Background
Discussion
Criteria for the indication of screening for unsafe driving
Are the consequences of the medical condition on road safety severe enough to move from an individual medical decision making to a systematic screening programme?
Is the potentially unsafe driving period long enough to be detected and to implement an effective early intervention?
Is there a reliable and valid test to detect unsafe driving and predict the risk of collision?
What should be the early intervention for drivers diagnosed unsafe?
Would the proposed screening programme result in more good than harm?
Would the minimal resources required to implement an effective screening programme be acceptable to the society?
Critical analysis of published articles pleading for or against screening
Search and study sampling
Database | Search terms |
---|---|
MEDLINE | "accidents, traffic/prevention and control" |
AND "automobile driver examination" | |
or | |
"accidents, traffic/prevention and control" | |
AND "automobile driving" AND "screening" | |
or | |
"accidents, traffic/prevention and control" | |
AND "automobile driving" AND "mass screening" | |
EMBASE | "automobile driving" AND "screening" |
FRANCIS/PASCAL | "vehicle driving" AND "performance evaluation" |
or | |
"vehicle driving" AND "medical screening" |
Criteria and corresponding indicators | Mentioned | Documented | ||
---|---|---|---|---|
n | % | n | % | |
1. Are the consequences of the medical condition on road safety severe enough?
|
25
|
70
|
14
|
39
|
High prevalence of the medical condition (Is
1
)
| 15 | 42 | 3 | 11 |
High proportion of individuals with medical condition who drive (Is
2
)
| 10 | 28 | 4 | 11 |
High proportion of drivers with medical condition who become unsafe (Is
3
)
| 0 | 0 | 0 | 0 |
Higher risk of collision of unsafe drivers due to medical condition (Is
4
)
| 21 | 58 | 6 | 17 |
Frequency of potential self-regulation strategies (Fms)
| 12 | 33 | 3 | 8 |
2. Is the potentially unsafe driving period defined and long enough?
|
1
|
3
|
0
|
0
|
Definition of a potential unsafe driving period | 0 | 0 | 0 | 0 |
Length of the unsafe driving period | 1 | 3 | 0 | 0 |
3. Is there a reliable and valid test?
|
24
|
67
|
13
|
36
|
Performance of diagnostic test to detect medical conditions (Ip
1
)
| 5 | 14 | 1 | 3 |
Performance of diagnostic test to detect unsafe driving (Ip
2
)
| 18 | 50 | 12 | 33 |
Prediction of collision risk (Ip
3
)
| 14 | 39 | 6 | 17 |
4. What should be the early intervention for drivers diagnosed unsafe?
|
20
|
55
|
15
|
42
|
Nature of intervention | 13 | 36 | 7 | 19 |
Expected positive effects (Ipe)
| 11 | 30 | 7 | 19 |
Expected negative effects (Ine)
| 12 | 33 | 2 | 5 |
5. Would the proposed screening programme result in more good than harm?
|
19
|
53
|
2
|
5
|
6. Would the minimal resources required to implement the screening programme acceptable?
|
8
|
22
|
2
|
5
|