Process and Outcomes Evaluation of Older Driver Screening Programs: The Assessment of Driving-Related Skills (ADReS) Older-Driver Screening Tool

摘要

Physicians are one resource for identification of older drivers who may be at risk for decreased safe driving ability. However, physicians have not had the tools to make decisions about the safe driving ability of their patients. With this in mind, the American Medical Association (AMA), with support from the National Highway Traffic Safety Administration, published the Physicians Guide to Assessing and Counseling Older Drivers to provide physicians with background information and screening tools (the Assessment of Driving-Related Skills (ADReS)) for dealing with older driver issues among their patients. This study examines the effectiveness of the ADReS in identifying older drivers who may or may not be at an increased risk for unsafe driving by comparing on-road performance of participants with ADReS results. Tests of vision, cognition, and physical function were administered to older drivers. Researchers monitored a behind-the-wheel (BTW) test that included a range of roadway conditions. The prevalence of unsafe drivers, based upon the results of the global rating of the BTW, was 24.6 percent. Analyses of the sensitivity of the ADReS identified 100 percent of those participants who were found to be unsafe drivers. Analyses of the specificity of the ADReS suggested that 32.6 percent of this sample was identified as requiring an intervention yet passed the onroad test. Although the ADReS identified all who failed the BTW, the results of this study suggest that the ADReS may not be an efficient predictor of those who need a driving evaluation. Based on the results of this sample, this tool may need to be revised in order to provide physicians with a more effective screening method. The report contains specific recommendations for changes to the ADReS tool.