Patients age 18 to 65 who present to the ED within 24 hours after minor MVC and who are unlikely to require admission are screened for eligibility. Patients with injuries likely to require hospitalization, fractures (other than small bone fractures), major lacerations (defined as a laceration more than 20 cm in length or more than four lacerations requiring sutures), intracranial injury, or spinal injury (defined as vertebral fracture or dislocation, or new neurologic deficit) are excluded. Patients who are deemed eligible but subsequently admitted overnight to the hospital are excluded. Patients who go to an ED observation area for a brief period (e.g. "6 hour rule out") remain eligible. Patients are excluded if they are prisoners, pregnant, not alert and oriented, or unable to read and understand English. Patients are also excluded if they take β-receptor antagonist or if they take opioids on a daily basis above a total daily dose of 20 mg of oxycodone or equivalent. In addition, due to the effects of ethnicity on genetic risk factor assessment (population stratification bias [17 (link)] that may require different ethnicities to be analyzed separately) and budget restrictions limiting sample size, enrollment is limited to European Americans. After assessment for eligibility, signed informed consent is obtained from all patients enrolled in the study.
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