Chiropractic & osteopathy最新文献

{"title":"Segment-specific association between cervical pillar hyperplasia (CPH) and degenerative joint disease (DJD).","authors":"Maja Stupar,&nbsp;Cynthia K Peterson","doi":"10.1186/1746-1340-14-21","DOIUrl":"https://doi.org/10.1186/1746-1340-14-21","url":null,"abstract":"<p><strong>Background: </strong>Cervical pillar hyperplasia (CPH) is a recently described phenomenon of unknown etiology and clinical significance. Global assessment of pillar hyperplasia of the cervical spine as a unit has not shown a relationship with degenerative joint disease, but a more sensible explanation of the architectural influence of CPH on cervical spine biomechanics may be segment-specific.</p><p><strong>Objective: </strong>The objective of this study was to determine the level of association between degenerative joint disease (DJD) and cervical pillar hyperplasia (CPH) in an age- and gender-matched sample on a [cervical spine] by-level basis.</p><p><strong>Research methods: </strong>Two-hundred and forty radiographs were collected from subjects ranging in age between 40 and 69 years. The two primary outcome measures used in the study were the segmental presence/absence of cervical pillar hyperplasia from C3 to C6, and segment-specific presence/absence of degenerative joint disease from C1 to C7. Contingency Coefficients, at the 5% level of significance, at each level, were used to determine the strength of the association between CPH and DJD. Odds Ratios (OR) with their 95% Confidence Intervals (95% CI) were also calculated at each level to assess the strength of the association.</p><p><strong>Results: </strong>Our study suggests that an approximately two-to-one odds, or a weak-to-moderate correlation, exists at C4 and C5 CPH and adjacent level degenerative disc disease (DDD); with the strongest (overall) associations demonstrated between C4 CPH and C4-5 DDD and between C5 CPH and C5-6 DDD. Age-stratified results demonstrated a similar pattern of association, even reaching the initially hypothesized OR >or= 5.0 (95% CI > 1.0) or \"moderately-strong correlation of C >or= .4 (p <or= .05)\" in some age categories, including the 40-44, 50-59, and 60-64 years of age subgroups; these ORs were as follows: OR = 5.5 (95% CI 1.39-21.59); OR = 6.7 (95% CI 1.65-27.34); and OR = 5.3 (95% CI 1.35-21.14), respectively.</p><p><strong>Conclusion: </strong>Our results suggest that CPH has around two-to-one odds, that is, only a weak-to-moderate association with the presence of DJD (DDD component) at specific cervical spine levels; therefore, CPH may be but one of several factors that contributes (to a clinically important degree) to the development of DJD at specific levels in the cervical spine.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"14 ","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2006-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-14-21","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26251543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of lower extremity electrodiagnostic findings following a trial of spinal manipulation and motion-based therapy.","authors":"Mark W Morningstar","doi":"10.1186/1746-1340-14-20","DOIUrl":"https://doi.org/10.1186/1746-1340-14-20","url":null,"abstract":"<p><strong>Background: </strong>Lumbar disc herniation is a problem frequently encountered in manual medicine. While manual therapy has shown reasonable success in symptomatic management of these cases, little information is known how manual therapy may affect the structure and function of the lumbar disc itself. In cases where lumbar disc herniation is accompanied by radicular symptoms, electrodiagnostic testing has been used to provide objective clinical information on nerve function. This report examines the treatment rendered for a patient with lower extremity neurological deficit, as diagnosed on electrodiagnostic testing. Patient was treated using spinal manipulation and exercises performed on a Pettibon Wobble Chair, using electrodiagnostic testing as the primary outcome assessment.</p><p><strong>Case presentation: </strong>An elderly male patient presented to a private spine clinic with right-sided foot drop. He had been prescribed an ankle-foot orthosis for this condition. All sensory, motor, and reflex findings in the right leg and foot were absent. This was validated on prior electromyography and nerve conduction velocity testing, performed by a board certified neurologist. Patient was treated using spinal manipulation twice-weekly and wobble chair exercises three times daily for 90 days total. Following this treatment, the patient was referred for follow-up electrodiagnostic studies. Significant improvements were made in these studies as well as self-rated daily function.</p><p><strong>Conclusion: </strong>Motion-based therapies, as part of a comprehensive rehabilitation program, may contribute to the restoration of daily function and the reversal of neurological insult as detected by electrodiagnostic testing. Electrodiagnostic testing may be a useful clinical tool to evaluate the progress of chiropractic patients with lumbar disc herniation and radicular pain syndromes.