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Determining Fitness to Drive for Older and Cognitively Impaired Drivers - DriveSafe DriveAware a Touch Screen Test for Medical Practice

Cheal, B, Bundy, A

Older Drivers/Users

ARSC conference 2015

Every year thousands of Australians are diagnosed with a medical condition that may impact ability to manage the cognitive aspects of driving, such as stroke, brain injury or dementia. Licensing authorities are managing large numbers of drivers with potential cognitive impairment who may be 'at risk'. Responsibility for determining fitness to drive ultimately falls to general practitioners, however general practitioners report lack of suitable, valid tools for predicting driving ability. _x000D_

_x000D_For more than 25 years, researchers have examined clinical tests that can accurately predict driving performance without taking drivers on road. DriveSafe DriveAware (DSDA) has been shown to have sufficient sensitivity and specificity to accurately predict on-road performance. This year, DSDA was converted into an iPad® application for general practitioners to use as a brief screen of cognitive fitness to drive._x000D_

A study was conducted to determine if touch-screen DSDA was a valid tool for determining fitness to drive for older and cognitively impaired patients._x000D_

_x000D_Method_x000D_

_x000D_The test was administered to 134 older (60+) and cognitively impaired (18+) drivers referred to 10 driving clinics across Australia and New Zealand. The psychometric properties and predictive validity of DSDA was compared to outcome of a standardised occupational therapy on-road assessment. _x000D_

_x000D_Results_x000D_

_x000D_Upper and lower cutoff scores were set. The Specificity of DSDA was 86%
and Sensitivity 91%. Positive Predictive Value was 83%, Negative Predictive Value 92%, and overall Accuracy of Classification was 88%. _x000D_

_x000D_Conclusion_x000D_

_x000D_Evidence supports the clinical utility of the test for predicting with substantial accuracy which patients require on-road assessment.