| Popis: |
The Driver and Vehicle Licensing Agency (DVLA) relies on self-declaration of a relevant medical condition, such as insulin-treated diabetes, in determining medical fitness for licensing Group 1 (car or motorcycle) drivers. Problems such as severe hypoglycaemia (requiring the assistance of another person) may lead to revocation of the licence, but may not always be reported. The aim of the present study was to assess the sensitivity and accuracy of medical self-declaration in drivers who had insulin-treated diabetes of long duration. The study took place in 2007–08, involving 2779 drivers who had insulin-treated diabetes for 15 years or more when applying to renew their Group 1 licence. The driver's self-declaration was compared with the assessment made independently by their doctor as a medical report. Responses were analysed to assess risk of severe hypoglycaemia and presence of impaired awareness of hypoglycaemia (IAH); the accuracy and sensitivity of self-declarations were evaluated. Overall, self-declarations of 293 drivers (10.5%) were inconsistent with their doctors' reporting of recorded episodes of severe hypoglycaemia or IAH. This inconsistency was greatest in those treated with insulin for 20 years or more and in older drivers aged over 49 years. Detailed examination of these 293 cases with inconsistent declarations resulted in 25 drivers (8.5% of this subgroup) being refused a licence. One in 10 drivers with insulin-treated diabetes of long duration (10.5%) had returned inaccurate self-reports, resulting in 25 (8.5% of this group) having their licence refused. This resulted in a review of the process of licence renewal for those with insulin-treated diabetes. Copyright © 2012 John Wiley & Sons. |
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