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

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.

Association between car driving and successful ageing. A cross sectional study on the "S.AGES" cohort

“…This may be achieved either by improving preventive medicine and comprehensive geriatric assessment in order to improve physiological and psychological components. Moreover, development of tools to screen for drivers with cognitive impairment is needed such as Screen for the Identification of Cognitively Impaired Medically At-Risk Drivers or Trail Making Test which have shown high rate of misclassification on pass/fail in a road test among drivers [ 43 , 44 ]. It is however interesting to note that according to a Canadian study of 108 older adults (mean age 80.6 +/- 4.9 y/o) on self-awareness of driving performance, 53% over-estimated themselves (vs. 19% underestimated themselves).…”