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Assessment tools for evaluating fitness to drive: a critical appraisal of evidence
Brenda H Vrkljan1, Colleen E McGrath, Lori J Letts
1Occupational Therapy Program, School of Rehabilitation Science, McMaster University, IAHS Bldg, Rm. 450,1400 Main St.W., Hamilton, ON, Canada L8S 1C7. vrkljan@mcmaster.ca
Background:
Many office-based assessment tools are used by occupational therapists to predict fitness to drive.
Purpose:
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.
Findings:
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.
