RSCH 2501 Week 5 - Meeker, 2000, Concepts Evidence-Based Chiropractic Theory

RSCH 2501 Week 5 - Meeker, 2000, Concepts Evidence-Based Chiropractic Theory

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Meeker: Evidence-Based Applications 67 Top Clin Chiropr 2000; 7(1): 67–73 © 2000 Aspen Publishers, Inc. 67 Concepts Germane to an Evidence-Based Application of Chiropractic Theory William C. Meeker, DC, MPH, FICC This work was partially supported by contract no. 230-98-0029 (a National Conference to Establish the Chiropractic Research Agenda) to the Palmer Center for Chiropractic Research from the Bureau of Health Professions, Health Resources and Services Administration. INTRODUCTION Although much has been written about the art, science, and philosophy of chiropractic over the past century, construction of a scientifically testable and robust chiropractic theory is still in its infancy. This is a major challenge because, unless and until a sound body of theory is established and tested, the profession will find it increasingly difficult to argue that its hallmark concepts can be clinically applied in an evidence- based fashion. Because scientific evidence has become the hallmark for health care decision making, this challenge has been recognized by some academic and field-based chiro- practic professionals, but it is still not recognized by rank-and- file chiropractors or many policy makers and politicians. Evidence-based health care implies that the procedures and behaviors associated with health care have been subjected to rigorous standards of scientific observation, experimentation, and documentation. The word scientific implies that efforts have been made to eliminate potential sources of error in the documentation process, such that there is a strong consensus among experts and confidence by consumers that the specific behavior or procedure actually does what it is supposed to do. The currency of this theme has been driven by the last two decades of health services research, which has demonstrated that much in modern medicine lacks strong back-up evidence. Ideally, the move to evidence-based health care is an attempt to increase quality, although in its name poor quality decisions have sometimes been made simply to cut costs. Now, the entire health care industry is undergoing at least the threat of detailed scientific scrutiny largely because the health industry has outgrown policy makers’ and funders’ willingness to financially support it. Chiropractic is no exception, and the profession must take the evidence-base challenge seriously. This article attempts to address an educational need for the future by defining key terms and concepts in theory creation and by linking them to important clinical decision-making steps in case management. There are strong implications related to this topic, which may necessitate a reexamination of the profession’s research agenda and use of limited resources. THEORY
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RSCH 2501 Week 5 - Meeker, 2000, Concepts Evidence-Based Chiropractic Theory

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