TY - JOUR
T1 - Interventions to evaluate fitness to drive among people with chronic conditions: Systematic review of literature
AU - Marino, Marta
AU - De Belvis, Antonio
AU - Basso, Danila
AU - Avolio, Maria
AU - Pelone, Ferruccio
AU - Tanzariello, Maria
AU - Ricciardi, Walter
PY - 2013
Y1 - 2013
N2 - When an health condition has been identified, the question of whether to continue driving depends not
on a medical diagnosis, but on the functional consequences of the illness. The complex nature of physical
and mental impairments and their relationship with safe driving make the availability of evidence based
tools necessary for health professionals.
The review aims at identifying and summarizing scientific findings concerning the relationship
between neuropsychological and clinical screening tests and fitness to drive among people with chronic
conditions.
Studies were searched for driving ability evaluation by road test or simulator, clinical/
neuropsychological examinations of participants with chronic diseases or permanent disablement
impairing driving performance, primary outcomes as fatal/non-fatal traffic injuries and secondary
outcomes as fitness to drive assessment.
Twenty-seven studies fulfilled the inclusion criteria. Some studies included more than one clinical condition.
The illness investigated were Alzheimer Disease (n = 6), Parkinson Disease (n = 8), Cardiovascular
Accident (n = 4), Traumatic Brain Injuries (n = 3), Sleep Apnea Syndrome (n = 2), Narcolepsy (n = 1), Multiple
Sclerosis (n = 1) and Hepatic Encephalopathy (n = 1), comorbidities (n = 3). No studies match inclusion
criteria about Myasthenia Gravis, Diabetes Mellitus, Renal Diseases, Hearing Disorders and Sight Diseases.
No studies referred to primary outcomes.
The selected studies provided opposite evidences. It would be reasonable to argue that some clinical and
neuropsychological tests are effective in predicting fitness to drive even if contrasting results support that
driving performance decreases as a function of clinical and neuropsychological decline in some chronic
diseases. Nevertheless we found no evidence that clinical and neuropsychological screening tests would
lead to a reduction in motor vehicle crashes involving chronic disabled drivers.
It seems necessary to develop tests with proven validity for identifying high-risk drivers so that physicians
can provide guidance to their patients in chronic conditions, and also to medical advisory boards
working with licensing offices
AB - When an health condition has been identified, the question of whether to continue driving depends not
on a medical diagnosis, but on the functional consequences of the illness. The complex nature of physical
and mental impairments and their relationship with safe driving make the availability of evidence based
tools necessary for health professionals.
The review aims at identifying and summarizing scientific findings concerning the relationship
between neuropsychological and clinical screening tests and fitness to drive among people with chronic
conditions.
Studies were searched for driving ability evaluation by road test or simulator, clinical/
neuropsychological examinations of participants with chronic diseases or permanent disablement
impairing driving performance, primary outcomes as fatal/non-fatal traffic injuries and secondary
outcomes as fitness to drive assessment.
Twenty-seven studies fulfilled the inclusion criteria. Some studies included more than one clinical condition.
The illness investigated were Alzheimer Disease (n = 6), Parkinson Disease (n = 8), Cardiovascular
Accident (n = 4), Traumatic Brain Injuries (n = 3), Sleep Apnea Syndrome (n = 2), Narcolepsy (n = 1), Multiple
Sclerosis (n = 1) and Hepatic Encephalopathy (n = 1), comorbidities (n = 3). No studies match inclusion
criteria about Myasthenia Gravis, Diabetes Mellitus, Renal Diseases, Hearing Disorders and Sight Diseases.
No studies referred to primary outcomes.
The selected studies provided opposite evidences. It would be reasonable to argue that some clinical and
neuropsychological tests are effective in predicting fitness to drive even if contrasting results support that
driving performance decreases as a function of clinical and neuropsychological decline in some chronic
diseases. Nevertheless we found no evidence that clinical and neuropsychological screening tests would
lead to a reduction in motor vehicle crashes involving chronic disabled drivers.
It seems necessary to develop tests with proven validity for identifying high-risk drivers so that physicians
can provide guidance to their patients in chronic conditions, and also to medical advisory boards
working with licensing offices
KW - Chronic diseases
KW - Fitness to drive
KW - Chronic diseases
KW - Fitness to drive
UR - http://hdl.handle.net/10807/51292
U2 - 10.1016/j.aap.2012.05.010
DO - 10.1016/j.aap.2012.05.010
M3 - Article
SN - 0001-4575
VL - 50
SP - 377
EP - 396
JO - Accident Analysis and Prevention
JF - Accident Analysis and Prevention
ER -