{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T07:18:49Z","timestamp":1789024729998,"version":"build-2803163510"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T00:00:00Z","timestamp":1674086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["PJT-148849"],"award-info":[{"award-number":["PJT-148849"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008002","name":"Vancouver Coastal Health Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000245","name":"Michael Smith Health Research BC","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000245","name":"Michael Smith Health Research BC","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"crossref"}]},{"name":"British Columbia Emergency Medicine Network"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Physicians are often asked to counsel patients about driving safety after syncope, yet little empirical data guides such advice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified a population-based retrospective cohort of 9,507 individuals with a driver license who were discharged from any of six urban emergency departments (EDs) with a diagnosis of \u2019syncope and collapse\u2019. We examined all police-reported crashes that involved a cohort member as a driver and occurred between 1 January 2010 and 31 December 2016. We categorized crash-involved drivers as \u2019responsible\u2019 or \u2019non-responsible\u2019 for their crash using detailed police-reported crash data and a validated responsibility scoring tool. We then used logistic regression to test the hypothesis that recent syncope was associated with driver responsibility for crash.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over the 7-year study interval, cohort members were involved in 475 police-reported crashes: 210 drivers were deemed responsible and 133 drivers were deemed non-responsible for their crash; the 132 drivers deemed to have indeterminate responsibility were excluded from further analysis. An ED visit for syncope occurred in the three months leading up to crash in 11 crash-responsible drivers and in 5 crash-non-responsible drivers, suggesting that recent syncope was not associated with driver responsibility for crash (adjusted odds ratio, 1.31; 95%CI, 0.40\u20134.74; p = 0.67). However, all drivers with cardiac syncope were deemed responsible, precluding calculation of an odds ratio for this important subgroup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Recent syncope was not significantly associated with driver responsibility for traffic crash. Clinicians and policymakers should consider these results when making fitness-to-drive recommendations after syncope.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0279710","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T13:31:45Z","timestamp":1674135105000},"page":"e0279710","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Syncope and subsequent traffic crash: A responsibility analysis"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1397-1503","authenticated-orcid":true,"given":"John A.","family":"Staples","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Erdelyi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketki","family":"Merchant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candace","family":"Yip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayesha","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4147-3544","authenticated-orcid":true,"given":"Donald A.","family":"Redelmeier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey R.","family":"Brubacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,1,19]]},"reference":[{"key":"pone.0279710.ref001","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.ccl.2015.04.014","article-title":"Syncope and driving.","volume":"33","author":"JC Guzman","year":"2015","journal-title":"Cardiol Clin"},{"key":"pone.0279710.ref002","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1093\/eurheartj\/ehl147","article-title":"Vasovagal syncope in medical students and their first-degree relatives","volume":"27","author":"A Serletis","year":"2006","journal-title":"Eur Heart J"},{"issue":"2","key":"pone.0279710.ref003","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1093\/europace\/euu327","article-title":"Syncope recurrence and mortality: a systematic review.","volume":"17","author":"M Solbiati","year":"2014","journal-title":"Europace"},{"issue":"4","key":"pone.0279710.ref004","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1001\/jamainternmed.2015.8617","article-title":"Syncope and the risk of a subsequent motor vehicle crash","volume":"176","author":"DA Redelmeier","year":"2016","journal-title":"JAMA Intern Med"},{"key":"pone.0279710.ref005","article-title":"The contribution of medical conditions to passenger vehicle crashes. Washington","author":"H. Refaat","year":"2009","journal-title":"DC: National Highway Traffic Safety Administration"},{"key":"pone.0279710.ref006","volume-title":"Clinician\u2019s guide to assessing and counseling older drivers","author":"A Pomidor","year":"2016","edition":"3"},{"issue":"2","key":"pone.0279710.ref007","doi-asserted-by":"crossref","first-page":"90","DOI":"10.15420\/aer.2019.13.2","article-title":"A review of driving restrictions in patients at risk of syncope and cardiac arrhythmias associated with sudden incapacity: differing global approaches to regulation and risk.","volume":"8","author":"AD Margulescu","year":"2019","journal-title":"Arrhythm Electrophysiol Rev."},{"issue":"8","key":"pone.0279710.ref008","doi-asserted-by":"crossref","first-page":"e155","DOI":"10.1016\/j.hrthm.2017.03.004","article-title":"2017 ACC\/AHA\/HRS guideline for the evaluation and management of patients with syncope: A report of the American College of Cardiology\/American Heart Association Task Force on Clinical 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Asbridge","year":"2013","journal-title":"Int J Epidemiol"},{"issue":"10","key":"pone.0279710.ref025","doi-asserted-by":"crossref","DOI":"10.1093\/sleep\/zsy144","article-title":"Acute sleep deprivation and culpable motor vehicle crash involvement.","volume":"41","author":"BC Tefft","year":"2018","journal-title":"Sleep"},{"issue":"6","key":"pone.0279710.ref026","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1136\/injuryprev-2020-043989","article-title":"Prescription opioid use among drivers in British Columbia, 1997\u20132016.","volume":"27","author":"JA Staples","journal-title":"Inj Prev2021"},{"issue":"6","key":"pone.0279710.ref027","doi-asserted-by":"crossref","first-page":"e374","DOI":"10.1016\/S2468-2667(21)00027-X","article-title":"Medications and risk of motor vehicle collision responsibility in British Columbia, Canada: a population-based case-control study","volume":"6","author":"JR Brubacher","year":"2021","journal-title":"Lancet Public 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