Research

The Direction of Chiropractic Pediatric Research: A Q&A w/ Dr. Brian Kelly, Life West President

By Frank M. Painter|October 27, 2011|Announcement, Research|

The Direction of Chiropractic Pediatric Research:
A Q&A w/ Dr. Brian Kelly, Life West President

By Claudia Anrig, DC

I would like to start this article by welcoming Dr. Brian Kelly and congratulating him as the new president of Life Chiropractic College West.

Dr. Kelly, for those who haven’t had the pleasure of meeting you yet, can you share some of your experiences from your tenure as president of New Zealand College of Chiropractic (NZCC)?

I was practicing full time in Melbourne, Australia, for 11 years, and was invited to join the Board of Trustees of the NZ College. Two years later an opportunity arose to apply for the presidency. Little did I think I would ever work in education! I was president for eight years (2003-2011) and thoroughly enjoyed it.

During this time, enrollment grew, we achieved accreditation with the CCE (Australasia), developed a meaningful research department and moved to a new campus. This was achieved while maintaining a vitalistic approach to chiropractic.

At NZCC you had a strong emphasis on research; why do you consider research such an important component of chiropractic?

A profession is defined (in part) by its unique body of knowledge. In fact chiropractic is a philosophy, art and science. Unless a profession continually works at answering great research questions, it may not evolve or have the same level of credibility as those that do. For example, imagine finding out better ways of taking care of patients? That alone would be one reason to do research. To this end, I served on the board of the Australian Spinal Research Foundation for 11 years. We raised funds and gave grants to chiropractic researchers. (more…)

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Application of a Diagnosis-Based Clinical Decision Guide in Patients with Low Back Pain

By Frank M. Painter|October 22, 2011|Evidence-based Medicine, Low Back Pain, Research|

Application of a Diagnosis-Based Clinical Decision Guide
in Patients with Low Back Pain

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2011 (Oct 22); 19: 26

By Donald R Murphy, DC, DACAN, and Eric L Hurwitz, DC, PhD

Rhode Island Spine Center, 600 Pawtucket Avenue, Pawtucket, RI 02860 USA

BACKGROUND

Low back pain (LBP) affects approximately 80% of adults at some time in life [1] and occurs in all ages [2, 3]. Despite billions being spent on various diagnostic and treatment approaches, the prevalence and disability related to LBP has continued to increase [4]. There has been a recent movement toward comparative effectiveness research [5], i.e., research that determines which treatment approaches are most effective for a given patient population. In addition, there is increased recognition of the importance of practice-based research which generates data in a “real world” environment as a tool for conducting comparative effectiveness research [6, 7]. This movement calls for greater participation of private practice environments in clinical research [7].

One of the reasons often given for the meager benefits that have been found with various LBP treatments is that these treatments are generally applied generically, without regard for specific characteristics of each patient, whereas the LBP population is a heterogeneous group, requiring individualized care [8]. Developing a strategy by which treatments can be targeted to the specific needs of patients has been identified as a research priority [9, 10].

There are more articles like this @ our:

Low Back Pain Page and the

A Clinical Model for the Diagnosis and Management Page

(more…)

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Mightier Than the Sword — Using Research to Promote and Defend Chiropractic

By Frank M. Painter|October 13, 2011|Research, Spinal Manipulation|

Mightier Than the Sword — Using Research to Promote and Defend Chiropractic

The Chiro.Org Blog

SOURCE: ACA News

By Daniel Redwood, DC

If the public is to be better educated about the benefits of chiropractic care, doctors of chiropractic must be the ones to do the educating. Research is the strongest tool we have to promote our healing art to those unfamiliar with its value and to defend it from unwarranted attacks. We owe it to our patients, our profession, ourselves and future generations to know the facts so that we can share them far and wide.

This does not mean that every practicing DC needs to become a full-time scholar, familiar with the details and nuances of the approximately 100 randomized clinical trials on spinal manipulation. It does mean that to be effective chiropractic ambassadors, we all need a good grasp of the overall picture, along with working knowledge of a small number of studies, reviews and guidelines that will allow us to most effectively deliver our message. And we need to stay up-to-date as new studies emerge.

For much of our history, prior to the dawn of the modern era of chiropractic research in the 1970s and 1980s, DCs had no choice but to rely completely on powerful, true stories about the patients we had helped in our offices. These individual stories still matter and can legitimately be shared with others as part of our outreach.But in this evidence-based era, we must use these anecdotes as the spice only, rather than the main course. Otherwise, we risk losing many opportunities to strengthen our case through strategic use of the increasingly broad and deep body of evidence researchers have made available to us. We best honor their work by sharing it widely, forcefully and accurately.