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"14 ","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2006-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-14-20","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26250429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amount of health care and self-care following a randomized clinical trial comparing flexion-distraction with exercise program for chronic low back pain.","authors":"Jerrilyn A Cambron,&nbsp;M Ram Gudavalli,&nbsp;Marion McGregor,&nbsp;James Jedlicka,&nbsp;Michael Keenum,&nbsp;Alexander J Ghanayem,&nbsp;Avinash G Patwardhan,&nbsp;Sylvia E Furner","doi":"10.1186/1746-1340-14-19","DOIUrl":"https://doi.org/10.1186/1746-1340-14-19","url":null,"abstract":"<p><strong>Background: </strong>Previous clinical trials have assessed the percentage of participants who utilized further health care after a period of conservative care for low back pain, however no chiropractic clinical trial has determined the total amount of care during this time and any differences based on assigned treatment group. The objective of this clinical trial follow-up was to assess if there was a difference in the total number of office visits for low back pain over one year after a four week clinical trial of either a form of physical therapy (Exercise Program) or a form of chiropractic care (Flexion Distraction) for chronic low back pain.</p><p><strong>Methods: </strong>In this randomized clinical trial follow up study, 195 participants were followed for one year after a four-week period of either a form of chiropractic care (FD) or a form of physical therapy (EP). Weekly structured telephone interview questions regarded visitation of various health care practitioners and the practice of self-care for low back pain.</p><p><strong>Results: </strong>Participants in the physical therapy group demonstrated on average significantly more visits to any health care provider and to a general practitioner during the year after trial care (p < 0.05). No group differences were noted in the number of visits to a chiropractor or physical therapist. Self-care was initiated by nearly every participant in both groups.</p><p><strong>Conclusion: </strong>During a one-year follow-up, participants previously randomized to physical therapy attended significantly more health care visits than those participants who received chiropractic care.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"14 ","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2006-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-14-19","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26218877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical injury assessment of male versus female chiropractic students when learning and performing various adjustive techniques: a preliminary investigative study.","authors":"Debra W Bisiacchi,&nbsp;Laura L Huber","doi":"10.1186/1746-1340-14-17","DOIUrl":"https://doi.org/10.1186/1746-1340-14-17","url":null,"abstract":"<p><strong>Background: </strong>Reports of musculoskeletal injuries that some chiropractic students experienced while in the role of adjustor became increasingly evident and developed into the basis of this study. The main objective of this study was to survey a select student population and identify, by gender, the specific types of musculoskeletal injuries they experienced when learning adjustive techniques in the classroom, and performing them in the clinical setting.</p><p><strong>Methods: </strong>A survey was developed to record musculoskeletal injuries that students reported to have sustained while practicing chiropractic adjustment set-ups and while delivering adjustments. The survey was modeled from similar instruments used in the university's clinic as well as those used in professional practice. Stratified sampling was used to obtain participants for the study. Data reported the anatomical areas of injury, adjustive technique utilized, the type of injury received, and the recovery time from sustained injuries. The survey also inquired as to the type and area of any past physical injuries as well as the mechanism(s) of injury.</p><p><strong>Results: </strong>Data obtained from the study identified injuries of the shoulder, wrist, elbow, neck, low back, and mid-back. The low back was the most common injury site reported by females, and the neck was the most common site reported by males. The reported wrist injuries in both genders were 1% male complaints and 17% female complaints. A total of 13% of female respondents reported shoulder injuries, whereas less than 1% of male respondents indicated similar complaints.</p><p><strong>Conclusion: </strong>The data collected from the project indicated that obtaining further information on the subject would be worthwhile, and could provide an integral step toward developing methods of behavior modification in an attempt to reduce and/or prevent the incidence of musculoskeletal injuries.