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In this episode, Dr. James Whedon and I discuss his research on chiropractic, opioids, adverse events, risk of injury, medicare, and much more. For instance, his research found the likelihood of filling a prescription for an opioid analgesic was significantly lower for recipients of services delivered by doctors of chiropractic compared with nonrecipients. Dr. Jim Whedon is Director of Health Services Research at Southern California University of Health Sciences and adjunct instructor at The Dartmouth Institute for Health Policy and Clinical Practice. He holds a DC degree from Logan College and an MS from Dartmouth College. He has authored 33 peer reviewed publications. He is advisor to the Project for Integrative Health and the Triple Aim, co-chair of the research working group of The Academic Consortium for Integrative Health, charter member of the Academy of Integrative Health & Medicine, and recipient of the Jerome F. McAndrews DC Memorial Research Fund Award from NCMIC Foundation.
Dr. Jim Whedon is a national award-winning, NIH-funded clinical and health services investigator with interests in trauma, integrative medicine, spinal disorders and Medicare health policy. Experience in clinical database development and medical editing. IRB and editorial advisory board member. Licensed chiropractic physician with 25 years clinical experience. Faculty appointment with Geisel School of Medicine at Dartmouth.
Much of his research has focused upon geographic variations in access to chiropractic services under Medicare. He conducts observational research using claims and registry data.
Dr. Whedon’s long-term research goals are to improve access to health services that people need and want, and to improve quality through systematic care of acute problems and conservative upstream care of chronic problems. He has a particular interest in helping to improve access to care for vulnerable populations.
He is also a member of the Advisory Team, Project for Integrative Health and the Triple Aim, and of the Research Working Group, Academic Consortium for Complementary and Alternative Health Care (ACCAHC).
See Dr. Whedon’s list of publications on researchgate.net.
How to cite this episode:
Smith DL. Chiropractic Science: Chiropractic, Opioids, Adverse Drug Events, and Medicare with Dr. James Whedon [internet]. Eaton, Ohio; Aug 23, 2018. Podcast: 1:05:21. Available from: https://chiropracticscience.com/podcast/drjameswhedon/
Below is a list of the articles Dr. Whedon discusses in this episode:
| 1. | Association Between Utilization of Chiropractic Services for Treatment of Low Back Pain and Risk of Adverse Drug Events. |
| Whedon JM, Toler AWJ, Goehl JM, Kazal LA. | |
| J Manipulative Physiol Ther. 2018 Jun;41(5):383-388. doi: 10.1016/j.jmpt.2018.01.004. Epub 2018 May 26. | |
| PMID: 29843912 [PubMed – in process] | |
| Similar articles |
| 2. | Association Between Utilization of Chiropractic Services for Treatment of Low-Back Pain and Use of Prescription Opioids. |
| Whedon JM, Toler AWJ, Goehl JM, Kazal LA. | |
| J Altern Complement Med. 2018 Jun;24(6):552-556. doi: 10.1089/acm.2017.0131. Epub 2018 Feb 22. | |
| PMID: 29470104 [PubMed – indexed for MEDLINE] | |
| Similar articles |
| 3. | Relevance of Quality Measurement to Integrative Healthcare in the United States. |
| Whedon JM, Punzo M, Dehen R, Menard MB, Fogel D, Olejownik J. | |
| J Altern Complement Med. 2016 Nov;22(11):853-858. Epub 2016 Sep 23. | |
| PMID: 27660896 [PubMed – indexed for MEDLINE] | |
| Similar articles |
| 4. | The Association Between Use of Chiropractic Care and Costs of Care Among Older Medicare Patients With Chronic Low Back Pain and Multiple Comorbidities. |
| Weeks WB, Leininger B, Whedon JM, Lurie JD, Tosteson TD, Swenson R, O’Malley AJ, Goertz CM. | |
| J Manipulative Physiol Ther. 2016 Feb;39(2):63-75.e1-2. doi: 10.1016/j.jmpt.2016.01.006. Epub 2016 Feb 19. | |
| PMID: 26907615 [PubMed – indexed for MEDLINE] Free PMC Article | |
| Similar articles |
| 5. | Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66 to 99 years. |
| Whedon JM, Mackenzie TA, Phillips RB, Lurie JD. | |