1. Low-Back Pain

(more…)

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Findings of the Bone and Joint Decade Neck Pain Task Force: Interview with Scott Haldeman, DC, MD, PhD

By Frank M. Painter|September 1, 2011|Neck Pain, Research|

Findings of the Bone and Joint Decade Neck Pain Task Force: Interview with Scott Haldeman, DC, MD, PhD

The Chiro.Org Blog

SOURCE: Health Insights Today

An Interview by Daniel Redwood, DC

Scott Haldeman chaired the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Related Disorders, the most comprehensive multidisciplinary review on neck pain ever undertaken.

As with similar projects, the Task Force reviewed and evaluated all existing research on the diagnosis and treatment of neck pain. But it went further, initiating original research in insufficiently explored areas, including the now-renowned study by David Cassidy and colleagues which demonstrated that strokes are no more likely after a visit to a chiropractor than after a visit to a medical doctor. In this Health Insights Today interview, Dr. Haldeman discusses the major findings of the Neck Pain Task Force and their implications for the management of this challenging condition.

Dr. Haldeman holds the positions of Clinical Professor, Department of Neurology, University of California, Irvine; Adjunct Professor, Department of Epidemiology, School of Public Health, University of California, Los Angeles; and Adjunct Professor, Department of Research, Southern California University of Health Sciences. He is Past President of the North American Spine Society, the American Back Society, the North American Academy of Manipulative Therapy, and the Orange County Neurological Society. He served on the Executive Council of the International Society for the Study of the Lumbar Spine. (more…)

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The Evolution of Chiropractic — Science & Theory

By Frank M. Painter|August 20, 2011|Research|

The Evolution of Chiropractic — Science & Theory

The Chiro.Org Blog

By Scott Haldeman, D.C., M.D., Ph.D.

Keynote Presentation
International Conference on Spinal Manipulation

I have had the privilege of being associated with chiropractic and chiropractic ideas all of my life through my father and grandmother, both of whom were practicing chiropractors. I have also been lucky to have participated in one of the most exciting phases in the evolution of chiropractic over the past 35 years. I thought that it would be of interest to younger researchers and clinicians to present my views on how the profession has evolved to its current position in society and how this evolution has impacted our understanding of chiropractic. I plan to discuss how we can put the changes in the role of science over the past 100 years in perspective and how these changes are likely to impact our lives as researchers, chiropractors, and physicians studying and treating patients with spinal disorders. (more…)

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The Inherent Problems With Randomized Controlled Trials

By Frank M. Painter|August 15, 2011|Editorial, Research|

The Inherent Problems With Randomized Controlled Trials (RCTs)

The Chiro.Org Blog

SOURCE: J Manip Physiol Ther 2003 (Sep); 26 (7): 460–467

Anthony Rosner, PhD

Foundation for Chiropractic Research and Education,
1330 Beacon Street, Suite 315,
Brookline, MA 02446, USA.

For 50 years, the accepted standard by which the usefulness of a therapeutic treatment is judged has been the randomized controlled trial (RCT), building from Hippocrates’ premise 2000 years ago that experience combined with reason was the therapy of choice for patients; that is, any treatment plan should both seem reasonable in theory and then be tested experimentally. Assuming that threats to both internal and external validity could be ruled out, the RCT became what is commonly regarded as the highest quality of clinical outcome study that could be mounted to allow inferences about cause and effect relationships to be drawn. The thinking was that the more rigorous and fastidious the design, the more credibility could be attached to the conclusions drawn from the outcomes of the study and the more likely the intervention was thought to have brought about those outcomes. [1] One of the strongest proponents of the RCT through the 1950s and 1960s was the British epidemiologist Archie Cochrane, who held that this type of experimental approach was essential for upgrading the quality of medical evidence. [2] In common hierarchical schemes of clinical experimental design, the RCT has been ranked the highest in rigor, as shown in Table 1.3 Even greater rigor has been presumed to occur with the statistical combination and weighting of the results of multiple RCTs in a meta-analysis to generate a more conclusive estimate of effect size. [4-5]

Table 1. Hierarchy of Experimental Designs [3]

Control group outcomes study (including RCTs).
Single-subject experiment, replicated single-subject experiments.
Single-group outcome study.
Systematic case study.
Anecdotal case report.

Designs are presented in descending order of rigor.

(more…)

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