Seffiger s lecture

Question 1

Define osteopathic research using the AOA definition:

Answer 1

a. “The proposal must address the tenets of osteopathic medicine. Specifically, … the investigator presents a persuasive argument on how the research question and study design have osteopathic significance, the quality of the osteopathic literature and how it supports the research proposal, and how the research project will advance the field of osteopathic medicine.”

Question 2

Describe the results of DO vs. MD care studies from the 20th Century (1918)

Answer 2

i. 1918 spanish flu: Doctor Smith reported that the mortality rate for a total of 110,120 patients with influenza treated by 2445 DOs was 0.25%. Mortality due to influenza in patients receiving traditional medical care, however, was estimated to be 5% to 6%. Patients with pneumonia treated with standard medical care had a mortality rate estimated at 33% overall, and as high as between 68% and 78% in some large cities. Of 6258 patients cared for by osteopathic physicians the death rate due to pneumonia was 10%.

Question 3

Describe the results of DO vs. MD care studies from the 20th Century (1932)

Answer 3

i. DO had 5.54 % mortality vs MD and DO 9.7%, DO 9.7 days average LOS vs MD+DO 16 days, 14% of coroner’s cases for both.

Question 4

Describe the results of DO vs. MD care studies from the 20th Century (1999)

Answer 4

Outcomes for patients were no different, except that the osteopathic group required less medication and less PT

Question 5

a. Recognize the challenges of OMM research.

Answer 5

i. Blinding – can blind data gatherers, analyzsrs and medical managers, but not operator or patient to OMT
ii. Control – technique vs no Tx, DO vs MD, wait list
iii. Placebo –no direct physiological effect. Sham?
iv. Size, power, drop out control – more likely if pts don’t receive OMT? If OMT is painful?
v. Inclusion criteria – must have SD Dx. Comorbidities, prior OMT experience and OMT contraindications are all exclusion criteria.
vi. Dependent variable measures: standardized outcome measures, physiological measures, morbidity and mortality, subjective vs objective measures
vii. Mentors: AAO, national osteopathic research center in FTW TX, foundation for osteopathic research and continuous education.