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Don Smitten AMA

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Elder Advocates Of Alberta Society

HAND DELIVERED

June 14, 2014

Mr. Don Smitten, President & CEO

Alberta Motor Association (AMA)

11220 109 St,

Edmonton, AB T5G 2T6

Dear Mr. Smitten:

Promoting ageism (discrimination against individuals because of age)

We are gratified to note that you have removed the presenter and promotion of the Simard MD and DriveABLE protocol from the AMA website.

However we are deeply dismayed to be informed that AMA is working closely with Alberta Health Services and its’ Occupational Therapists to develop a new driving assessment protocol. Why? Why are you attempting to fix something that is not broken?

You state that this will be based upon one’s medical fitness to drive and not age. We strongly fear that, essentially, this will mean more of the same. The founders of the SIMARD MD and the MARD website which sponsors the SIMARD MD continuously assures us that it is not age but illness. Nevertheless, numbers of physicians and medical clinics across the province, routinely submit every client over 75 years of age to this testing. Furthermore, Dr.’s Allan and Mrs. Bonnie Dobbs stress in their public presentations, that every senior should be subjected to cognitive testing. Mrs. Dobbs recently published that such testing should begin at age 70.

We are further dismayed to learn that:

the AMA is currently conducting a research study through the University of Calgary to better understand the current process for driving assessments and where there are gaps. Our researchers will be talking with everyone involved in a driving assessment process from the Doctor who refers individuals, to an occupational therapist who completes the assessments.  They will also talk with patients and their families to understand concerns they have. We believe that this study will clearly point to areas where Alberta needs to improve”.

________________________________________________________________________

elderadv@shaw.ca  Tel/Fax (780) 438 8314 www.elderadvocates.ca

Box # 76138, Edmonton, AB. T6H 5Y7

It must be clearly understood, that these persons, whom you refer to as patients who attend at a physician’s office for the purpose of a physical examination, in order to renew their driving license, are not sick persons in need of medical care. They are not patients, they are healthy individuals who would not attend at doctor’s office. Also, these persons have not been involved in a car accident and often, have never been involved in any car accident.

However, they are individuals, who have come because of a government edict, which directs that seniors must undergo a medical assessment in order to renew their driving license.

This is at a cost of millions of dollars to the Alberta Taxpayer. A physician can charge Alberta Health up $160.00 for the medical assessment and $75.00 for the cost of administering the Simard MD test. In BC, the cost is over 2M where driver testing starts at age 80 . The cost will be much higher here, because driver testing starts at age 75.

Unfortunately, it appears that there is intent to continue to target seniors, subjecting them to testing when in fact it is not seniors who are causing the carnage on Alberta roads, take for example Highway # 63.

According to Alberta Transportation statistics, seniors are the safest drivers on Alberta roads, it is documented they have the lowest casualty rates. It is also reality, that they do not cause the carnage on Alberta roads. This is true across Canada, seniors are the safest drivers.

The fact that seniors are safe drivers, has now been reinforced by the United States Insurance Institute for Highway Safety. They stated that they were wrong in thinking that an older population would lead to more accidents, just the reverse has happened. This was published on February 14, 2014 by Joan Lowy of the Associated Press.

Anne McCartt, the United States Insurance Institute for Highway Safety senior vice president and co-author of the study has commented, “This should help ease fears that aging baby boomers are a safety threat”.

Furthermore in jurisdictions that have rejected compulsory, senior driving assessments, it was observed that normal ageing does not increase crash risk as older drivers generally regulate their own driving and compensate for any gradual decline in driving abilities. 

There are those who are locked in a time warp, who continue to believe the mythical, underlying presumptive policy that older drivers threaten road safety.

There are also those, who continue to have a powerful, vested interest to keep seniors locked in this injustice so they can feed off of a most lucrative industry.

