title: Prediction of on-road driving ability after traumatic brain injury and stroke.
abstract: OBJECTIVE
  The aim of the study was to examine the predictive value of widely used standardized neuropsychological tests in a clinical setting for on-road driving performance in patients with cerebral stroke or traumatic brain injury (TBI), and to provide cut-off values for neuropsychological test results under which driving should not be recommended.
  
  
  METHODS
  Data from 78 patients who had undergone comprehensive driving assessment after stroke or TBI were retrospectively included in the analysis. Patients underwent medical examination, neuropsychological testing and on-road assessment. Medical data, demographic variables and neuropsychological performance were used as predictors in a stepwise logistic regression analysis with pass/fail after the on-road test as the dependent variable. Receiver operating characteristic curve analysis was employed to select cut-off values for the tests that were significant predictors for on-road performance.
  
  
  RESULTS
  Forty-three patients passed and 35 failed the on-road driving task. Logistic regression analysis revealed three significant neuropsychological tests (CalCap simple reaction time, Trail Making Test A, Grooved Pegboard) as predictors for on-road performance explaining 46% of the variance with an overall classification accuracy of 82.1%. Receiver operating characteristic curve analysis showed the following cut-off values: CalCap, 395 ms; Trail Making Test A, 46 s; Grooved Pegboard, 97.5 s.
  
  
  CONCLUSIONS
  The results suggest that driving ability after brain damage and cerebral disease with no severe neurological deficits can be measured with a few distinctive neuropsychological tests together with medical examination and on-road assessment. Cut-off scores are a useful supplement to normative data/scaled scores.
authors.affiliation: Department of Rehabilitation, University Hospital North Norway, Tromsø, Norway. per.aslaksen@uit.no
authors.forename: P M
authors.initials: PM
authors.lastname: Aslaksen
authors.forename: M
authors.initials: M
authors.lastname: Ørbo
authors.forename: R
authors.initials: R
authors.lastname: Elvestad
authors.forename: C
authors.initials: C
authors.lastname: Schäfer
authors.forename: A
authors.initials: A
authors.lastname: Anke
mesh_terms: D001334:Automobile Driving; D001930:Brain Injuries / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011597:Psychomotor Performance / Q000502:physiology; D012372:ROC Curve; D011930:Reaction Time; D020521:Stroke / Q000150:complications*
keywords: driving; neuropsychology; stroke; traumatic brain injury