r of examination ranging from a laying on of hands to video fluoroscopy, but in the end, all he may be able to identify, based on my subjective responses to his inquiries or his subjective evaluation of the films is that I may have some level of soft tissue injury or some manner of misalignment. Like the Ortho, he may ask when the symptoms began (key word: SYMPTOMS), to which I respond "about the time my car was rearended by another car." What more does he have to go on than the Ortho? Nothing, but NOW we have an "injury," because we find a subluxation or some manner of misalignment that is described, in the Chiropractor's frame of reference, as an "injury."

HOWEVER, for one to adopt the epidemiological approach you suggest, Greg, which typically forms the basis for a causal link between the very low delta-V crash and the "injury," one has to (a) adopt YOUR definition of injury to the exclusion of the Ortho's, (b) adopt there was actually a crash which CAN directly be related to this injury OBJECTIVELY and (c) that the crash SEVERITY (which, like it or not, IS described objectively in terms of acceleration: delta-V and delta-T) can be reliably quantified by the patient's SUBJECTIVE PERCEPTION of the event whether or not we take into account the obvious potential for bias on the part of a plaintiff, er, I mean patient referred to the Chrio by the lawyer. Greg, your assertion that you "agree that patients are often wrong about distances, speeds and many other crash parameters, I believe that they are often correct about their head position at the time of the crash, their body position, their head restraint position, the distance between th
eir head and their head restraint (backset), and many other human factors during the collision" is not only wholly contradictory but again has no basis in reality much less common sense. People OBJECTIVELY don't have the first hope of getting what you're calling "the human factors" part right but being wrong "just" about the other FACTS.

PERCEPTION is not objectivity. They're not focused on what they were actually doing when the crash occurred, they're changing the CD, lighting the cigarette, dialing the take out place. They realize AFTER the event there was an event and then, under questioning by the doctor or lawyer which is seeking specific information and which may be more than a little LEADING, they piece together what was happening. Again, we're back to the SUBJECTIVE.

To apply epidemiology to the study of "low speed crash injury" one must necessarily rely on the false application of science. It is nothing more than intellectual dishonesty to take subjective complaints of pain made to a doctor of ANY kind by patients coupled with that patient's subjective description of the event which may or may not have lead to what may or may not be actually experiencing and conclude that low speed crashes routinely cause injury. Studying nothing more than doctor records of patient exams which are based on the SUBJECTIVE complaint of pain, a SUBJECTIVE description of the event and a SUBJECTIVE finding that there can be a link between the two is NOT OBJECTIVE science. Epidemiology may "look at real world drivers" but there are no "real world injuries" that can be directly and OBJECTIVELY linked to either the driver of some specific event. Epidemiology has its place in medical science and is typically used in connection with objective observations and a commonl
y defined definition of the illness.

You make the statement: "I have witnessed injuries at 6 mph delta V." In what setting, how was that delta-V quantified and what are you calling an "injury."

You mention the Lithuanian studies. OK, let's make the comparison...we have crashes recorded in that study from crashes reported primarily to police. In the epidemiological studies, we have crashes reported to doctors by patients seeking treatment (what about those who had crashes and never sought treatment???). In the Lithuanian study we have a low incidence of complaints of pain foll