| Spine (Phila Pa 1976). 2015 Feb 15;40(4):264-70. doi: 10.1097/BRS.0000000000000725. | |
| PMID: 25494315 [PubMed – indexed for MEDLINE] Free PMC Article | |
| Similar articles |
| 6. | Risk of stroke after chiropractic spinal manipulation in medicare B beneficiaries aged 66 to 99 years with neck pain. |
| Whedon JM, Song Y, Mackenzie TA, Phillips RB, Lukovits TG, Lurie JD. | |
| J Manipulative Physiol Ther. 2015 Feb;38(2):93-101. doi: 10.1016/j.jmpt.2014.12.001. Epub 2015 Jan 14. | |
| PMID: 25596875 [PubMed – indexed for MEDLINE] Free PMC Article | |
| Similar articles |
| 7. | Comparing Propensity Score Methods for Creating Comparable Cohorts of Chiropractic Users and Nonusers in Older, Multiply Comorbid Medicare Patients With Chronic Low Back Pain. |
| Weeks WB, Tosteson TD, Whedon JM, Leininger B, Lurie JD, Swenson R, Goertz CM, O’Malley AJ. | |
| J Manipulative Physiol Ther. 2015 Nov-Dec;38(9):620-8. doi: 10.1016/j.jmpt.2015.10.005. Epub 2015 Nov 5. | |
| PMID: 26547763 [PubMed – indexed for MEDLINE] Free PMC Article | |
| Similar articles |
In this episode, Dr. Robert Vining and I discuss his involvement in chiropractic research at a specialty hospital in New Hampshire, low back pain classification and strategies on how to implement evidence into practice. Dr. Vining is an Associate Professor and Research Clinic Director at the Palmer Center for Chiropractic Research, Palmer College of Chiropractic. Beginning in private practice in Pennsylvania, he eventually transitioned to the role of clinician/educator, teaching courses in clinical biomechanics at Cleveland Chiropractic College (now Cleveland University), and serving as a teaching clinic director at Logan College of Chiropractic. More recently, Dr. Robert Vining has taken on the role of clinician/scientist, serving as a co-investigator on 11 federally funded clinical studies including those conducted within Veterans Affairs and the US Department of Defense health systems. He was also co-principal investigator on a series of privately funded research projects focused on integrating chiropractic care into a rehabilitation specialty hospital. Dr. Vining is a lead or co-author on over 30 peer reviewed scientific journal articles, 2 book chapters, and numerous other publications related to chiropractic care, musculoskeletal diagnosis, and translating research evidence into clinical practice.
You can view Dr. Vining’s research articles at researchgate.
How to cite this episode:
Smith DL. Chiropractic Science: Interdisciplinary Care and Strategies to Incorporate Evidence Into Practice With Dr. Robert Vining [internet]. Eaton, Ohio; Aug 7, 2018. Podcast: 1:21:13. Available from: https://chiropracticscience.com/podcast/drrobertvining/
| 1. | “Be good, communicate, and collaborate”: a qualitative analysis of stakeholder perspectives on adding a chiropractor to the multidisciplinary rehabilitation team. |
| Salsbury SA, Vining RD, Gosselin D, Goertz CM. | |
| Chiropr Man Therap. 2018 Jun 22;26:29. doi: 10.1186/s12998-018-0200-4. eCollection 2018. | |
| PMID: 29977521 [PubMed – in process] Free PMC Article | |
| Similar articles |
| 2. | Patients receiving chiropractic care in a neurorehabilitation hospital: a descriptive study. |
| Vining RD, Salsbury SA, Cooley WC, Gosselin D, Corber L, Goertz CM. | |
| J Multidiscip Healthc. 2018 May 3;11:223-231. doi: 10.2147/JMDH.S159618. eCollection 2018. | |
| PMID: 29760552 [PubMed] Free PMC Article | |
| Similar articles |
| 3. | Interdisciplinary rehabilitation for a patient with incomplete cervical spinal cord injury and multimorbidity: A case report. |
| Vining RD, Gosselin DM, Thurmond J, Case K, Bruch FR. | |
| Medicine (Baltimore). 2017 Aug;96(34):e7837. doi: 10.1097/MD.0000000000007837. | |
| PMID: 28834891 [PubMed – indexed for MEDLINE] Free PMC Article | |
| Similar articles |
| 4. | An evidence-based diagnostic classification system for low back pain. |
| Vining R, Potocki E, Seidman M, Morgenthal AP. | |
| J Can Chiropr Assoc. 2013 Sep;57(3):189-204. | |
| PMID: 23997245 [PubMed] Free PMC Article | |