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"14 ","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2006-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-14-17","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26218415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of an evidence-based chiropractic continuing education workshop on participant knowledge of evidence-based health care.","authors":"Ronald J Feise,&nbsp;Jaroslaw P Grod,&nbsp;Anne Taylor-Vaisey","doi":"10.1186/1746-1340-14-18","DOIUrl":"https://doi.org/10.1186/1746-1340-14-18","url":null,"abstract":"<p><strong>Background: </strong>Chiropractors must continue to learn, develop themselves professionally throughout their careers, and become self-directed and lifelong learners. Using an evidence-based approach increases the probability of optimal patient outcomes. But most chiropractors lack knowledge and interest in evidence-based approaches. The purpose of this study was to develop and measure the effectiveness of evidence-based training for chiropractic practitioners in a continuing education setting.</p><p><strong>Methods: </strong>We developed and evaluated a continuing education workshop on evidence-based principles and methods for chiropractic practitioners. Forty-seven chiropractors participated in the training and testing. The course consisted of 12.5 hours of training in which practitioners learned to develop focused questions, search electronic data bases, critically review articles and apply information from the literature to specific clinical questions. Following the workshop, we assessed the program performance through the use of knowledge testing and anonymous presentation quality surveys.</p><p><strong>Results: </strong>Eighty-five percent of the participants completed all of the test, survey and data collection items. Pretest knowledge scores (15-item test) were low (47%). Post intervention scores (15-item test) improved with an effect size of 2.0. A 59-item knowledge posttest yielded very good results (mean score 88%). The quality of presentation was rated very good, and most participants (90%) would \"definitely recommend\" or \"recommend\" the workshop to a colleague.</p><p><strong>Conclusion: </strong>The results of the study suggest that the continuing education course was effective in enhancing knowledge in the evidence-based approach and that the presentation was well accepted.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"14 ","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2006-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-14-18","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26218416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inappropriate use of the title 'chiropractor' and term 'chiropractic manipulation' in the peer-reviewed biomedical literature.","authors":"Adrian B Wenban","doi":"10.1186/1746-1340-14-16","DOIUrl":"https://doi.org/10.1186/1746-1340-14-16","url":null,"abstract":"<p><strong>Background: </strong>The misuse of the title 'chiropractor' and term 'chiropractic manipulation', in relation to injury associated with cervical spine manipulation, have previously been reported in the peer-reviewed literature. The objectives of this study were to--1) Prospectively monitor the peer-reviewed literature for papers reporting an association between chiropractic, or chiropractic manipulation, and injury; 2) Contact lead authors of papers that report such an association in order to determine the basis upon which the title 'chiropractor' and/or term 'chiropractic manipulation' was used; 3) Document the outcome of submission of letters to the editors of journals wherein the title 'chiropractor', and/or term 'chiropractic manipulation', had been misused and resulted in the over-reporting of chiropractic induced injury.</p><p><strong>Methods: </strong>One electronic database (PubMed) was monitored prospectively, via monthly PubMed searches, during a 12 month period (June 2003 to May 2004). Once relevant papers were located, they were reviewed. If the qualifications and/or profession of the care provider/s were not apparent, an attempt was made to confirm them via direct e-mail communication with the principal researcher of each respective paper. A letter was then sent to the editor of each involved journal.</p><p><strong>Results: </strong>A total of twenty four different cases, spread across six separate publications, were located via the monthly PubMed searches. All twenty four cases took place in one of two European countries. The six publications consisted of four case reports, each containing one patient, one case series, involving twenty relevant cases, and a secondary report that pertained to one of the four case reports. In each of the six publications the authors suggest the care provider was a chiropractor and that each patient received chiropractic manipulation of the cervical spine prior to developing symptoms suggestive of traumatic injury. In two of the four case reports contact with the principal researcher revealed that the care provider was not a chiropractor, as defined by the World Federation of Chiropractic. The authors of the other two case reports did not respond to my communications. In the case series, which involved twenty relevant cases, the principal researcher conceded that the term chiropractor had been inappropriately used and that his case series did not relate to chiropractors who had undergone appropriate formal training. The author of the secondary report, a British Medical Journal editor, conceded that he had misused the title chiropractor. Letters to editors were accepted and published by all four journals to which they were sent. To date one of the four journals has published a correction.