Assessment Tools for Evaluating Fitness to Drive: A Critical Appraisal of Evidence

TLDR

Office‑based assessment tools are commonly used by occupational therapists to predict driving fitness. This review aimed to appraise the psychometric properties, particularly predictive validity, of such tools for on‑road performance. The authors conducted a literature search and applied a standardized appraisal process to rate each tool’s psychometric.

Abstract

Many office-based assessment tools are used by occupational therapists to predict fitness to drive.To appraise psychometric properties of such tools, specifically predictive validity for on-road performance.A literature search was conducted to identify assessment tools and studies involving on-road outcomes (behind-the-wheel evaluation, crashes, traffic violations). Using a standardized appraisal process, reviewers rated each tool's psychometric properties, including its predictive validity with on-road performance.Seventeen measures met the inclusion criteria. Evidence suggests many tools do not have cutoff scores linked with on-road outcomes, although some had stronger evidence than others. Implications. When making a determination regarding driver fitness, clinicians should consider the psychometric properties of the tool as well as existing evidence concerning its utility in predicting on-road performance. Caution is warranted in using any one office-based tool to predict driving fitness; rather, a multifactorial-based assessment approach that includes physical, cognitive, and visual-perceptual components, is recommended.