Abstract Details

Title Validation of a Clinical Screening Battery To Predict Fitness To Drive in Parkinson Disease

Topic Movement Disorders

Presentation(s) P04 - (-)

Poster/Presentation
Number 190

Objective

Background BACKGROUND: PD leads to motor, cognitive, and visual impairments, which are associated with poor driving performance. However, determination of fitness to drive in PD in the clinic still remains a challenge due to heterogeneity of the disease. There is need for a validated clinical screening battery to assist care providers in determining fitness to drive in PD.

Design/Methods DESIGN/METHODS: This study included 60 drivers with PD. We used our original battery (consisting of contrast sensitivity, UPDRS-motor section score, Clinical Dementia Rating score, and disease duration), to predict panel decisions (pass/fail) on driver fitness by a state agency where drivers underwent road testing in addition to detailed cognitive, visual, and motor testing. We also tested if adding other individually significant predictors (e.g., age of onset, Hoehn-Yahr stage instead of UPDRS motor score, performance on driving simulation) improved the predictive accuracy of the clinical model. For direct comparison between models, we kept the sensitivity constant.

Results RESULTS: Twenty-four participants (40%) failed the official driving evaluation. The screening battery correctly classified 46 (77%) participants (sensitivity and negative predictive value = 96%; specificity and positive predictive value = 64%). Adding other clinical predictor failed to improve the specificity of the model. However, a driving simulator evaluation improved the specificity of the model to 94%, when the sensitivity was kept constant at 96%.

Conclusions CONCLUSIONS: Our original clinical battery is a highly sensitive and cost-effective screening tool that accurately identifies fit drivers with PD and selects those who need more detailed testing at specialized centers. Adding a validated driving simulator evaluation increased the specificity of the screening battery.

Authors/Disclosures
Hannes Devos (Georgia Regents University) PRESENTER	No disclosure on file
Wim Vandenberghe (Dept. Neurology, University Hospital Leuven)	Dr. Vandenberghe has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Jeffrey Dawson	Jeffrey Dawson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for iotaMotion. Jeffrey Dawson has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Congress of Neurological Surgeons. The institution of Jeffrey Dawson has received research support from Department of Veterans Affairs. The institution of Jeffrey Dawson has received research support from NIH.
Ergun Y. Uc, MD (University of Iowa)	An immediate family member of Dr. Uc has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for American Board of Pediatrics. The institution of Dr. Uc has received research support from Department of Veterans Affairs. The institution of Dr. Uc has received research support from Department of Defense. The institution of an immediate family member of Dr. Uc has received research support from NIH. The institution of Dr. Uc has received research support from NIH. The institution of Dr. Uc has received research support from NIH. The institution of Dr. Uc has received research support from Parkinson's Foundation. The institution of Dr. Uc has received research support from NIH.

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