THE NOSOLOGIC STATUS OF THE WHIPLASH SYNDROME - A CRITICAL-REVIEW BASED ON A METHODOLOGICAL APPROACH

Study design. Empirical studies concerning the Whiplash syndrome are r eviewed from the point of view of epidemiologic methodology. Objective . To assess the nosologic status of the whiplash syndrome. Summary of background data. Although a large number of studies concerning the syn drome exist, there is still controversy concerning the existence of th e syndrome. Methods. The manner in which each study contributes to the validity of the syndrome is determined on the basis of the methodolog ic design (descriptive, case-control, cohort, and intervention/experim ental) of the study. Results. Whereas the face validity of the syndrom e is excellent, the descriptive, construct, and predictive validity ar e rather poor. In particular, convincing empirical evidence for a caus al link (construct validity) between the trauma mechanism and chronic symptoms is sparse. Conclusions. Carefully conducted studies designed to assess the degree to which head and neck trauma contribute to the d evelopment of chronic pain, particularly head and neck pain, are urgen tly needed.