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

Authors

  • 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

DOI:

https://doi.org/10.5770/cgj.24.444

Keywords:

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

Abstract

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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Published

2021-02-18

How to Cite

1.
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 2022 Nov. 26];24(1):14-21. Available from: https://cgjonline.ca/index.php/cgj/article/view/444

Issue

Section

Original Research