A Comparison of a Driving Simulator and a Road Test in the Assessment of Driving Ability after a Stroke

This study investigated the value of a driving simulator as an assessment procedure for stroke patients who wished to resume driving. Thirty-eight stroke patients who had been driving immediately prior to their stroke were assessed using a driving simulator. On the basis of this assessment, patients were graded into ‘pass’, ‘borderline’ or ‘fail' categories. Patients were then given a road test and were again graded into the same three groups by a driving instructor. Judgements of fitness to drive obtained using a simulator were compared with those of a road test using the Kappa coefficient to define levels of agreement. The simulator and road test gradings showed poor agreement (K=0.29). This indicates that a simulator should not be used as the sole indication of fitness to drive for stroke patients.