Scholars@Duke
Christine Goertz

Christine Goertz

Professor in Orthopaedic Surgery
Orthopaedic Surgery
christine.goertz@duke.edu
300 W Morgan St, Office #441, Durham, NC 27701

Selected Publications

Machine learning in the diagnosis, management, and care of patients with low back pain: a scoping review of the literature and future directions.

Journal Article Spine J · September 25, 2024 BACKGROUND CONTEXT: Low back pain (LBP) remains the leading cause of disability globally. In recent years, machine learning (ML) has emerged as a potentially useful tool to aid the diagnosis, management, and prognostication of LBP. PURPOSE: In this review, ... Full text Open Access Link to item Cite

Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations.

Journal Article J Clin Med · September 24, 2024 Chiropractors diagnose and manage musculoskeletal disorders, commonly using spinal manipulative therapy (SMT). Over the past half-century, the chiropractic profession has seen increased utilization in the United States following Medicare authorization for ... Full text Link to item Cite

Patient engagement in designing, conducting, and disseminating clinical pain research: IMMPACT recommended considerations.

Journal Article Pain · May 1, 2024 In the traditional clinical research model, patients are typically involved only as participants. However, there has been a shift in recent years highlighting the value and contributions that patients bring as members of the research team, across the clini ... Full text Link to item Cite

Healthcare provider perspectives on integrating a comprehensive spine care model in an academic health system: a cross-sectional survey.

Journal Article BMC Health Serv Res · January 23, 2024 BACKGROUND: Healthcare systems (HCS) are challenged in adopting and sustaining comprehensive approaches to spine care that require coordination and collaboration among multiple service units. The integration of clinicians who provide first line, evidence-b ... Full text Link to item Cite

Development of a low back pain care pathway in an academic hospital system: results of a consensus process.

Journal Article J Orthop Surg Res · January 3, 2024 BACKGROUND: Low back pain (LBP) is the leading cause of disability worldwide and a significant component of healthcare expenditures. Clinical practice guidelines (CPGs) have been highlighted as a key resource to improve the quality of care. This study aime ... Full text Link to item Cite

Association between chiropractic spinal manipulation and cauda equina syndrome in adults with low back pain: Retrospective cohort study of US academic health centers.

Journal Article PLoS One · 2024 BACKGROUND: Cauda equina syndrome (CES) is a lumbosacral surgical emergency that has been associated with chiropractic spinal manipulation (CSM) in case reports. However, identifying if there is a potential causal effect is complicated by the heightened in ... Full text Link to item Cite

Effect of chiropractic care on low back pain for active-duty military members: Mediation through biopsychosocial factors.

Journal Article PLoS One · 2024 This study evaluates biopsychosocial factors as mediators of the effect of chiropractic care on low back pain (LBP) intensity and interference for active-duty military members. Data from a multi-site, pragmatic clinical trial comparing six weeks of chiropr ... Full text Link to item Cite

Chiropractic Day 2023: A Report and Qualitative Analysis of How Thought Leaders Celebrate the Present and Envision the Future of Chiropractic.

Journal Article J Chiropr Humanit · December 2023 OBJECTIVE: This study aimed to (1) collect and analyze statements about how to celebrate chiropractic in the present and roles that chiropractors may fulfill in the future, (2) identify if there was congruence among the themes between present and future st ... Full text Link to item Cite

Overcoming Barriers to the Implementation of Integrated Musculoskeletal Pain Management Programs: A Multi-Stakeholder Qualitative Study.

Journal Article J Pain · May 2023 Integrated pain management (IPM) programs can help to reduce the substantial population health burden of musculoskeletal pain, but are poorly implemented. Lessons learned from existing programs can inform efforts to expand IPM implementation. This qualitat ... Full text Open Access Link to item Cite

Care Outcomes for Chiropractic Outpatient Veterans (COCOV): a qualitative study with veteran stakeholders from a pilot trial of multimodal chiropractic care

Journal Article Pilot and Feasibility Studies · December 1, 2022 Background: Low back pain (LBP) is common among military veterans seeking treatment in Department of Veterans Affairs (VA) healthcare facilities. As chiropractic services within VA expand, well-designed pragmatic trials and implementation studies are neede ... Full text Cite

Care Outcomes for Chiropractic Outpatient Veterans (COCOV): a single-arm, pragmatic, pilot trial of multimodal chiropractic care for U.S. veterans with chronic low back pain

Journal Article Pilot and Feasibility Studies · December 1, 2022 Background: Over 25% of veterans seeking care at U.S. Veterans Health Administration facilities have chronic low back pain (LBP), with high rates of mental health comorbidities. The primary objective of this study was to assess the feasibility of participa ... Full text Cite

Health-Related Quality of Life Among United States Service Members with Low Back Pain Receiving Usual Care Plus Chiropractic Care vs Usual Care Alone: Secondary Outcomes of a Pragmatic Clinical Trial.

