Establishing the Predictive Validity of the ScanCourse for Assessing On-Road Driving Performance.

Abstract

IMPORTANCE\nScanning the environment is critical for driving safety. The ScanCourse is a functional assessment that assesses a person s ability to scan the environment for visual information while in motion. Measurement properties for the ScanCourse have been reported; however, its predictive validity is unknown.\n\n\nOBJECTIVE\nTo determine the predictive validity of the ScanCourse for on-road driving performance and establish clinical cutoff scores.\n\n\nDESIGN\nRetrospective chart reviews were conducted over a 6-mo period.\n\n\nSETTING\nFour Canadian driver rehabilitation programs.\n\n\nPARTICIPANTS\nCharts from patients with neurological or vision conditions were eligible if they contained ScanCourse and on-road driving evaluation results between September 1, 2008, and August 30, 2018. Three hundred twenty-five charts were included for analysis.\n\n\nOUTCOMES AND MEASURES\nArea under the curve (AUC) analysis was used to determine the predictive validity of ScanCourse scores for on-road outcomes; cutoff scores were established by optimizing sensitivity and specificity.\n\n\nRESULTS\nThe ScanCourse had an AUC of .702. The optimal cutoff score was 18/20 with a sensitivity of 76.7% and a specificity of 47.1%.\n\n\nCONCLUSIONS AND RELEVANCE\nAssessing the scanning abilities of at-risk drivers who intend to return to driving after sustaining an injury can help identify safety risks and inform interventions. The ScanCourse was found to have acceptable discriminatory ability for on-road driving performance. This study provides evidence supporting its continued use as a screening tool to assess driver fitness with an identified optimal cutoff score for clinical use.\n\n\nWHAT THIS ARTICLE ADDS\nMeasuring the predictive ability of the ScanCourse assessment in relation to on-road driving performance provides occupational therapists with an evidence-based clinical tool to assist with screening fitness to drive among at-risk people.