Screening protocol s have high predictive values to detect cervical spine fracture in alert , low-risk patients seeking emergency care after blunt neck trauma .
Computerized tomography ( CT ) scans had better validity ( in adults and elderly ) than radiographs in assessing high-risk and /or multi-injured blunt trauma neck patients .
In the absence of serious pathology , clinical physical examinations are more predictive at excluding than confirming structural lesions causing neurologic compression .
One exception is the manual provocation test for cervical radiculopathy , which has high positive predictive value .
There was no evidence that specific MRI findings are associated with neck pain , cervicogenic headache , or whiplash exposure .
No evidence supports using cervical provocative discography , anesthetic facet , or medial branch blocks in evaluating neck pain .
Reliable and valid self-report question naires are useful in assessing pain , function , disability , and psychosocial status in individuals with neck pain .
CONCLUSION The scientific evidence supports screening protocol s in emergency care for low-risk patients ; and CT-scans for high-risk patients with blunt trauma to the neck .
In nonemergency neck pain without radiculopathy , the validity of most commonly used objective tests is lacking .
OBJECTIVE To critically appraise and synthesize the literature on assessment of  neck pain .
SUMMARY OF BACKGROUND DATA The published literature on assessment of neck pain is large and of variable quality .
There have been no prior systematic review s of this literature .
Reliability of the visual analog scale for measurement of acute pain.
OBJECTIVE Reliable and valid measures of pain are needed to advance research initiatives on appropriate and effective use of analgesia in the emergency department ( ED ) . The reliability of  visual analog scale ( VAS ) scores  has not been demonstrated in the acute setting where pain fluctuation might be greater than for chronic pain . The objective of the study was to assess the reliability of the  VAS  for measurement of acute pain . METHODS This was a prospect i ve convenience sample of adults with acute pain presenting to two EDs . Intraclass correlation coefficients ( ICCs ) with 95 % confidence intervals ( 95 % CIs ) and a Bl and -Altman analysis were used to assess reliability of  paired VAS measurements  obtained 1 minute apart every 30 minutes over two hours . RESULTS The summary ICC for all paired VAS scores was 0.97 [ 95 % CI = 0.96 to 0.98 ] . The Bl and -Altman analysis showed that 50 % of the paired measurements were within 2 mm of one another , 90 % were within 9 mm , and 95 % were within 16 mm . The paired measurements were more reproducible at the extremes of pain intensity than at moderate levels of pain . CONCLUSIONS Reliability of the  VAS  for acute pain measurement as assessed by the ICC appears to be high . Ninety percent of the pain ratings were reproducible within 9 mm . These data suggest that the VAS is sufficiently reliable to be used to assess acute pain
Screening protocol s have high predictive values to detect cervical spine fracture in alert , low-risk patients seeking emergency care after blunt neck trauma .
Computerized tomography ( CT ) scans had better validity ( in adults and elderly ) than radiographs in assessing high-risk and /or multi-injured blunt trauma neck patients .
In the absence of serious pathology , clinical physical examinations are more predictive at excluding than confirming structural lesions causing neurologic compression .
One exception is the manual provocation test for cervical radiculopathy , which has high positive predictive value .
There was no evidence that specific MRI findings are associated with neck pain , cervicogenic headache , or whiplash exposure .
No evidence supports using cervical provocative discography , anesthetic facet , or medial branch blocks in evaluating neck pain .
Reliable and valid self-report question naires are useful in assessing pain , function , disability , and psychosocial status in individuals with neck pain .
CONCLUSION The scientific evidence supports screening protocol s in emergency care for low-risk patients ; and CT-scans for high-risk patients with blunt trauma to the neck .
In nonemergency neck pain without radiculopathy , the validity of most commonly used objective tests is lacking .
OBJECTIVE To critically appraise and synthesize the literature on assessment of  neck pain .
SUMMARY OF BACKGROUND DATA The published literature on assessment of neck pain is large and of variable quality .
There have been no prior systematic review s of this literature .