Finally, if the purpose of the said research encompasses drivers of all ages, it will be fair and valuable. However, if it is focused only on older Albertans, we strongly submit that it will promote further ageism and planned, deliberate, targeted elder abuse.

Thank you.

We would be grateful to be in receipt of your response by the 27th June, 2014.

Yours truly,

Elder Advocates Of Alberta Society

c.c Honourable Associate Minister of Seniors, Mr. Dave Quest

Honourable Minister of Transportation, Mr. Wayne Drysdale.

Mr. Steve Young MLA

Ms. Carol Libman, CARP

The Simard-DriveABLE protocol has been opposed by the Canadian Association of Retired Persons, Elder Advocates of Alberta Society, Voice for Seniors, the B.C. Federation of Retired Union Members, the British Columbia Retired Teachers? Association, The Council of Senior Citizens of B.C., Candrive which is funded by The Canadian Institutes of Health Research, by numbers of physicians and by members of the research community.

A screening tool should be able to tell us with considerable accuracy who can drive and who can?t drive because the quality of people?s lives are at stake. Researchers have mentioned that the more indeterminate scores a screening tool produces, the less useful it is.

According to Dr. Bonnie Dobbs? own data, the initial screening tool, the Simard MD, administered in the physician?s office, tends to produce an indeterminate score about 50% of the time. Those who receive an indeterminate score are then referred to a DriveABLE Assessment Centre for the touch-screen test.

A recent retrospective study released by Dr. Allen Dobbs showed that the DriveABLE has yielded indeterminate scores 46% of the time. 13.7% passed the DriveABLE outright, 40% failed, and 46% received an indeterminate score. We have 50% indeterminate referring patients to 46% indeterminate for a $200 or $250 fee. Both the Simard MD and the DriveABLE have an unacceptable rate of false positives and false negatives, incorrect fails and incorrect passes. Dr. Bonnie Dobbs co- authored the Simard MD test which sends patients to her husband?s business. Dr. Allen Dobbs created the DriveABLE and he is president and CEO of the DriveABLE Assessment Centres. The DriveABLE Assessment Centres are majority owned and controlled by a venture capital fund, Foundation Equity Corporation.

Dr. Allen Dobbs? recently published retrospective study, published March 2013, attempted to demonstrate the accuracy of the DriveABLE , although DriveABLE Assessment Corporation Inc. was widely marketed in early 2005. by CEO Henry Yip.

That study can be found on the Internet under Canadian Family Physician and it is titled

ACCURACY OF THE DRIVEABLE COGNITIVE ASSESSMENT TO DETERMINE COGNITIVE FITNESS TO DRIVE.

There are informed comments underneath. From 2007 to 2010, 3662 patients were given a driver?s test, his DORE, so that the on-road test results could be compared to the DriveABLE results. A strange analysis came to completely illogical conclusions. The conclusion was that the DriveABLE is highly accurate, but an indeterminate score 46% of the time isn?t highly accurate , and the overall raw agreement between the in-office assessment and on-road tests is only 50.4%. The calculations that showed that the DriveABLE was only 1.7% inaccurate for passes and only 5.6% inaccurate for fails suffered from a problem with numerator and denominator.

For those who passed, the percentage of incorrect passes should have been the number of incorrect passes divided by the total number of passes multiplied by 100. Instead, the number of incorrect passes was divided by all of the passes, all of the fails, and all of the indeterminates.

A similar misleading calculation was used to calculate the percentage of incorrect fails. The introduction of the Simard MD disregarded the Knowledge-to-Action Framework required by the Canadian Institutes of Health Research.

There should have first been a synthesis of studies, a sharing of information, and a debate. The required prospective study that would have allowed decisions to be justified in terms of demonstrable and quantified crash risk/crash rate reduction was not done before the DriveABLE was allowed to have a critical role in licensing decisions. The DriveABLE did so poorly the only time that it was independently tested (51% accurate for fails), that it has not been available for independent research ever since.

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