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SIMARD-MD is not an Effective Driver Screening Tool

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HOME / ARCHIVES / VOL. 24 NO. 1 (2021) / Original Research

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

DOI: https://doi.org/10.5770/cgj.24.444
Keywords: SIMARD-MD, cognitive impairment, driving performance, older drivers, dementia,
comprehensive driving evaluation, sensitivity, specificity


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.



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.


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.

Entered on website July 22, 2022


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