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Table 4 Comparison of primary HCP-reported evidence–based treatment provided, therapeutic relationship and resource distribution between risk groups

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

Variables

N

All

participants

(n = 53)

Low risk

(n = 7)

Medium risk

(n = 26)

High risk

(n = 16)

P-value

Diagnosed received, n (%)

53

43 (81%)

5 (71%)

22 (85%)

13 (81%)

0.725

 WAD (grade unspecified)

 

14 (35%)

1 (20%)

6 (27%)

7 (54%)

 

 WAD I

 

2 (5%)

1 (20%)

1 (5%)

0 (0%)

 

 WAD II

 

12 (30%)

2 (40%)

8 (36%)

2 (15%)

 

 WAD III

 

2 (5%)

0 (0%)

2 (9%)

0 (0%)

 

 Other

 

10 (25%)

1 (20%)

5 (23%)

4 (31%)

0.412

Practitioner–assessed risk level, n (%)

53

     

 Low

 

29 (55%)

6 (86%)

14 (54%)

8 (50%)

 

 Medium

 

18 (34%)

0 (0%)

10 (39%)

6 (38%)

 

 High

 

6 (11%)

1 (14%)

2 (8%)

2 (13%)

0.377

Total cases of risk assessed correctly, n (%)

42

14 (26%)

6 (86%)***

10 (39%)

2 (13%)

0.004

Canadian Cervical Spine rule, n (%)

 Total X-rays required and received

52

35 (66%)

3 (43%)

20 (77%)

12 (75%)

0.194

 Total X-rays required and not received

52

14 (26%)

4 (57%)

5 (19%)

3 (19%)

0.095

 Total X-rays not required and received

52

2 (4%)

0 (0%)

0 (0%)

1 (6%)

0.349

 Total X-rays not required and not received

52

1 (2%)

0 (0%)

1 (4%)

0 (0%)

0.637

Cases of Cervical Spine rule correctly applied, n (%)

52

36 (68%)

3 (43%)

21 (80%)

12 (75%)

0.129

Appropriate treatment

 Number of treatments, mean (SD)

53

12 (8)

6 (4)***

10 (8)

15 (9)

0.035

 Number of treatments appropriate, n (%)

43

14 (26%)

2 (33%)

8 (36%)

11 (79%)

0.634

Management of high – risk individuals

 Number referred^, n (%)

53

19 (36%)

0 (0%)l*

8 (31%)

9 (56%)

0.028

  Medical

53

5 (9%)

0 (0%)

3 (12%)

2 (13%)

0.626

  Surgical

53

5 (9%)

0 (0%)

2 (8%)

2 (13%)

0.597

  Pain specialist

53

6 (11%)

0 (0%)l*

1 (4%)

5 (31%)

0.018

  Psychologist or Psychiatrist

53

5 (9%)

0 (0%)

1 (4%)

3 (19%)

0.160

  Physiotherapy specialist

53

3 (6%)

0 (0%)

1 (4%)

1 (6%)

0.781

  Other

53

1 (2%)

0 (0%)

1 (4%)

0 (0%)

0.637

Mean time to referral, weeks, mean (SD)

17

5 (4)

–

6 (5)

5 (4)

0.746

Referral appropriate, n (%)

47

38 (72%)

7 (100%)

22 (96%)

8 (50%)*

< 0.001

Therapeutic relationship score (9–45/45), mean (SD)

53

39 (4)

37 (5)

40 (4)m*

36 (8)

0.046

Awareness of Australian whiplash guidelines, n (%)

53

40 (76%)

5 (71%)

18 (69%)

13 (81%)

0.687

Name of guidelines, n (%)

14

     

 Described Australian whiplash guidelines

 

23 (43%)

3 (60%)

10 (52%)

8 (73%)

 

 Described other

 

10 (19%)

2 (40%)

6 (32%)

2 (18%)

 

 Did not describe any guidelines

 

6 (11%)

0 (0%)

2 (13%)

1 (9%)

0.715

Guidelines informed patient management, n (%)

53

33 (62%)

5 (71%)

15 (60%)

10 (63%)

0.859

  1. Abbreviations: GPE Global perceived effect, NDI Neck Disability Index, SIRA State Insurance Regulatory Authority, WAD Whiplash associated disorder
  2. Post hoc significance: *high vs. low and med; ***low vs. med and high; l*low vs. med; m*med vs. high. p < 0.05. NB. Percentage scores for ‘all participants’ are calculated as a percentage of the 53 primary health care providers completing interviews. ^Participants with whiplash may be referred to more than one specialist practitioner