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
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.

Author Biographies

Alexander M. Crizzle, University of Waterloo, University of Saskatchewan

School of Public Health, School of Public Health and Health Systems

Nadia Mullen, Lakehead University

Centre for Research on Safe Driving

Ryan Toxopeus, University of Saskatchewan

School of Public Health

Carrie Gibbons, St. Joseph’s Care Group

Centre for Applied Health Research

Simeon Ostap, Lakehead University

Centre for Research on Safe Driving

Sacha Dubois, Lakehead University

Centre for Research on Safe Driving, Centre for Applied Health Research, St. Joseph’s Care Group, Human Sciences Division, Northern Ontario School of Medicine

Michel Bédard, Lakehead University

Centre for Research on Safe Driving, Centre for Applied Health Research, St. Joseph’s Care Group, Human Sciences Division, Northern Ontario School of Medicine

Published
2021-02-18
How to Cite
Crizzle, A. M., Mullen, N., Mychael, D., Meger, N., Toxopeus, R., Gibbons, C., Ostap, S., Dubois, S., & Bédard, M. (2021). The SIMARD-MD is not an Effective Driver Screening Tool for Determining Fitness-To-Drive . Canadian Geriatrics Journal, 24(1), 14-21. https://doi.org/10.5770/cgj.24.444
Section
Original Research