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Clinical Skills

More on Diagnostic Testing

Within our profession we have many technique systems, and in each of those systems, we have diagnostic procedures whose primary goal seems to be to locate subluxation so that we can then provide an effective adjustment for our patients. So much of our education is didactic; that is, we take courses in which we...
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Guidelines for treating adults with neck pain

Clinical guidelines are, in short, recommendations for evidence-based care constructed from a synthesis of clinical trials and systematic reviews. Recently, guidelines for chiropractic treatment of adults with acute and chronic neck pain were published in the Journal of Manipulative and Physiological Therapeutics.(1) The guidelines focus on several types of care provided by doctors of...
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Informed Consent for Participation in Human Subject Research

All of us who are involved in the practice of chiropractic are well acquainted with the concept of informed consent. We know we should sit down with our patients and describe our treatment plan with them, letting them know of the possible risks that might occur should they wish to be treated. This is...
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A PROMIS for the future

It does get rather confusing. If you look at a variety of studies on different interventions for chronic low back pain, drawing concrete conclusions is difficult. Often there are differences in the participant sample because of different inclusion and exclusion criteria. Or the definition for ‘chronic’ is operationally defined inconsistently. Or the outcomes of...
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The complex diagnostic process

The diagnostic investigation at its core seeks to discover key information necessary to better understand the patient, the condition, and to better inform care tailored to the patient’s needs and desires. If this statement can be accepted at face value, then I submit that the information seeking at the heart of the diagnostic process...
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From the Great Articles Department: Bovine’s description of D.D. Palmer’s Adjustive Technique

Among the many topic areas of chiropractic areas, the one that gets the least attention is chiropractic history. Beyond chiropractic history having, well, “historical interest,” awareness of what has gone before may certainly have an impact on the present. As the years have gone by, on most of the those occasions when I thought...
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Epidemiological Research Study Designs

Epidemiological research is designed to answer the kinds of questions clinical trials cannot. For example, if we wish to study the effects of smoking on lung cancer rates, the most effective way to do so would be to design a clinical trial that divided a population into a group that did not smoke and...
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Validity, precision and magnitude

Essential concepts filtered down to 3 words. When it comes to assessing the applicability of a study to a particular patient it is these three things that the practitioner needs to understand. Validity Is the study valid? There are a number of tools available to get at this question, most in the form of...
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A clinical prediction rule

In a previous post, I introduced the evidence-based diagnostic classification system for low back pain (LBP) developed at the Palmer Center for Chiropractic Research (1). We developed the system to facilitate our clinical trial research and to provide a resource for others who wish to use it, especially those in practice settings. The system...
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Human Subject Research

Working in an evidence-based practice relies upon a combination of strong research evidence, well-developed clinical expertise, and patient values. With regard to that strong research evidence, it occurs within a regulatory context designed to protect the human participants who volunteer for clinical trials and other forms of scientific and clinical research. Something needs to...
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