title: Assessment tools for evaluating fitness to drive: a critical appraisal of evidence.
abstract: BACKGROUND
  Many office-based assessment tools are used by occupational therapists to predict fitness to drive.
  
  
  OBJECTIVE
  To appraise psychometric properties of such tools, specifically predictive validity for on-road performance.
  
  
  METHODS
  A literature search was conducted to identify assessment tools and studies involving on-road outcomes (behind-the-wheel evaluation, crashes, traffic violations). Using a standardized appraisal process, reviewers rated each tool's psychometric properties, including its predictive validity with on-road performance.
  
  
  RESULTS
  Seventeen measures met the inclusion criteria. Evidence suggests many tools do not have cutoff scores linked with on-road outcomes, although some had stronger evidence than others. Implications. When making a determination regarding driver fitness, clinicians should consider the psychometric properties of the tool as well as existing evidence concerning its utility in predicting on-road performance. Caution is warranted in using any one office-based tool to predict driving fitness; rather, a multifactorial-based assessment approach that includes physical, cognitive, and visual-perceptual components, is recommended.
authors.affiliation: Occupational Therapy Program, School of Rehabilitation Science, McMaster University, IAHS Bldg, Rm. 450,1400 Main St.W., Hamilton, ON, Canada L8S 1C7. vrkljan@mcmaster.ca
authors.forename: Brenda H
authors.initials: BH
authors.lastname: Vrkljan
authors.forename: Colleen E
authors.initials: CE
authors.lastname: McGrath
authors.forename: Lori J
authors.initials: LJ
authors.lastname: Letts
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology* / Q000523:psychology*; D001333:Automobile Driver Examination; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D011594:Psychometrics; D015203:Reproducibility of Results