The whiplash debate

In a review published in The Left Atrium, Walter Rosser¹ lauds as a “remarkable book” Andrew Malleson's Whiplash and Other Useful Illnesses.² Rosser writes that Malleson “challenges many different groups … for their self-interest and their failure to critically assess the medical case for whiplash.” Yet in Malleson's book, no study that found evidence of a valid whiplash syndrome is accurately presented, whereas those against are highly praised.

As just one example, Malleson promotes a Norwegian–Lithuanian paper that claimed that 202 drivers involved in rear-end collisions resembled control subjects at the end of 2 years.³ He writes, “Schrader and his Norwegian colleagues … had cut too close to the quick. Like frightful Vikings from the past, they had threatened to wreak havoc with the profitable whiplash industry.” This paper was evaluated by the Norwegian Centre for Health Technology Assessment, a group established by the Department of Health and Social Affairs for Norway and operating as a unit within SINTEF Unimed, a nonprofit independent research organization. The expert group who wrote the Centre's report⁴ concluded that more than 4000 individuals in each group would be needed to discover with 80% probability a statistically significant difference in the occurrence of chronic neck complaints between subjects who had and had not been involved in a collision, and the Schrader study was denied validity.

Harold Merskey Professor Emeritus of Psychiatry University of Western Ontario London, Ont.