The SIMARD-MD is not an Effective Driver Screening Tool for Determining Fitness-To-Drive
DOI:
https://doi.org/10.5770/cgj.24.444Keywords:
SIMARD-MD, cognitive impairment, driving performance, older drivers, dementia, comprehensive driving evaluation, sensitivity, specificityAbstract
Background
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.
Methods
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.
Results
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).
Conclusions
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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