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The Centre For Research on Safe Driving

Analysing the validity of DriveABLE Cognitive tests

 

RESEARCH - Bédard M, Marshall S, Man-Son-Hing M, Weaver B, Gélinas I, Korner-Bitensky N, Mazer B, Naglie G, Porter MM, Rapoport MJ, Tuokko H, Vrkljan B.


Source: Centre for Research on Safe Driving, Lakehead University, Thunder Bay, Ontario, Canada; St. Joseph's Care Group, Thunder Bay, Ontario, Canada; Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada. Electronic address: mbedard@lakeheadu.ca.

Abstract
BACKGROUND:
A new tool, the SIMARD-MD, has been proposed to help physicians identify cognitively impaired drivers who may be unfit to drive, but little empirical evidence is available to justify its use. We analyzed data from a cohort of older Canadian drivers who had undergone cognitive testing to:
(1) correlate the SIMARD-MD with other tools that measure cognition (e.g., trail-making test),
(2) identify how many drivers, using published cut-offs on the SIMARD-MD, would be recommended to lose their license, or be considered fit to drive, or be required to undergo further driving assessment, and
(3) determine if the SIMARD-MD is biased by level of education as many cognitive tools are.

METHODS: Cross-sectional data from 841 drivers aged 70 and over from seven Canadian sites who are enrolled in a 5-year cohort study were used for the analyses. Scores on the SIMARD-MD were correlated with scores on the other cognitive measures. The recommendations that would be made based on the SIMARD-MD scores were based on published cut-off values suggested by the authors of the tool. The impact of education status was examined using linear regression controlling for age.

RESULTS: Correlations between the SIMARD-MD and other cognitive measures ranged from .15 to .86. Using published cut-off scores, 21 participants (2.5%) would have been recommended to relinquish their licenses, 428 (50.9%) would have been deemed fit to drive, and 392 (46.6%) would have been required to undergo further testing. We found a difference of 8.19 points (95% CI=4.99, 11.40, p<.001) in favor of drivers with post-secondary education versus those without, representing over 11% of the mean score.

DISCUSSION: The SIMARD-MD is unlikely to be valuable to clinicians because it lacks sufficient precision to provide clear recommendations about fitness-to-drive.
Recommendations based solely on the SIMARD-MD may place many seniors at risk of losing their transportation mobility or incurring unnecessary stress and costs to prove they are safe to drive.
Furthermore, the education bias may create an unwanted structural inequity. Hence, adoption of the SIMARD-MD as a tool to determine fitness-to-drive appears premature.
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Why are all clients, who are driver license applicants, being subjected to the Simard MD test, although we are told ad nauseum that Simard MD testing is intended  for those who are "medically at risk"?
 We have been advised by academics who are familiar with the Simard MD that this testing sets up the senior for failure,
 not only by the nature of the questions but also by the way the test is scored. The almost guaranteed failure then results in the senior being directed to the $250.+ GST, DriveABLE (Ontario $400.00)
computer test sponsored by the private for Profit, multi-million dollar, DriveABLE  Assessment Corp. Inc. which is a product of Alberta Deal Generator, the largest investor network in Canada which represents over $400 million in available capital.
A $1-million investment into Edmonton-based DriveABLE  Assessment Centres made by Foundation Equity Corporation in 2005, an angel capital group based in St. Albert, AB. is touted in 2013
by Alberta Deal Generator as one of four, top lucrative investments.
The Simard MD was developed by Bonnie Dobbs and the DriveABlE test developed by her husband Allan Dobbs.  He has a 15.7 % interest in the DriveABLE  Assessment Corp. Inc.
______________________________________________________
We challenge the veracity of the Simard MD. test
http://elderadvocates.ca/challenging-the-veracity-of-the-simard-md-protocol/

Sincerely, Ed. Rockburne,RCMP, Retired, erockburne@cogeco.ca