Arrhythmias & electrophysiology
Predicting the risk of motor vehicle crash in the first year after cardioverter-defibrillator implantation
Authors' conclusion
Crash prediction models based on health and driving data had a limited ability to distinguish individuals who subsequently crashed from individuals who did not. Observed crash risks are likely to be strongly influenced by unobserved changes in road exposure (the hours or miles of driving per week), limiting the application of these risk scores by clinicians and policy-makers.
Study context
- Population
- Licensed drivers in British Columbia, Canada, with a first implantable cardioverter-defibrillator (ICD) implantation between 1998 and 2018ICD recipients analysed, by ICD indication · Primary prevention ICD recipients 3,652 · Secondary prevention ICD recipients 3,408Events: 352 crashes among 3652 primary prevention ICD recipients and 270 crashes among 3408 secondary prevention ICD recipients
- Predictors
- Baseline health and driving data
- Predicted outcome
- Motor vehicle crash in the first year after ICD implantation (1-year crash risk)
Methodological details22 years of population-based administrative data, stratified by ICD indication (primary vs secondary prevention of sudden cardiac death), optimism-corrected discrimination and calibration using 200 bootstrapped samples
- 22 years of population-based administrative data
- Stratified by ICD indication (primary vs secondary prevention of sudden cardiac death)
- Optimism-corrected discrimination and calibration using 200 bootstrapped samples
Model performance
As reported in the abstract
C-statistic
Primary prevention ICD recipients
0.60
Secondary prevention ICD recipients
0.61
| Test or model | Calibration slope |
|---|---|
| Primary prevention ICD recipients | 1.14 |
| Secondary prevention ICD recipients | 1.07 |
Calibration slope
Primary prevention ICD recipients1.14
Secondary prevention ICD recipients1.07
Further findings
Strongest predictors of crash, primary prevention ICD recipients
- Male sex, active vehicle insurance in the past year and the number of crashes in the past year
Strongest predictors of crash, secondary prevention ICD recipients
- Male sex, no history of seizure, an active prescription for opioids and active vehicle insurance in the past year
Original publication
Predicting the risk of motor vehicle crash in the first year after cardioverter-defibrillator implantation. Heart. Published 24 June 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →