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A Lesson in Causation

Causation: the relation of cause to effect.

Motor vehicle accidents cause  significant amounts of injury.  Structures commonly injured include cervical facets, lumbar intervertebral discs and sacro-iliac joints(SI).

What and who caused the pain is often a point of contention which  led some patients to the pursue legal action.  Thousands of dollars are spent in accident reconstruction, analysis of vector speeds and inspection and documentation of damage sustained by vehicles involved.

The concept  of causation is not taught in medical school and as a rule is not well understood by physicians.

Centeno and Freeman had recently simplified the process in their recent publication:  A Systematic Approach to Clinical Determinations of Causation.

Three key questions provide a systematic framework:

1) Biologic Plausibility:  Can a motor vehicle injury of any severity cause such an injury?

2) Temporal Association:  Did the motor vehicle accident precede the symptoms?

3)  Lack of likely alternative explanations:  Is there another reason or event that could have caused the symptoms.

Thank you gentlemen.