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Medical screening of older drivers is not evidence based

BMJ 2012; 345 doi: (Published 25 September 2012) Cite this as: BMJ 2012;345:e6371
  1. Desmond O’Neill, consultant physician in geriatric and stroke medicine, Centre for Ageing, Neurosciences and the Humanities, Trinity College, Dublin, Ireland
  1. doneill{at}

Older drivers have an enviable crash record,1 but they also increase traffic safety among other generations: the risk of serious injury to children is halved if driven by grandparents rather than parents.2 Yet the belief that older drivers pose a disproportionate risk to other road users refuses to die. Disappointingly, a recent report from a UK parliamentary charity3 overstates the risk of older drivers and recommends training for them—an unnecessary measure of dubious value.4 Likewise, many jurisdictions demand medical screening of all older drivers5 with the tacit or active acquiescence of the medical profession.

Age related testing of drivers breaks almost every tenet of screening proposed by the World Health Organization. Doctors’ lack of resistance typifies a worrying lack of due diligence given that screening persists in the face of mounting evidence of an association with increased traffic fatalities among older road users.6 7 Multiple factors contribute to this professional lassitude. Traffic medicine is at the periphery of much clinical practice, and …

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