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Join Dr. John Mayer and I as we discuss his extensive clinical and research experience in therapeutic exercise, wellness, chiropractic and first responders. John M. Mayer, DC, PhD, CCRP, FACSM is the Lincoln Endowed Chair in Biomechanical & Chiropractic Research, Executive Director of the Center for Neuromusculoskeletal Research, and Professor of the School of Physical Therapy & Rehabilitation Sciences, Morsani College of Medicine, University of South Florida. He is Director of Research and Innovation for U.S. Spine & Sport Foundation, Chief Scientific Officer of Excellcior LLC, and Co-Founder of Pillar of Health LLC
Dr. Mayer obtained a Doctor of Chiropractic (DC) degree from the National College of Chiropractic (currently known as National University of Health Sciences) and a PhD degree in Exercise Science/Science Education from Syracuse University. He is a licensed Chiropractic Physician in the state of Florida, a Fellow of the American College of Sports Medicine (FACSM), and a Certified Clinical Research Professional (CCRP) from the Society of Clinical Research Associates. He has extensive clinical and research experience in occupational health, wellness, and therapeutic exercise. Dr. Mayer has led teams on numerous clinical trials across the country on various aspects of wellness, clinical management, and prevention funded through federal, state, industry, and foundation sources, including the largest single financial commitment by the US Department of Homeland Security on low back injury prevention in firefighters. He serves on the Scientific Secretariat for the Global Spine Care Initiative and Clinical and the Scientific Advisory Board for World Spine Care. Dr. Mayer received the 2012 Safety Award from Tampa Fire Rescue, 2014 “Researcher of the Year” Award by the American Chiropractic Association, and 2015 “Outstanding Research Achievement Award” by USF.
View Dr. Mayer’s research publications on Research Gate.
Here is a listing of the articles we discussed today:
| 1. | Effect of Lumbar Progressive Resistance Exercise on Lumbar Muscular Strength and Core Muscular Endurance in Soldiers. |
| Mayer JM, Childs JD, Neilson BD, Chen H, Koppenhaver SL, Quillen WS. | |
| Mil Med. 2016 Nov;181(11):e1615-e1622. | |
| PMID: 27849497 [PubMed – indexed for MEDLINE] | |
| Similar articles |
| 2. | Impact of a supervised worksite exercise program on back and core muscular endurance in firefighters. |
| Mayer JM, Quillen WS, Verna JL, Chen R, Lunseth P, Dagenais S. | |
| Am J Health Promot. 2015 Jan-Feb;29(3):165-72. doi: 10.4278/ajhp.130228-QUAN-89. | |
| PMID: 24524384 [PubMed – indexed for MEDLINE] | |
| Similar articles |
| 3. | Worksite back and core exercise in firefighters: Effect on development of lumbar multifidus muscle size. |
| Mayer JM, Nuzzo JL. | |
| Work. 2015;50(4):621-7. doi: 10.3233/WOR-141831. | |
| PMID: 24448017 [PubMed – indexed for MEDLINE] | |
| Similar articles |
| 4. | Evidence-informed management of chronic low back pain with lumbar extensor strengthening exercises. |
| Mayer J, Mooney V, Dagenais S. | |
| Spine J. 2008 Jan-Feb;8(1):96-113. doi: 10.1016/j.spinee.2007.09.008. Review. | |
| PMID: 18164458 [PubMed – indexed for MEDLINE] | |
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Listen as Dr. Pierre Côté and I discuss his involvement in hugely impactful research on stroke, lumbar disc herniations and neck pain. He provides chiropractors with key information that helps de-mystify these topics. Pierre Côté DC, PhD is an epidemiologist. In 2013, he was awarded the prestigious Canada Research Chair in Disability Prevention and Rehabilitation from the Canadian Government. He is currently an Associate Professor in the Faculty of Health Sciences at the University of Ontario Institute of Technology, director of the UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation and an Associate Professor in the Dalla Lana School of Public Health at the University of Toronto. Dr. Côté graduated from the Canadian Memorial Chiropractic College in 1989. In 1996, he obtained a Master’s Degree in Surgery from the University of Saskatchewan. He completed his PhD in epidemiology at the University of Toronto in 2002. In 2003, he received a New Investigator Award from the Canadian Institutes of Health Research.