Journal Article Pain Med · August 31, 2022 OBJECTIVE: This study examines Patient-Reported Outcome Measurement Information System (PROMIS®)-29 v1.0 outcomes of chiropractic care in a multi-site, pragmatic clinical trial and compares the PROMIS measures to: 1) worst pain intensity from a numerical p ... Full text Link to item Cite

Optimizing the Impact of Pragmatic Clinical Trials for Veteran and Military Populations: Lessons From the Pain Management Collaboratory.

Journal Article Mil Med · July 1, 2022 Pragmatic clinical trials (PCTs) are well-suited to address unmet healthcare needs, such as those arising from the dual public health crises of chronic pain and opioid misuse, recently exacerbated by the COVID-19 pandemic. These overlapping epidemics have ... Full text Link to item Cite

TIDieR-telehealth: precision in reporting of telehealth interventions used in clinical trials - unique considerations for the Template for the Intervention Description and Replication (TIDieR) checklist.

Journal Article BMC Med Res Methodol · June 2, 2022 BACKGROUND: Recent international health events have led to an increased proliferation of remotely delivered health interventions. Even with the pandemic seemingly coming under control, the experiences of the past year have fueled a growth in ideas and tech ... Full text Link to item Cite

Characteristics of Chiropractic Patients in the Veterans Health Administration During the COVID-19 Pandemic: A Cross-Sectional Analysis.

Journal Article J Manipulative Physiol Ther · 2022 OBJECTIVE: The purpose of this study was to determine whether patient characteristics were associated with face-to-face (F2F) and telehealth visits for those receiving chiropractic care for musculoskeletal conditions in the US Veterans Health Administratio ... Full text Link to item Cite

Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021.

Journal Article The Journal of orthopaedic and sports physical therapy · November 2021 Low back pain (LBP) remains a musculoskeletal condition with an adverse societal impact. Globally, LBP is highly prevalent and a leading cause of disability. This is an update to the 2012 Academy of Orthopaedic Physical Therapy (AOPT), formerly the Orthopa ... Full text Open Access Cite

Characteristics and Practice Patterns of U.S. Veterans Health Administration Doctors of Chiropractic: A Cross-sectional Survey.

Journal Article J Manipulative Physiol Ther · September 2021 OBJECTIVE: The purpose of this study was to survey U.S. Veterans Health Administration (VA) chiropractors to assess current demographic and professional characteristics, including practice parameters, interprofessional collaboration, academic experience, a ... Full text Link to item Cite

Changes in the Use of Telehealth and Face-To-Face Chiropractic Care in the Department of Veterans Affairs Before and After the COVID-19 Pandemic.

Journal Article J Manipulative Physiol Ther · September 2021 OBJECTIVE: The purpose of this study was to describe the use of face-to-face and telehealth chiropractic care in the U.S. Veterans Health Administration (VHA) before and after the declaration of the COVID-19 pandemic. METHODS: A cross-sectional study was p ... Full text Link to item Cite

Back and neck pain: in support of routine delivery of non-pharmacologic treatments as a way to improve individual and population health.

Journal Article Transl Res · August 2021 Chronic back and neck pain are highly prevalent conditions that are among the largest drivers of physical disability and cost in the world. Recent clinical practice guidelines recommend use of non-pharmacologic treatments to decrease pain and improve physi ... Full text Link to item Cite

Harmonized outcome measures for use in degenerative lumbar spondylolisthesis patient registries and clinical practice.

Journal Article J Neurosurg Spine · June 1, 2021 OBJECTIVE: The development of new treatment approaches for degenerative lumbar spondylolisthesis (DLS) has introduced many questions about comparative effectiveness and long-term outcomes. Patient registries collect robust, longitudinal data that could be ... Full text Link to item Cite

Extrapolating Beyond the Data in a Systematic Review of Spinal Manipulation for Nonmusculoskeletal Disorders: A Fall From the Summit.

Journal Article J Manipulative Physiol Ther · May 2021 OBJECTIVE: The purpose of this article is to discuss a literature review-a recent systematic review of nonmusculoskeletal disorders-that demonstrates the potential for faulty conclusions and misguided policy implications, and to offer an alternate interpre ... Full text Link to item Cite

Patient-Reported Physician Treatment Recommendations and Compliance Among U.S. Adults with Low Back Pain.

