Useful field of view as a reliable screening measure of driving performance in people with Parkinson's disease: results of a pilot study.
OBJECTIVE
To determine the correlations of the Useful Field of View (UFOV), compared to other clinical tests of Parkinson's disease (PD); vision; and cognition with measures of on-road driving assessments and to quantify the UFOV's ability to indicate passing/failing an on-road test in people with PD.


METHODS
Nineteen randomly selected people with idiopathic PD, mean age = 74.8 (6.1), 14 (73.7%) men, 18 (94.7%) Caucasians, were age-matched to 104 controls without PD. The controls had a mean age of 75.4 (6.4), 59 (56.7%) men, 96 (92.3%) Caucasians. Both groups were referred for a driving evaluation after institutional review board approval.


RESULTS
Compared to neuropsychological and clinical tests of vision and cognition, the UFOV showed the strongest correlations (r > .75, p < 0.05) with measures of failing a standardized road test and number of driving errors. Among PD patients, the UFOV Risk Index score of 3 (range 1-5) was established as the optimal cutoff value for passing the on-road test, with sensitivity 87 percent and specificity 82 percent, AUC = 92 percent (SE 0.61, p = .002). Similarly, the UFOV 2 (divided attention) optimum cutoff value is 223 ms (range 16-500 ms), sensitivity 87.5 percent, specificity 81.8 percent, AUC = 91 percent (SE 0.73, p = .003). The UFOV 3 (selected attention) optimal cutoff value is 273 ms (range 16-500 ms), sensitivity 75 percent, specificity 72.7 percent, AUC = 87 percent (SE 0.81, p = .007).


CONCLUSIONS
In this pilot study among PD patients, the UFOV may be a superior screening measure (compared to other measures of disease, cognition, and vision) for predicting on-road driving performance but its rigor must be verified in a larger sample of people with PD.
Classen
S
S
National Older Driver Research and Training Center, Department of Occupational Therapy, University of Florida, Gainesville, Florida, USA. sclassen@phhp.ufl.edu
McCarthy
D P
DP
Shechtman
O
O
Awadzi
K D
KD
Lanford
D N
DN
Okun
M S
MS
Rodriguez
R L
RL
Romrell
J
J
Bridges
S
S
Kluger
B
B
Fernandez
H H
HH
D000368:Aged; D019540:Area Under Curve; D001333:Automobile Driver Examination; D001334:Automobile Driving / Q000706:statistics & numerical data; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000503:physiopathology*; D010865:Pilot Projects; D011597:Psychomotor Performance; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014794:Visual Fields; D014796:Visual Perception