Rethinking Seizure Care Blog

Epilepsy and Being Fit to Drive: A New Model

Posted by RSC Diagnostics on Jul 2, 2019

Smiling woman sitting at the wheel of her new car at new car showroom

Being able to drive is a point of contention among many who suffer from epilepsy. There is the allure of the freedom that being able to drive and having a vehicle of your own can provide. However, there is also a huge risk involved when it comes to epilepsy patients getting behind the wheel of a vehicle. If a patient suffers from a seizure when they are driving, there is a huge risk to them, the passengers and anyone else who is on the road near them. There are often issues that occur between the patients and the doctors that are supposed to determine whether they are able to drive or not, as well.

Typically, the patient’s doctor will be partially responsible for helping to determine whether a patient should be able to drive or not. The doctor knows the medical history of the patient and they know the last time that the patient suffered a seizure. They should be a good judge of how safe it will be for the patient to get behind the wheel. Ideally, a doctor would be able to provide objective clinical information to the authorities that issue driver’s licenses in the area. They make their decision based on national standards.

However, this can sometimes cause damage to the relationship between the patient and the doctor. It can also lead to some unsafe decisions when a doctor wants to make a patient happy and it exposes the doctor to greater legal liability. A recent study looked at the feasibility of using a decision tree as a method to determine fitness to drive based on standards in Australia.

What Methods Were Used for the Study?

The researchers created a decision tree that utilized clinical data as a means to determine if a patient could meet the national standards that are currently in place to drive an automobile in Australia. The use of the tree could determine whether the patient failed to meet the requirements or if there needed to be an additional assessment to come to a decision.

The form was designed to collect all of the needed clinical data from the patient’s primary physician. They then created a computerized version of the decision tree, which was used in a pilot study in two Australian states. They were used in parallel with the certification system that already existed in the state. During the study, they found that 439 drivers “declared epilepsy and their treating physicians were invited to participate when their annual driver's license review was due.”

What Were the Results?

Out of the aforementioned drivers, 253 of the forms were returned. All of these patients were determined to be fit to drive by their physician. Out of this number, 76% of the patients had not had a seizure in more than two years. There were agreements between the decision tree and the treating physician in 88.1% of the cases. There were 3.6% of the cases that were determined by the tree to require review. In addition, there were 6.3% of patients who were determined fine to drive by their doctors, but who did not meet the national standards to be behind the wheel.

Making the Roads Safer?

The implementation of this decision tree in these jurisdictions, and hopefully other jurisdictions in the future, it not about suspending a person’s privilege to drive. It’s about making sure that the roads are as safe as possible. With the success of the pilot study, it should be possible to adapt the decision tree to work for other countries and requirements. This can provide a standardized means of improving road safety.

 

Sources: https://www.cureepilepsy.org/news/improving-road-safety-by-using-a-new-model-to-determine-fitness-to-drive-in-epilepsy/

Topics: Driving and Epilepsy