DriveABLE responds
Gordon Turnbull’s letter is replete with false and misinformed statements needing correction. Contrary to Turnbull’s contention, DriveABLE does not replace the good judgment of the medical community.
Gordon Turnbull’s letter is replete with false and misinformed statements needing correction. Contrary to Turnbull’s contention, DriveABLE does not replace the good judgment of the medical community. Rather, the DriveABLE assessment provides relevant information to physicians and licensing authorities to assist them in making decisions about a driver’s cognitive competence to drive safely.
Our goal is to assist in making the best decision concerning the driver’s safety for the well-being of the person, the passengers, and other road users. The DriveABLE assessment was developed at the request of physicians because the diagnostic tests used by the medical community were not developed for, nor do they provide, a sufficient basis for decisions about continued driving when there is cognitive impairment.
Moreover, contrary to Turnbull’s assertion, the DriveABLE assessment is not the result of a grad project. The research, which led to implementation of the DriveABLE assessment in jurisdictions in Canada, the United States, Australia, New Zealand, and Puerto Rico, was conducted over 8 years, and recognized by a national award for research excellence (Alzheimer Society of Canada, 1999 Prix d’Excellence, Claude P. Beaubien—Award of Excellence).
DriveABLE does not provide routine retesting for licence renewal. Drivers with clean driving records and who have no indication of cognitive decline that might impair their ability to drive safely are not referred to DriveABLE.
Contrary to Turnbull’s statements, DriveABLE does not revoke driver licences “on the spot” or at any other time. Issuing and revoking driver licences are done exclusively by the Office of the Superintendent of Motor Vehicles (OSMV) in British Columbia.
The DriveABLE assessment results are recommendations that the OSMV combines with medical and driving-record data to make appropriate decisions about the driving safety of the driver.
Turnbull is especially critical of the memory test used in the DriveABLE in-office assessment. This is curious as none of the subtests are labeled or considered to be a memory test. He also is critical of DriveABLE’s computer testing because “most seniors are totally unfamiliar with computers.”
The in-office assessment is computer-presented, but computer expertise is not relevant. Responses to simple visual test materials are made by pushing a button or touching the touch-sensitive screen. The touch responding is at the same difficultly level as pointing to an X on a piece of paper.
Moreover, the person is not left to be “computer tested.” Instead, an assessor guides the person through each test, providing instructions and practice. The assessor is a medical professional and not a computer clerk.
Turnbull cites the Monash University Accident Research Centre (MUARC) findings as negative evidence for DriveABLE. Instead, those findings emphasize the importance of the extensive research effort that went into the DriveABLE road test, the second part of the DriveABLE assessment. In the MUARC study, the criterion was a government road test.
Government road tests are “rules of the road” tests. Automatic failing errors include errors such as a rolled stop. These errors may be a reason to preclude a novice driver from attaining his or her licence until remedied, but they are not reasons for experienced drivers to lose their licence.
In the research phase of developing the DriveABLE road test, almost 30% of healthy older drivers, and almost as many younger healthy drivers, failed the road test using government scoring. Distinguishing the driving errors that are associated with cognitive competence declines from those that are the bad-habit errors of experienced drivers is essential for defining an appropriate competence criterion.[1]
The MUARC study authors were interested in re-scoring their criterion to include only competence driving errors. Unfortunately, the individual driving errors from their road testing were not saved, disallowing the use of a driving competence criterion.
Predictive accuracy concerning a noncompetence criterion is of questionable utility when evaluating a driving competence testing procedure. The DriveABLE road test scores only driving errors demonstrated[2] to be associated with cognitive competence declines and safety. This protects safe drivers of all ages from being misidentified as unsafe.
The DriveABLE assessment represents a significant advance in assessing the driving competence of cognitively impaired drivers. Results from the DriveABLE in-office assessment and road test allow physicians and the OSMV to make evidence-based decisions about driving competency, preserving driving privileges for those who remain competent to drive, and identifying those who are no longer safe to drive.
—Allen R. Dobbs, PhD
Founder and CSO
DriveABLE Assessment Centres
References
1. Dobbs AR. The development of scientifically based driving assessment and standardization procedures for evaluating medically at-risk drivers. Presented at the 15th Canadian Multidisciplinary Road Safety Conference, Fredericton, NB, 5-8 June 2005. Accessed 9 February 2011. www.carsp.ca/documents/113.
2. Dobbs AR, Heller, RB, Schopflocher, D. A comparative approach to identify unsafe older drivers. Accid Anal Prev 1998;30:363-370.
