Details of HTA project
Last updated: 31 August 2010 - Next update due: 7 September 2010
Research type: |
Primary Research (e.g. trial) |
Project title: |
Managing Injuries of the Neck Trial (MINT) |
 Outputs in journals arising from this project
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Project ref: |
02/35/02 |
Cost: |
£755,337 |
Chief Investigator : |
Professor Sarah (Sallie) Lamb, Director, Warwick Clinical Trials Unit, Warwick Clinical Trials Unit, University of Warwick |
Start Date: |
November 2004 |
Estimated date of publication in HTA journal series: |
November 2010. This project is at the editorial review stage. Delays in the review process can cause the forecast publication date to be delayed. |
Plain English Summary |
Whiplash injuries are very common in the UK. The injury is usually caused by rapid deceleration in a car accident. The head and neck are whipped forward and then back. Head restraints help to reduce the damage, but seat belts may exacerbate the problem. In the first few days the neck usually becomes difficult to move because of muscle and ligament damage. Symptoms may range from mild pain and discomfort to pain radiating into the arm and back. The majority of people will recover, usually within the first few months. At 6 months about 30% of people will develop late whiplash syndrome that is characterized by chronic pain and stiffness sufficient to interfere with work and enjoyment of life. This study will examine a stepped care approach to treatment for whiplash, that recognises not all people require intensive treatment. The usual treatment for whiplash is advice given at A&E, and then at some later point, symptoms are reviewed and further treatment is provided. In this study we will test what type of advice should be given at A&E, and what type of further treatment is most effective. We will be able to make recommendations at the end of the study about which patients should be routinely reviewed and would benefit most from supplementary treatments. We will also examine the costs of the treatments, from the perspective of individual patients, society and the health service. |
Project Abstract: |
(1) To estimate the clinical effectiveness of a stepped care approach over a 12 month period after an acute injury 1.1 Step One: The Whiplash Booklet versus usual care advice in Accident and Emergency 1.2 Step Two: In patients with symptoms persisting at 3 weeks (Whiplash Associated Disorder Grade I-III), supplementary treatment comprising either a package of physiotherapy treatments and re-enforcement of advice versus re-enforcement of advice provided at the initial A&E contact only. 1.3 The combined effect of the various treatments using a 2 by 2 factorial design. (2) To estimate the clinical effectiveness in pre-specified sub-groups of patients - those with prior neck problems, psychological or physical risk factors for poor outcome, and those seeking compensation. (3) To estimate the costs of each strategy including treatment and subsequent health care costs over a period of 12 months and to estimate cost effectiveness. All patients recruited into the trial will receive standard emergency care comprising a routine clinical consultation to screen out fracture/dislocation if required. The overall aim is to undertake a high quality definitive trial of treatments that if effective, can be readily disseminated into NHS departments dealing with acute injuries. We will include a qualitative sub-study to explore the acceptability of different treatments, and provide a consumer perspective. The study will comply with good practice guidelines and MRC guidance on evaluating complex interventions. |
MeSH* index primary terms: |
NECK-INJURIES Q-rehabilitation; PHYSICAL-THERAPY-TECHNIQUES; WHIPLASH-INJURIES Q-rehabilitation |
MeSH* index secondary terms: |
HUMANS; RANDOMIZED-CONTROLLED-TRIAL; CLINICAL-TRIAL; COST-BENEFIT-ANALYSIS; RISK-FACTORS |
NRR* number, if applicable: |
N0484152856 (*National Research Register). The National Research Register was a public database of ongoing and recently completed research projects funded by, or of interest to, the United Kingdom's National Health Service (NHS). It is now an archive of projects from early 2000 to September 2007. Search the NRR archive. |
ISRCTN* number: | ISRCTN 33302125 (*International Standard Randomised Controlled Trial Number) URL of this project on the Controlled Trials Website: http://www.controlled-trials.com/ISRCTN33302125 |
Project Protocol: |
Project protocol (pdf format, 251 kbytes) |
URL of this page: |
http://www.hta.ac.uk/1399 |
Outputs from this project
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