Variabilidad interobservador del baremo de tráfico (Ley 35/2015) y utilidad de las pruebas biomecánicas en la valoración de las secuelas

Cristina Herrera Ligero , María José Vivas Broseta , Carmen Ferrer Gómez , Helios de Rosario Martínez , Elvira Garrido-Lestache López-Belmonte , Ignacio Bermejo Bosch
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Abstract

Introduction

Law 35/2015 assesses damages in traffic accidents and tries to guarantee an equal response to identical situations. Biomechanical functional assessment (BFA) is a complementary medical test that provides objectivity in the evaluation of post-traumatic neck pain. This study analyzes the interobserver variability of the assessment system defined by Law 35/2015 and studies the effect of having BFA tests and the profile of the evaluator in determining sequelae.

Materials and methods

To do this, 49 professionals in the assessment of bodily injury evaluated 5 clinical cases of accident victims with post-traumatic neck pain; a month later, 35 of them assessed the same cases including a BFA report.

Results

The results show high variability in determining the days of personal injury (Kappa coefficients between 0.04 and 0.073) with or without BFA; high interobserver variability in the assessment of sequelae in cases without BFA (Kappa coefficients between 0.022 and 0.044), which slightly improves with BFA (Kappa coefficients between 0.128 and 0.26), even showing weak concordance. The BFA has an influence on the determination of sequelae (p < 0.01), but the profile of the evaluator does not. More than 79.4% of the evaluators found the BFA tests useful to reveal or to confirm symptoms, recovery, or simulation.

Conclusions

There is variability in the application of Law 35/2015 for the assessment of traffic accidents among professionals of bodily injury. The BFA is useful for evaluators and influences the determination of sequelae.

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交通比额表观察者间变异性(第35/2015号法律)和生物力学测试在评估后遗症方面的有用性
第35/2015号法律评估交通事故的损害,并试图保证对相同情况的平等反应。生物力学功能评估(BFA)是一种补充医学测试,为创伤后颈部疼痛的评估提供了客观性。本研究分析了第35/2015号法律定义的评估系统的观察者之间的可变性,并研究了进行BFA测试的影响以及评估者在确定后遗症方面的概况。材料与方法为此,对49名身体损伤评估专业人员对5例临床事故受害者创伤后颈部疼痛进行评估;一个月后,其中35人评估了同样的病例,包括一份BFA报告。结果结果显示,有或没有BFA的人在确定人身伤害天数(Kappa系数在0.04 ~ 0.073之间)方面具有较高的变异性;无BFA病例的后遗症评估具有较高的观察者间可变性(Kappa系数在0.022 ~ 0.044之间),而有BFA病例(Kappa系数在0.128 ~ 0.26之间)的后遗症评估略有改善,甚至显示出弱一致性。BFA对后遗症的测定有影响(p < 0.01),但评价者的概况没有影响。超过79.4%的评估者发现BFA测试有助于揭示或确认症状、恢复或模拟。在适用第35/2015号法律评估人身伤害专业人员的交通事故方面存在差异。BFA对评估者有用,并影响后遗症的确定。
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来源期刊
Revista Espanola de Medicina Legal
Revista Espanola de Medicina Legal Medicine-Pathology and Forensic Medicine
CiteScore
1.90
自引率
0.00%
发文量
27
审稿时长
41 days
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