Dr. Côté was a member of the scientific secretariat of the 2000-2010 Bone and Joint Task Force on Neck Pain and its Associated Disorders; a large international collaboration aimed at synthesizing the scientific evidence on the problem of neck pain. In 2010, he reviewed and proposed modifications to the definition of catastrophic impairment related to traffic collision for the Financial Services Commission of Ontario. More recently in 2012, he was mandated by the Government of Ontario to develop evidence- based Clinical Practice Guidelines for the management of traffic injuries. He submitted his report on the management of Common Traffic injuries to the Ontario Government in 2015. Dr. Côté’s research focuses on understanding the etiology, prognosis and evidence-based management of musculoskeletal pain and disability and mental health. Dr. Côté has published more than 200 scientific papers in prestigious peer-reviewed journals such as the New England Journal of Medicine, the Annals of Internal Medicine, Pain and the American Journal of Epidemiology. His 2017 Google Scholar h-index is 56 and it is 48 according to Scopus.
Website: www.cdpr-research.org
You can find a listing of Dr. Côté’s research at researchgate.
Below are the articles we discuss in this interview:
| 1. | Chiropractic care and risk for acute lumbar disc herniation: a population-based self-controlled case series study. |
| Hincapié CA, Tomlinson GA, Côté P, Rampersaud YR, Jadad AR, Cassidy JD. | |
| Eur Spine J. 2017 Oct 16. doi: 10.1007/s00586-017-5325-y. [Epub ahead of print] | |
| PMID: 29038870 [PubMed – as supplied by publisher] | |
| Similar articles |
| 2. | Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. |
| Cassidy JD, Boyle E, Côté P, He Y, Hogg-Johnson S, Silver FL, Bondy SJ. | |
| Spine (Phila Pa 1976). 2008 Feb 15;33(4 Suppl):S176-83. doi: 10.1097/BRS.0b013e3181644600. Erratum in: Spine (Phila Pa 1976). 2010 Mar 1;35(5):595. | |
| PMID: 18204390 [PubMed – indexed for MEDLINE] | |
| Similar articles |
| 3. | Management of neck pain and associated disorders: A clinical practice guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. |
| Côté P, Wong JJ, Sutton D, Shearer HM, Mior S, Randhawa K, Ameis A, Carroll LJ, Nordin M, Yu H, Lindsay GM, Southerst D, Varatharajan S, Jacobs C, Stupar M, Taylor-Vaisey A, van der Velde G, Gross DP, Brison RJ, Paulden M, Ammendolia C, David Cassidy J, Loisel P, Marshall S, Bohay RN, Stapleton J, Lacerte M, Krahn M, Salhany R. | |
| Eur Spine J. 2016 Jul;25(7):2000-22. doi: 10.1007/s00586-016-4467-7. Epub 2016 Mar 16. Review. | |
| PMID: 26984876 [PubMed – in process] | |
| Similar articles |
| 4. | The annual incidence and course of neck pain in the general population: a population-based cohort study. |
| Côté P, Cassidy JD, Carroll LJ, Kristman V. | |
| Pain. 2004 Dec;112(3):267-73. | |
| PMID: 15561381 [PubMed – indexed for MEDLINE] | |
| Similar articles |
Is sitting killing you? What kind of posture should you have seated or standing? How much time should you sit versus stand at work? How much spine flexion is too much? Can chiropractic manipulation help with seated postures? These are some of the many questions that are addressed in this interview. Dr. Diana De Carvalho is an Assistant Professor at Memorial University of Newfoundland in the Discipline of Medicine, Faculty of Medicine. She holds the Canadian Chiropractic Research Foundation Professorship in Spine Biomechanics and is cross-appointed to the School of Human Kinetics and Recreation.
After completing a BSc in Human Kinetics at the University of Guelph (2002), she attended the Canadian Memorial Chiropractic College graduating with the class of 2006. Concurrent to part-time clinical practice, Dr. De Carvalho completed a Certificate in University Teaching along with her MSc (2008) and PhD (2015) in Kinesiology at the University of Waterloo. She has extensive experience with industry-partnered research involving both automotive and ergonomic office seating.
