Kay Lynnette G, Bundy Anita C, Clemson Lindy, Cheal Beth, Glendenning Trinity
Occupational Therapy, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
Aust Occup Ther J. 2012 Feb;59(1):89-97. doi: 10.1111/j.1440-1630.2011.00989.x. Epub 2011 Dec 28.
BACKGROUND/AIM: Driving is an essential activity of daily living. Because it is easily disrupted by illness or injury, it is a common subject of occupational therapy assessment. Assessments of driving are critically important and carry legal implications for therapists. A full occupational therapy assessment comprising both off- and on-road testing is time and labour intensive and therefore expensive. Off-road tests are used to inform on-road assessments, and, if they have sufficient sensitivity and specificity they may replace an on-road assessment for some clients. The twofold purpose of this article is to compare and critique off-road tests to predict driving performance and to determine if any is sufficiently accurate to identify drivers who do not require an on-road assessment.
We reviewed tests commonly used by researchers to predict driving capacity (i) that have been used in research since 2000 and (ii) for which sensitivity and specificity had been (or could be) calculated. We compared the tests on five characteristics: diagnostic makeup of samples, sample sizes, outcome measures, sensitivity and specificity and potential for use as a supplement to on-road assessment or to identify drivers for whom an on-road assessment is not necessary.
No gold standard off-road test exists for predicting on road performance. DriveSafe/DriveAware and SMC Tests had the highest reported sensitivity and specificity. Thus, with further research, one or both may be found to predict on-road performance accurately and to minimise the need for on road assessment. Several other tests are a useful supplement to on-road testing.
背景/目的：驾驶是日常生活中的一项基本活动。由于它很容易因疾病或受伤而受到干扰，因此是职业治疗评估的常见主题。驾驶评估至关重要，对治疗师具有法律影响。全面的职业治疗评估包括路外和上路测试，既耗时又费力，因此成本高昂。路外测试用于为上路评估提供信息，如果它们具有足够的敏感性和特异性，对于某些客户来说，它们可能会取代上路评估。本文的双重目的是比较和评判路外测试以预测驾驶表现，并确定是否有任何测试足够准确，能够识别出不需要进行上路评估的驾驶员。
我们回顾了自2000年以来研究人员用于预测驾驶能力的常用测试，以及（ii）已计算（或可计算）敏感性和特异性的测试。我们从五个方面对这些测试进行了比较：样本的诊断构成、样本量、结果指标、敏感性和特异性，以及用作上路评估补充或识别无需上路评估的驾驶员的潜力。
不存在用于预测上路表现的金标准路外测试。DriveSafe/DriveAware和SMC测试的敏感性和特异性报告最高。因此，随着进一步的研究，可能会发现其中一项或两项测试能够准确预测上路表现，并尽量减少上路评估的需求。其他几项测试是上路测试的有用补充。
