Reliability of a Road Test After Stroke

Abstract

Background: Despite physical, perceptual and cognitive impairments, amongst others, which might affect driving after stroke, some patients have demonstrated the ability to resume safe driving. Such patients are identified following strictly administered predriving evaluations. The road test is generally acclaimed to be the most valid test of driving performance. Aim: The purpose of this study was to determine the reliability of the road test when performed by stroke patients in Belgium. Method: This was a prospective study of a predriving evaluation at the Belgian Road Safety Institute. Thirty subjects with sequelae of stroke were included. Subjects were accompanied and evaluated during the road test by one of two assessors (A or B) from the road safety institute in an automatic car fitted with a video camera for recording driving performance. Inter-rater reliability was evaluated by comparing results from (1) real-life performance and video recording and (2) between-video judgements. Results: Most sub-items of the road test showed >80% scoring agreement between the various evaluations. Intraclass correlation coefficient (ICC) of the items varied from-0.08 to 1.0. ICC of the overall performance was 0.62 when real-life scores were compared with video evaluations and 0.80 in video versus video comparison. Conclusion: Driving is important for optimal participation in daily and social activities. The reliability of assessing overall performance of the on-road test is moderately high and better when assessed using same evidence. Yet, the reliability of some items needs further attention.

Validation of Driving Simulation to Assess On-Road Performance in Huntington Disease

“…Content validity was established after revision of the TRIP by driving instructors from Dutch and Belgian fitness to drive evaluation centers. We used a modified version as some items were found to be unreliable in assessing driving ability after stroke (Akinwuntan et al, 2003). (Table 1).…”

The Addenbrooke's Cognitive Examination Revised as a potential screening test for elderly drivers

“…The DBOG (Driving Behaviours Observation Grid) is a driving performance evaluation (unpublished) that was developed for a research project on the neuropsychological assessment of older drivers. Based on a literature review of studies with road tests for people with cognitive disabilities (Akinwuntan et al, 2003;De Raedt and Ponjaert-Kristoffersen, 2001;Fitten et al, 1995;Hunt et al, 1997;Janke and Eberhard, 1998;Radford, 2001), the present version was developed with the consensus of two independent experts on driving examinations. To develop a valid driving assessment for older people, the driving habits and difficulties that previous research found for this group (Ferreira et al, 2007) were also taken into account.…”

The Safety of Driving a Commercial Motor Vehicle After a Stroke

“…30,31,[33][34][35][36] In a retrospective study that included 104 stroke survivors, performance in an on-road test was the most important predictor of the decision of being fit or not to drive. 32 Although a standardized on-road test is a valid and reliable test of driving ability after stroke, 51,52 it does not test the full potential for accident proneness. This is because of the unpredictability of traffic during testing and the experience of the examiner in assessing persons with TIA or minor stroke.…”