winders

This is stupid logic. Minimum standards aren't something that are fluid. Minimum standards are supposed to be reasonable. In other words, you would not set a minimum standard so low as to require case by case investigation to determine if a higher standard should be applied. That would be no standard at all. The whole point of a minimum standard is to avoid moving targets.

Minimum standards certainly can be revisited and revised if data showed they are inadequate. This would not be an arbitrary process applied to some people and not others.

At this point, since logical arguments have failed, I am not sure what there is but legalistic arguments.

LuigiVampa

+1

2022 GTC6 Champion; 2023 GTC6 Runner-up

Wow, imagine if I wasn't driving impaired!

Manifold

It should not be about arguments at all, the parties should be pragmatic and reasonable, check their egos, compromise, and resolve this.

In saying that, I'm generally laying the blame for not doing that on the PCA side, though if were in Luigi's shoes I would have just given whatever CPAP data I had and let the good doctor feel that he won the fight. I don't see much value in letting this little fight escalate into a battle and now bordering on becoming a war.

thebishman

Interesting your last paragraph.

I was looking at some Medical Articles yesterday including one from the NIH that was discussing the effects of cessation of CPAP usage in a person with chronic OSA. In fact it was a Randomised Clinical Trial where some individuals were continued on their CPAP device for 1-2 weeks, whereas others were continued on a ‘Sham’ CPAP device, hence whilst by appearance they were being treated, they weren’t.

Noted during the 1-2 week study was that whilst there were almost immediate consequences of not using CPAP even within 24 hours, none were life threatening in the short term and most were minor in nature. Of note: functionality in a ‘Driving Simulator’ and Reaction time did not become impaired during this 1-2 week cessation of CPAP.

So even if Todd had not been using his CPAP in the short term and he says he was, as this all stemmed from a data collection issue, he, according to this study would not have been impaired from a driving standpoint!

Why the Medical Committee couldn’t look at this logically and say something along the lines of: yep, normally we require ‘X’ amount of data, but 1: you state you’ve been in compliance using your CPAP machine; 2: you’ve got a new machine or there’s an issue with your current machine’s memory such that you don’t have the normal amount of data we like to see, so 3: we will grant a limited exception to our rule for the upcoming race weekend you already have scheduled because your personal physician states you are cleared to race, just get us the necessary data as soon as you can. But no, apparently there’s no one on the Committee who thinks logically.

Last point: as any physician knows, about 70%-80% of the population who in fact have clinically relevant OSA are undiagnosed! What in the hell is the Medical Committee’s response to that; it appears they simply ignore it, because if it’s not listed on a form, how can it be an issue. 🤦‍♂️

peterp

????? There are many studies on sleep apnea. Find one that says that anybody with sleep apnea should drive anything without consistent CPAP use. Spoiler alert, you won't.

Doesn't anybody realize how incredibly self-defeating it is to post over and over again that CPAP isn't important, and then at the same time to ask for blind trust that they use the machine?????

I don't even know what the point is of the minimum standard and making it so friggin' complex. Instead or stating "minimum standard" over and over again, with absolutely no context whatsoever, explain how you recommend solving the problem in specific terms.

The problem is simple. The solution can be simple -- add a checkbox to the form where the driver commits to using it daily (transferring PCA liability to the driver). Done.

We are all with you in spirit, but you guys are taking a huge gun and shooting yourselves in the foot over and over again with self-defeating arguments and imposing ridiculous complexity for something that is very simple.

Then you're going to complain the PCA is discriminating against you. You're shooting your own feet.

winders

How in the world did people survive driving cars before 1985 when CPAP machines were first commercially available?

What about today with this statement from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096276/ :

"Although OSA is a relatively common medical condition, it is believed that more than 85% of patients with clinically significant OSA have never been diagnosed."

NightBlueTTS

It is interesting how you have avoided my question on multiple occasions and then jump to generalizations that are made by doctors that all non-doctors should treat as law.

TBC - I never said that a CPAP is or isn’t important. my point is different. You claim there is an impairment, and I am asking for you to put the impairment into the appropriate perspective. Not every person will face the same level of impairment. This is even denoted in the way OSA is labeled (mild, moderate, severe).

Once there is a clear measurable standard, we can have a separate debate on whether it is too low or too high.

To make it easy for you, just post the data that you use to determine if a person is impaired beyond the minimum standard. A chart or table format is fine….unless perhaps this is all being done ad hoc and subjectively.

peterp

This is absolutely true, but it's impossible to do anything on the medical form, or processing of that form, for conditions the racers themselves don't even know they have. The medical screening process should simply protect anything that is known and preventable. For those who are aware they have OSA, the issues are preventable with CPAP. Unless they are driving alone on track, hey don't have the right to decide using CPAP daily isn't important because the risk is to other people.

Yes, some people don't know they have OSA, or a serious heart condition, or a brain or heart aneurysm, or a million other things. None of that is relevant at all to the medical screening form.

jdistefa

Quite correct. I didn't know I had gonorrhea until Todd told me.

LuigiVampa

It was court ordered.

Manifold

https://www.perplexity.ai/search/Wha...TS2x1uQB6viblg

Mahler9th

"For those who are aware they have OSA, the issues are preventable with CPAP."

This is not how CPAP rx works.

NightBlueTTS

Now apply that in an objective and measurable way to an individual.

Data on a population is different than what is happening to any given individual. This is a common issue when dealing with medical professionals who tend to revert to probabilities within a population vs specific data that applies to one particular person.

Manifold

Wouldn't applying it to an individual mean that, if someone is diagnosed with OSA and their doctor has prescribed use of a CPAP, then they should attest that they're using the CPAP? Or ask that they provide data evidencing use of the CPAP? Not sure what else could or should be done.

I've changed my view about whether OSA could increase the chance of an incident when someone is driving on track. The evidence seems to indicate that it could, and it's not just a matter of being sleepy or falling asleep. I was wrong to assume that OSA couldn't increase risk simply because one's adrenaline is pumping when they're on track.

NightBlueTTS

No, but you could assess the level of impairment that a given individual is exhibiting and then compare that to the population data.

Again, that would also only be useful if comparing to some standard of performance so as to understand how the medical issue is impacting the person in comparison to what is required to compete.

What I keep seeing is the application of generalized population data that assumes an impact of an unknown severity and without a precise probability that can be applied to a particular person.

AND no clear standard by which to evaluate.