Process and Outcomes Evaluation of Older Driver Screening Programs: The Assessment of Driving-Related Skills (ADReS) Older-Driver Screening Tool
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Summary
This study evaluates the effectiveness of the Assessment of Driving-Related Skills (ADReS), a screening tool developed by the American Medical Association for physicians to identify older drivers at risk for unsafe driving. The research addresses the lack of evidence-based, clinically practical tools for physicians to assess driving fitness, aiming to determine if ADReS accurately predicts on-road driving competence. The study compares ADReS results against behind-the-wheel (BTW) driving assessments, considered the criterion standard for determining driving ability. The researchers recruited 120 participants aged 65 to 89 who held valid driver’s licenses and met Florida visual acuity requirements. Participants underwent a telephone interview, a clinical examination including the ADReS battery, and a standardized BTW test. The ADReS assesses vision (visual acuity and field), motor function (range of motion, strength, and Rapid Pace Walk), and cognition (Clock Drawing Test and Trailmaking Test Part B). The BTW test was conducted by a driver rehabilitation specialist on a fixed course ranging from residential areas to interstate highways. Driving performance was rated on a four-point scale: Pass, Pass with Recommendations, Fail but Remediable, and Fail, Not Remediable. For analysis, these ratings were collapsed into "Pass" and "Fail" categories to calculate the sensitivity and specificity of the ADReS. The prevalence of unsafe drivers, defined as those failing the BTW test, was 24.6 percent. The ADReS demonstrated 100 percent sensitivity, correctly identifying all participants who failed the on-road test. However, the tool exhibited low specificity, with only 32.6 percent of the sample correctly identified as not requiring intervention. Consequently, 75.4 percent of participants were flagged for intervention by the ADReS, yet the majority of these individuals passed the BTW test. Specific sub-tests varied in predictive value; for instance, the Rapid Pace Walk and Trails-B showed stronger associations with BTW failure than vision or range of motion tests. The Clock Drawing Test yielded a high false-positive rate, with 60.3 percent of the sample failing the test despite many passing the road test. The findings indicate that while the ADReS is effective at ruling out unsafe drivers (high sensitivity), it is inefficient at predicting who actually needs a driving evaluation due to its low specificity. The high rate of false positives suggests that using the current ADReS criteria would lead to unnecessary referrals and potential premature driving cessation. The authors conclude that the tool requires revision to improve its predictive accuracy and provide physicians with a more effective screening method. Recommendations include refining cut-off scores and potentially replacing or supplementing certain tests, such as the confrontational visual field test and the Clock Drawing Test, with more sensitive measures.
Key finding
The ADReS screening tool achieved 100 percent sensitivity in identifying unsafe drivers but demonstrated low specificity, flagging 32.6 percent of safe drivers for unnecessary intervention.
Methodology
mixed_methods
Sample size: 120
Provenance
The full processing record for this entry. Every stage of this paper's journey through the pipeline is logged — what ran, with which tool and model, how many attempts it took, and when it last completed. Discovered via bulk_ingest_rosap on 2026-05-23 (6 acquisition events logged).
| Stage | Outcome | Tool | Model | Prompt | Attempts | Completed |
|---|---|---|---|---|---|---|
| discover | success | rosap | — | — | 2 | 2026-05-23 |
| archive | success | — | — | — | 1 | 2026-05-23 |
| extract | success | cached | — | — | 2 | 2026-06-10 |
| clean | success | — | — | — | 1 | 2026-06-01 |
| chunk | success | — | — | — | 1 | 2026-06-01 |
| embed | success | — | — | — | 1 | 2026-06-02 |
| enrich | success | — | — | — | 1 | 2026-05-23 |
| promote | success | — | — | — | 1 | 2026-05-23 |
| summarize | success | llm | qwen3.6-27b-prismaquant | summ-v5 | 3 | 2026-06-10 |
| tag | success | vector_similarity | — | — | 19 | 2026-06-11 |
| verify | success | — | — | — | 2 | 2026-06-10 |
Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.
Topics
Ranked by relevance to this paper. Hover a topic for its definition.
- fitness to drive assessment
- older driver retraining
- mci dementia driving
- cognitive impairment
- useful field of view
- licensing policy
Information type
What kind of knowledge this paper contributes, grouped by family — independent of topic (what it is about) and method (how it was studied).
- Methodological Resource: validation psychometrics, measurement protocol, tool software