Evidence-Based Aeromedical Assessments

INTRODUCTION: Assessment of fitness for flight constitutes one of the core tasks of aeromedical professionals. The value of such evaluations depends on the decision to be based on complete medical information, valid risk methodology, and genuine flight safety indicators. To achieve these goals, the aeromedical practitioner should ensure an evidence-based approach.

METHODS: This article describes a pragmatic and evidence-based methodology for aeromedical fitness assessments, grounded on already validated principles within scientific epistemology and evidence-based clinical medicine.

RESULTS: The aeromedical assessment should integrate both individual variables of the particular applicant, deductive reasoning by relevant experts, and the best available scientific evidence. Each of these three pillars includes a set of specific aspects based on knowledge of precision medicine, flight environment, risk methodology, statistics, metacognition, and scientific method.

DISCUSSION: Despite evidence-based approach being the benchmark, the aeromedical practitioner should be aware of limitations and potential pitfalls. The conclusion should be based on both functional performance and future risk of medical incapacitation using a transparent and objective risk matrix.

Saehle T. Evidence-based aeromedical assessments. Aerosp Med Hum Perform. 2025; 96(1):71–77.