TY  - JOUR
PY  - 2014//
TI  - Canadian epileptologists' counseling of drivers amidst guideline inconsistencies
JO  - Canadian journal of neurological sciences
A1  - Jirsch, Jeffrey
A1  - Gross, Donald W.
A1  - Jetté, Nathalie
A1  - Federico, Paolo
A1  - Dubeau, François
A1  - Téllez-Zenteno, Jose F.
A1  - Pohlmann-Eden, Bernhard
A1  - Burneo, Jorge G.
A1  - McLachlan, Richard
A1  - Ahmed, Syed N.
A1  - Deacon, Charles
A1  - Javidan, Manouchehr
A1  - Nguyen, Dang K.
A1  - Sadler, R. Mark
A1  - Spiller, Allison
A1  - Townsend, Tiffany
A1  - Veilleux, Martin
A1  - Wennberg, Richard A.
A1  - Wiebe, Samuel
A1  - Yankovsky, Alexei
SP  - 413
EP  - 420
VL  - 41
IS  - 4
N2  - BACKGROUND: Epilepsy is a common medical condition for which physicians perform driver fitness assessments. The Canadian Medical association (CMA) and the Canadian Council of Motor Transportation Administrators (CCMTA) publish documents to guide Canadian physicians' driver fitness assessments    OBJECTIVES: We aimed to measure the consistency of driver fitness counseling among epileptologists in Canada, and to determine whether inconsistencies between national guidelines are associated with greater variability in counseling instructions. <br><br>METHODS: We surveyed 35 epileptologists in Canada (response rate 71%) using a questionnaire that explored physicians' philosophies about driver fitness assessments and counseling practices of seizure patients in common clinical scenarios. of the nine scenarios, CCMta and CMa recommendations were concordant for only two. Cumulative agreement for all scenarios was calculated using Kappa statistic. agreement for concordant (two) vs. discordant (seven) scenarios were split at the median and analyzed using the Wilcoxon signed rank sum test. <br><br>RESULTS: overall the agreement between respondents for the clinical scenarios was not acceptable (Kappa=0.28). for the two scenarios where CMa and CCMta guidelines were concordant, specialists had high levels of agreement with recommendations (89% each). a majority of specialists disagreed with CMa recommendations in three of seven discordant scenarios. the lack of consistency in respondents' agreement attained statistical significance (p<0.001). <br><br>CONCLUSIONS: Canadian epileptologists have variable counseling practices about driving, and this may be attributable to inconsistencies between CMA and CCMTA medical fitness guidelines. This study highlights the need to harmonize driving recommendations in order to prevent physician and patient confusion about driving fitness in Canada.<p />  <p>Language: en</p>
LA  - en
SN  - 0317-1671
UR  - http://dx.doi.org/
ID  - ref1
ER  -