title: A diagnostic screening tool for identifying safe drivers among dialysis patients.
abstract: BACKGROUND
  Studies have shown that adverse effects of dialysis are associated with increased risk of driving impairment. While recommendations have been made that physicians should place an increased focus on detecting risks for driving impairment among patients on dialysis, there are currently no diagnostic tools designed to help physicians assess driving impairment among this patient population. In addition to driver self-assessment tools provided by AAA (American Automobile Association), one of the only tools specifically designed to help physicians assess driver safety is the "Am I a Safe Driver?" checklist, originally designed to assess for driving impairment among geriatric patients. This study aimed to determine the utility of this checklist in detecting dialysis patients at risk for driving impairment.
  
  
  METHODS
  The checklist was administered to dialysis patients who were predetermined to either be at risk or not at risk for driving impairment. The checklist was used to identify patients who test positive for driving impairment. ROC (receiver operationg characteristic) analysis was done to identify the best cut off to consider as a positive test.
  
  
  RESULTS
  The study found that the checklist is very good in detecting risk for driving impairment among dialysis patients. ROC analysis determined that answering âyesâ to at least two statements in the "Am I a Safe Driver?" checklist gives the highest sensitivity and specificity combination (Youden's index = 0.42).
  
  
  CONCLUSIONS
  Higher sensitivity and lower specificity of the "Am I Safe Driver" checklist implies that it is effective only as a preliminary screening test for ruling out risk of driving impairment among dialysis patients.
authors.forename: Daniel
authors.initials: D
authors.lastname: Varela
authors.forename: Indika
authors.initials: I
authors.lastname: Mallawaarachchi
authors.forename: Pedro
authors.initials: P
authors.lastname: Blandon
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D001334:Automobile Driving / Q000592:standards*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety / Q000592:standards*; D012372:ROC Curve; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D012307:Risk Factors; D055815:Young Adult