Vito Erin, Barkla Anna, Coventry Linda
Sir Charles Gairdner Osborne Park Health Care Group, Osborne Park Hospital, Stirling, Western Australia, Australia.
Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
Australas J Ageing. 2023 Mar;42(1):53-63. doi: 10.1111/ajag.13166. Epub 2023 Jan 5.
Driving is an activity of daily living that significantly affects independence, and driving cessation is associated with poor health, lower quality of life, cognitive decline and early entry into care facilities. There is no consensus regarding the best off-road tool to assess driving safety. Therefore, this review explored the diagnostic accuracy, reliability and clinical utility of DriveSafe DriveAware (DSDA) compared with an on-road driving assessment.
This review adhered to the PRISMA guidelines. Electronic databases for all English language articles published prior to December 2021 were searched. Studies were assessed for methodological quality and results were synthesised using a narrative descriptive approach.
Six studies were reviewed, consisting of 1332 participants. Four studies assessed diagnostic accuracy, two studies assessed reliability and three were relevant to clinical utility since they used DSDA as a standalone tool. Some studies demonstrated high levels of diagnostic accuracy, with specificity and sensitivity above 90% for those who fall into the safe and unsafe categories (50% of those assessed). Inter-rater reliability showed substantial agreement, and test-retest reliability was demonstrated for all age groups. DSDA was assessed as having high clinical utility (as a standalone tool) based on time taken to conduct, cost effectiveness and equipment required to complete the assessment.
DriveSafe DriveAware appears to be an ideal tool for the subacute setting; however, at present, inadequate evidence exists to support its use as a standalone tool for directing driving decisions. Further research is required.
驾驶是一项显著影响独立性的日常生活活动，停止驾驶与健康状况不佳、生活质量降低、认知能力下降以及过早进入护理机构相关。关于评估驾驶安全性的最佳非道路工具尚无共识。因此，本综述探讨了与道路驾驶评估相比，DriveSafe DriveAware（DSDA）的诊断准确性、可靠性和临床实用性。
本综述遵循PRISMA指南。检索了2021年12月之前发表的所有英文文章的电子数据库。评估研究的方法学质量，并采用叙述性描述方法综合结果。
共审查了六项研究，包括1332名参与者。四项研究评估了诊断准确性，两项研究评估了可靠性，三项研究与临床实用性相关，因为它们将DSDA用作独立工具。一些研究显示出较高的诊断准确性，对于属于安全和不安全类别的人（占评估者的50%），特异性和敏感性高于90%。评分者间信度显示出高度一致性，所有年龄组均显示出重测信度。基于进行评估所需的时间、成本效益和设备，DSDA被评估为具有较高的临床实用性（作为独立工具）。
DriveSafe DriveAware似乎是亚急性环境中的理想工具；然而，目前尚无足够证据支持将其用作指导驾驶决策的独立工具。需要进一步研究。
