Validation of a short cognitive battery to screen for fitness-to-drive of people with multiple sclerosis

Eur J Neurol. 2018 Oct;25(10):1250-1254. doi: 10.1111/ene.13690. Epub 2018 Jun 22.

Abstract

Background and purpose: Some symptoms of multiple sclerosis (MS) affect driving. In a recent study, performance on five cognitive tests predicted the on-road test performance of individuals with relapsing-remitting MS with 91% accuracy, 70% sensitivity and 97% specificity. However, the accuracy with which the battery will predict the driving performance of a different cohort that includes all types of MS is unknown.

Methods: Participants (n = 118; 48 ± 9 years of age; 97 females) performed a comprehensive off-road evaluation that lasted about 3 h and a standardized on-road test that lasted approximately 45 min over a 2-day period within the same week. Performance on the five cognitive tests was used to predict participants' performance on the standardized on-road test.

Results: Performance on the five tests together predicted outcome of the on-road test with 82% accuracy, 42% sensitivity and 90% specificity.

Conclusions: The accuracy of predicting the on-road performance of a new MS cohort using performance on the battery of five cognitive tests remained very high (82%). The battery, which was administrable in <45 min and cost ~$150, was better at identifying those who actually passed the on-road test (90% specificity). The sensitivity (42%) of the battery indicated that it should not be used as the sole determinant of poor driving-related cognitive skills. A fail performance on the battery should only imply that more comprehensive testing is warranted.

Keywords: cognition; driving; evaluation; multiple sclerosis; vision.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Automobile Driver Examination*
  • Automobile Driving / psychology*
  • Cognition / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / psychology*
  • Neuropsychological Tests
  • Sensitivity and Specificity