PMID: 9653012Jul 4, 1998Paper

Congruence between decisions to initiate chiropractic spinal manipulation for low back pain and appropriateness criteria in North America

Annals of Internal Medicine
P G ShekelleR H Brook

Abstract

Recent U.S. practice guidelines recommend spinal manipulation for some patients with low back pain. If followed, these guidelines are likely to increase the number of persons referred for chiropractic care. Concerns have been raised about the appropriate use of chiropractic care, but systematic data are lacking. To determine the appropriateness of chiropractors' decisions to use spinal manipulation for patients with low back pain. Retrospective review of chiropractic office records against preset criteria for appropriateness that were developed from a systematic review of the literature and a nine-member panel of chiropractic and medical specialists. Appropriateness criteria reflect the expected balance between risk and benefit. 131 of 185 (71%) chiropractic offices randomly sampled from sites in the United States and Canada. 10 randomly selected records of patients presenting with low back pain from each office (1310 patients total). Sociodemographic data on patients and chiropractors; use of health care services by patients; assessment of the decision to initiate spinal manipulation as appropriate, uncertain, or inappropriate. Of the 1310 patients who sought chiropractic care for low back pain, 1088 (83%) had spinal manipulat...Continue Reading

Citations

Jun 25, 2005·Annales de réadaptation et de médecine physique : revue scientifique de la Société française de rééducation fonctionnelle de réadaptation et de médecine physique·G EgiziiP Vautravers
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Dec 26, 2018·Journal of Health Services Research & Policy·Ian CoulterUNKNOWN Members of CERC Team
Aug 19, 2021·The Journal of Chiropractic Education·Claire D JohnsonPaul G Shekelle

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