Kay Lynnette G, Bundy Anita C, Clemson Lindy M
Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, Australia.
Arch Phys Med Rehabil. 2009 Sep;90(9):1514-22. doi: 10.1016/j.apmr.2009.03.011.
To examine the psychometric properties of DriveSafe and DriveAware and their predictive validity.
Prospective study compared screening tests with criterion standard.
Two driving rehabilitation centers affiliated with a university and a geriatric rehabilitation facility.
Consecutive sample of drivers with functional impairments (n=115) and subgroup of drivers with cognitive impairments (n=96) referred for a driving assessment.
Not applicable.
Driving performance was measured by a standardized assessment in real traffic.
Rasch analysis provided evidence for construct validity and internal reliability of both tests. Tests trichotomized drivers into unsafe, safe, and further testing categories. The optimal lower cutoff identified unsafe drivers with a specificity of 97% (95% confidence interval [CI], 83-100) in the test sample and 96% (95% CI, 80-100) in the validation sample. The optimal upper cutoff identified safe drivers with a sensitivity of 93% (95% CI, 77-99) and 95% (95% CI, 76-100), respectively.
By using DriveSafe and DriveAware, drivers with cognitive impairments referred for a driving assessment can be categorized as unsafe, safe, or requiring further testing, with only 50% needing an on-road assessment. Before clinical practice is changed, these findings should be replicated.
检验DriveSafe和DriveAware的心理测量特性及其预测效度。
前瞻性研究，将筛查测试与标准对照进行比较。
隶属于一所大学的两个驾驶康复中心和一个老年康复机构。
连续选取的有功能障碍的驾驶员样本（n = 115）以及认知障碍驾驶员亚组（n = 96），这些驾驶员被转介进行驾驶评估。
不适用。
通过实际交通中的标准化评估来测量驾驶表现。
Rasch分析为两项测试的结构效度和内部信度提供了证据。测试将驾驶员分为不安全、安全和需进一步测试三类。最佳下限在测试样本中识别出不安全驾驶员的特异性为97%（95%置信区间[CI]，83 - 100），在验证样本中为96%（95% CI，80 - 100）。最佳上限分别以93%（95% CI，77 - 99）和95%（95% CI，76 - 100）的灵敏度识别出安全驾驶员。
通过使用DriveSafe和DriveAware，被转介进行驾驶评估的认知障碍驾驶员可被分类为不安全、安全或需要进一步测试，仅50%的人需要进行上路评估。在改变临床实践之前，这些发现应进行重复验证。
