Consistent evidence was found to support the use of ' red flags ' to screen for serious pathologies , judicious use of imaging through clinical decision rule application and promotion of functional exercise coupled with advice and reassurance .
Neck pain and whiplash injuries are a common presentation to the ED , and a frequent cause of disability globally .
This rapid review investigated best practice for the assessment and management of musculoskeletal neck pain in the ED .
Derivation of a clinical prediction rule to identify both chronic moderate/severe disability and full recovery following whiplash injury
Summary A clinical prediction rule comprising relevant biopsychosocial factors was derived to predict both  chronic moderate/severe disability and full recovery following whiplash injury . Abstract Recovery following a whiplash injury is varied : approximately 50 % of individuals fully recover , 25 % develop persistent moderate/severe pain and disability , and 25 % experience milder levels of disability . Identification of individuals likely to develop moderate/severe disability or to fully recover may help direct therapeutic re sources and optimise treatment . A clinical prediction rule ( CPR ) is a research ‐generated tool used to predict outcomes such as likelihood of developing moderate/severe disability or experiencing full recovery from whiplash injury . The purpose of this study was to assess the plausibility of developing a CPR . Participants from 2 prospect i ve , longitudinal studies that examined prognostic factors for poor functional recovery following whiplash injury were used to derive this tool . Eight factors , previously identified as predictor variables of poor recovery , were included in the analyses : initial neck disability index ( NDI ) , initial neck pain ( visual analogue scale ) , cold pain threshold , range of neck movement , age , gender , presence of headache , and posttraumatic stress symptoms ( Posttraumatic Diagnostic Scale [ PDS ] ) . An increased probability of developing chronic moderate/severe disability was predicted in the presence of older age and initially higher levels of NDI and hyperarousal symptoms ( PDS ) ( positive predictive value [ PPV ] = 71 % ) . The probability of full recovery was increased in younger individuals with initially lower levels of neck disability ( PPV = 71 % ) . This study provides initial evidence for a CPR to predict both chronic moderate/severe disability and full recovery following a whiplash injury . Further research is needed to vali date the tool , determine the acceptability of the proposed CPR by practitioners , and assess the impact of inclusion in practice
Consistent evidence was found to support the use of ' red flags ' to screen for serious pathologies , judicious use of imaging through clinical decision rule application and promotion of functional exercise coupled with advice and reassurance .
Neck pain and whiplash injuries are a common presentation to the ED , and a frequent cause of disability globally .
This rapid review investigated best practice for the assessment and management of musculoskeletal neck pain in the ED .