PREDICTING ABILITY TO DRIVE AFTER STROKE

Objective: To determine the ability of perceptual testing to predict o n-road driving outcome in subjects with stroke. Study Design: Historic al cohort study of 84 individuals with stroke who completed both the p erceptual testing and the on-road driving evaluation conducted in a dr iving evaluation service. Measures: Perceptual tests, such as the Moto r Free Visual Perception Test (MVPT) and Trail Making B test, and an o n-road driving evaluation. Based on driving behaviors, a pass or fail outcome was determined by the examiners. Results: Subjects who passed the on-road evaluation had better average scores on the majority of pe rceptual tests compared with those who failed. The MVPT was the most p redictive of on-road performance (positive predictive value = 86.1%; n egative predictive value = 58.3%), The combination of tests resulting in the most predictive and parsimonious model was the MVPT plus Trail Making B, such that those who scored poorly on both were 22 times more likely to fail the on-road evaluation. Conclusion: A screening proces s is useful in identifying persons who are not ready to undergo an on- road driving evaluation. (C) 1998 by the American Congress of Rehabili tation Medicine and the American Academy of Physical Medicine and Reha bilitation.