Directly related to decreased productivity, decreased quality of life and high health care costs, low back pain might be the first of many negative health outcomes experienced by sedentary workers. Dr. De Carvalho’s research program focuses on spine mechanics, especially in response to sustained flexion, in order to better define and direct early diagnosis, prevention and intervention strategies for low back pain.
In addition to numerous peer-reviewed conference presentations both at the national and international level, Dr. De Carvalho has published articles in such journals as JMPT, Applied Ergonomics and Human Factors and she is an editorial board member of the Journal of the Canadian Chiropractic Association.
Here is a link to Dr. De Carvalho’s webpage at Memorial University.
You can find Dr. De Carvalho’s publications here.
Below are the articles we discussed in the podcast:
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In this interview, Dr. Ammendolia and I discuss his work regarding chiropractic care and lumbar spinal stenosis including his recent randomized controlled trial in this area of study. Carlo Ammendolia, DC, PhD is the Director of the Spine Clinic and the Spinal Stenosis Program at the Rebecca MacDonald Centre for Arthritis and Autoimmune Diseases at Mount Sinai Hospital. He received his MSc degree in Clinical Epidemiology and Health Care Research his PhD in Clinical Evaluative Sciences from the University of Toronto. Dr. Ammendolia is an Assistant Professor in the Institute of Health Policy, Management and Evaluation, the Department of Surgery and the Institute of Medical Sciences at the University of Toronto. In 2012, Dr. Ammendolia was recipient of the Professorship in Spine Award from the Department of Surgery in the Faculty of Medicine. In 2015 he was award the Chiropractor of the Year Award from the Ontario Chiropractic Association and in 2016 the Researcher of the Year Award from the Canadian Chiropractic Association. Dr. Ammendolia has been in clinical practice for over 30 years and now combines clinical practice and research in the area of non-operative treatment of mechanical, degenerative and inflammatory spinal disorders with a special interest in degenerative lumbar spinal stenosis.
Visit Dr. Carlo Ammendolia’s research profile here.
Visit Dr. Carlo Ammendolia’s website spinemobility.com where you can learn about this Not-for-Profit Research and Resource Centre aimed at developing and testing innovative programs and devices with the goal of maximizing function, improving quality of life and reducing the risk of disability caused by spine and spine related conditions. A key component of what they do is to provide clinicians with the tools, knowledge, skills and self-confidence to implement in their clinics our evidence-based programs.
Below are the articles we discussed in this podcast interview. A link the the abstract from the randomized controlled trial is found here.
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Learn what happens in your brain when a chiropractor adjusts your spine. Dr Heidi Haavik is a chiropractor and a neurophysiologist who has worked in the area of human neurophysiology for over 15 years. Heidi has a PhD in human neurophysiology from the University of Auckland. Her work has been instrumental in building the base of scientific evidence demonstrating the efficacy of chiropractic care in improving people’s health and wellbeing. As a researcher, she has investigated the effects of chiropractic adjustments of dysfunctional spinal segments (vertebral subluxations) on somatosensory processing, sensorimotor integration and motor cortical output.
Dr Haavik is the Director of Research at the New Zealand College of Chiropractic where she has established the Centre for Chiropractic Research. Dr Haavik is also an Adjunct Professor at the University of Ontario, Institute of Technology in Oshawa, Canada and is a member of the World Federation of Chiropractic’s Research Council. Dr Haavik has received numerous research awards and has published a number of papers in chiropractic and neurophysiology journals. She has presented her work to both chiropractic and neuroscience communities around Australasia, North America and Europe. She is on the Editorial Board of the Journal of Manipulative and Physiological Therapeutics and Journal of Chiropractic Education. She was named Chiropractor of the year in 2007 by both the New Zealand Chiropractic Association and the New Zealand College of Chiropractic Alumni Association. She is also the author of a textbook – The Reality Check which describes in easy to understand language what happens in the brain when a chiropractor adjusts dysfunctional segments in your spine.
Read about Dr Haavik at her website, and get her book and posters at heidihaavik.com. Subscribe to Dr Haavik’s research service at haavikresearch.com to get great evidence-informed marketing material for chiropractic practices including among other things, videos for your website that explain how chiropractic works. Interested in donating toward her research efforts? Contact her at haavikresearch.com.
Dr. Haavik and Dr. Smith at the Ohio State Chiropractic Association Convention, 2015
Dr. Haavik’s book: The Reality Check
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