that binary logistic regression would correctly predict the classification of 86% of an independent referral group as on-road pass or fail, while NCRA would correctly predict 76%. Results indicate that the predictive model based on binary logistic regression would be slightly more accurate than NCRA at predicting on-road pass or fail in an independent subject group. Conversely, the NCRA model also provides valuable information on the extent to which a subject would pass or fail an on-road driving assessment and identifies the deficit which most limits their driving ability.
authors.affiliation: Van der Veer Institute for Parkinson's Disease and Brain Research, Department of Medicine, Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand.
authors.forename: Carrie
authors.initials: C
authors.lastname: H Innes
authors.forename: Richard
authors.initials: R
authors.lastname: Jones
authors.forename: Tim
authors.initials: T
authors.lastname: Anderson
authors.forename: John
authors.initials: J
authors.lastname: Dalrymple-Alford
authors.forename: Sarah
authors.initials: S
authors.lastname: Hayes
authors.forename: Sue
authors.initials: S
authors.lastname: Hollobon
authors.forename: Julie
authors.initials: J
authors.lastname: Severinsen
authors.forename: Gwyneth
authors.initials: G
authors.lastname: Smith
authors.forename: Angela
authors.initials: A
authors.lastname: Nicholls