The SIMARD-MD is not an Effective Driver Screening Tool for Determining Fitness-To-Drive


  • Alexander M. Crizzle University of Waterloo, University of Saskatchewan
  • Nadia Mullen Lakehead University
  • Diane Mychael St. Joseph’s Health Centre Guelph
  • Natasha Meger Saskatchewan Health Authority
  • Ryan Toxopeus University of Saskatchewan
  • Carrie Gibbons St. Joseph’s Care Group
  • Simeon Ostap Lakehead University
  • Sacha Dubois Lakehead University
  • Michel Bédard Lakehead University



SIMARD-MD, cognitive impairment, driving performance, older drivers, dementia, comprehensive driving evaluation, sensitivity, specificity



Studies have reported poor sensitivity and specificity of the Screen for the Identification of Cognitively Impaired Medically At-Risk Drivers, a modification of the DemTech (SIMARD-MD) to screen for drivers with cognitive impair­ment. The purpose of this study was to determine whether the SIMARD-MD can accurately predict pass/fail on a road test in drivers with cognitive impairment (CI) and healthy drivers.


Data from drivers with CI were collected from two compre­hensive driving assessment centres (n=86) and compared with healthy drivers (n=30). All participants completed demo­graphic measures, clinical measures, and a road rest (pass/fail). Analyses consisted of correlations between the SIMARD-MD and the other clinical measures, and a receiver-operating-characteristic (ROC) curve to determine the predictive ability of the SIMARD-MD.


All healthy drivers passed the road test compared with 44.2% of the CI sample. On the SIMARD-MD, the CI sample scored significantly worse than healthy drivers (p < .001). The ROC curve showed the SIMARD-MD, regardless of any cut-point, misclassified a large number of CI individuals (AUC=.692; 95% CI = 0.578, 0.806).


Given the high level of misclassification, the SIMARD-MD should not be used with either healthy drivers or those with cognitive impairment for making decisions about driving.


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How to Cite

Crizzle AM, Mullen N, Mychael D, Meger N, Toxopeus R, Gibbons C, Ostap S, Dubois S, Bédard M. The SIMARD-MD is not an Effective Driver Screening Tool for Determining Fitness-To-Drive . Can Geriatr J [Internet]. 2021 Feb. 18 [cited 2023 Nov. 29];24(1):14-21. Available from:



Original Research