Adaptation of The Stroke Driver Screening Assessment (SDSA) to Malaysian Version (MySDSA) and its Validation for Fitness to Drive after Stroke


  • Nor Farizah Abdul Munin Department of Rehabilitation Medicine, Ministry of Health, Malaysia
  • Mazlina Mazlan Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Malaya, Malaysia
  • Sheela Theivanthiran Department of Rehabilitation Medicine, Hospital Rehabilitasi Cheras, Malaysia
  • Norazlina Abdul Aziz Department of Rehabilitation Medicine, Hospital Rehabilitasi Cheras, Malaysia
  • Azizah Mohd Isa Hospital Rehabilitasi Cheras, Malaysia
  • Nurul Huda Abd Rahman Department of Rehabilitation Medicine, University Malaya Medical Center


driving, rehabilitation, stroke, assessment


Objectives: To adapt the Stroke Drivers Screening Assessment (SDSA) to the Malaysian version (MySDSA) and to establish its criterion validity and predictive ability in assessing fitness to drive after a stroke in Malaysia.

Study design: A universal sampling method.

Setting: A tertiary hospital in an urban setting in Malaysia.

Subjects: Stroke survivors referred for assessment of fitness to drive.

Methods: The MySDSA was adapted from the original SDSA. An expert panel of doctors, occupational therapists, and represen-tatives from the Malaysia Road Transport Department and the Malaysia Institute of Road Safety Research was formed and a consensus decision was made to substitute all road signs in the SDSA Road Sign Recognition section with the Malaysian equivalent. No further changes to the SDSA were made, and the original English language was maintained. After that, stroke patients who had been referred for driving fitness assessment were recruited. The patients were tested using MySDSA and were classified as pass or fail using a discriminant equation. The patient’s performance on the MySDSA was then compared with their performance on a computerised driving simulator using Receiver Operating Charac-teristic (ROC) analysis. The assessor for the driving simulator was blinded from the MySDSA results.

Results: Twenty stroke survivors (mean age 50 years ±10) of the initial 35 stroke survivors recruited completed both the MySDSA and the driving simulator assessment. There was no statistically significant association between either demographic or stroke characteristics and MySDSA performance. MySDSA predicted driving performance on the simulator with 74% adjusted accuracy and above moderate effect size (Cohen’s d=0.661).

Conclusions: MySDSA has acceptable accuracy for predicting driving performance on the driving simulator test after a stroke, but it is not recommended to be used alone as a replacement for a driving simulator.


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