Validation of the Stroke Drivers' Screening Assessment in people with stroke in the Spanish context

Abstract

Objective

To culturally adapt the Stroke Drivers’ Screening Assessment (SDSA) and evaluate its construct and predictive validity in a Spanish stroke population.

Design

Cultural adaptation and validation study.

Setting

Hospitals and neurorehabilitation clinics in Spain.

Participants

Forty-five stroke patients completed the SDSA-Spain, a neuropsychological battery, and a road test.

Adaptation process

A panel of experts (two occupational therapists, a psychologist specializing in driving, and a driving instructor) adapted the SDSA to the Spanish context.

Main measures

The correlations of the SDSA-Spain with attention and memory tests, its ability to discriminate between fit and unfit drivers according to the instructor's judgment, and its predictive validity for the road test were analyzed.

Results

The SDSA-Spain correlated significantly with the Useful Field of View subtests 2 and 3, and with the Trail Making Test-part B time. No significant differences were observed in discriminative ability alone between pass and fail participants. A logistic regression was performed selecting Dot Cancellation-time, Dot Cancellation-errors, Road Sign Recognition from the Spanish SDSA, and Useful Field of View-subtest 2. The model achieved an area under the curve of 0.81, accuracy of 0.73, specificity of 0.75, and sensitivity of 0.714.

Conclusions

The SDSA-Spain is an off-road tool that can be useful for assessing fitness to drive in stroke patients, especially when combined with other tests.