Journal Article J Altern Complement Med · March 2021 Objectives: Numerous recently published clinical care guidelines, including the 2017 American College of Physicians (ACP) Guideline for Low Back Pain (LBP), call for nonpharmacological approaches to pain management. However, little data exist regarding the ... Full text Link to item Cite

Visit Frequency and Outcomes for Patients Using Ongoing Chiropractic Care for Chronic Low-Back and Neck Pain: An Observational Longitudinal Study.

Journal Article Pain Physician · January 2021 BACKGROUND: Chronic spinal pain is prevalent and long-lasting. Although provider-based nonpharmacologic therapies, such as chiropractic care, have been recommended, healthcare and coverage policies provide little guidance or evidence regarding long-term us ... Link to item Cite

In Reply: Misleading Article by Goertz et al.

Journal Article J Manipulative Physiol Ther · 2021 Full text Link to item Cite

In Reply: A Missed Opportunity.

Journal Article J Manipulative Physiol Ther · 2021 Full text Link to item Cite

Chiropractic Services and Diagnoses for Low Back Pain in 3 U.S. Department of Defense Military Treatment Facilities: A Secondary Analysis of a Pragmatic Clinical Trial.

Journal Article J Manipulative Physiol Ther · 2021 OBJECTIVE: The purpose of this study was to describe the diagnoses and chiropractic services performed by doctors of chiropractic operating within 3 military treatment facilities for patients with low back pain (LBP). METHODS: This was a descriptive second ... Full text Link to item Cite

Stakeholder Engagement in Pragmatic Clinical Trials: Emphasizing Relationships to Improve Pain Management Delivery and Outcomes.

Journal Article Pain Med · December 12, 2020 BACKGROUND: The NIH-DOD-VA Pain Management Collaboratory (PMC) supports 11 pragmatic clinical trials (PCTs) on nonpharmacological approaches to management of pain and co-occurring conditions in U.S. military and veteran health organizations. The Stakeholde ... Full text Link to item Cite

Veteran Response to Dosage in Chiropractic Therapy (VERDICT): Study Protocol of a Pragmatic Randomized Trial for Chronic Low Back Pain.

Journal Article Pain Med · December 12, 2020 BACKGROUND: Low back pain is a leading cause of disability in veterans. Chiropractic care is a well-integrated, nonpharmacological therapy in Veterans Affairs health care facilities, where doctors of chiropractic provide therapeutic interventions focused o ... Full text Link to item Cite

Transforming low back pain care delivery in the United States.

Journal Article Pain · December 2020 Low back pain (LBP) continues to be a challenging condition to manage effectively. Recent guideline recommendations stress providing non-pharmacological care early, limiting diagnostic testing, and reducing exposure to opioid pain medications. However, the ... Full text Link to item Cite

Differential Outcomes With Edetate Disodium-Based Treatment Among Stable Post Anterior vs. Non-Anterior Myocardial Infarction Patients.

Journal Article Cardiovasc Revasc Med · November 2020 BACKGROUND: The Trial to Assess Chelation Therapy (TACT) found that chelation therapy significantly reduced clinical events in patients with a history of myocardial infarction (MI). The initial report of TACT included the observation of an interaction betw ... Full text Link to item Cite

Possible differential benefits of edetate disodium in post-myocardial infarction patients with diabetes treated with different hypoglycemic strategies in the Trial to Assess Chelation Therapy (TACT).

Journal Article J Diabetes Complications · August 2020 BACKGROUND: The NIH-funded Trial to Assess Chelation Therapy (TACT) randomized 1708 stable patients age ≥50 who were ≥6 months post myocardial infarction to 40 infusions of an edetate disodium-based regimen or placebo. In 633 patients with diabetes, edetat ... Full text Link to item Cite

Effects of Chiropractic Care on Strength, Balance, and Endurance in Active-Duty U.S. Military Personnel with Low Back Pain: A Randomized Controlled Trial.

Journal Article Journal of alternative and complementary medicine (New York, N.Y.) · July 2020 Objectives: To investigate whether chiropractic care influences strength, balance, and/or endurance in active-duty United States military personnel with low back pain (LBP). Design: This study employed a prospective randomized c ... Full text Cite

A united statement of the global chiropractic research community against the pseudoscientific claim that chiropractic care boosts immunity.

Journal Article Chiropr Man Therap · May 4, 2020 BACKGROUND: In the midst of the coronavirus pandemic, the International Chiropractors Association (ICA) posted reports claiming that chiropractic care can impact the immune system. These claims clash with recommendations from the World Health Organization ... Full text Link to item Cite

NIH-DoD-VA Pain Management Collaboratory.

