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Chiropractic Science Delivers the Evidence with Convenience (and It’s Free)

ChiropracticScienceLogo1American chiropractors are very similar to chiropractors in other countries, as well as other health professionals in terms of their favorable attitudes towards evidence based practice (EBP) (1-2). The purpose of EBP is to promote effective chiropractic practice and enhance public health. Evidence based practice incorporates the best research evidence with individual clinical expertise and patient choice/values (3). There are however several limitations and barriers to implementing EBP that chiropractors express such as lack of research relevance, lack of time and insufficient skills for locating and appraising research (1). It is important to note that these same obstacles are also encountered by other professions including medicine and nursing.

In a recent survey, very few DCs indicated that computer, internet, or database access were barriers to their uptake of EBP (1). Since chiropractors are interested in implementing EBP, these findings underscore the importance of providing clinicians with training in EBP skills, particularly through online resources. It is likely that comprehensive and multi-faceted approaches that take into account all the relevant levels affecting EBP will likely be needed to integrate research into practice (1).

As a practitioner as well as a researcher, I realize the importance and barriers of translating research into practice. I have also begun to realize how I can give back to the profession. Some of you may recognize my On Target research summaries.  Others may be familiar with my chiropractic science podcast.  While there may be many ways to tackle the evidence-practice gap, one convenient educational method is a podcast. This is one of the ways that I have been utilizing to help get chiropractic research out to the masses. For those not familiar, a podcast describes audio and/or video files that can be downloaded and played on a personal computer or mobile device.

Podcast is the term commonly used to refer to a series of digital media files that are released periodically and can be subscribed to using an RSS (Really Simple Syndication) feed. This means of digital delivery is what makes podcasting different from other means of accessing media files over the internet.  Of course one can still download the audio and/or video files that makeup a podcast.  The automatically downloaded files can be stored locally on a computer or other device (such as your mobile phone) ready for offline use, providing simple and convenient access to regular releases.

Podcasting has been used successfully in teaching and learning in many different student groups (4-5). In theory podcasts provide educational content in a format that is convenient and available 24 hours a day and can be accessed whenever and wherever the learner chooses (4-5). Learners have the ability to replay a podcast as many times as they wish in order to improve understanding. In addition, podcasting offers the ability to embed additional content from researchers or clinicians to help make links between theoretical concepts and practice.

While many chiropractic podcasts exist, chiropractic science (CS) is the only podcast that exclusively interviews chiropractic researchers about the science of chiropractic. CS publicizes and disseminates chiropractic research. Hear about chiropractic research from the authors in plain English, not through the media, nor a middleman. Think about recent media coverage concerning the evidence of chiropractic in magazines or online.  While reports of chiropractic studies in the media may be very good (or very poor), some things get lost in translation.  By interviewing the chiropractic experts that are actually doing the research, you’ll get the information direct – the way the author intended it.

Making scientific findings available to the public is an important part of the research process.  Publicizing these interviews passes on the benefits of chiropractic research to other researchers, chiropractors in practice as well as practitioners from other disciplines and the wider community. In addition to publicizing the interviews, other goals of the podcast are to encourage collaboration of researchers to promote future high quality chiropractic research as well as to motivate and assist practitioners and students alike to pursue research careers in chiropractic science!

Why Chiropractic Science?

  • There is a lot of excellent chiropractic research published by top scientists in the field that deserve our attention
  • Incorporating the latest evidence into your practice of chiropractic is good for everyone
  • Reduce the evidence – practice gap and promote knowledge translation from the chiropractic research laboratory to the clinic
  • Engage clinicians in evidence based practice in a fun, easy to access manner
  • Learn from the experts and gain confidence in your knowledge and communications with others about chiropractic
  • A chiropractic resource for students, doctors and patients

Feedback about Chiropractic Science

  • “It has been such an inspiration to listen to all the greats in the world of chiropractic research”
  • “It has certainly made an impact on my practice and gives me a tremendous amount of certainty in what we do as chiropractors”
  • “I find the information profoundly motivating”
  • “It is difficult to read and interpret journal articles for a seasoned chiropractor. This saves time and hearing it explained from your colleagues themselves in language that I can communicate with my patients is invaluable”
  • “I am humbled by the sacrifice, hard work and accomplishments of all the researchers you have interviewed”
  • “Being in practice for many years, I am weary of ideologically biased forums when 21st Century chiropractic can have and bring it all; evidence and practice based science WITH a strong philosophical foundation. Highest accolades to Dr. Dean Smith for his untiring success at bringing the bar, raising colleagues and conversations together to articulate just how pertinent chiropractic is in contemporary health care”

