Association of risky driving behavior with psychiatric disorders among Iranian drivers: A case-control study / 中华创伤杂志(英文版)

PURPOSE@#This study aimed to investigate the possible association between psychological disorders and risky driving behavior (RDB) in Iran.@*METHODS@#This case-control study conducted in Shiraz, Iran in 2021. The case group included drivers with psychological disorders and the control group included those without any disorders. The inclusion criteria for selecting patients were: active driving at the time of the study, being 18 - 65 years old, having a driving license, having a psychological disorder including depression, bipolar disorder, anxiety spectrum disorder, or psychotic disorder spectrum confirmed by a psychiatrist, and completing an informed consent form. The exclusion criterion was the existence of conditions that interfered with answering and understanding the questions. The inclusion criteria for selecting the healthy cases were: active driving at the time of the study, being 18 - 65 years old, having a driving license, lack of any past or present history of psychiatric problems, and completing an informed consent form. The data were gathered using a researcher-made checklist and Manchester driving behavior questionnaire. First, partition around medoids method was used to extract clusters of RDB. Then, backward logistic regression was applied to investigate the association between the independent variables and the clusters of RDB.@*RESULTS@#The sample comprised of 344 (153 with psychological disorder and 191 without confirmed psychological disorder) drivers. Backward elimination logistic regression on total data revealed that share of medical expenditure ≤ 10% of total household expenditure (OR = 3.27, 95% CI: 1.48 - 7.24), psychological disorder (OR = 3.08, 95% CI: 1.67 - 5.70), and substance abuse class (OR = 6.38, 95% CI: 3.55 - 11.48) were associated with high level of RDB.@*CONCLUSION@#Substance abuse, psychological illnesses, and share of medical costs from total household expenditure were found to be main predictors of RDB. Further investigations are necessary to explain the impact of different psychological illnesses on driving behavior.

Diagnostic accuracy of rapid ultrasound in shock [RUSH] exam; A systematic review and meta-analysis

Objective: To perform a diagnostic accuracy of the rapid ultrasound in shock [RUSH] to diagnose the etiology of undifferentiated shock in patients presenting to the emergency department [ED]

Methods: We searched the Medline via PubMed, Scopus, and ISI Web of Knowledge till July 2017. Two independent reviewers screened studies for eligibility. Our study analysis is planned in accordance with the guidelines for meta–analysis of diagnostic studies. In the systematic search, of 397 references, 295 were excluded on the basis of the title and abstract. For the remaining 102 articles, the full text was retrieved and critically reviewed. After the selection process, five papers were included

Results: The pooled estimate of all data showed that the RUSH protocol exhibited high sensitivity [0.87, 95% Confidence Interval [CI]: 0.80-0.92, I[2]=46.7%] and specificity [0.98, 95% C. I.: 0.96-0.99, [I]2=30.8%]. The AUC for SROC, a global measure of the RUSH protocol performance, was 0.98+/-0.01, indicates the high accuracy of the test. Positive and negative likelihood ratios reported from the studies ranged from 9.83 to 51.32 and 0.04 to 0.33, respectively. The pooled estimate of all data showed that the RUSH protocol exhibited high positive likelihood ratio [19.19, 95% C. I.: 11.49-32.06, I[2]=14.1%] and low negative likelihood ratio [0.23, 95% C. I.: 0.15-0.34, I[2]=18.4%]

Conclusion: This meta-analysis suggests that RUSH protocol has generally good role to distinguish the states of shock in patients with undifferentiated shock referred to the emergency department