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58. Inter-rater reliability of the Quebec Task Force classification system for recent-onset Whiplash Associated Disorders

Author

Shergill, Yaadwinder, Côté, Pierre, Shearer, Heather, Wong, Jessica J., Stupar, Maja, Tibbles, Anthony, and Cassidy, J. David

Subjects
Original Articles
Abstract

The inter-rater reliability of the Quebec Task Force (QTF) classification system for Whiplash-Associated Disorders (WAD) remains unknown. Our objective was to determine the inter-rater reliability of the WAD classification between an experienced chiropractic clinician and two chiropractic residents.We conducted an inter-rater reliability study using baseline clinical data from 80 participants assessed for inclusion in a randomized clinical trial of the conservative management of WAD grades I and II. We reported reliability using Cohen's kappa (k) and 95% confidence intervals (CI).The mean duration of WAD symptoms was 7.6 days (s.d.=5.2). In our study, the interrater reliability of the WAD grade classification varied from k=0.04 (95% CI -0.04 to 0.12) to k=0.80 (95% CI 0.67 to 0.94).Inter-rater reliability of the WAD classification varied greatly across raters and may be associated with the experience of the raters and with their understanding of the criteria. Our results suggest that clinicians may benefit from training to standardize how they classify WAD. Furthermore, our results need to be tested in a different sample of patients and with a range of clinicians from different clinical disciplines.La fiabilité inter-utilisateur du système de classification des troubles associés au coup de fouet cervical (TACF) établi par le Groupe de travail du Québec (GTQ) demeure inconnue. Notre étude visait à établir la fiabilité inter-évaluateur du système de classification des troubles associés au TACF utilisé par un chiropraticien clinicien d’expérience et deux résidents en chiropratique.On a effectué notre étude à l’aide de données cliniques de départ sur 80 participants à un essai clinique, à répartition aléatoire, sur le traitement conservateur du TACF de stades I et II. On a utilisé le coefficient kappa (k) de Cohen et des intervalles de confiance (IC) à 95 % pour évaluer la fiabilité.La durée moyenne des symptômes du TACF était de 7,6 jours (écart-type :5,2). La fiabilité inter-utilisateur de la classification des TACF a varié de k = 0,04 (IC à 95 % – de 0,04 à 0,12) à k = 0,80 (IC à 95 % de 0,67 à 0,94).La fiabilité inter-utilisateur de la classification des TACF a beaucoup varié d’un évaluateur à l’autre; l’écart pourrait être lié à l’expérience de l’évaluateur et à sa compréhension des critères de classification. Selon les résultats de notre étude, les cliniciens pourraient bénéficier d’une formation servant à normaliser leur méthode de classification des TACF. Nos résultats devraient être confirmés par une autre étude utilisant un autre échantillon de patients et un éventail de cliniciens appartenant à diverses disciplines.

Published
2021

74. Methods for the Best Evidence Synthesis on Neck Pain and Its Associated Disorders: The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders

Author

Carroll, Linda J., Cassidy, J. David, Peloso, Paul M., Giles-Smith, Lori, Cheng, C. Sam, Greenhalgh, Stephen W., Haldeman, Scott, van der Velde, Gabrielle, Hurwitz, Eric L., Côté, Pierre, Nordin, Margareta, Hogg-Johnson, Sheilah, Holm, Lena W., Guzman, Jaime, and Carragee, Eugene J.

Published
2009
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99. Methods for the Best Evidence Synthesis on Neck Pain and Its Associated Disorders: The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders

Author

Carroll, Linda J., Cassidy, J. David, Peloso, Paul M., Giles-Smith, Lori, Cheng, C. Sam, Greenhalgh, Stephen W., Haldeman, Scott, van der Velde, Gabrielle, Hurwitz, Eric L., Côté, Pierre, Nordin, Margareta, Hogg-Johnson, Sheilah, Holm, Lena W., Guzman, Jaime, and Carragee, Eugene J.

Published
2008
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100. Expectations for recovery important in the prognosis of whiplash injuries

Author

Holm, Lena W., Carroll, Linda J., Cassidy, J. David, Skillgate, Eva, and Ahlbom, Anders

Subjects
Biological sciences
Abstract

Background Individuals' expectations on returning to work after an injury have been shown to predict the duration of time that a person with work-related low back pain will remain on benefits; individuals with lower recovery expectations received benefits for a longer time than those with higher expectations. The role of expectations in recovery from traumatic neck pain, in particular whiplash-associated disorders (WAD), has not been assessed to date to our knowledge. The aim of this study was to investigate if expectations for recovery are a prognostic factor after experiencing a WAD. Methods and Findings We used a prospective cohort study composed of insurance claimants in Sweden. The participants were car occupants who filed a neck injury claim (i.e., for WAD) to one of two insurance companies between 15 January 2004 and 12 January 2005 (n = 1,032). Postal questionnaires were completed shortly (average 23 d) after the collision and then again 6 mo later. Expectations for recovery were measured with a numerical rating scale (NRS) at baseline, where 0 corresponds to 'unlikely to make a full recovery' and 10 to 'very likely to make a full recovery.' The scale was reverse coded and trichotomised into NRS 0, 1-4, and 5-10. The main outcome measure was self-perceived disability at 6 mo postinjury, measured with the Pain Disability Index, and categorised into no/low, moderate, and high disability. Multivariable polytomous logistic regression was used for the analysis. There was a dose response relationship between recovery expectations and disability. After controlling for severity of physical and mental symptoms, individuals who stated that they were less likely to make a full recovery (NRS 5-10), were more likely to have a high disability compared to individuals who stated that they were very likely to make a full recovery (odds ratio [OR] 4.2 [95% confidence interval (CI) 2.1 to 8.5]. Forthe intermediate category (NRS 1-4), the OR was 2.1 (95% CI 1.2 to 3.2). Associations between expectations and disability were also found among individuals with moderate disability. Conclusions Individuals' expectations for recovery are important in prognosis, even after controlling for symptom severity. Interventions designed to increase patients' expectations may be beneficial and should be examined further in controlled studies., Introduction Whiplash is an acceleration-deceleration mechanism resulting from an energy transfer to the neck that may lead to a variety of clinical manifestations (whiplash-associated disorders [WAD]) [1]. Despite substantial research [...]

Published
2008

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