title: Agreement Between Physician's Recommendation and Fitness-to-Drive Decision in Multiple Sclerosis.
abstract: OBJECTIVE
  To investigate the agreement of fitness-to-drive decisions made by the referring physicians and by the on-road assessors in individuals with multiple sclerosis (MS).
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Driving institute.
  
  
  METHODS
  A sample of individuals with MS (N=218) who completed the medical and driving questionnaire and performed an official on-road test.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Fitness-to-drive decision made by the on-road assessor.
  
  
  RESULTS
  The referring physician and on-road assessor agreed on fitness to drive in 191 (88%) of the cases (prevalence-adjusted and bias-adjusted κ=.81, P<.0001). When compared with the on-road assessor's judgment, the physician's recommendation of fitness to drive was overestimated in 16 individuals with MS and underestimated in 11 individuals with MS. Patients with poor binocular acuity were more likely to be inaccurately classified by the physician (P=.001).
  
  
  CONCLUSIONS
  This study showed a high level of agreement between the fitness-to-drive decisions made by the physicians and the on-road assessors in individuals with MS. Visual functions should be assessed in the doctor's office for more accurate referrals.
authors.affiliation: Department of Physical Therapy, College of Allied Health Sciences, Georgia Regents University, Augusta, GA. Electronic address: mranchet@gru.edu.
authors.forename: Maud
authors.initials: M
authors.lastname: Ranchet
authors.affiliation: Department of Physical Therapy, College of Allied Health Sciences, Georgia Regents University, Augusta, GA; Dean's Office, College of Allied Health Sciences, Georgia Regents University, Augusta, GA.
authors.forename: Abiodun Emmanuel
authors.initials: AE
authors.lastname: Akinwuntan
authors.affiliation: Belgian Road Safety Institute, Brussels, Belgium.
authors.forename: Mark
authors.initials: M
authors.lastname: Tant
authors.affiliation: Department of Physical Therapy, College of Allied Health Sciences, Georgia Regents University, Augusta, GA.
authors.forename: Erin
authors.initials: E
authors.lastname: Neal
authors.affiliation: Department of Physical Therapy, College of Allied Health Sciences, Georgia Regents University, Augusta, GA.
authors.forename: Hannes
authors.initials: H
authors.lastname: Devos
mesh_terms: D001333:Automobile Driver Examination; D001334:Automobile Driving; D015897:Comorbidity; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology*; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D012017:Referral and Consultation; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
keywords: Automobile driving; Multiple sclerosis; Physician; Rehabilitation