A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature.
A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature.
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DOI：
10.1097/00007632-200110010-00020
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发表时间：
2001-10-01
期刊：
影响因子：
3
通讯作者：
Bombardier, C
中科院分区：
文献类型：
--
作者：
Cote, P;Cassidy, J D;Bombardier, C
研究设计：对急性颈部扭伤预后研究的系统回顾。目的：更新魁北克扭伤相关疾病工作组发表的关于急性扭伤预后的系统回顾，并提出一个新的概念框架来对预后进行系统回顾。背景数据摘要：1995年，魁北克工作组发表了对颈部扭伤文献的系统回顾，得出的结论是其预后良好。然而，几乎没有发现预后因素。最近的研究增加了这方面的知识，并且有必要更新魁北克工作组进行的审查。方法：对四个电子数据库进行书目检索，以确定 1995 年之后发表的急性颈部扭伤的预后研究。按照标准审查标准对文献进行评价。评估了研究之间证据的一致性。设计了一个概念框架，根据方法学质量、目标人群和调查阶段对文献进行分类。结果：本综述纳入了 13 项队列研究。本研究中使用的框架表明，最近的大多数预后研究本质上都是描述性的。急性颈部扭伤的预后根据抽样人群和允许个人索赔的保险/补偿制度而有所不同。除了年龄、性别、基线颈部疼痛强度、基线头痛强度以及基线神经根体征和症状外，关于颈椎扭伤恢复的预后因素的文献几乎没有一致性。结论：自魁北克工作组报告发布以来，人们对颈椎扭伤的预后了解甚少。然而，越来越明显的是，保险和赔偿制度对急性颈部扭伤的恢复有很大影响。本研究中使用的概念框架表明，调查广泛的预后因素的大型队列研究对于提高对这一问题的理解是必要的。
STUDY DESIGN: Systematic review of prognostic studies of acute whiplash.OBJECTIVES: To update the systematic review on the prognosis of acute whiplash published by the Quebec Task Force on Whiplash-Associated Disorders and to propose a new conceptual framework to conduct systematic reviews on prognosis.SUMMARY OF BACKGROUND DATA: In 1995, the Quebec Task Force published a systematic review of the literature on whiplash and concluded that its prognosis is favorable. However, few prognostic factors were identified. Recent studies have added to this knowledge, and there is a need to update the review conducted by the Quebec Task Force.METHODS: A bibliographic search of four electronic databases was performed to identify prognostic studies of acute whiplash published after 1995. The literature was appraised with standard review criteria. The consistency of evidence across studies was assessed. A conceptual framework was designed to classify the literature according to methodologic quality, target population, and phases of investigation.RESULTS: Thirteen cohort studies were included in the review. The framework used in this study demonstrates that most of the recent prognostic studies are descriptive in nature. The prognosis of acute whiplash varies according to the population sampled and the insurance/compensation system under which individuals are allowed to claim benefits. Besides age, gender, baseline neck pain intensity, baseline headache intensity, and baseline radicular signs and symptoms, there is little consistency in the literature about the prognostic factors for the recovery of whiplash.CONCLUSIONS: Scant knowledge about the prognosis of whiplash has been gained since the release of the Quebec Task Force report. However, it is becoming obvious that the insurance and compensation systems have a large impact on recovery from acute whiplash injuries. The conceptual framework used in this study demonstrates that large cohort studies investigating a wide range of prognostic factors are necessary to improve the understanding of this problem.