Research Reports - Prediction of on-road driving ability after traumatic brain injury

Eur J Neurol. 2013 Apr 5

Aslaksen PM, Orbo M, Elvestad R, Schäfer C, Anke A

BACKGROUND AND PURPOSE: The aim of the study was to examine the predictive value
of widely used standardized neuropsychological tests in a clinical setting for
on-road driving performance in patients with cerebral stroke or traumatic brain
injury (TBI), and to provide cut-off values for neuropsychological test results
under which driving should not be recommended. METHODS: Data from 78 patients who
had undergone comprehensive driving assessment after stroke or TBI were
retrospectively included in the analysis. Patients underwent medical examination,
neuropsychological testing and on-road assessment. Medical data, demographic
variables and neuropsychological performance were used as predictors in a
stepwise logistic regression analysis with pass/fail after the on-road test as
the dependent variable. Receiver operating characteristic curve analysis was
employed to select cut-off values for the tests that were significant predictors
for on-road performance. RESULTS: Forty-three patients passed and 35 failed the
on-road driving task. Logistic regression analysis revealed three significant
neuropsychological tests (CalCap simple reaction time, Trail Making Test A,
Grooved Pegboard) as predictors for on-road performance explaining 46% of the
variance with an overall classification accuracy of 82.1%. Receiver operating
characteristic curve analysis showed the following cut-off values: CalCap,
395 ms; Trail Making Test A, 46 s; Grooved Pegboard, 97.5 s. CONCLUSION: The
results suggest that driving ability after brain damage and cerebral disease with
no severe neurological deficits can be measured with a few distinctive
neuropsychological tests together with medical examination and on-road
assessment. Cut-off scores are a useful supplement to normative data/scaled

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