Background: These researchers previously reported that performance on the Stroke Driver Screening Assessment (SDSA), a battery of four cognitive tests that takes less than 30 min to administer, predicted the driving performance of MSers on a road test with 86% accuracy, 80% sensitivity, and 88% specificity.
Objectives: In this study, they further investigated if the addition of driving-related physical and visual tests and other previously identified cognitive predictors, including performance on the Useful Field of View test, will result in a better accuracy of predicting participants' on-road driving performance.
Methods: Forty-four individuals with RRMS (age = 46 ± 11 years, 37 females) and Expanded Disability Status Scale values between 1 (mild impairment) and 7 (wheelchair) were administered selected physical, visual and cognitive tests including the SDSA. The model that explained the highest variance of participants' performance on a standardized road test was identified using multiple regression analysis. A discriminant equation containing the tests included in the best model was used to predict pass or fail performance on the test.
Results: Performance on 12 cognitive and three visual tests were significantly associated with performance on the road test. Five of the tests together explained 59% of the variance and predicted the pass or fail outcome of the road test with 91% accuracy, 70% sensitivity, and 97% specificity.
Conclusion: Participants' on-road performance was more accurately predicted by the model identified in this study than using only performance on the SDSA test battery. The five psychometric/off-road tests should be used as a screening battery, after which a follow-up road test should be conducted to finally decide the fitness to drive of individuals with relapsing-remitting MS.
"It is always a difficult call for someone with MS to decide when to stop driving. This battery of tests will help make that decision. It is better for you and your neurology team to help pre-empt the driving issue, rather that it becoming a crisis. I am aware that in some environments, and countries, not being able to drive has a major impact on quality of life. However, we have to remember that it is not just the safety of the MSer and his/her occupants, but other users of the road that we need to take into account. Any thoughts on how to deal with this issue?"