ArticleJournal of general internal medicine2008
Risks and advantages of detecting individuals unfit to drive: a Markov decision analysis.
Article in Journal of general internal medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Driving assessment for maintaining mobility and safety in drivers with dementia.The Cochrane database of systematic reviews · 2013Pooled it
- A randomized trial to evaluate the effectiveness of an individual, education-based safe transport program for drivers aged 75 years and older.BMC public health · 2013Trial
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany countries have initiated legislation to detect individuals who are unfit to drive, without any evidence that positive effects of these screening procedures outweigh negative effects.
objectiveTo measure the potential effectiveness of a screening program to detect individuals unfit to drive.
designMarkov decision analysis was used to compare no screening to two potential screening strategies.
participantsHypothetical cohorts of 10,000 45-year-old, 65-year-old, 75-year-old and 85-year-old individuals seen in primary care practices.
interventionsWithin the screening strategies: a clinical test without on-road confirmatory testing; a clinical test with on-road confirmatory testing, and an imposed driving cessation for patients with a positive test. MEASUREMENTS: For each strategy, we compared for two conditions (sleep disorders and dementia) the numbers of crash-related consequences prevented and of adverse events induced (primary objective) and measured the gain in quality-adjusted life years (secondary objective).
resultsFor sleep disorders, on-road confirmatory annual testing was the preferred strategy. Whatever the medical condition and age when screening starts, no screening was always better than single-test screening without an on-road confirmatory testing. In sensitivity analyses, these baseline conclusions were only affected by extreme values of test specificity.
conclusionBecause of the expected difficult application and cost of road tests and annual screening by clinicians, the most acceptable strategy from public health, clinical, and individual points of view is likely to be no screening.
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Registered trials
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