title: Predictors of fitness to drive in people with Parkinson disease.
abstract: OBJECTIVE
  To develop an efficient clinical screening battery to accurately predict the fitness to drive in people with Parkinson disease (PD).
  
  
  METHODS
  This prospective study included 80 participants: 40 patients with PD and 40 healthy age- and sex-matched control subjects. All participants were assessed using a driving simulator, a driving history survey, and the Clinical Dementia Rating. The patients with PD also underwent a clinical test battery and an evaluation of fitness to drive performed by an official center, which included visual, cognitive, and on-road tests. A two-class decision from this driving assessment center was the main outcome measure.
  
  
  RESULTS
  A screening battery assessing four clinical variables (disease duration, contrast sensitivity, Clinical Dementia Rating, and motor part of the Unified Parkinson's Disease Rating Scale) provided the best model (R(2) = 0.52) to predict the fitness to drive and correctly classified 36 (90%) of the patients with PD as pass or fail (sensitivity = 91%, specificity = 90%). The Test Ride for Investigating Practical fitness to drive (TRIP) driving simulator score discriminated significantly between drivers with PD and their healthy peers (p = 0.0008). When the TRIP driving simulator score was added to the clinical model, the total explained variance increased (R(2) = 0.60) and correctly classified 39 (97.5%) of drivers with PD into the pass/fail category (sensitivity = 91%, specificity = 100%).
  
  
  CONCLUSIONS
  A short clinical screening battery that measures disease duration, contrast sensitivity, cognitive and motor functions can predict fitness to drive in people with Parkinson disease with a high degree of accuracy.
authors.affiliation: Katholieke Universiteit Leuven, Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences, Tervuursevest 101, BE-3001 Leuven, Belgium. Hannes.Devos@faber.kuleuven.be
authors.forename: H
authors.initials: H
authors.lastname: Devos
authors.forename: W
authors.initials: W
authors.lastname: Vandenberghe
authors.forename: A
authors.initials: A
authors.lastname: Nieuwboer
authors.forename: M
authors.initials: M
authors.lastname: Tant
authors.forename: G
authors.initials: G
authors.lastname: Baten
authors.forename: W
authors.initials: W
authors.lastname: De Weerdt
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control / Q000523:psychology; D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D001334:Automobile Driving / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D011237:Predictive Value of Tests; D011446:Prospective Studies