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Clinical Skills

Treatment options

Are supine high-velocity low-amplitude (HVLA) manipulative procedures appropriate for managing cases with symptomatic cervical disc herniation? Results from a study conducted in Switzerland provide evidence that supine HVLA procedures can be used safely and effectively. A clinical trial described in The Journal of Manipulative and Physiological Therapeutics reports on a study conducted with patients...
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Seminal Papers in Evidence-Based Medicine

There are simply thousands of papers on evidence-based practice, but sometimes it is good to see how it all started. Below are some of the seminal papers on EBM that were published in the early days of the movement. Evidence-Based Medicine Working Group. Evidence-based medicine. A new approach to teaching the practice of medicine....
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Surrogates are everywhere

Last month the British Medical Journal published a systematic review and meta-analysis on calcium intake and bone mineral density. It has long been hypothesized that adequate calcium in the diet is important for “healthy bones.” There has been quite a bit of research on the subject. In fact the authors identified 59 randomized controlled...
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Apps for Evidence-Based Practice

We live in a busy and mobile world where we have access to more information on our cell phones that earlier people did by visiting a library. And we live in a world where evidence is increasingly important to us in the practice of chiropractic. Can we yoke our developing technology to our practices?...
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Focusing on pain may be part of a solution

During the past several years, neuroscience research has confirmed that our brains process the pain from physical injury and social disconnection (e.g., loss of a loved one, or a broken close relationship) in the same regions and in a similar manner.(1;2) The current thinking is that these two seemingly disparate circumstances are each processed...
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Texts about EBCP and Research

There is a wealth of good texts available related to evidence-based practice and to research. Here are just some, in no particular order. Harris M, Taylor G, Jackson D. Clinical evidence made easy. Scion Publishing; Banbury, England, 2014 Harden R, Laidlaw J. Essential skills for a medical teacher: an introduction to teaching and learning...
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How clinicians think

Last September and October my friend and colleague, Dr. Dana Lawrence, wrote a series of blogs in this column on diagnostic testing. He gave readers clear explanations on a variety of related topics including pre-test probability, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, nomograms and post-test probability. He gave...
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Hot peppers

Finally, the peppers are starting to come in. Fresh chile peppers from the garden can add such a delightful kick to a meal. Grill up some onions, green peppers and chilies with a little coriander and cumin, add some black beans, fresh tomato, lime and cilantro to a tortilla and you have a fantastic...
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Qualitative Research

Consider a clinical trial in which we are looking for change in self-reported pain scores, where our participants record those scores using a numerical rating scale from 0 (no pain) to 10 (worst pain imaginable). Participant #1 scores his pain a 5 on the day it is recorded, and participant #2 also scores her...
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Relationships can be deceiving

Have you ever discussed research findings with a patient? Perhaps it went something like this: “This article states that Vitamin D is linked to colorectal cancer.” Should I be taking vitamin D supplements? Perhaps you haven’t been asked that exact question, but I suspect that many DCs find themselves in similar situations. The hypothetical...
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