2010 BC Guide in Determining Fitness to Drive

Chapter 9:Introduction to the Medical Condition Chapters9.1 Purpose of the medical condition chaptersThe medical condition chapters in this part of the Manual: identify what conditions may have an impact on an individual’s fitnessto drive highlight the risk of impairment and crash associated with certainmedical conditions identify appropriate screening and assessment tools to evaluate fitnessto drive of an individual with a medical condition identify compensation strategies, devices and/or training that may beimplemented to compensate for the effects of a medical condition ondriving, and include guidelines to assist OSMV staff in determining whether anindividual with a medical condition is fit to drive and appropriate reassessmentintervals.9.2 Source of the medical condition chaptersThe medical condition chapters in this Manual are based primarily on theintegrative review of Dr. Bonnie Dobbs and her report Medical Conditionsand Driving: Current Knowledge 2010 (pending). In preparing thatdocument, Dr. Dobbs used a multi-step process to critically evaluate andcompile evidence from a number of sources, including research studies,consensus conference guidelines and expert opinion.The best available evidence for a medical condition depends on how muchresearch has been conducted on that condition and driving and the qualityof the research. Unfortunately, the impact of some medical conditions onthe functions necessary for driving has not been studied or has not beenstudied in depth. A lack of evidence does not mean that the condition hasno impact. Rather, it simply means that the relevant research has not beenconducted. In each medical condition chapter, the evidence associatingthe medical condition with an increased crash risk or an impairment of thefunctions necessary for driving is clearly stated.In general, due to the variability in methodology and variability inoutcome measures and statistical analyses, the evidence supporting arelationship between a medical condition and driving performance is based79