Section 6

HIGH PRIORITY QUESTIONS - RESEARCH TO BE INITIATED IN THE NEAR TERM

1) What is the prognostic significance of factors detectable and measurable at the outset of a collision in WAD? Which factors predict good outcomes, notably early return to full function and usual work? Which factors predict poor outcomes?

2) What is the performance, including validity and cost-effectiveness, of diagnostic approaches for WAD at inception? Approaches needing immediate assessment include:

  • History taking
  • Physical examination
  • Plain X ray and other imaging techniques

3) What is the efficacy and cost-effectiveness of common therapeutic interventions for WAD? The interventions needing immediate assessment include:

  • Prescribed rest
  • Manipulation
  • Specific physiotherapeutic and physical medicine treatments
  • Mobilization
  • Other exercises
  • Postural advice
  • Traction
  • Passive modalities/electrotherapies
  • Psychotherapeutic interventions

4) What is the effect in WAD of a clinical strategy encompassing early intervention and emphasizing activation, the promotion of mobility and assertive occupational rehabilitation?

5) What are the results of implementing the Quebec Patient Care Guidelines for WAD? An evaluative process should be incorporated into their implementation.

The problems deemed to be "urgent and essential" imply studies that can be completed in five years. At that time, a new Task Force should be established to monitor new evidence, the resulting changes and to contemplate new opportunities.