Driving ability in patients with dizziness: a systematic review

Eur Arch Otorhinolaryngol. 2022 Apr;279(4):1813-1829. doi: 10.1007/s00405-021-06881-8. Epub 2021 May 31.

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Dizziness; Driving ability; Driving license; Fitness to drive; Vertigo; Vestibular disorder.

Publication types

  • Systematic Review

MeSH terms

  • Dizziness* / diagnosis
  • Dizziness* / etiology
  • Humans
  • Prospective Studies
  • Self Report
  • Vertigo / diagnosis
  • Vestibular Diseases* / complications
  • Vestibular Diseases* / diagnosis