Validation of a screening battery to predict driving fitness in people with Parkinson's disease

National Advanced Driving Simulator, University of Iowa, Iowa City, Iowa, USA
Movement Disorders (Impact Factor: 5.68). 05/2013; 28(5). DOI: 10.1002/mds.25387
Source: PubMed


We previously developed a short clinical battery, consisting of contrast sensitivity, Clinical Dementia Rating, the Unified Parkinson's Disease Rating Scale-motor section (UPDRS III), and disease duration, which correctly classified 90% of drivers with Parkinson's Disease (PD). The aim of this study was to validate that screening battery in a different sample of PD drivers.

Sixty drivers with PD were enrolled to validate our original screening battery to predict driving fitness decisions (pass-fail) by a state agency where drivers underwent detailed visual, cognitive, and on-road testing.

Twenty-four participants (40%) failed the driving evaluation. The screening battery correctly classified 46 (77%) participants (sensitivity and negative predictive value = 96%; specificity and positive predictive value = 64%). Adding other clinical predictors (e.g., age of onset, Hoehn-Yahr stage instead of UPDRS III) failed to improve the specificity of the model when the sensitivity was kept constant at 96%. However, a driving simulator evaluation improved the specificity of the model to 94%.

The original clinical battery proved to be a valid screening tool that accurately identifies fit drivers with PD and select those who need more detailed testing at specialized centers.

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    • "Em condutores com doença de Parkinson, outra doença neurodegenerativa frequente na população idosa, o UFOV Test, o Trail Making Test A & B (Cavaco et al., 2013) e a cópia da Figura Complexa de Rey (Bonifácio, Cardoso-Pereira, & Pires, 2003; Espírito-Santo et al., 2015) constituem preditores significativos do desempenho de condução real (Klimkeit, Bradshaw, Charlton, Stolwyk, & Georgiou-Karistianis, 2009). A CDR, em conjunto com o exame motor da Unified Parkinson's Disease Rating Scale, evidencia também um valor incremental na avaliação clínica de condutores com doença de Parkinson (Devos et al., 2013). "

    Full-text · Article · Jan 2015
    • "Whether or not this type of tool can help understand some elements of on-road performance depends fundamentally on how the question is framed and adapted to the constraints of this type of driving simulator[33]. Recent research supports the appropriateness of driving simulators in determining fitness to drive[12]. In his discussion of cross-platform validation issues, Jamson[20]indicates that low cost driving simulators are appropriately used in small-scale research studies, where the perception of the scene is the key component, and for driver training when requirements are relatively unchallenging. "
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    ABSTRACT: The purpose of this study was to determine how comparable driving performance on a ‘Low-Cost Desktop’ single screen driving simulator and a ‘Mid-level’ fixed-base driving simulator (STISIM, Systems Technology Inc.) is. Fifty-two participants completed a 12 km virtual driving course on each simulator with at least 14 days separating both sessions. Driving performance was assessed using overall driving errors recorded by the simulator and through an observer-based demerit point scoring system. Speed and lane deviation parameters were used as local indicators of driving responses. Moderate to high correlations between the two platforms indicated that participants reacted similarly on both platforms. Our findings suggest that the two platforms yielded comparable data and that the ‘Low-Cost Desktop’ simulators could be used as a reliable replacement option to ‘Mid-Level’ driving simulators. 2014 Aracne Editrice.All Rights Reserved.
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    Full-text · Article · Jan 2013 · Movement Disorders
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