Section 1


During 1989-1990, the Quebec Automobile Insurance Society (Société d'assurance automobile du Québec - SAAQ) approached Dr. W. O. Spitzer, of the Department of Epidemiology and Biostatistics, McGill University, about the possibility of an in-depth analysis of clinical, public health, social and financial determinants of "the whiplash problem." The frequency of the clinical entity labeled as whiplash is high; the residual disability of victims appears significant in magnitude and the costs of care and indemnity are high and rising. There is considerable inconsistency about diagnostic criteria, indications for therapeutic intervention, rehabilitation and the appropriate role of clinicians at all phases of the syndrome. Little is known about primary prevention of the condition and virtually nothing about tertiary prevention of serious disability.

The leaders of the SAAQ appreciated the need to understand the epidemiology, mechanisms of injury, clinical definitions and syndromes, natural history, evidence of effectiveness of prevention/treatment/rehabilitation, the role of psychosocial factors and the impact of the health services system in general in order to formulate a rational approach to the problem. The Task Force was charged to make specific recommendations to deal with these issues. The SAAQ was committed to a system that would provide fairness and compassion to persons with neck injury following motor-vehicle collision, medical care of the highest scientific standards, realistic strategies of primary prevention and judicious management of society's resources. Most importantly, the SAAQ acknowledged the preeminence of scientific evidence.