Older driver testing holy grail: has it been found?
The holy grail of older driver testing has been waiting to be found by a road safety Sir Galahad for a long time, but do we really need it?THROUGHOUT the developed world, older driver testing takes the form of a medical test, except in New South Wales, where from age 85 drivers need to pass not only a medical test but also a road test.
CPSA thinks that road testing serves no conceivable purpose other than push older NSW drivers off Australian roads, in NSW but also in all other states and territories.
CPSA has always supported age-based medical testing to establish suitability to drive. However, that support comes with the realisation that medical tests to determine driver ability are complex.
What do doctors think?
And CPSA is not alone. There’s a special Medicare Benefit for it, but GPs as a rule would rather have nothing to do with older driver medical testing. A fifteen-minute consultation is unlikely to be thorough and fair. A quick test is inappropriate, given the impact of any decision to disqualify someone from driving a car for the rest of their life.
As Ipswich GP and University of Queensland emeritus professor Geoff Mitchell told the ABC, doctors rely on “blunt instruments”, like basic memory tests, when signing off on people’s fitness to hold a driver’s licence.
“There is a real dilemma of determining when that line has been crossed,” he said.
“[A memory test is] good at picking out really severely unwell people, but it’s not very good at testing judgement.
“You have to make a call based on their physical appearance — how quickly they walk into the surgery — and how sharp they are.”
In other words, GPs realise that they are generally not properly equipped to rule on someone’s suitability to get behind the steering wheel of a car. Unless obvious, cognitive decline and vision impairment require a specialist’s diagnosis.
The reality of current testing
In the absence of a generally available older driver testing capability involving gerontologists, ophthalmologists and specialised occupational therapists, any medical and on-road older driver testing is a hit-and-miss proposition.
For decades, road safety experts have been saying that on-road testing of older people does not have any effect on road safety casualty statistics.
Current medical testing may get a few obvious diehard cases of older drivers with dementia or poor vision off the road, but in the main it appears to be ineffective.
Is video-based testing the answer?
Given that medical and on-road older driver testing in their current forms range from dubious to ineffective, what about the efforts by academics to come up with a cheap alternative for mass-testing of older drivers through computer applications?
Earlier this year, CPSA News wrote positively about the University of Queensland initiative to develop video-based driver safety tests for use by GPs. However and in spite of what we wrote, the question is: is a video-based test using a simulator going to be any better than cursory medical tests by GPs and on-road tests at picking out older drivers who shouldn’t be on the road?
Would these video-based tests be any more than a sop to public opinion, which holds, against all available evidence, that we must test older drivers come hell or high water?
Isn’t a video-based test anything more than a simulated road test?
“We favoured measuring hazard perception response time by using a video-based test rather than an on-road assessment because hazards are relatively infrequent events; participants would have to drive for many hours to encounter the number of hazards that can be presented in a few minutes on a video, and video-based simulation allows for a much higher degree of experimental control than is possible in the real world”.
So, a video-based simulated road test packs in hazard after hazard, unlike a drive to and from the shopping centre. Sounds pretty stressful and unrealistic. It doesn’t sound like a test to determine if an older driver is fit to drive in normal conditions.
A computer video-based older driver test in a simulator could well be at least as inappropriate as the NSW on-road test, which is ineffective according to academic consensus.
Holy grail of older driver testing
A senior road safety researcher once referred to finding an effective older driver test as a search for the holy grail of road safety.
However, thus far the only meaningful way to test an older person’s driver ability is to refer them to a gerontologist, ophthalmologist or a specialised occupational therapist for examination.
Obviously, it would be prohibitively expensive to refer every person over 75 for an examination by a specialist health professional.
Meaningful testing may not be a matter for a road safety researcher with the qualities of a Sir Galahad finding the holy grail of older driver testing.
The question really is if the normal processes to get dangerous drivers of any age off the road aren’t as adequate for older drivers as they are for younger drivers?
Demerit points systems and disqualifications by police or the courts are deemed adequate for people under 75.
