What is the motor vehicle crash risk for drivers with epilepsy? A systematic review

Sjaan Koppel; Marilyn Di Stefano; Bleydy Dimech-Betancourt; Mohammed Aburumman; Rachel Osborne; Sujanie Peiris; Gabrielle Williams; Aaron McInnes; Amanda Stephens; Morris Odell; Peteris Darzins; Patrick Carney; Mark Cook; Samuel F. Berkovic; Mark J. Rapoport; Jamie Dow; Des O'Neill; Judith L. Charlton

doi:10.1016/j.jth.2021.101286

What is the motor vehicle crash risk for drivers with epilepsy? A systematic review

Sjaan Koppel, Marilyn Di Stefano, Bleydy Dimech-Betancourt, Mohammed Aburumman, Rachel Osborne, Sujanie Peiris, Gabrielle Williams, Aaron McInnes, Amanda Stephens, Morris Odell, Peteris Darzins, Patrick Carney, Mark Cook, Samuel F. Berkovic, Mark J. Rapoport, Jamie Dow, Des O'Neill, Judith L. Charlton

Research output: Contribution to journal › Review Article › Research › peer-review

4 Citations (Scopus)

Abstract

Objectives: To establish the crash risk for drivers with epilepsy and quantify any impacts on on-road driving performance. Methods: A systematic search of public health-, psychology-, and transport-databases was conducted. This systematic review was registered with PROSPERO (see CRD42019129664). The quality of evidence for each study was rated using the National Heart, Lung and Blood Institute Quality Assessment tools. Results: Twenty-three studies using various designs published between 1961 and 2017 met the inclusion criteria (n = 18 rated ‘good’ or ‘fair’). Of these 18 studies, only 11 (case-control: n = 2; cohort: n = 8; cross-sectional: n = 1) specifically addressed crash risk for drivers with epilepsy, with five reporting evidence for increased crash risk, (n = 3 rated ‘good), three reporting evidence no difference in crash risk relative to controls (n = 2 rated ‘good’), and three reporting inconclusive evidence (n = 1 rated ‘good’. The remaining seven studies examined crash responsibility, injury severity, anti epileptic medicine, seizure-free intervals, and the influence of auras for drivers with epilepsy. No studies investigated the impacts of epilepsy on on-road driving performance. Significance: There is evidence for a slight elevation of risk for drivers with epilepsy. Generalisability is limited by lack of controlling for confounds and wide time period over which medical treatment and licensing authority requirements applied. Development of consensus based medical and licensing standards taking these findings into account.

Original language	English
Article number	101286
Number of pages	20
Journal	Journal of Transport & Health
Volume	23
DOIs	https://doi.org/10.1016/j.jth.2021.101286
Publication status	Published - Dec 2021

Keywords

Crash risk
Epilepsy
Fitness-to-drive
Road safety
Seizure disorder

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jth.2021.101286

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Koppel, S., Di Stefano, M., Dimech-Betancourt, B., Aburumman, M., Osborne, R., Peiris, S., Williams, G., McInnes, A., Stephens, A., Odell, M., Darzins, P., Carney, P., Cook, M., Berkovic, S. F., Rapoport, M. J., Dow, J., O'Neill, D., & Charlton, J. L. (2021). What is the motor vehicle crash risk for drivers with epilepsy? A systematic review. Journal of Transport & Health, 23, Article 101286. https://doi.org/10.1016/j.jth.2021.101286

@article{665717f70d6840ce96e28bf4e5e82129,

title = "What is the motor vehicle crash risk for drivers with epilepsy? A systematic review",

abstract = "Objectives: To establish the crash risk for drivers with epilepsy and quantify any impacts on on-road driving performance. Methods: A systematic search of public health-, psychology-, and transport-databases was conducted. This systematic review was registered with PROSPERO (see CRD42019129664). The quality of evidence for each study was rated using the National Heart, Lung and Blood Institute Quality Assessment tools. Results: Twenty-three studies using various designs published between 1961 and 2017 met the inclusion criteria (n = 18 rated {\textquoteleft}good{\textquoteright} or {\textquoteleft}fair{\textquoteright}). Of these 18 studies, only 11 (case-control: n = 2; cohort: n = 8; cross-sectional: n = 1) specifically addressed crash risk for drivers with epilepsy, with five reporting evidence for increased crash risk, (n = 3 rated {\textquoteleft}good), three reporting evidence no difference in crash risk relative to controls (n = 2 rated {\textquoteleft}good{\textquoteright}), and three reporting inconclusive evidence (n = 1 rated {\textquoteleft}good{\textquoteright}. The remaining seven studies examined crash responsibility, injury severity, anti epileptic medicine, seizure-free intervals, and the influence of auras for drivers with epilepsy. No studies investigated the impacts of epilepsy on on-road driving performance. Significance: There is evidence for a slight elevation of risk for drivers with epilepsy. Generalisability is limited by lack of controlling for confounds and wide time period over which medical treatment and licensing authority requirements applied. Development of consensus based medical and licensing standards taking these findings into account.",

keywords = "Crash risk, Epilepsy, Fitness-to-drive, Road safety, Seizure disorder",

