A large number of studies have tried to assess how various aspects of driver health influence driver involvement in accidents. The objective of this paper is to provide a framework for a critical assessment of the quality these studies from a methodological point of view. Examples are given of how various sources of bias and confounding can produce study findings that are highly misleading. Ten potential sources of error and bias in epidemiological studies of the contribution of driver health impairments to road accidents are discussed. Examples are given of how all these items may influence the findings of a single study or make synthesising findings from multiple studies difficult. A checklist for assessing study quality is provided. (A) Reprinted with permission from Elsevier.
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