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C Mullen, T Novack, A-59 Sensitivity and Specificity of Neuropsychological Performance on Successful Return to Driving One Year Post Assessment, Archives of Clinical Neuropsychology, Volume 34, Issue 6, August 2019, Page 919, https://doi.org/10.1093/arclin/acz034.59
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Abstract
A significant concern for patients as well as practitioners is patient safety for return to driving (RTD) after a traumatic brain injury (TBI). Numerous studies have examined neuropsychological test performance and decision making of patients to RTD. However, there is limited information pertaining to longitudinal outcomes on such performance.
This was a retrospective study of TBI patients (n = 36) seen at UAB Spain Rehabilitation Center who completed neuropsychological testing. Measures that have previously demonstrated relationships with RTD were examined: Trail Making Test-Part B (TMT-B), Useful Field of Vision (UFOV), California Verbal Learning Test (Test), and Wisconsin Card Sorting Test (WCST). Performance on the Cog-Log was also examined. Patients were followed across time as part of the Traumatic Brain Injury Model System study. Safe RTD one year post neuropsychological evaluation was measured by patient report. Accuracy of determining safety of RTD based on neuropsychological performance and respective cut scores was determined with receiver operating characteristic curve analysis.
The Cog-Log Total Score and TMT-B demonstrated statistically significance in predicting safe RTD (AUC = .803, SE = .100, p = .023; AUC = .788, SE = .109, p = .030). Cut points of sensitivity and specificity for each measure will be presented. Positive predictive value (PPV) of the Cog-Log was 70.59% for scores less than 25 out of 30, indicative of impairment. PPV of various completion times of the TMT-B will be presented.
Preliminary results can help inform practitioners of essential measures to include in cognitive testing in consideration of long-term safety of RTD.
