Parnes L S, Sindwani R
Department of Otolaryngology, University of Western Ontario, London, Canada.
Am J Otol. 1997 Jan;18(1):79-85.
Legislation for reporting unfit-to-drive patients by physicians varies dramatically among U.S. states and Canadian provinces. The impact of vestibular disease on driving safety is not well described in the literature.
(1) to learn more about the critical issues and current practices of neurotologists regarding reporting of vestibular patients and (2) to make recommendations for reporting patients with vestibular disorders.
A mailed census of members of the American Neurotology Society using a questionnaire based on a modified Dillman Total Design Survey Method.
Most respondents are aware of the potential safety risks of patients who drive with vestibular diseases, most notably those with Tumarkins' attacks. Although many have counselled patients (94%) and considered reporting vestibular patients (75%), few actually have (14%). There was no consensus of opinion on a method of reporting unfit-to-drive patients. Only 18.9% of respondents supported mandatory physician reporting. Respondents who live in states where reporting is not mandatory and who are aware of this fact are (a) more satisfied with their state's legislation (chi 2 = 60.1, p = 0.001) and (b) less likely to report patients who they consider unfit-to-drive (chi 2 = 10.6, p = 0.03).
In that there is no general consensus amongst respondents and the relative safety risks seem low in comparison to other disorders, at present we do not advocate mandatory reporting of patients with vestibular disorders.
美国各州和加拿大各省在医生报告不适合驾驶的患者方面的立法差异很大。前庭疾病对驾驶安全的影响在文献中并未得到充分描述。
（1）更多地了解神经耳科医生在报告前庭疾病患者方面的关键问题和当前做法；（2）为报告前庭疾病患者提出建议。
采用基于改良迪尔曼全面设计调查方法的问卷对美国神经耳科学会成员进行邮寄普查。
大多数受访者意识到患有前庭疾病的患者驾车存在潜在安全风险，尤其是那些患有图尔马克斯发作的患者。虽然许多人曾向患者提供过咨询（94%）并考虑报告前庭疾病患者（75%），但实际报告的人很少（14%）。对于报告不适合驾驶患者的方法没有达成共识。只有18.9%的受访者支持医生强制报告。居住在报告非强制性州且知晓这一情况的受访者：（a）对本州立法更满意（卡方检验=60.1，p = 0.001）；（b）报告他们认为不适合驾驶患者的可能性较小（卡方检验=10.6，p = 0.03）。
由于受访者之间没有普遍共识，且与其他疾病相比，相对安全风险似乎较低，目前我们不主张强制报告前庭疾病患者。
