The Introduction of a New Screening Tool for the Identification of Cognitively Impaired Medically At-Risk Drivers: The SIMARD A Modification of the DemTect
The Introduction of a New Screening Tool for the Identification of Cognitively Impaired Medically At-Risk Drivers: The SIMARD A Modification of the DemTect
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DOI：
10.1177/2150131910369156
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发表时间：
2010-07-01
影响因子：
3.6
通讯作者：
Schopflocher, Donald
中科院分区：
文献类型：
--
作者：
Dobbs, Bonnie M.;Schopflocher, Donald
由于痴呆或其他与年龄相关的疾病而导致认知障碍的驾驶员数量将在未来30年内显着增加。医生能够很好地识别医学上有风险的驱动因素，但由于缺乏有效、易于管理的筛查工具而受到阻碍。这项研究开发并验证了一个简短的筛选工具，用于初级保健环境中，以确定司机与认知障碍与或不痴呆。初始研究参与者：一个队列的146个连续转介从社区为基础的家庭医生，诊断为未分化的认知障碍或痴呆症，以及35个社区居住的健康对照。验证研究：192名连续转诊患者和52名社区居住健康对照者的队列研究。标准测量：通过/未通过道路评价。预测指标：DemTect的子测试，这是Kalbe及其同事开发的认知障碍或痴呆症的筛查测试。1初步研究：三个DemTect指标预测了道路结果（R-2 =.262）。回归结果被用来开发一个简单的评分算法，通过识别那些最有可能失败并通过道路评估的人，以及那些需要驾驶评估以确定驾驶能力的人，来得出临界点。89人得分在不确定范围内，分别有49人和43人预测失败和通过-86%和84%的预测失败和通过的人随后失败和通过。验证研究：123人得分在不确定范围内，分别有66人和55人预测失败和通过-80%和87%的预测失败和通过的人随后失败和通过。结论：SIMRAD A DemTect（识别认知受损的医疗风险驾驶员的筛查）是一种简单的纸笔筛查工具，具有高度的准确性，可用于临床环境中的即时决策。
The number of drivers with a cognitive impairment due to dementia or other age-associated pathologies will increase significantly over the next 3 decades. Physicians are well placed to identify medically at-risk drivers, but are hampered by the lack of a valid, easy to administer screening tool. This research develops and validates a brief screening tool for use in the primary care setting to identify drivers with cognitive impairment with or without dementia. Initial Study Participants: A cohort of 146 consecutive referrals from community-based family physicians, diagnosed with an undifferentiated cognitive impairment or dementia, as well as 35 community dwelling healthy controls. Validation Study: A cohort of 192 consecutive referrals carrying the same diagnosis as above and 52 community dwelling healthy controls. Criterion Measure: Pass/fail on an On-Road evaluation. Predictor Measures: Subtests of the DemTect, a screening test for cognitive impairment or dementia developed by Kalbe and colleagues. 1 Initial Study: Three of the DemTect measures predicted On-Road outcomes (R-2 =.262). Regression results were used to develop a simple scoring algorithm, with cut-points then derived by identifying those most at risk for failing and passing the On-Road assessment, and those needing a driving assessment for determination of driving competency. 89 individuals scored in the indeterminate range, with 49 and 43 predicted to fail and pass, respectively-86% and 84% of those predicted to fail and pass did subsequently fail and pass. Validation Study: 123 individuals scored in the indeterminate range, with 66 and 55 predicted to fail and pass, respectively-80% and 87% of those predicted to fail and pass did subsequently fail and pass. Conclusions: The SIMARD A Modification of the DemTect (Screen for the Identification of cognitively impaired Medically At-Risk Drivers) is a brief paper and pencil screening tool with a high degree of accuracy that can be used for immediate decisions in the clinical setting.