In short, CS is starting to achieve what it set out to do, but this just the beginning. I am humbled by the feedback I have received from chiropractors about the podcast and am looking forward to interviewing as many chiropractic researchers as possible.  If you haven’t listened to the podcast, check them out.  If you like what you hear, please leave a great review on iTunes. This will help position CS as a leading health podcast – enlightening the masses about the evidence of chiropractic.  Listen to the podcast on iTunes or download the files directly to your device from chiropracticscience.com.  Enjoy and share with everyone.

References:

  1. Schneider MJ, Evans R, Haas M, Leach M, Hawk C, Long C, Cramer GD, Walters O, Vihstadt C, Terhorst L. US chiropractors’ attitudes, skills and use of evidence-based practice: A cross-sectional national survey. Chiropr Man Therap. 2015 May 4;23:16.
  2. Alcantara J, Leach MJ. Chiropractic Attitudes and Utilization of Evidence-Based Practice: The Use of the EBASE Questionnaire. Explore (NY). 2015 Sep-Oct;11(5):367-76.
  3. Lefebvre R, Peterson D, Haas M. Evidence-Based Practice and Chiropractic Care. J Evid Based Complementary Altern Med. 2012 Dec 28;18(1):75-79.
  4. Burke S, Cody W. Podcasting in undergraduate nursing programs. Nurse Educ. 2014 Sep-Oct;39(5):256-9.
  5. Strickland K, Gray C, Hill G. The use of podcasts to enhance research-teaching linkages in undergraduate nursing students. Nurse Educ Pract. 2012 Jul;12(4):210-4.


Dr. Dean Smith is founder of chiropractic science – dedicated to publicizing and disseminating chiropractic research through podcast interviews with the experts that are doing the research.  Listen to free chiropracticscience.com interviews on iTunes.  Dr. Smith is also a clinical professor at Miami University in Oxford, Ohio.  He has a practice of chiropractic in Eaton, Ohio.

Podcast

Dr. Michele Maiers

020- Patient Perspectives, Integrative Care and Health Policy with Dr. Michele Maiers

Dr. Michele MaiersDr. Michele Maiers and I discuss the patient perspective in chiropractic clinical trials, integrative care and  leveraging research to inform health care policy.

“We’re drowning in information and starving for knowledge.”   ~Rutherford Rogers

This axiom aptly characterizes how many see research as it relates to health care delivery.  Dr. Maiers’ professional goal is to facilitate the pragmatic use of research to both inform clinical practice and shape public health policy. Her research has focused on clinical trials that answer practical questions, including, are patient outcomes improved with co-management by different provider types? Is short term treatment or long term management a better approach for chronic musculoskeletal conditions? What aspects of care matter most to patients? It is essential that the information gained in these and other studies is translated into knowledge that improves patient care, policy guidelines, access and reimbursement. Dr. Maiers is excited about her work because she believes in the capacity for integrative and complementary professions to be a positive force to improving the landscape of health care.  When not at work, she enjoys traveling, reading, running and baking pies.

See Dr. Maiers publications on researchgate.

Here are the links to the articles we discussed in this interview:

1. What do patients value about spinal manipulation and home exercise for back-related leg pain? A qualitative study within a controlled clinical trial.
Maiers M, Hondras MA, Salsbury SA, Bronfort G, Evans R.
Man Ther. 2016 Dec;26:183-191. doi: 10.1016/j.math.2016.09.008.
PMID: 27705840 [PubMed – in process]
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2. Adverse events among seniors receiving spinal manipulation and exercise in a randomized clinical trial.
Maiers M, Evans R, Hartvigsen J, Schulz C, Bronfort G.
Man Ther. 2015 Apr;20(2):335-41. doi: 10.1016/j.math.2014.10.003.
PMID: 25454683 [PubMed – indexed for MEDLINE]
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3. Perceived value of spinal manipulative therapy and exercise among seniors with chronic neck pain: a mixed methods study.
Maiers M, Vihstadt C, Hanson L, Evans R.
J Rehabil Med. 2014 Nov;46(10):1022-8. doi: 10.2340/16501977-1876.
PMID: 25258045 [PubMed – indexed for MEDLINE] Free Article
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4. Spinal manipulative therapy and exercise for seniors with chronic neck pain.
Maiers M, Bronfort G, Evans R, Hartvigsen J, Svendsen K, Bracha Y, Schulz C, Schulz K, Grimm R.
Spine J. 2014 Sep 1;14(9):1879-89. doi: 10.1016/j.spinee.2013.10.035.
PMID: 24225010 [PubMed – indexed for MEDLINE]
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5. Integrative care for the management of low back pain: use of a clinical care pathway.
Maiers MJ, Westrom KK, Legendre CG, Bronfort G.
BMC Health Serv Res. 2010 Oct 29;10:298. doi: 10.1186/1472-6963-10-298.
PMID: 21034483 [PubMed – indexed for MEDLINE] Free PMC Article
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Dr. Scott Haldeman - Pioneering Chiropractic Research, Chiropractic Science

