Predictors of driving in individuals with relapsing–remitting multiple sclerosis

Abstract

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. Future studies are needed to confirm and validate the findings in this study.

Validation of a Cognitive Screening Battery to Predict Fitness-to-Drive in Individuals with Multiple Sclerosis: A Preliminary Report

“…This finding can be attributed to the differences in the cohort of individuals with MS in this study and the previous one (Akinwuntan et al, 2013a). In this study, individuals with all types of MS and with moderate disability in one functional system; or mild disability in three or four functional systems, though fully ambulatory (EDSS = 3) to those unable to walk beyond 5 meters even with aid (EDSS = 7) were included.…”

“…In this preliminary report, we sought to validate the predictive accuracy of the five cognitive tests identified in a previous study (Akinwuntan et al, 2013a) as predictive of the driving performance of individuals with MS in a new cohort of individuals with MS. Our findings showed that the battery of five cognitive tests, including the Stroop Color test, the Direction, Compass, and Road Sign Recognition tests of the SDSA battery, and the Speed of Processing subtest of the UFOV test, appears to be a very good predictor of the on-road driving ability of individuals with MS. The three primary cognitive domains assessed by the five tests are some of the most important cognitive skills required for safe driving.…”

“…The SDSA battery consists of four tests that together measure driving-related attention, concentration, and executive reasoning abilities (Akinwuntan et al, 2013a;2013b). The four tests include dot cancellation test, square matrix direction test, square matrix compass test, and road sign recognition test.…”

“…In the first study of the series, we identified five cognitive tests from 24 physical, visual, and cognitive tests that together predicted the on-road driving performance of MS patients with 91% accuracy, 70% sensitivity, and 97% specificity. The five tests included the Stroop Color test (Stroop, 1935), the Direction, Compass, and Road Sign Recognition tests of the Stroke Driver Screening Assessment battery (Akinwuntan et al,. 2013a;2013b), and the Speed of Processing sub-test of the Useful Field of View (UFOV) test (Ball et al, 1990).…”

“…The study included 44 participants with diagnosis of relapsing-remitting MS: age = 46 ± 11 years, 84% females and whose disease severity were classified as being between stages 1 and 7 according to the Expanded Disability Status Scale Expanded Disability Status Scale (EDSS) (Kurtzke, 1983). Each participant had a valid driver license, ≥ 5 years of driving experience, drove at least once a month in the last 1 year, and met minimum legal visual requirements to drive in accordance with Georgia laws (Akinwuntan et al, 2013a). In this report, we present the preliminary findings of an on-going study to validate the predictive accuracy of the battery of five tests in a new cohort of individuals with MS. Cross-validation is the most effective method to complete the task because of identifying the best predictors of fitness-to-drive of individuals with MS. A model that only fits the population on which it was identified is not sufficient to change current clinical practice.…”