</p><p><strong>Conclusion: </strong>The results of this year-long prospective review suggests that the words 'chiropractor' and 'chiropractic manipulation' are often used inappropriately by European biomedica","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"14 ","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2006-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-14-16","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26271934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chiropractic manipulation in adolescent idiopathic scoliosis: a pilot study.","authors":"Dale E Rowe,&nbsp;Ronald J Feise,&nbsp;Edward R Crowther,&nbsp;Jaroslaw P Grod,&nbsp;J Michael Menke,&nbsp;Charles H Goldsmith,&nbsp;Michael R Stoline,&nbsp;Thomas A Souza,&nbsp;Brandon Kambach","doi":"10.1186/1746-1340-14-15","DOIUrl":"https://doi.org/10.1186/1746-1340-14-15","url":null,"abstract":"<p><strong>Background: </strong>Adolescent idiopathic scoliosis (AIS) remains the most common deforming orthopedic condition in children. Increasingly, both adults and children are seeking complementary and alternative therapy, including chiropractic treatment, for a wide variety of health concerns. The scientific evidence supporting the use chiropractic intervention is inadequate. The purpose of this study was to conduct a pilot study and explore issues of safety, patient recruitment and compliance, treatment standardization, sham treatment refinement, inter-professional cooperation, quality assurance, and outcome measure selection.</p><p><strong>Methods: </strong>Six patients participated in this 6-month study, 5 of whom were female. One female was braced. The mean age of these patients was 14 years, and the mean Cobb angle was 22.2 degrees. The study design was a randomized controlled clinical trial with two independent and blinded observers. Three patients were treated by standard medical care (observation or brace treatment), two were treated with standard medical care plus chiropractic manipulation, and one was treated with standard medical care plus sham manipulation. The primary outcome measure was Cobb, and the psychosocial measure was Scoliosis Quality of Life Index.</p><p><strong>Results: </strong>Orthopedic surgeons and chiropractors were easily recruited and worked cooperatively throughout the trial. Patient recruitment and compliance was good. Chiropractic treatments were safely employed, and research protocols were successful.</p><p><strong>Conclusion: </strong>Overall, our pilot study showed the viability for a larger randomized trial. This pilot confirms the strength of existing protocols with amendments for use in a full randomized controlled trial.</p><p><strong>Trial registration: </strong>This trial has been assigned an international standard randomized controlled trial number by Current Controlled Trials, Ltd. http://www.controlled-trials.com/isrctn/. The number is ISRCTN41221647.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"14 ","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2006-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-14-15","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26212280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review conclusions by Ernst and Canter regarding spinal manipulation refuted.","authors":"Gert Bronfort,&nbsp;Mitchell Haas,&nbsp;David Moher,&nbsp;Lex Bouter,&nbsp;Maurits van Tulder,&nbsp;John Triano,&nbsp;Willem J J Assendelft,&nbsp;Roni Evans,&nbsp;Simon Dagenais,&nbsp;Anthony Rosner","doi":"10.1186/1746-1340-14-14","DOIUrl":"https://doi.org/10.1186/1746-1340-14-14","url":null,"abstract":"<p><p>In the April 2006 issue of the Journal of Royal Society of Medicine, Ernst and Canter authored a review of the most recent systematic reviews on the effectiveness of spinal manipulation for any condition. The authors concluded that, except for back pain, spinal manipulation is not an effective intervention for any condition and, because of potential side effects, cannot be recommended for use at all in clinical practice. Based on a critical appraisal of their review, the authors of this commentary seriously challenge the conclusions by Ernst and Canter, who did not adhere to standard systematic review methodology, thus threatening the validity of their conclusions. There was no systematic assessment of the literature pertaining to the hazards of manipulation, including comparison to other therapies. Hence, their claim that the risks of manipulation outweigh the benefits, and thus spinal manipulation cannot be recommended as treatment for any condition, was not supported by the data analyzed. Their conclusions are misleading and not based on evidence that allow discrediting of a large body of professionals using spinal manipulation.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"14 ","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2006-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-14-14","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26181796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Journal publications by Australian chiropractic academics: are they enough?","authors":"Wayne Hoskins,&nbsp;Henry Pollard,&nbsp;John Reggars,&nbsp;Andrew Vitiello,&nbsp;Rod Bonello","doi":"10.1186/1746-1340-14-13","DOIUrl":"https://doi.org/10.1186/1746-1340-14-13","url":null,"abstract":"<p><strong>Purpose: </strong>To document the number of journal publications attributed to the academic faculty of Australian chiropractic tertiary institutions. To provide a discussion of the significance of this output and to relate this to the difficulty the profession appears to be experiencing in the uptake of evidence based healthcare outcomes and cultures.