Agreement Between Physician's Recommendation and Fitness-to-Drive Decision in Multiple Sclerosis

Abstract

Objective: To investigate the agreement of fitness-to-drive decisions made by the referring physicians and by the on-road assessors in individuals with multiple sclerosis (MS).

Design: Retrospective analysis.

Setting: Driving institute.

Participants: A sample of individuals with MS (N=218) who completed the medical and driving questionnaire and performed an official on-road test.

Interventions: Not applicable.

Main outcome measure: Fitness-to-drive decision made by the on-road assessor.

Results: The referring physician and on-road assessor agreed on fitness to drive in 191 (88%) of the cases (prevalence-adjusted and bias-adjusted κ=.81, P<.0001). When compared with the on-road assessor's judgment, the physician's recommendation of fitness to drive was overestimated in 16 individuals with MS and underestimated in 11 individuals with MS. Patients with poor binocular acuity were more likely to be inaccurately classified by the physician (P=.001).

Conclusions: This study showed a high level of agreement between the fitness-to-drive decisions made by the physicians and the on-road assessors in individuals with MS. Visual functions should be assessed in the doctor's office for more accurate referrals.

Keywords: Automobile driving; Multiple sclerosis; Physician; Rehabilitation.