{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:20:40Z","timestamp":1787836840869,"version":"build-2784847793"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Sam Ryan Memorial Award 2017 and the Cure Brain Cancer Foundation","award":["Sam Ryan Memorial Award 2017"],"award-info":[{"award-number":["Sam Ryan Memorial Award 2017"]}]},{"name":"Canberra Hospital Private Practice Fund"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Rehabil"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the predictive validity and potential clinical relevance of the DriveSafe DriveAware assessment for predicting on-road driving outcomes in medically at-risk drivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Fitness-to-drive assessment pathway involving a driver licensing authority, medical review clinic, and occupational therapy driver assessors in the Australian Capital Territory, Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A convenience sample of 138 drivers referred for occupational therapy driving assessment because of medical fitness-to-drive concerns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants completed the DriveSafe DriveAware, comprising DriveSafe and DriveAware subtests, before an on-road driving assessment. On-road outcomes were dichotomised as pass (unrestricted licence) or fail (conditional licence, reassessment, or licence cancellation). Receiver operating characteristic analyses, Youden's Index, and classification accuracy metrics were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      DriveSafe DriveAware demonstrated strong classification performance, with 86% sensitivity, 100% specificity, 100% positive predictive value, and 93% overall accuracy. Eighty-seven percent of participants were classified as\n                      <jats:italic toggle=\"yes\">Likely to Pass<\/jats:italic>\n                      or\n                      <jats:italic toggle=\"yes\">Likely to Fail<\/jats:italic>\n                      , with 13% classified as\n                      <jats:italic toggle=\"yes\">Further Testing<\/jats:italic>\n                      . No participants classified as\n                      <jats:italic toggle=\"yes\">Further Testing<\/jats:italic>\n                      achieved an unconditional pass. DriveSafe and DriveAware subtests showed excellent discrimination (area under the curve\u2009=\u20090.96 and 0.95, respectively). Optimal cut-offs were broadly consistent with previously proposed thresholds. Drivers who failed the on-road assessment were older and had lower DriveSafe and DriveAware subtest scores than those who passed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DriveSafe DriveAware showed strong predictive validity in this sample and may support triage and clinical decision-making within fitness-to-drive assessment pathways.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692155261471411","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:15:49Z","timestamp":1787670949000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictive validity and clinical relevance of DriveSafe DriveAware as a cognitive assessment of fitness to drive in medically at-risk drivers"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9819-2383","authenticated-orcid":false,"given":"Belinda Joy","family":"Johnston","sequence":"first","affiliation":[{"name":"The University of Sydney"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2662-6306","authenticated-orcid":false,"given":"Joan Margaret","family":"O'Donnell","sequence":"additional","affiliation":[{"name":"The University of Sydney"},{"name":"Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Nursing, Midwifery and Health Sciences, The University of Notre Dame Australia, Chippendale, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5274-4915","authenticated-orcid":false,"given":"Vanita","family":"Parekh","sequence":"additional","affiliation":[{"name":"Canberra Health Services"},{"name":"The Australian National University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4359-2443","authenticated-orcid":false,"given":"Jacqueline","family":"Wesson","sequence":"additional","affiliation":[{"name":"The University of Sydney"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1597-2051","authenticated-orcid":false,"given":"Lynette","family":"Mackenzie","sequence":"additional","affiliation":[{"name":"The University of Sydney"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"Assessing fitness to drive: for commercial and private vehicle drivers","author":"Austroads; National Transport Commission","year":"2022","unstructured":"Austroads; National Transport Commission. 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