Protocol for an economic evaluation alongside the University Health Network Whiplash Intervention Trial: cost-effectiveness of education and activation, a rehabilitation program, and the legislated standard of care for acute whiplash injury in Ontario

The economic evaluation will use participant-level data from the University Health Network Whiplash Intervention Trial and will be conducted from the societal perspective over the trial's one-year follow-up. Resource use (costs) will include all health care goods and services, and benefits provided during the trial's 1-year follow-up. The primary health effect will be the quality-adjusted life year. We will identify the most cost-effective intervention using the incremental cost-effectiveness ratio and incremental net-benefit. Confidence ellipses and cost-effectiveness acceptability curves will represent uncertainty around these statistics, respectively. A budget impact analysis will assess the total annual impact of replacing the current legislated standard of care with each of the other interventions. An expected value of perfect information will determine the maximum research expenditure Canadian society should be willing to pay for, and inform priority setting in, research of WAD management.Results will provide health care decision makers with much needed economic evidence on common interventions for acute whiplash management.http://ClinicalTrials.gov webcite identifier NCT00546806 [Trial registry date: October 18, 2007; Date first patient was randomized: February 27, 2008]Whiplash injury affects 83% of persons involved in a traffic collision [1]. In the short-term, this injury leads to whiplash-associated disorder (WAD), a clinical syndrome characterized by neck pain and clusters of physical and psychological symptoms [2,3]. In the long-term, whiplash injury increases the incidence of future health problems. Persons with a history of whiplash are more likely to suffer from future neck pain, headaches, low back pain, shoulder pain and sleep disturbances, compared to those without a history of whiplash [1,4-6]. WAD represents an important and growing burden both in terms of direct medical costs (associated with health care use) and indirect costs (associated with