title: Predicting fitness to drive in people with cognitive impairments by using DriveSafe and DriveAware.
abstract: 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.
authors.affiliation: Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, Australia. lynngkay@gmail.com
authors.forename: Lynnette G
authors.initials: LG
authors.lastname: Kay
authors.forename: Anita C
authors.initials: AC
authors.lastname: Bundy
authors.forename: Lindy M
authors.initials: LM
authors.lastname: Clemson
mesh_terms: 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