author = "Sjaan Koppel and {Di Stefano}, Marilyn and Bleydy Dimech-Betancourt and Mohammed Aburumman and Rachel Osborne and Sujanie Peiris and Gabrielle Williams and Aaron McInnes and Amanda Stephens and Morris Odell and Peteris Darzins and Patrick Carney and Mark Cook and Berkovic, {Samuel F.} and Rapoport, {Mark J.} and Jamie Dow and Des O'Neill and Charlton, {Judith L.}",

note = "Funding Information: This review was funded by Road Safety Victoria, Department of Transport (Victoria, Australia) . Publisher Copyright: {\textcopyright} 2021 Elsevier Ltd",

year = "2021",

month = dec,

doi = "10.1016/j.jth.2021.101286",

language = "English",

volume = "23",

journal = "Journal of Transport & Health",

issn = "2214-1405",

publisher = "Elsevier BV",

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Koppel, S, Di Stefano, M, Dimech-Betancourt, B, Aburumman, M, Osborne, R, Peiris, S, Williams, G, McInnes, A, Stephens, A, Odell, M, Darzins, P, Carney, P, Cook, M, Berkovic, SF, Rapoport, MJ, Dow, J, O'Neill, D & Charlton, JL 2021, 'What is the motor vehicle crash risk for drivers with epilepsy? A systematic review', Journal of Transport & Health, vol. 23, 101286. https://doi.org/10.1016/j.jth.2021.101286

TY - JOUR

T1 - What is the motor vehicle crash risk for drivers with epilepsy? A systematic review

AU - Koppel, Sjaan

AU - Di Stefano, Marilyn

AU - Dimech-Betancourt, Bleydy

AU - Aburumman, Mohammed

AU - Osborne, Rachel

AU - Peiris, Sujanie

AU - Williams, Gabrielle

AU - McInnes, Aaron

AU - Stephens, Amanda

AU - Odell, Morris

AU - Darzins, Peteris

AU - Carney, Patrick

AU - Cook, Mark

AU - Berkovic, Samuel F.

AU - Rapoport, Mark J.

AU - Dow, Jamie

AU - O'Neill, Des

AU - Charlton, Judith L.

PY - 2021/12

Y1 - 2021/12

N2 - Objectives: To establish the crash risk for drivers with epilepsy and quantify any impacts on on-road driving performance. Methods: A systematic search of public health-, psychology-, and transport-databases was conducted. This systematic review was registered with PROSPERO (see CRD42019129664). The quality of evidence for each study was rated using the National Heart, Lung and Blood Institute Quality Assessment tools. Results: Twenty-three studies using various designs published between 1961 and 2017 met the inclusion criteria (n = 18 rated ‘good’ or ‘fair’). Of these 18 studies, only 11 (case-control: n = 2; cohort: n = 8; cross-sectional: n = 1) specifically addressed crash risk for drivers with epilepsy, with five reporting evidence for increased crash risk, (n = 3 rated ‘good), three reporting evidence no difference in crash risk relative to controls (n = 2 rated ‘good’), and three reporting inconclusive evidence (n = 1 rated ‘good’. The remaining seven studies examined crash responsibility, injury severity, anti epileptic medicine, seizure-free intervals, and the influence of auras for drivers with epilepsy. No studies investigated the impacts of epilepsy on on-road driving performance. Significance: There is evidence for a slight elevation of risk for drivers with epilepsy. Generalisability is limited by lack of controlling for confounds and wide time period over which medical treatment and licensing authority requirements applied. Development of consensus based medical and licensing standards taking these findings into account.

AB - Objectives: To establish the crash risk for drivers with epilepsy and quantify any impacts on on-road driving performance. Methods: A systematic search of public health-, psychology-, and transport-databases was conducted. This systematic review was registered with PROSPERO (see CRD42019129664). The quality of evidence for each study was rated using the National Heart, Lung and Blood Institute Quality Assessment tools. Results: Twenty-three studies using various designs published between 1961 and 2017 met the inclusion criteria (n = 18 rated ‘good’ or ‘fair’). Of these 18 studies, only 11 (case-control: n = 2; cohort: n = 8; cross-sectional: n = 1) specifically addressed crash risk for drivers with epilepsy, with five reporting evidence for increased crash risk, (n = 3 rated ‘good), three reporting evidence no difference in crash risk relative to controls (n = 2 rated ‘good’), and three reporting inconclusive evidence (n = 1 rated ‘good’. The remaining seven studies examined crash responsibility, injury severity, anti epileptic medicine, seizure-free intervals, and the influence of auras for drivers with epilepsy. No studies investigated the impacts of epilepsy on on-road driving performance. Significance: There is evidence for a slight elevation of risk for drivers with epilepsy. Generalisability is limited by lack of controlling for confounds and wide time period over which medical treatment and licensing authority requirements applied. Development of consensus based medical and licensing standards taking these findings into account.

KW - Crash risk

KW - Epilepsy

KW - Fitness-to-drive

KW - Road safety

KW - Seizure disorder

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DO - 10.1016/j.jth.2021.101286

M3 - Review Article

AN - SCOPUS:85118848914

SN - 2214-1405

VL - 23

JO - Journal of Transport & Health

JF - Journal of Transport & Health

M1 - 101286

ER -

What is the motor vehicle crash risk for drivers with epilepsy? A systematic review

Abstract

Keywords

UN SDGs

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