Abstract
This pilot study of primary care whiplash associated disorder (WAD) patients investigated the predictive capacity of screening questionnaires and patient reported outcomes (PROs) in determining recovery status at six months. Thirty participants, age 37 ± 14, 77% female, were recruited from eight primary care sources. Recovery status at six months was determined by impairment classification scores from six PROs using common 100% scales. Data were analysed at two separate cutoff levels: ≥ 8% (non-recovered) and ≥ 28% (severe) with participants dichotomised at each level. Baseline data included demographics, cervical rotation at impact, psycho-social screening using the Generic Screening Tool (GST) and impairment status using six standardized PROs. Repeated PRO measures were made at one, three and six months. Sensitivity, specificity and subsequent likelihood ratios (LR) were used for data analysis. At six months 30% of patients were non-recovered and 17% remained severe. These outcomes were best predicted by two separate baseline measures: non-recovered–by screening alone (GST cut-off 109 points) was 78% sensitive and 86% specific (LR = 5.4); severe–by the same screening cut-off score and the presence of Cervical Rotation at Impact was 100% sensitive and 87% specific (LR of 7.7). Neither demographic data nor baseline individual PROs provided prediction. This study found recovery status at six months following a WAD in primary care patients can be predicted using a screening cut-off score of 109 GST-points, whilst severe impairment is predicted from the screening score in the presence of cervical rotation at impact. A larger population study investigating these protocols is warranted.