Evidence map›Paper›PMID 30679283›Full record

Trial reportBMJ open2019

Is a government-regulated rehabilitation guideline more effective than general practitioner education or preferred-provider rehabilitation in promoting recovery from acute whiplash-associated disorders? A pragmatic randomised controlled trial.

Pierre Côté, Eleanor Boyle, Heather M Shearer, Maja Stupar, Craig Jacobs, John David Cassidy, Simon Carette, Gabrielle van der Velde, Jessica J Wong, Sheilah Hogg-Johnson and 4 more

Registry-linked trialOpen access · goldAbstract readComparative StudyMulticenter StudyPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00546806 (The University Health Network Whiplash Intervention Trial), which is not on this map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
1.7field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00546806 phase3completednot on this map

The University Health Network Whiplash Intervention Trial: A Randomized Controlled Trial of the Effectiveness and Cost-effectiveness of Three Programs of Care for the Treatment of Whiplash-associated Disorders

TypeinterventionalSponsorUniversity Health Network, TorontoRan2008 to 2012Enrolled340ConditionsWhiplash InjuriesArmsPrograms of Care
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 12 institutions in 6 countries.

Pierre CôtéFaculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada.
Eleanor BoyleDalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Heather M ShearerFaculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada.
Maja StuparFaculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada.
Craig JacobsFaculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada.
John David CassidyDalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Simon CaretteDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Gabrielle van der VeldeToronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto General Hospital, Toronto, Ontario, Canada.
Jessica J WongUOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Ontario, Canada.
Sheilah Hogg-JohnsonDalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Carlo AmmendoliaInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Jill Alison HaydenDepartment of Community Health & Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Maurits van TulderDepartment of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
John W FrankDalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Centre for Disability Prevention and Rehabilitation · CAUniversity of Ontario Institute of Technology · CA3M (United States) · USCanadian Memorial Chiropractic College · CADalhousie University · CADepartment of Medical Sciences · BYHealth Net · USInstitute of Health Services and Policy Research · CAPublic Health Ontario · CAToronto Public Health · CAUniversity of Edinburgh · GBUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the effectiveness of a government-regulated rehabilitation guideline compared with education and activation by general practitioners, and to a preferred-provider insurance-based rehabilitation programme on self-reported global recovery from acute whiplash-associated disorders (WAD) grade I-II.

designPragmatic randomised clinical trial with blinded outcome assessment.

settingMultidisciplinary rehabilitation clinics and general practitioners in Ontario, Canada.

participants340 participants with acute WAD grade I and II. Potential participants were sampled from a large automobile insurer when reporting a traffic injury.

interventionsParticipants were randomised to receive one of three protocols: government-regulated rehabilitation guideline, education and activation by general practitioners or a preferred-provider insurance-based rehabilitation. PRIMARY AND SECONDARY OUTCOME MEASURES: Our primary outcome was time to self-reported global recovery. Secondary outcomes included time on insurance benefits, neck pain intensity, whiplash-related disability, health-related quality of life and depressive symptomatology at 6 weeks and 3, 6, 9 and 12 months postinjury.

resultsThe median time to self-reported global recovery was 59 days (95% CI 55 to 68) for the government-regulated guideline group, 105 days (95% CI 61 to 126) for the preferred-provider group and 108 days (95% CI 93 to 206) for the general practitioner group; the difference was not statistically significant (Χ

conclusionsTime-to-recovery did not significantly differ across intervention groups. We found no differences between groups with regard to neck-specific outcomes, depression and health-related quality of life. TRIAL REGISTRATION NUMBER: NCT00546806.

Indexed as

General PractitionersGovernment RegulationPatient Education as TopicPractice Guidelines as TopicAcute DiseaseAdultComorbidityFemaleHumansKaplan-Meier EstimateMaleMiddle AgedOntarioProportional Hazards ModelsQuality of LifeSelf Reportactivationphysician educationphysiotherapyrandomized controlled trialtreatmentwhiplash-associated disorders

Identifiers

PMID30679283
PMCPMC6347946
OpenAlexW2914831377

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.