Departments of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium.
Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Eur Arch Otorhinolaryngol. 2022 Apr;279(4):1813-1829. doi: 10.1007/s00405-021-06881-8. Epub 2021 May 31.
The aim of this systematic review was to identify and evaluate studies dealing with driving performance of dizzy patients or patients with a vestibular disorder.
A systematic review was performed according to the preferred reporting items for systematic reviews and meta-analysis guidelines. (1) PubMed, Embase, and Cochrane library. (2) Study selection: articles about driving ability and reported driving difficulties in patients with dizziness, or a diagnosed vestibular disorder, were included. (3) Data extraction was performed by two independent authors using predefined data fields: patient's characteristics, diagnostic criteria, sample size, and type of evaluation of driving ability and outcome of the study.
Eight out of 705 articles matched the inclusion criteria but varied widely regarding the study population, study design, and outcome measures. The majority of studies reported a negative impact of dizziness and/or vestibular disorders on self-reported driving ability and car accidents. Yet several studies could not identify any impairment of driving ability.
Driving ability was negatively affected by dizziness or a vestibular disorder in the majority of included studies with low risk of bias. This systematic review revealed a significant heterogeneity in studies reporting driving performance and contradictory results. We were, therefore, unable to identify a causal relationship between dizziness and driving ability. There is a need for prospective studies in populations with different vestibular disorders using subjective and objective outcome measures that have been validated to evaluate driving performance.
本系统评价的目的是识别和评估与头晕患者或前庭障碍患者驾驶表现相关的研究。
根据系统评价和荟萃分析报告的首选条目进行了系统评价。（1）PubMed、Embase 和 Cochrane 图书馆。（2）研究选择：纳入了关于驾驶能力以及头晕患者或诊断为前庭障碍患者报告的驾驶困难的文章。（3）两名独立作者使用预定义的数据字段进行数据提取：患者特征、诊断标准、样本量以及驾驶能力评估类型和研究结果。
在 705 篇文章中，有 8 篇符合纳入标准，但在研究人群、研究设计和结果测量方面差异很大。大多数研究报告称头晕和/或前庭障碍对自我报告的驾驶能力和车祸有负面影响。然而，一些研究并未发现任何驾驶能力的损害。
在纳入的研究中，大多数研究都发现头晕或前庭障碍对驾驶能力有负面影响，这些研究的偏倚风险较低。本系统评价显示，报告驾驶表现的研究存在显著的异质性和相互矛盾的结果。因此，我们无法确定头晕与驾驶能力之间存在因果关系。需要使用经过验证的主观和客观结局指标，针对具有不同前庭障碍的人群开展前瞻性研究，以评估驾驶表现。
