Whiplash: the possible impact of context on diagnosis

This study explores the importance of context when diagnosing Whiplash Associated Disorders (WAD). Whiplash is a complex injury and there is considerable variation in its diagnosis and treatment. Research has focussed on RTAs, whilst there is a paucity of evidence relating to WAD in sport. It is unclear whether WAD is simply not occurring in sport, or if such injuries are occurring but are not identified as WAD. In the current study, 87 postgraduate physiotherapists were asked to classify an injury reported in a short vignette. Two parallel vignettes were used, which were identical except for the context of the injury (one being an RTA and the other being within sport). Each participant responded to only one of these. It was found that, even within a sample of experienced physiotherapists, the injury environment impacted on diagnosis, despite the symptoms being identical. A significantly higher proportion of therapists diagnosed WAD within the RTA context than within the sporting context. Additionally, there were differences between the two context groups in relation to the diagnostic terminology used by participants. Most respondents had heard of the CSP whiplash guidelines but only a minority had actively used these. The majority of respondents were also aware of the litigation aspects of RTAs.