Miscellaneous

 

Death by Medicine
      Life Extension Magazine ~ March 2004

           No one had ever analyzed and combined ALL of the published literature dealing with injuries and deaths caused by government-protected medicine. That has now changed. A group of researchers meticulously reviewed the statistical evidence and their findings are absolutely shocking. This fully referenced report shows the number of people having in-hospital, adverse reactions to prescribed drugs to be 2.2 million per year. The number of unnecessary antibiotics prescribed annually for viral infections is 20 million per year. The number of unnecessary medical and surgical procedures performed annually is 7.5 million per year. The number of people exposed to unnecessary hospitalization annually is 8.9 million per year. The most stunning statistic, however, is that the total number of deaths caused by conventional medicine is an astounding 783,936 per year.

 

Educational Deficiencies in Musculoskeletal Medicine
Journal of Bone and Joint Surgery 2002 (Apr);   84–A (4):   604–608

According to the standard suggested by the program directors of internal medicine residency departments, a large majority of the examinees once again failed to demonstrate basic competency in musculoskeletal medicine on the examination. It is therefore reasonable to conclude that medical school preparation in musculoskeletal medicine is inadequate. NOTE: This is a follow-up article to the study cited below, which demonstrated that medical students were inadequately trained to diagnose and treat musculoskeletal complaints. What would the headlines would say if, after 4 years, our profession had failed to improve it's skills in musculoskeletal assessment and management? Ask your self why medicine is shown more slack than we are?


The Adequacy of Medical School Education in Musculoskeletal Medicine
Journal of Bone and Joint Surgery 1998 (Oct);   80-A (10):   1421–1427

This is the original article, which found that 82 per cent of medical school graduates failed a valid musculoskeletal competency examination. They concluded that "we therefore believe that medical school preparation in musculoskeletal medicine is inadequate" and that medical students were inadequately trained to diagnose and treat musculoskeletal complaints.

 

A Comparison of Chiropractic Student Knowledge Versus Medical Residents
Proceedings of the World Federation of Chiropractic Congress 2001 Pgs. 255

A previously published knowledge questionnaire designed by chief orthopedic residents was given to a Chiropractic student group for comparison to the results of the medical resident group. Based on the marking scale determined by the chief residents, the Chiropractic group (n = 51) showed statistically significant higher average grade than the orthopedic residents. Expressed in other terms, 70% of chiropractic students passed the knowledge questionnaire, compared to an 80% failure rate for the residents

 

An Investigation into the Validity of Cervical Spine Motion Palpation Using Subjects with Congenital Block Vertebrae as a 'Gold Standard'
BMC Musculoskelet Disord 2004 (Jun 15);   5 (1):   19 ~ FULL TEXT

Twenty fourth year chiropractic students examined the cervical spines of three subjects with single level congenital block vertebrae, using two commonly employed motion palpation tests. The examiners, who were blinded to the presence of congenital block vertebrae, were asked to identify the most hypomobile segment(s). This study indicates that relatively inexperienced examiners are capable of correctly identifying inter-segmental fixations (CBV) in the cervical spine using 2 commonly employed motion palpation tests. The use of a 'gold standard' (CBV) in this study and the substantial agreement achieved lends support to the validity of motion palpation in detecting major spinal fixations in the cervical spine.

 

Occupational Injuries Suffered by Classical Musicians Through Overuse
Clinical Chiropractic 2004 (Jun);   7 (2):   55—66

There is a high rate of injury to professional classical musicians and teachers that can be disruptive to practice and potentially threatening to careers. Females and string players were discovered to be of particular risk. The majority of injuries were to the shoulder and proximal thoracic spine and the absence of injuries in amateur players suggests a relationship to overuse. The author suggests that the incorporation of postural and ergonomic into musical education and chiropractic treatment programmes for classical musicians and teachers could be of benefit. 

 

The Cost-effectiveness of Chiropractic
           The cost advantages for chiropractic for matched conditions appear to be so dramatic that Pran Manga, the aforementioned Canadian health economist, has concluded that doubling the utilization of chiropractic services from 10% to 20% may realize savings as much as $770 million in direct costs and $3.8 billion in indirect costs.20 When iatrogenic effects [yet to be discussed] are factored in, the cost advantages of spinal manipulation as a treatment alternative become even more prominent.

 

Patient Satisfaction With Chiropractic
           For matched back pain conditions, patient satisfaction with chiropractic treatment has invariably been shown to be significantly greater than that with conventional management [administered by a primary care physician, an orthopedist, or an HMO provider]. Read the results of a variety of studies right here!

 

Does Pain Affect Your Job Performance?
           To Your Health ChiroWeb Newsletter

           The average employee misses several days of work each year because of the common cold; two or three more for personal or family emergencies; and a few extra "just because." With the exception of those seven or eight days, plus scheduled vacation time and holidays, the average employee spends his or her time engaged in blissful work productivity, right? Well, not exactly. Just because you're at work doesn't necessarily mean you're being productive. In fact, according to a study published in the Journal of the American Medical Association, U.S. employers lose more than $60 billion a year because workers aren't as productive as they could be. The culprit: pain. 

