{"id":18762,"date":"2014-06-18T00:00:00","date_gmt":"2014-06-18T00:00:00","guid":{"rendered":"https:\/\/carsp.ca\/?p=18762"},"modified":"2022-10-29T22:50:58","modified_gmt":"2022-10-29T22:50:58","slug":"major-impediments-towards-identifying-unsafe-senior-drivers-and-successfully-supporting-those-who-are-safe","status":"publish","type":"post","link":"https:\/\/carsp.ca\/en\/presentations-and-papers\/2014-cmrsc-ccmsr-xxiv-vancouver\/major-impediments-towards-identifying-unsafe-senior-drivers-and-successfully-supporting-those-who-are-safe\/","title":{"rendered":"Major impediments towards identifying unsafe senior drivers and successfully supporting those who are safe."},"content":{"rendered":"Author(s): Michel B\u00e9dard and Bruce Weaver<\/p>\n

Slidedeck Presentation Only (no paper submitted):<\/h2>\n

6B Bedard_Major Impediments Towards Identifying Unsafe Senior Drivers<\/a><\/p>\n

<\/div>\n

Abstract:<\/h2>\n

Background<\/p>\n

Identifying senior drivers who may have a cognitive impairment affecting their ability to drive safely is a focus of many researchers.\u00a0 Some researchers have claimed to have found tools that achieve this goal with precision - we dispute such claims.<\/p>\n

Aims<\/p>\n

The focus of this presentation will be to highlight some of the major impediments towards identifying unsafe senior drivers while successfully supporting those who are safe.<\/p>\n

Methods<\/p>\n

We have reviewed the literature on cognition and driving in seniors.<\/p>\n

Results<\/p>\n

We identified six important issues:<\/p>\n

    \n
  1. We must focus on specificity (labeling safe drivers as \u201csafe\u201d) over sensitivity (identifying truly \u201cunsafe\u201d drivers).\u00a0 It is accepted that driving cessation can have negative consequences, that we are not facing a tsunami of unsafe senior drivers, that crashes are relatively rare events, and that senior drivers pose a greater risk to themselves (due to their frailty) than to others.\u00a0 Focusing first on specificity is the logical extension of these statements.<\/li>\n
  2. We must understand the added value of tests over chronological age.\u00a0 Understanding the contribution of age to test results and ensuring that tests are more than just a proxy measure for age is necessary to justify their use.<\/li>\n
  3. We must identify the most appropriate \u201cgold standard\u201d of \u201ccognitive fitness to drive\u201d.\u00a0 Current gold standards (e.g., on-road evaluations, crashes) are multi-factorial and best explained by more than just cognitive capacity.\u00a0 Hence, the assessment of cognition alone should be contrasted to a gold standard that represents the appropriate operationalization.<\/li>\n
  4. We must use the word \u201cclassification\u201d rather than \u201cscreening\u201d when referring to brief tests of cognition.\u00a0 \u201cScreening\u201d as currently used in the driving literature is a misnomer.\u00a0 Tests are used to \u201cclassify\u201d by determining whether one should be allowed to drive or not, or be required to undergo further evaluation.\u00a0 There is no attempt to identify proactively issues before they become a problem (as would be done in the Public Health sense of \u201cscreening\u201d).<\/li>\n
  5. We must follow the testing of senior drivers with actions that support their well-being.\u00a0 Testing serves a greater purpose than just \u201clabeling\u201d and taking away licenses.\u00a0 As such, we need to consider the beneficial nature of tests.\u00a0 For example, tests should highlight potential areas for remediation.\u00a0 License revocation should be followed by transportation mobility interventions.<\/li>\n
  6. We must pay attention to \u201ccargo-cult science\u201d and conflicts of interest.\u00a0 \u201cCargo-cult science\u201d, the conduct of flawed research under the guise of \u201cscience-based\u201d research and\/or the inability to objectively assess one\u2019s own results, is not science.\u00a0 It may arise because of a lack of training, by being overly enthusiastic about one\u2019s findings, or because of conflicts of interest.<\/li>\n<\/ol>\n

    Discussion<\/p>\n

    We have presented six important issues that may help us make further progress on how to identify senior drivers who have a cognitive impairment that prevents them from driving safely, while avoiding false positives, and supporting safe drivers.\u00a0 Attention to these issues does not represent a drastic change in current practice but may spark a much-needed conversation to move the field forward.<\/p>\n

    <\/div>","protected":false},"excerpt":{"rendered":"

    Michel B\u00e9dard and Bruce Weaver<\/p>\n","protected":false},"author":163,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_kad_post_transparent":"default","_kad_post_title":"default","_kad_post_layout":"default","_kad_post_sidebar_id":"","_kad_post_content_style":"default","_kad_post_vertical_padding":"default","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"_kad_post_classname":"","footnotes":""},"categories":[128,346],"tags":[],"class_list":["post-18762","post","type-post","status-publish","format-standard","hentry","category-2014-cmrsc-ccmsr-xxiv-vancouver","category-research-and-evaluation"],"acf":[],"_links":{"self":[{"href":"https:\/\/carsp.ca\/en\/wp-json\/wp\/v2\/posts\/18762","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/carsp.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/carsp.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/carsp.ca\/en\/wp-json\/wp\/v2\/users\/163"}],"replies":[{"embeddable":true,"href":"https:\/\/carsp.ca\/en\/wp-json\/wp\/v2\/comments?post=18762"}],"version-history":[{"count":1,"href":"https:\/\/carsp.ca\/en\/wp-json\/wp\/v2\/posts\/18762\/revisions"}],"predecessor-version":[{"id":18871,"href":"https:\/\/carsp.ca\/en\/wp-json\/wp\/v2\/posts\/18762\/revisions\/18871"}],"wp:attachment":[{"href":"https:\/\/carsp.ca\/en\/wp-json\/wp\/v2\/media?parent=18762"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/carsp.ca\/en\/wp-json\/wp\/v2\/categories?post=18762"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/carsp.ca\/en\/wp-json\/wp\/v2\/tags?post=18762"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}