Evidence map›Paper›PMID 31694622›Full record

ArticleBMC health services research2019

Evidence-based care in high- and low-risk groups following whiplash injury: a multi-centre inception cohort study.

Alexandra Griffin, Jagnoor Jagnoor, Mohit Arora, Ian D Cameron, Annette Kifley, Michele Sterling, Justin Kenardy, Trudy Rebbeck

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. 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

8 authors.

Alexandra GriffinFaculty of Health Sciences, The University of Sydney, 75 East St, Lidcombe, NSW, Australia. agri3036@uni.sydney.edu.au.ORCID http://orcid.org/0000-0001-9858-008X
Jagnoor JagnoorJohn Walsh Centre for Rehabilitation Research, The University of Sydney, Kolling Institute, St Leonards, NSW, Australia.
Mohit AroraJohn Walsh Centre for Rehabilitation Research, The University of Sydney, Kolling Institute, St Leonards, NSW, Australia.
Ian D CameronJohn Walsh Centre for Rehabilitation Research, The University of Sydney, Kolling Institute, St Leonards, NSW, Australia.
Annette KifleyJohn Walsh Centre for Rehabilitation Research, The University of Sydney, Kolling Institute, St Leonards, NSW, Australia.
Michele SterlingNHMRC Centre of Research Excellence in Road Traffic Injury, The University of Queensland, Brisbane, QLD, Australia.
Justin KenardyRecover Injury Research Centre, The University of Queensland, Level 7, UQ Oral Health Centre, Herston, QLD, Australia.
Trudy RebbeckFaculty of Health Sciences, The University of Sydney, 75 East St, Lidcombe, NSW, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStudies aimed at improving the provision of evidence-based care (EBC) for the management of acute whiplash injuries have been largely successful. However, whether EBC is broadly provided and whether delivery of EBC varies based on risk of non-recovery, is uncertain. Receiving EBC should improve recovery, though this relationship has yet to be established. Further, mitigating the effect of EBC is the relationship with the practitioner, a phenomenon poorly understood in WAD. This study aimed to determine the proportion of individuals with whiplash, at differing baseline risk levels, receiving EBC. This study also aimed to determine whether receiving EBC and the therapeutic relationship were associated with recovery at 3 months post injury.

methodsParticipants with acute whiplash were recruited from public hospital emergency departments, private physiotherapy practices, and State Insurance Regulatory Authority (SIRA) databases. Participants completed questionnaires at baseline (demographics, risk of non-recovery) and 3-months (treatment received, risk identification, therapeutic relationship) post injury. Primary health care providers (HCPs) treating these participants also completed questionnaires at 3-months. Recovery was defined as neck disability index ≤4/50 and global perceived effect of ≥4/5.

resultsTwo-hundred and twenty-eight people with acute whiplash, and 53 primary care practitioners were recruited. The majority of the cohort reported receiving EBC, with correct application of the Canadian C-spine rule (74%), and provision of active treatments (e.g. 89% receiving advice) high. Non-recommended (passive) treatments were also received by a large proportion of the cohort (e.g. 50% receiving massage). The therapeutic relationship was associated with higher odds of recovery, which was potentially clinically significant (OR 1.34, 95% CI 1.18-1.62). EBC was not significantly associated with recovery.

conclusionsGuideline-based knowledge and practice has largely been retained from previous implementation strategies. However, recommendations for routine risk identification and tailored management, and reduction in the provision of passive treatment have not. The therapeutic relationship was identified as one of several important predictors of recovery, suggesting that clinicians must develop rapport and understanding with their patients to improve the likelihood of recovery.

Indexed as

Evidence-Based PracticeAdultFemaleHumansMaleMiddle AgedPhysical Therapy ModalitiesProspective StudiesSurveys and QuestionnairesWhiplash InjuriesYoung AdultClinical practice guidelinesCohortEvidence-based health carePractice guidelinesWhiplash injuries

Identifiers

PMID31694622
PMCPMC6836463

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.