 

Effects of Inclusion of a Chiropractic Benefit on the Utilization of Health Care Resources in Managed Health Care Plan
A four-year longitudinal study using administrative claims data compared 700,000 health plan members with chiropractic coverage to 1 million health plan members without chiropractic coverage. This study demonstrates that the inclusion of a chiropractic benefit in a managed health care plan results in a reduction in the overall utilization of health care resources, and thereby, cost savings. There are four mechanism that produce this cost reduction: 1. A favorable selection process; 2. A substitution effect of chiropractic care for medical care; 3. Lower rates of use of high cost procedures; 4. Lower cost management of care episodes by chiropractors. You might also enjoy this sidebar article on this topic.

 

Manual Therapy Eases Neck Pain, Cheaply
           WebMD Medical News ~ Thursday, April 24, 2003

           A hands-on approach to treating neck pain by manual therapy may help people get better faster and at a lower cost than more traditional treatments, according to a new study. After seven and 26 weeks, the study found significant improvements in recovery rates in the manual therapy group compared to the others. For example, at week seven, 68% of the manual therapy group had recovered from their neck pain vs. 51% in the physical therapy group and 36% in the medical care group. You may also enjoy the FULL TEXT article in the British Medical Journal 2003 (Apr 26):   326 (7395):   911.

 

Is Chiropractic Evidence Based? A Pilot Study
           J Manipulative Physiol Ther 2003 (Jan);   26 (1):   47 ~ FULL TEXT

           When patients were used as the denominator, the majority of cases in a chiropractic practice were cared for with interventions based on evidence from good-quality, randomized clinical trials. When compared to the many other studies of similar design that have evaluated the extent to which different medical specialties are evidence based, chiropractic practice was found to have the highest proportion of care (68.3%) supported by good-quality experimental evidence.

 

Manual Medicine Diversity:
Research Pitfalls and the Emerging Medical Paradigm

J Am Osteopath Assoc 2001 (Aug);   101 (8):   441-444

Recent studies published in leading medical journals have concluded that chiropractic treatment is not particularly helpful for relieving asthma and migraine symptoms because even though study participants showed notable improvement in symptoms, those subjects who received sham manual medicine treatments also showed improvement. Yet the sham treatment received by control groups in these studies is reminiscent in many ways of traditional osteopathic manipulation. This seems to represent not only a failure to recognize the value of many manual medicine techniques but also an ignorance of the broad spectrum of manual medicine techniques used by various practitioners, from osteopathic physicians to chiropractors to physical therapists.

 

Placebo Surgery
           Chiropractic Journal 2002; September

          Many scientists and clinicians consider the placebo-controlled trial the "gold standard" for evidence-based practice. Interestingly, surgical procedures are often exempt from such scrutiny. Ethical considerations are considered barriers to the use of placebo-controlled investigations for surgical procedures. [3,4] Interestingly, there have been five studies where placebo surgery was used as a control. The placebo group generally did as well or better than the group receiving the real operation.   You may enjoy more articles like this at the Problem with Placebos Page in our Chiropractic Research Section.


Chronic Spinal Pain Syndromes: A Clinical Pilot Trial Comparing Acupuncture, A Nonsteroidal Anti-inflammatory Drug, and Spinal Manipulation
J Manipulative Physiol Ther 1999 (July);   22 (6):   376-381

The consistency of the results provides, in spite of several discussed shortcomings of this pilot study, evidence that in patients with chronic spinal pain syndromes spinal manipulation, if not contraindicated, results in greater improvement than acupuncture and medicine.

 

Back and Neck Problems Among Dentists and Dental Auxiliaries
J Contemp Dent Pract 2001 (Aug 15);   2 (3):   17-30

In the practice of dentistry, stress, tension, and postural practices can contribute to back and neck problems. Two hundred and four dentists and dental auxiliary (87 males and 117 females) in Riyadh city, Saudi Arabia were surveyed to determine the prevalence of postural problems. The candidates were interviewed and observed during practice. The data obtained showed that 111 (54.4%) of the subjects complained of neck pain and 150 (73.5%) complained of back pain.

 

Patient Satisfaction With the Chiropractic Clinical Encounter: Report From a Practice-based Research Program
Journal of the Neuromusculoskeletal System 2001:   9 (4):   109-117

Researchers examined aspects of clinical care in chiropractic practices and determined patient satisfaction with treatment. Nearly 3,000 adult patients reported that: 88% felt their DC always respected their opinion; 85% said their DC always listened to them carefully and explained treatment clearly: and that 76% felt their DC involved them in decisions "as much as they wanted" .

 

Utilization, Cost, and Effects of Chiropractic Care on Medicare Program Costs
This June 2001 study was commissioned by the ACA, and is the first study of its type to compare the global, per capita Medicare expenditures of chiropractic patients to those of non-chiropractic patients receiving care in the federal Medicare program.

 

Antibiotics/Antimicrobials Ineffective for Treatment of Children With Acute Sinusitis
PEDIATRICS 2001;   107 (4) April:   619–625

This randomized trial found that neither amoxicillin nor amoxicillin-clavulanate offered any clinical benefit compared with placebo for children with clinically diagnosed acute sinusitis.

 

Breathing Normal - And Then Some
           Charles Masarsky, DC

           In the 1980s, two chiropractic practitioners in Virginia published a report on breathing capacity in a series of new patients.1,2 They measured the liters of air exhaled by their patients when forcing out a full breath; this measurement is called forced vital capacity, often abbreviated to FVC. They also measured the liters of air exhaled in the first second of forcing out a full breath; this measurement is called forced expiratory volume in one second, often abbreviated to FEV-1. When repeat measurements were taken after one to three chiropractic adjustments, both FVC and FEV-1 had improved significantly.

 

 
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