Predicting fitness to drive in people with cognitive impairments by using DriveSafe and DriveAware.
OBJECTIVE
To examine the psychometric properties of DriveSafe and DriveAware and their predictive validity.


METHODS
Prospective study compared screening tests with criterion standard.


METHODS
Two driving rehabilitation centers affiliated with a university and a geriatric rehabilitation facility.


METHODS
Consecutive sample of drivers with functional impairments (n=115) and subgroup of drivers with cognitive impairments (n=96) referred for a driving assessment.


METHODS
Not applicable.


METHODS
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.
Kay
Lynnette G
LG
Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, Australia. lynngkay@gmail.com
Bundy
Anita C
AC
Clemson
Lindy M
LM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving / Q000523:psychology* / Q000592:standards; D003072:Cognition Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011581:Psychological Tests; D011594:Psychometrics; D015203:Reproducibility of Results; D018570:Risk Assessment; D055815:Young Adult