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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