Chiropractic Controversies Flashcards
Covering module 2
Existing literature indicates that benign adverse events following manual treatments to the spine are ___, while serious adverse events are ___
benign adverse events are common
serious adverse events are rare
Why are incidence and causal relationships between spinal manipulation and serious adverse events challenging to establish?
Gaps in the literature and inherent methodological limitations of studies
What is vitalism?
Doctrine that all living organisms are sustained by an inexplicable non-physical vital force
“both different from and greater than physical and chemical forces”
What is the common phrase within vitalism?
The whole is greater than the sum of its parts
The “vital force” is believed to not only be the source of life, but also…
a key component of health and healing
What are four concerns regarding vaccination?
- Safety
- Efficacy
- Possible alternatives
- Public policy vs personal choice
immune function and chiropractic
Does stimulus imply treatment effect?
No
Is it known whether HVLA controlled vertebral thrusts have a clinically relevant impact on immunity?
No, further research is needed to explore this
What is currently the most performed orthopedic procedure in the world?
What do studies show about this?
Arthroscopic partial meniscectomy (APM)
Studies conclusively show that outcomes are no better than a sham/placebo surgery
What is now being touted as a viable and effective alternative to APM (arthroscopic partial meniscectomy)?
Meniscal repair
What are three important aspects of an open-clinic?
- HIPAA
- Privacy
- Comfort
Over service can be combatted by what model?
Fee-for-service model:
* Salary
* Fee for performance
What is a subluxation to a medical doctor?
What is it to a chiropractor?
Medical: a partial dislocation
Chiropractic: a slight misalignment of the vertebrae
A chiropractic subluxation is often referring to…
the vertebral subluxation complex: nerve, muscle, CT, etc.
Why might one criticize chiropractic for implausible diagnostics and therapies?
- Construct validity
- Physiological mechanism of action
Describe the evidence behind wellness care in chiropractic
Evidence is scarce for prevention
What are some issues with treating visceral or non-musculoskeletal conditions?
- Construct validity
- Still testing mechanism of action
Does literature support that mechanical stimulation of the spine modulates organ functions?
Literature confirms modulation in some organ functions in some cohorts
If organ functions are modulated by mechanical stimulation of the spine, what is the rationale?
A comprehensive neurobiological rationale for this general phenomenon has yet to appear
What is a general belief of chiropractors around drugs and medicine?
There is evidence of over-medicalization and over-prescription
What is an issue with the advertising of chiropractic?
It can be misleading (as can other advertising)
What is the evidence of the benefits of routine spinal X-rays?
Postulated benefits have limited or non-existent evidence
What are some potential harms associated with spinal X-rays?
- Increased ionizing radiation exposure
- Overdiagnosis
- Subsequent low-value investigation and treatment procedures
- Increased, unnecessary costs
In the vast majority of cases who present to chiropractors, does the potential benefit from spinal X-rays outweigh the potential harms?
No
Should spinal X-rays be performed as a routine part of chiropractic practice?
No, decision to perform diagnostic imaging should be informed by evidence based clinical practice guidelines and clinician judgement
In chiropractic care of infants, what is the likelihood of serious injury?
Very rare
What are some concerns with chiropractic care of infants?
- Safety
- Efficacy
What are some arguments that say chiropractic disregards evidence informed practice?
- Non-specific treatment effects
- Placebo
- Natural history
