PubMed · 5551593
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M S Stock, W O Light, F D Burg, J M Douglas. 1971. Licensing the driver with respiratory dysfunction.. https://doi.org/10.1378/chest.59.4.451
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Driving-license holders with health problems are morally obliged to report this to the Driver Licensing Centre (CBR). The CBR can then further investigate the matter and either insist that technical modifications be made to the vehicle or declare the driver (temporarily) unfit to drive a vehicle. After an epileptic seizure a driver may not drive a car or ride a motorcycle for six months. Following multiple seizures this period is extended to one year after the last seizure. Exceptions can be made only if certain established criteria are fulfilled. Following cerebral infarction or cerebral haemorrhage, the driving-license holder is considered unfit to drive for at least six months. After this period fitness-to-drive is dependent on the presence of any disorders of function and the results of a CBR driving test. Persons with an intracranial tumour are assessed on the presence of any disorders of function and may be given a driving license valid for a limited period of time only. A transient ischaemic attack (TIA) or the chance discovery of an unruptured intracranial aneurysm or vascular malformation which does not need treatment, does not necessarily affect fitness to drive. Persons with syncope, progressive neurological disorders or stationary functional disorders should undergo medical assessment and, if necessary, take a CBR driving test. In the case of all neurological disorders, the rules are stricter for professional drivers of cars and motorcycles as well as holders of driving licenses for heavy-goods vehicles and buses.
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OBJECTIVE: To determine the reliability of the road test performed by stroke patients. DESIGN: Prospective study of a 6-month predriving evaluation. SETTING: Driving safety center in Belgium. PARTICIPANTS: Thirty patients with sequelae of stroke. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Results of driving performance as judged by 2 assessors from the Center for Determination of Fitness to Drive and Car Adaptations (CARA), in a car fitted with a video camera. A third assessor also evaluated all the video recordings. Interrater reliability was evaluated by comparing results from real-life performance and video recording, as judged by the CARA assessors and video judgments between CARA assessors and the third assessor. RESULTS: Most subitems of the road test showed more than 80% scoring agreement between the various evaluations. Intraclass correlation coefficients (ICCs) of the items varied from -.08 to 1.0. The ICC of the overall performance was.62 when real-life scores were compared with video evaluations and.80 in video versus video comparison. CONCLUSION: The reliability of assessing overall performance of stroke patients in the road test is moderately high and better when assessed using the same evidence. Yet, the reliability of some items needs further attention.