Association Between Symptoms and Health Outcomes in Chronic Whiplash-Associated Disorders: a Series of Mediation Analyses
Bibliographic record
Abstract
OBJECTIVE: The purpose of this study was to investigate the relationship between symptoms across body systems and health outcomes in individuals with chronic whiplash-associated disorders (WADs). METHODS: A cross-sectional study was conducted at a multidisciplinary chronic pain center in Calgary, Canada, between October 2019 and December 2021. Participants with a history of WAD completed questionnaires assessing pre-existing symptoms across bodily systems and related health outcomes. Mediation analyses evaluated the associations between symptom profiles and health outcomes, as well the role of pain cognitions. RESULTS: Of 305 participants in the registry database, 238 were eligible. The majority reported symptoms from 2 or more body systems, especially neurological, gastrointestinal, and psychological symptoms. Participants demonstrated moderate-to-severe pain and disability, with low physical health-related quality of life. While multiple symptoms correlated with worse health outcomes, mediation analyses revealed pain cognitions primarily influenced these associations, except for eye-related symptoms, which directly correlated with pain and disability. CONCLUSION: The study highlights that chronic WAD is characterized by a complex symptom profile across various bodily systems. Although a broader symptom profile is linked to poorer health outcomes, the effects are often mediated by pain cognitions. Notably, prior health conditions did not adversely impact outcomes, suggesting a need for targeted interventions focusing on cognitive aspects in patients with chronic WAD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.030 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.005 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".