Why not for people 75 and over?
It wouldn’t be because of blatant age-discrimination, would it?
THROUGHOUT the developed world, older driver testing takes the form of a medical test, except in New South Wales, where from age 85 drivers need to pass not only a medical test but also a road test.
CPSA thinks that road testing serves no conceivable purpose other than push older NSW drivers off Australian roads, in NSW but also in all other states and territories.
CPSA has always supported age-based medical testing to establish suitability to drive. However, that support comes with the realisation that medical tests to determine driver ability are complex.
What do doctors think?
And CPSA is not alone. There’s a special Medicare Benefit for it, but GPs as a rule would rather have nothing to do with older driver medical testing. A fifteen-minute consultation is unlikely to be thorough and fair. A quick test is inappropriate, given the impact of any decision to disqualify someone from driving a car for the rest of their life.
As Ipswich GP and University of Queensland emeritus professor Geoff Mitchell told the ABC, doctors rely on “blunt instruments”, like basic memory tests, when signing off on people’s fitness to hold a driver’s licence.
“There is a real dilemma of determining when that line has been crossed,” he said.
“[A memory test is] good at picking out really severely unwell people, but it’s not very good at testing judgement.
“You have to make a call based on their physical appearance — how quickly they walk into the surgery — and how sharp they are.”
In other words, GPs realise that they are generally not properly equipped to rule on someone’s suitability to get behind the steering wheel of a car. Unless obvious, cognitive decline and vision impairment require a specialist’s diagnosis.
The reality of current testing
In the absence of a generally available older driver testing capability involving gerontologists, ophthalmologists and specialised occupational therapists, any medical and on-road older driver testing is a hit-and-miss proposition.
For decades, road safety experts have been saying that on-road testing of older people does not have any effect on road safety casualty statistics.
Current medical testing may get a few obvious diehard cases of older drivers with dementia or poor vision off the road, but in the main it appears to be ineffective.
Is video-based testing the answer?
Given that medical and on-road older driver testing in their current forms range from dubious to ineffective, what about the efforts by academics to come up with a cheap alternative for mass-testing of older drivers through computer applications?
Earlier this year, CPSA News wrote positively about the University of Queensland initiative to develop video-based driver safety tests for use by GPs. However and in spite of what we wrote, the question is: is a video-based test using a simulator going to be any better than cursory medical tests by GPs and on-road tests at picking out older drivers who shouldn’t be on the road?
Would these video-based tests be any more than a sop to public opinion, which holds, against all available evidence, that we must test older drivers come hell or high water?
Isn’t a video-based test anything more than a simulated road test?
“We favoured measuring hazard perception response time by using a video-based test rather than an on-road assessment because hazards are relatively infrequent events; participants would have to drive for many hours to encounter the number of hazards that can be presented in a few minutes on a video, and video-based simulation allows for a much higher degree of experimental control than is possible in the real world”.
So, a video-based simulated road test packs in hazard after hazard, unlike a drive to and from the shopping centre. Sounds pretty stressful and unrealistic. It doesn’t sound like a test to determine if an older driver is fit to drive in normal conditions.
A computer video-based older driver test in a simulator could well be at least as inappropriate as the NSW on-road test, which is ineffective according to academic consensus.
Holy grail of older driver testing
A senior road safety researcher once referred to finding an effective older driver test as a search for the holy grail of road safety.
However, thus far the only meaningful way to test an older person’s driver ability is to refer them to a gerontologist, ophthalmologist or a specialised occupational therapist for examination.
Obviously, it would be prohibitively expensive to refer every person over 75 for an examination by a specialist health professional.
Meaningful testing may not be a matter for a road safety researcher with the qualities of a Sir Galahad finding the holy grail of older driver testing.
The question really is if the normal processes to get dangerous drivers of any age off the road aren’t as adequate for older drivers as they are for younger drivers?
Demerit points systems and disqualifications by police or the courts are deemed adequate for people under 75.
Why not for people 75 and over?
It wouldn’t be because of blatant age-discrimination, would it?