</p><p><strong>Methods: </strong>The departmental websites for the three Australian chiropractic tertiary institutions were accessed and a list of academic faculty compiled. It was noted whether each academic held a chiropractic qualification or research Doctoral (not professional) degree qualification A review of the literature was conducted using the names of the academics and cross-referencing to publications listed independently in the PubMed and Index to Chiropractic Literature (ICL) databases (from inception to February 27 2006). Publications were excluded that were duplicates, corrected reprints, conference abstracts/proceedings, books, monographs, letters to the editor/comments or editorials. Using this information an annual and recent publication rate was constructed.</p><p><strong>Results: </strong>For the 41 academics there was a total of 155 PubMed listed publications (mean 3.8, annual rate per academic 0.31) and 415 ICL listed publications (mean 10.1, annual rate 0.62). Over the last five years there have been 50 PubMed listed publications (mean 1.2, annual rate 0.24) and 97 ICL listed publications (mean 2.4, annual rate 0.47). Chiropractor academics (n = 31) had 29 PubMed listed publications (mean 2.5, annual rate 0.27) and 265 ICL listed publications (mean 8.5, annual rate 0.57). Academics with a doctoral degree (n = 13) had 134 PubMed listed publications (mean 10.3, annual rate 0.70) and 311 ICL listed publications (mean 23.9, annual rate 1.44). Academics without a Doctoral degree (n = 28) had 21 PubMed listed publications (mean 0.8, annual rate 0.13) and 104 ICL listed publications (mean 3.7, annual rate 0.24).</p><p><strong>Conclusion: </strong>While several academics have compiled an impressive list of publications, overall there is a significant paucity of published research authored by the majority of academics, with a trend for a falling recent publication rate and not having a doctoral degree being a risk factor for poor publication productivity. It is suggested that there is an urgent necessity to facilitate the acquisition of research skills in academic staff particularly in research methods and publication skills. Only when undergraduate students are exposed to an institutional environment conducive to and fostering research will concepts of evidence based healthcare really be appreciated and implemented by the profession.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"14 ","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2006-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-14-13","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26168860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-professional and inter-professional referral patterns of chiropractors.","authors":"Monica Smith,&nbsp;Barry R Greene,&nbsp;Mitchell Haas,&nbsp;Veerasathpurush Allareddy","doi":"10.1186/1746-1340-14-12","DOIUrl":"https://doi.org/10.1186/1746-1340-14-12","url":null,"abstract":"<p><strong>Background: </strong>With the increasing popularity of chiropractic care in the United States, inter-professional relationships between conventional trained physicians (MDs and DOs) and chiropractors (DCs) will have an expanding impact on patient care. The objectives of this study are to describe the intra-professional referral patterns amongst DCs, describe the inter-professional referral patterns between DCs and conventional trained medical primary care physicians (MDPCPs), and to identify provider characteristics that may affect these referral behaviors.</p><p><strong>Methods: </strong>A survey instrument to assess the attitudes and patterns of referral and consultation between MD primary care physicians (MDPCPs) and DCs was developed and sent to all DCs in the state of Iowa. Multivariable logistic regression models were built to assess the impact of provider characteristics on intra-professional and inter-professional referral patterns.</p><p><strong>Results: </strong>Of all DCs contacted, 452 (40.7%) participated in the study. Close to 8% of DCs reported that they never send a case report when referring a patient to another DC, while 13% never send a case report to a MDPCP. About 10% of DCs never send follow-up clinical information to referring doctors. DCs that perform differential diagnosis were significantly more likely to have engaged in inter-professional referral than DCs who did not perform differential diagnosis.</p><p><strong>Conclusion: </strong>The tendency toward informality, in both referral practices and sharing of clinical documentation for referred patients between MDPCPs and DCs, is an explicit marker of concerns that need to be addressed in order to improve coordination and continuity of care for patients shared between these provider types.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"14 ","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2006-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-14-12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26132162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}