Perspectives on whiplash-associated disorders classification systems: A survey among healthcare providers, researchers, insurance personnel, and people with lived experience.

Perspectives on whiplash-associated disorders classification systems: A survey among healthcare providers, researchers, insurance personnel, and people with lived experience.

Chen, Junze; Farrell, Scott F; Sterling, Michele
musculoskeletal science & practice 2026 Vol. 85 pp. 103615
3
junze2026perspectives

Abstract

The Quebec Task Force (QTF) Whiplash-Associated Disorders (WAD) classification was developed in 1995 to support diagnosis, research comparability, and to gauge prognosis. Advances in understanding of WAD have raised questions about its contemporary clinical and research relevance. To explore perspectives of healthcare providers, researchers, insurance personnel, and people with lived experience of WAD regarding (i) use of WAD classification systems; (ii) perceived adequacy of existing WAD classification systems; and (iii) priorities for features to include in a revised classification. Cross-sectional mixed-methods survey. An online survey was conducted between March-November 2025 using four tailored versions. Quantitative data were summarised descriptively. Open-text responses were analysed using inductive thematic analysis with iterative team discussion. The Standards for Reporting Qualitative Research (SRQR) was used. 150 respondents were included (88 healthcare providers, 45 researchers, 7 insurance personnel, 10 people with lived experience of WAD). 72.0% reported using a classification system (or awareness of their provider using a system), with QTF use most reported (87.0%). 39.7% perceived current systems as adequate, while most supported revision. Qualitative themes indicated that QTF was valued for simplicity and early triage, but limited by poor clinical nuance, lack of specificity and insufficient inclusion of biopsychosocial and pain-mechanism factors. Psychological and pain-related factors were prioritised for inclusion in a revised classification. Stakeholders commonly use the QTF WAD classification system but noted limited adequacy for contemporary needs. Findings support consensus-driven refinement, particularly within WAD II, and stronger integration of psychological and pain-related dimensions alongside physical signs.

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