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Predicting long term impairment in general practitioner whiplash patients: a simple approach
Conference presentation

Predicting long term impairment in general practitioner whiplash patients: a simple approach

Charles P Gabel
2009 University Research Conference Program Book, p.18
USC Research Conference, 2009 (Sunshine Coast, Australia, 09-Nov-2009)
University of the Sunshine Coast
2009
url
http://www.usc.edu.au/View
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Abstract

Public Health and Health Services whiplash associated disorder general practitioner
To investigate, through a pilot study on a General Practitioner {GP) primary care population, if patient reported outcomes {PROs) and screening questionnaires could measure and predict recovery status at six months following a Whiplash Associated Disorder {WAD). There is a need predict those individuals who are at risk of delayed recovery from a whiplash associated disorder as they incur the highest costs, financial and societal. Participants {n=30, age=37+/-14, 770/o female) were recruited from eight Sunshine Coast GPs. To determine recovery status at six months severity impairment scored on a Global scale. Data was analysed at two separate cutoff levels: >80/o (non-recovered) and >280/o {severe) with participants dichotomised at each level. Initial assessment data gave: general demographics including the presence of 'cervical rotation at impact'; psycho-social screening using Screening and impairment status using standardised PROs - repeated at one, three and six months. Sensitivity and Specificity charts with subsequent Likelihood Ratios (LR) were used for data analysis. The sample size was too small for regression analysis.At 6 months 300/o of patients were non-recovered (>80/o impairment) and 170/o remained severe (>280/o). Outcomes were best predicted by two separate baseline measures: for non-recovered - screening alone (at a cut-off score of 109 points had a LR = 5.4; for severe the screening combined with the presence of Cervical Rotation at Impact was 1000/o sensitive with LR of 7.7. Neither Demographic data nor initial individual PROs scores provided acceptable levels of prediction. Recovery status, at six months following a WAD for P primary care patients may be predicted with a 109 point cut-off screening score. Severe impairment may be predicted with this screening combined with cervical rotation at impact. A larger population study investigating these protocols is warranted.

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