009- Scott Haldeman, DC, PhD, MD: Pioneering and Contemporary Chiropractic Science

Haldeman1In this episode, it is my great privilege to interview Scott Haldeman, DC, PhD, MD.  Dr. Haldeman is a pioneer of chiropractic science and a world leader in spine research. Dr. Haldeman holds the positions of Adjunct Professor, Department of Epidemiology, School of Public Health, University of California, Los Angeles, and Clinical Professor, Department of Neurology, University of California, Irvine.

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, and is currently Chairman Emeritus of the Research Council of the World Federation of Chiropractic. He is certified by the American Board of Neurology and Psychiatry and is a Fellow of the Royal College of Physicians of Canada and a Fellow of the American Academy of Neurology. He is a Diplomat of the American Board of Electrodiagnostic Medicine, the American Board of Electroencephalography and Neurophysiology and the American Board of Clinical Physiology. He also served on the US department of Health AHCPR Clinical Guidelines Committee on Acute Low Back Problems in Adults as well as four other Clinical Guidelines Committees. He presided over The Bone and Joint Decade 2000 to 2010 Task Force on Neck Pain and Its Associated Disorders.

Scott Haldeman sits on the editorial boards of six journals, and has published over 200 articles or book chapters, over 70 scientific abstracts, and has authored or edited seven books. He was awarded an honorary Doctor of Humanities degree from the Southern California University of Health Sciences and an honorary Doctor of Science degree from the Western States Chiropractic College. He received the David Selby Award from the North American Spine Society. A resident of Santa Ana, California, he maintains an active clinical practice.

World Spine Care is a global charity on a mission to treat the disease with the greatest economic impact in the developing world: Spinal Disorders. To donate or volunteer to the project, please click below.

 

World Spine Care

 

For a list of Dr. Haldeman’s scientific publications please click here.

Here is a list of the publications we discuss during this interview:

1. The McAndrews Leadership Lecture: February 2015, by Dr Scott Haldeman. Challenges of the Past, Challenges of the Present.
Haldeman S, McAndrews GP, Goertz C, Sportelli L, Hamm AW, Johnson C.
J Chiropr Humanit. 2015 Nov 18;22(1):30-46. doi: 10.1016/j.echu.2015.09.001.
PMID: 26770177 [PubMed] Free PMC Article
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2. A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States.
Dagenais S, Brady O, Haldeman S, Manga P.
BMC Health Serv Res. 2015 Oct 19;15:474. doi: 10.1186/s12913-015-1140-5. Review.
PMID: 26482271 [PubMed – indexed for MEDLINE] Free PMC Article
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3. Commentary: we can tell where it hurts, but can we tell where the pain is coming from or where we should manipulate?
Brady O, Haldeman S.
Chiropr Man Therap. 2013 Oct 21;21(1):35. doi: 10.1186/2045-709X-21-35.
PMID: 24499590 [PubMed] Free PMC Article
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4. Advancements in the management of spine disorders.
Haldeman S, Kopansky-Giles D, Hurwitz EL, Hoy D, Mark Erwin W, Dagenais S, Kawchuk G, Strömqvist B, Walsh N.
Best Pract Res Clin Rheumatol. 2012 Apr;26(2):263-80. doi: 10.1016/j.berh.2012.03.006. Review.
PMID: 22794098 [PubMed – indexed for MEDLINE]
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5. Is it time to discard the term “diagnosis” when examining a person with uncomplicated axial neck pain?
Haldeman S.
Spine J. 2011 Mar;11(3):177-9. doi: 10.1016/j.spinee.2011.01.032. No abstract available.
PMID: 21377599 [PubMed – indexed for MEDLINE]
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