“A window into the soul of the chiropractic profession”: JMPT 2006; 29(9)

jmpt.jpg  The November/December 2006 issue of the Journal of Manipulative and Physiological Therapeutics has just been published. Editor Claire Johnson calls this new collection of white papers “a window into the soul of the chiropractic profession”. Below are the abstracts for the five white papers that update the collection published in 1997.
PubMed Records    ICL Records for 1997 and 2006 papers   Current JMPT issue

Johnson C. Chiropractic white papers: an update [editorial]. J Manipulative Physiol Ther 2006; 29(9):689.

Excerpt: If one wanted to take the pulse of the current state of chiropractic, this issue of the JMPT would be a good place to start. The contents of this issue represents hundreds of hours of work. Literature searches, manuscript review, discussions, critique, all from some of the best minds in the chiropractic profession, have resulted in a snapshot of where some feel we are and where we need to go.
These white papers, although not original experimental research themselves, provide a window into the soul of the chiropractic profession. They allow us to reflect on our past as well as help us to chart a course for future research. Compared with a similar set of white papers published approximately 10 years ago, one can see how the research focus has changed and our course continues to evolve.

Lawrence DJ, Meeker WC. Commentary: the National Workshop to Develop the Chiropractic Research Agenda: 10 years on, a new set of white papers. J Manipulative Physiol Ther 2006; 29(9):690-694.

Abstract: This commentary reports on the advances that have occurred over the 10-year period since the first National Workshop to Develop the Chiropractic Research Agenda was held and introduces the second set of white papers that were produced as a result of the 10th annual Research Agenda Conference. Four working groups were convened to update the original 5 white papers that represented the most significant results from the first workshop in 1996. Each group was to review the first report, examine the action steps and recommendations that were published in each report to see how much had been completed in the past decade, and develop new action steps and recommendations for the future. Four new articles were developed, each updating and adding significant amounts of new research to the original versions. New action steps and recommendations will help move the profession forward into the future. Chiropractic scientists have worked diligently over the past decade to address the recommendations noted in the first set of white papers. Despite significant advances in knowledge and scientific capacity, the chiropractic profession is still confronted with a large number of research challenges.

Haas M, Bronfort G, Evans RL. Chiropractic clinical research: progress and recommendations. J Manipulative Physiol Ther 2006; 29(9):695-706.

OBJECTIVE: The purpose of this white paper is to help inform the chiropractic clinical research agenda with a focus on the United States.
METHODS AND DISCUSSION: The recommendations and action items from 2 previous articles published in 1997 are discussed within the context of 3 broad topics: research culture, research infrastructure, and clinical research studies. Progress made toward the action items in these areas is summarized. A summary of findings is presented of the most influential clinical research studies during the past decade performed by or with major contributions by chiropractic investigators. In light of the current evidence and previous recommendations, new clinical research recommendations are proposed.
CONCLUSIONS: Based on the assessment of the scientific literature and research currently underway, it is evident that members of the chiropractic research community have made important progress in becoming active players in the clinical research arena. During the past decade, the work of chiropractic researchers has contributed substantially to the amount and quality of the evidence for or against spinal manipulation in the management of low back pain, neck pain, headache, and other conditions.

Mootz RD, Hansen DT, Breen A, Killinger LZ, Nelson C. Health services research related to chiropractic: review and recommendations for research prioritization by the chiropractic profession. J Manipulative Physiol Ther 2006; 29(9):707-725.

PURPOSE: This project updates a previous effort to inventory health services research conducted on chiropractic and makes recommendations for a subsequent research agenda. A qualitative review of social sciences, medical, chiropractic, and health services research literature regarding chiropractic was done with emphasis on research published since the initial health services research agenda effort in 1995. This work informed development of updated health services research recommendations.
METHODS: Literature was gathered through searches of electronic health care database retrieval systems and citation tracking. In addition to general collecting of new studies, the authors considered to what extent the 1995 research recommendations had been addressed in the new literature. A seed set of refined recommendations was formulated and initially distributed expert review and revision. The recommendations were made available for public comment and hearing at the 10th Annual Research Agenda Conference for Chiropractic in March 2005.
DISCUSSION: The past 10 years have seen numerous health service research studies related to chiropractic; however, nearly all of the research priorities identified in 1995 remain unaddressed and remain as important priorities. Thus, recommendations were reprioritized and revised to submit for open comment and hearing.
CONCLUSION: A smaller number of more concise recommendations with more specific action steps are proposed for clinical quality improvement, performing cost analyses, and assessing use barriers for chiropractic.

Cramer G, Budgell B, Henderson C, Khalsa P, Pickar J. Basic science research related to chiropractic spinal adjusting: the state of the art and recommendations revisited. J Manipulative Physiol Ther 2006; 29(9):726-761.

OBJECTIVE: The objectives of this white paper are to review and summarize the basic science literature relevant to spinal fixation (subluxation) and spinal adjusting procedures and to make specific recommendations for future research.
METHODS: PubMed, CINAHL, ICL, OSTMED, and MANTIS databases were searched by a multidisciplinary team for reports of basic science research (since 1995) related to spinal fixation (subluxation) and spinal adjusting (spinal manipulation). In addition, hand searches of the reference sections of studies judged to be important by the authors were also obtained. Each author used key words they determined to be most important to their field in designing their individual search strategy. Both animal and human studies were included in the literature searches, summaries, and recommendations for future research produced in this project.
DISCUSSION: The following topic areas were identified: anatomy, biomechanics, somatic nervous system, animal models, immune system, and human studies related to the autonomic nervous system. A relevant summary of each topic area and specific recommendations for future research in each area were the primary objectives of this project.
CONCLUSIONS: The summaries of the literature for the 6 topic sections (anatomy, biomechanics, somatic nervous system, animal models, immune system, and human studies related to the autonomic nervous system) indicated that a significant body of basic science research evaluating chiropractic spinal adjusting has been completed and published since the 1997 basic science white paper. Much more basic science research in these fields needs to be accomplished, and the recommendations at the end of each topic section should help researchers, funding agencies, and other decision makers develop specific research priorities.

Mrozek JP, Till H, Taylor-Vaisey AL, Wickes D. Research in chiropractic education: an update. J Manipulative Physiol Ther 2006; 29(9):762-773.

PURPOSE: The objectives of this review were to update the 1997 report on research in chiropractic education from the Research Agenda Conference in 1996 and to provide recommendations for the future direction of this research.
METHODS: We conducted a review of the medical and chiropractic literature from March 1997 to March 2005 on the 7 thematic areas identified in the Research Agenda Conference’s 1997 article (ie, curriculum, assessment, instructional methods, admissions, faculty development and evaluation, postgraduate and continuing education, and patient centeredness). We searched the following databases: MEDLINE, CINAHL, Alt HealthWatch, Index to Chiropractic Literature, MANTIS, and ERIC. We hand searched conference proceedings and relevant journals along with the reference lists of retrieved articles.
DISCUSSION: Although research studies in chiropractic education have been conducted on the 7 cited thematic areas, much have focused on instruction, curriculum, assessment, and faculty development. Research studies on areas recommended in the 1997 article, such as patient centeredness and continuing education, are less evident.
CONCLUSIONS: Researchers in chiropractic education need to focus their efforts on key areas of importance and interest. They should consider collaborating across the professions with individuals who share the same interest and who have a productive and successful research track record. Individual researchers should be willing to share and acknowledge the work of other colleagues in and across professions. One such area of research that meets these criteria and that which is recommended for consideration is professionalism.

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