Federal Motor Carrier Safety Administration's Medical Standards Update and Development Program: Turning Evidence into Recommendations – Role of Medical Expert Panels and the Medical Review Board

Phase 2 of the Risk-Based Regulatory Decision Making Framework used by the Federal Motor Carrier Safety Administration (FMCSA), as part of the Medical Standards Update and Development Program, involves the management of identified risks to commercial motor vehicle (CMV) driving safety associated with certain medical conditions. In addition to consideration of the quantitative and qualitative outputs of the risk assessment process, the selection of a particular regulatory option involves consideration of the public health, economic, social, and political consequences of implementation. Other factors of significance include the technical feasibility, the desired level of control, the ability to enforce regulations, uncertainty in scientific data and the corresponding inferential bridges used to fill gaps in knowledge, and public perception and level of information. Integral to this process of risk management are inputs from two distinct panels of experts: the Medical Expert Panel (MEP) and the Medical Review Board (MRB). The MEP is an independent panel of physicians, clinicians, and scientists who are experts in their specialty field. The MEP reviews the evidence about a question or topic, and provides expert opinion to FMCSA about medical standards and guidelines. The MRB is composed of physicians who have expertise in a medical specialty, an understanding of research methods, and knowledge of transportation medical issues. In this presentation, we will describe in detail the risk management considerations and processes that are used by the FMCSA Office of Medical Programs and the role of panels of medical experts to facilitate the development of scientifically based recommendations.