title: Cold hyperalgesia as a prognostic factor in whiplash associated disorders: a systematic review.
abstract: OBJECTIVE
  To review and critically evaluate the existing literature for the prognostic value of cold hyperalgesia in Whiplash Associated Disorders (WAD).
  
  
  METHODS
  Embase, PsycINFO, and Medline databases were systematically searched (from inception to 20th September 2011) for prospective studies investigating a prognostic ability for cold hyperalgesia in WAD. Reference lists and lead authors were cross-referenced. Two independent reviewers selected studies, and consensus was achieved via a third reviewer. The risk of bias in identified studies was systematically evaluated by two reviewers using previously published guidance. The influences of seven potential covariates of cold hyperalgesia were considered. Quantitative synthesis was planned and homogeneity assessed. A modified Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach was used to qualitatively assess trials.
  
  
  RESULTS
  The review screened 445 abstracts, from these 20 full text studies were retrieved and assessed for eligibility. Six prospective studies on four cohorts were identified and reviewed. Findings from all four cohorts supported cold hyperalgesia as a prognostic factor in WAD.
  
  
  CONCLUSIONS
  There is moderate evidence supporting cold hyperalgesia as a prognostic factor for long-term pain and disability outcome in WAD. Further validation of the strength of this relationship and the influence of covariates are required. The mechanism for this relationship is unknown.
authors.affiliation: Cardiff and Vale University Health Board, Cardiff, UK. Robert.Goldsmith@CardiffandVale.wales.nhs.uk
authors.forename: Robert
authors.initials: R
authors.lastname: Goldsmith
authors.forename: Chris
authors.initials: C
authors.lastname: Wright
authors.forename: Sarah F
authors.initials: SF
authors.lastname: Bell
authors.forename: Alison
authors.initials: A
authors.lastname: Rushton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014911:Whiplash Injuries / Q000150:complications* / Q000175:diagnosis*; D055815:Young Adult