Reliability and validity of on-road driving tests in vulnerable adults: a systematic review

Abstract

The on-road driving test is considered a 'gold standard' evaluation; however, its validity and reliability have not been sufficiently reviewed. This systematic review aimed to map out and synthesize literature regarding on-road driving tests using the Consensus-based Standards for the Selection of Health Measurement Instruments checklist. Cochrane Library, PubMed, CINAHL, and Web of Science databases were searched from initiation through February 2018. All articles addressing reliability or validity of on-road driving tests involving adult rehabilitation patients were included. The search output identified 513 studies and 36 articles, which were included in the review. The Washington University Road Test/Rhode Island Road Test, performance analysis of driving ability, test ride for investigating practical fitness-to-drive, and K-score demonstrated high reliability and validity in regard to the Consensus-based Standards for the Selection of Health Measurement Instruments checklist. The Washington University Road Test/Rhode Island Road Test and test ride for investigating practical fitness-to-drive were analyzed based on Classical Test Theory techniques, and performance analysis of driving ability and K-score were analyzed based on Item Response Theory techniques. The frequency of studies were Washington University Road Test/Rhode Island Road Test (n=9), Test Ride for Investigating Practical fitness-to-drive (n=8), performance analysis of driving ability (n=4), and K-score (n=1). From the viewpoint of accuracy and generalization, the Washington University Road Test/Rhode Island Road Test, test ride for investigating practical fitness-to-drive, and performance analysis of driving ability were identified as highly qualified concerning on-road driving tests. However, the ability to assess real-world driving depends on various environmental conditions.

Fig. 1

COSMIN checklist process. COSMIN is standardized checklist methodology of the reliability and validity. It consists of four steps. COSMIN, Consensus-based Standards for the Selection of Health Measurement Instruments; IRT, item response theory.

Fig. 2

Systematic review process. ADPE, Area Driving Performance Evaluation; BOST, Basic Operator Skills Test; BTW, Behind-the-Wheel Driving Performance Assessment; DBOG, Driving Behaviors Observation Grid; HES, Hazardous Error Score; JRHREF, Jewish Rehabilitation Hospital Road Evaluation Form; MDPE, Modified Driving Performance Evaluation; NNDA, Nottingham Neurological Driving Assessment; OTADS, Occupational Therapy Assessment of Open-Road Driving Performance Score; P-drive, Performance Analysis of Driving Ability; PBDE, Performance-Based Driving Evaluation; RIDE, Rhode Island Driving Evaluation; RIRT, Rhode Island Road Test; ROA, Ryd On-road Assessment; RODE, Record of Driving Errors; SRT, Sepulveda Road Test; TRIP, test ride for investigating practical fitness-to-drive; UWO, University of Western Ontario’s on-road assessment; WURT, Washington University Road Test.