175794 Reporting adverse effects associated with chiropractic care: An analysis of literature in PubMed

Monday, October 27, 2008: 12:50 PM

Claire Johnson, MSEd, DC , Editor, Professor, National Univerisity of Health Sciences, Oceanside, CA
Bart Green, MSEd, DC , Branch Medical Clinic MCAS Miramar, Naval Medical Center San Diego, San Diego, CA
Background: Adverse effects resulting from healthcare practices should be reported for the sake of public safety. The chiropractic profession has a responsibility to participate in reporting adverse effects associated with care.

Objective: This study provides a descriptive analysis of the literature included in PubMed that reports adverse effects associated with chiropractic care. A better understanding of reporting trends may help develop more effective approaches for the prevention of adverse effects.

Methods: PubMed was searched from the earliest date through January 2008 using the MeSH terms chiropractic and adverse effects. All languages and article types, except editorials, commentaries, and correspondence, were included. Articles were evaluated for relevance, trends, study type, author degrees, and journal type.

Results: There were 337 articles retrieved and 51 fit the inclusion criteria. Eleven were primary studies, 13 were literature reviews, and 27 were case reports/series. All case reports originated from medical authors. Literature reviews were authored by DCs (39%), DC/MD teams (15%), or MD (46%) authors. Primary research studies were authored by DCs (73%), whereas 27% were authored by MDs. Only 1 of 3 chiropractic-focused journals published articles about adverse effects and chiropractic; this journal published only 20% of the 51 articles.

Conclusion: More articles were authored by medical sources and more were published in medical vs. chiropractic-oriented journals. However, more primary research studies were from DC authors. Chiropractic organizations and researchers should increase involvement in reporting adverse effects to increase participation of the chiropractic profession in the protection of public health and safety.

Learning Objectives:
1. Recognize the sources and trends of PubMed articles reporting adverse effects associated with chiropractic care. 2. Discuss how reporting adverse events associated with chiropractic has changed over the past 30 years, including the increasing participation of the chiropractic profession and accurately recognizing what is and is not a “chiropractic” association. 3. Analyze how one chiropractic journal (the Journal of Manipulative and Physiological Therapeutics) has made a constructive and positive impact on reporting adverse events and chiropractic care. 4. Discuss the responsibility of the chiropractic profession in reporting adverse events and how to increase participation in related practice and policy development. 5. Recommend future development for how the chiropractic profession can become more involved with reporting and preventing adverse events associated with chiropractic care.

Keywords: Public Health, Chiropractic

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have met all 3 of the criteria for authorship: 1) substantial contributions to conception and design, acquisition of data, and analysis and interpretation of data; 2) drafting the article and revising it critically for important intellectual content; and 3) final approval of the version to be submitted. I am a journal editor and have taught on this subject before.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Current Research in Chiropractic II
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