Long-term follow-up of whiplash injuries reported to insurance companies: a cohort study on patient-reported outcomes and impact of financial compensation

Rydman, Eric; Ponzer, Sari; Brisson, Rosa; Ottosson, Carin; Pettersson-Järnbert, Hans

doi:10.1007/s00586-018-5507-2

Cited by 12 publications

(9 citation statements)

References 21 publications

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“…It may also be assumed that whiplash subjects with a high degree of pain may be compensated more frequently. However, one study did not find any statistical association between the level of pain and compensation status (50). Instead, it found correlation between the relatively high levels of mental distress (not defined) and financial compensation (50).…”

Section: Limitationsmentioning

confidence: 96%

Psychiatric Sequelae Following Whiplash Injury: A Systematic Review

et al. 2022

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BackgroundAnxiety, depression, post-traumatic stress disorder (PTSD), and sleep disturbance are reported following whiplash injury. However, the prevalence of these condition varies among studies. In this review, anxiety, depression, PTSD, and sleep disturbance will be referred as psychiatric outcomes.MethodsWe performed a systematic literature search on PubMed and Embase (from database inception until March 20, 2021) to identify studies reporting on the relative frequency of these psychiatric outcomes. Three independent investigators screened titles, abstracts and full-texts. Studies including patients with whiplash injury and where the number of patients with whiplash and anxiety, depression, PTSD, or sleep disturbances could be extrapolated, were included. Furthermore, to be included, studies had to defined psychiatric outcomes in accordance with diagnostic criteria [i.e., Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD)] or by use of a validated instrument with cut-off scores for assessing psychiatric symptoms. Quality rating was done using the Newcastle-Ottawa Scale (NOS) on the included studies. A protocol was registered with PROSPERO (CRD42021232037).ResultsThe literature search identified 5,068 citations, of which five articles were eligible for inclusion. The relative frequency of depressive symptoms following whiplash injury was 32.8% at 6 months, and 34.0% at 6–12 months. The relative frequency of PTSD symptoms after whiplash injury was 9.0–22.3% at 3 months, 15.8% at 6 months and 14.6–17.1% at 12 months. No studies evaluating the relative frequency of anxiety and sleep disturbances were eligible for inclusion.Discussion and ConclusionOur results suggest that there are persistent psychiatric outcomes following whiplash trauma. However, we found considerable heterogeneity among the studies. Thus, we have focused on the most notable limitations of the included studies: 1) small sample sizes, 2) differences in enrollment criteria, 3) lack of control groups, 4) considerable variation in the method used for outcome assessment, 5) directionality of association is difficult to determine and 6) incomplete assessment of compensation factors. We highlight these methodological limitations and outline recommendations for future research. Since psychiatric outcomes are potentially modifiable, future studies should optimize and address the identified methodological limitations so psychiatric sequelae following whiplash injury may be prevented.

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Section: Limitationsmentioning

confidence: 96%

Psychiatric Sequelae Following Whiplash Injury: A Systematic Review

et al. 2022

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“…While until NFHAS type 4 the ROM CV increases gradually, the type 5 shows a greater jump, not following a linear increment. Insurance environments have shown signs of negatively influencing patient reported outcomes [38]. Some incentives, such as the financial one, can encourage people to intentionally exaggerate some of their symptoms [39].…”

Section: Plos Onementioning

confidence: 99%

Artificial intelligence prediction of the effect of rehabilitation in whiplash associated disorder

Fidalgo-Herrera¹,

Martínez-Beltrán

Torre-Montero

et al. 2020

PLoS ONE

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The active cervical range of motion (aROM) is assessed by clinicians to inform their decision-making. Even with the ability of neck motion to discriminate injured from non-injured subjects, the mechanisms to explain recovery or persistence of WAD remain unclear. There are few studies of ROM examinations with precision tools using kinematics as predictive factors of recovery rate. The present paper will evaluate the performance of an artificial neural network (ANN) using kinematic variables to predict the overall change of aROM after a period of rehabilitation in WAD patients. To achieve this goal the neck kinematics of a cohort of 1082 WAD patients (55.1% females), with mean age 37.68 (SD 12.88) years old, from across Spain were used. Prediction variables were the kinematics recorded by the EBI® 5 in routine biomechanical assessments of these patients. These include normalized ROM, speed to peak and ROM coefficient of variation. The improvement of aROM was represented by the Neck Functional Holistic Analysis Score (NFHAS). A supervised multi-layer feed-forward ANN was created to predict the change in NFHAS. The selected architecture of the ANN showed a mean squared error of 308.07–272.75 confidence interval for a 95% in the Monte Carlo cross validation. The performance of the ANN was tested with a subsample of patients not used in the training. This comparison resulted in a medium correlation with R = 0.5. The trained neural network to predict the expected difference in NFHAS between baseline and follow up showed modest results. While the overall performance is moderately correlated, the error of this prediction is still too large to use the method in clinical practice. The addition of other clinically relevant factors could further improve prediction performance.

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“…The significance of the impact biomechanics for assessing the cervical vertebrae and clinical symptoms are discussed, e.g., in other studies [20,21], whereas another article [22] presents a study of the relationship between the recovery of a road accident victim with a whiplash injury and the insurance claim.…”

Section: Conditions For a Whiplash Injurymentioning

confidence: 99%

Verification of the Conditions for Whiplash-Type Injuries With the SDC Method Using the SRS-Airbag System Activation Parameters

Aleksandrowicz

Aleksandrowicz²

2020

Transport Problems

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A problem of car insurance frauds usually refers to reporting non-existent car crash circumstances to acquire the funds required for a car repair. However, the problem is not limited only to this kind of costs. Recently, numerous damage claims connected with spine trauma caused by rear-end collisions have been reported. These are the so-called whiplash injuries caused by a rear impact. Such damage is difficult to verify and hence a necessity to use more effective claim verification methods. An analysis of a collision in the SDC convention makes it possible to determine whether its circumstances were consistent with the reports of drivers involved in it. The aim of the analysis presented in this article has been to determine a possibility of using SRS-AIRBAG activation parameters to determine, with the SDC method, whether the circumstances of a collision reported were consistent with those responsible for a whiplash injury. The article provides an analysis of a series of rear-end collisions of vehicles moving in a column. The results have proven that the SDC procedure can be applied to verify the probability of a whiplash injury. With the above, this study is both academic and practical, and the results can provide benefits to vehicle collision researchers, experts, and students.

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Long-term follow-up of whiplash injuries reported to insurance companies: a cohort study on patient-reported outcomes and impact of financial compensation

Cited by 12 publications

References 21 publications

Psychiatric Sequelae Following Whiplash Injury: A Systematic Review

Psychiatric Sequelae Following Whiplash Injury: A Systematic Review

Artificial intelligence prediction of the effect of rehabilitation in whiplash associated disorder

Verification of the Conditions for Whiplash-Type Injuries With the SDC Method Using the SRS-Airbag System Activation Parameters

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