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The Pre-Registry Commercial Driver Medical Examination: Screening Sensitivity and Certification Lengths for Two
Stephen Vincent Burks1, Jon Eugene Anderson, Bibhudutta Panda
1Division of Social Science, University of Minnesota Morris (UMN Morris) (Burks, Panda, R Haider, Shi, Li, Cagle, Sun, Zaharick), Institute of Labor Economics (IZA), Bonn, DE (Burks), Region Five Roadway Safety Institute, University of Minnesota Twin Cities (Burks), Division of Science and Math, University of Minnesota Morris (UMN Morris) (Anderson, HS Haider, Ostroushko), Virginia Tech Transportation Institute, Blacksburg, Virginia (Hickman, Mabry), Precision Pulmonary Diagnostics, Houston, Texas (Berger), Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts (Czeisler), Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts (Czeisler, Kales), Department of Environmental & Occupational Medicine & Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts (Kales) and Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts (Kales).
Objective:
Use independent diagnostic data to analyze the screening effectiveness of the pre-Registry commercial driver medical examination (CDME) for obstructive sleep apnea (OSA), and its sensitivity for hypertension; analyze certification lengths where relevant.
Methods:
CDME screening results for 1668 drivers were compared to polysomnogram diagnostic test results, and CDME screening results were evaluated for 1155 drivers with at least one insurance claim with a hypertension diagnostic code. Any CDME documentation of the medical condition was considered as detection by screening.
Results:
CDME sensitivity was 20.7% for moderate OSA (AHI ≥ 15). While sensitivity was 77.5% for hypertension, 93.3% of drivers with Stage 3 hypertension were certified, contrary to Federal Motor Carrier Safety Administration standards.
Conclusions:
The pre-Registry CDME was ineffective in screening commercial drivers for OSA. Screening was better for hypertension; incorrect certifications were given to many hypertensive drivers.