Journal Article Pain Med · December 1, 2019 Full text Link to item Cite

Development of a Clinical Decision Aid for Chiropractic Management of Common Conditions Causing Low Back Pain in Veterans: Results of a Consensus Process.

Journal Article Journal of manipulative and physiological therapeutics · November 2019 ObjectiveThe purpose of this study was to develop a clinical decision aid for chiropractic management of common conditions causing low back pain (LBP) in veterans receiving treatment in US Veterans Affairs (VA) health care facilities.Methods Full text Cite

Interprofessional Attitudes and Interdisciplinary Practices for Older Adults With Back Pain Among Doctors of Chiropractic: A Descriptive Survey.

Journal Article J Manipulative Physiol Ther · May 2019 OBJECTIVE: The purpose of this study is to report on attitudes of doctors of chiropractic (DCs) toward integrative medicine and their self-reported interdisciplinary practices for older adults with back pain. METHODS: This descriptive survey was conducted ... Full text Link to item Cite

The Impact of Spinal Manipulation on Migraine Pain and Disability: A Systematic Review and Meta-Analysis.

Journal Article Headache · April 2019 BACKGROUND: Several small studies have suggested that spinal manipulation may be an effective treatment for reducing migraine pain and disability. We performed a systematic review and meta-analysis of published randomized clinical trials (RCTs) to evaluate ... Full text Link to item Cite

Effect of chiropractic manipulative therapy on reaction time in special operations forces military personnel: a randomized controlled trial.

Journal Article Trials · January 3, 2019 BACKGROUND: Chiropractic manipulative therapy (CMT) has been shown to improve reaction time in some clinical studies. Slight changes in reaction time can be critical for military personnel, such as special operation forces (SOF). This trial was conducted t ... Full text Link to item Cite

Assessment of chiropractic care on strength, balance, and endurance in active-duty U.S. military personnel with low back pain: a protocol for a randomized controlled trial.

Journal Article Trials · December 5, 2018 BACKGROUND: Low back pain (LBP) is a common cause of disability among U.S. military personnel. Approximately 20% of all diagnoses resulting in disability discharges are linked to back-related conditions. Because LBP can negatively influence trunk muscle st ... Full text Link to item Cite

Unique Review Criteria and Patient and Stakeholder Reviewers: Analysis of PCORI's Approach to Research Funding.

Journal Article Value Health · October 2018 OBJECTIVE: The Patient-Centered Outcomes Research Institute (PCORI) uses a unique approach to Merit Review that includes patients and stakeholders as reviewers with scientists, and includes unique review criteria (patient-centeredness and active engagement ... Full text Link to item Cite

Researchers, Patients, and Stakeholders Evaluating Comparative-Effectiveness Research: A Mixed-Methods Study of the PCORI Reviewer Experience.

Journal Article Value Health · October 2018 OBJECTIVES: The Patient-Centered Outcomes Research Institute (PCORI) includes patients and stakeholders alongside scientists in reviewing research applications using unique review criteria including patient-centeredness and patient and/or stakeholder engag ... Full text Link to item Cite

The Global Spine Care Initiative: classification system for spine-related concerns.

Journal Article Eur Spine J · September 2018 PURPOSE: The purpose of this report is to describe the development of a classification system that would apply to anyone with a spine-related concern and that can be used in an evidence-based spine care pathway. METHODS: Existing classification systems for ... Full text Link to item Cite

The Global Spine Care Initiative: care pathway for people with spine-related concerns.

Journal Article Eur Spine J · September 2018 PURPOSE: The purpose of this report is to describe the development of an evidence-based care pathway that can be implemented globally. METHODS: The Global Spine Care Initiative (GSCI) care pathway development team extracted interventions recommended for th ... Full text Link to item Cite

The Global Spine Care Initiative: methodology, contributors, and disclosures.

Journal Article Eur Spine J · September 2018 PURPOSE: The purpose of this report is to describe the Global Spine Care Initiative (GSCI) contributors, disclosures, and methods for reporting transparency on the development of the recommendations. METHODS: World Spine Care convened the GSCI to develop a ... Full text Link to item Cite

The Global Spine Care Initiative: resources to implement a spine care program.

Journal Article Eur Spine J · September 2018 PURPOSE: The purpose of this report is to describe the development of a list of resources necessary to implement a model of care for the management of spine-related concerns anywhere in the world, but especially in underserved communities and low- and midd ... Full text Link to item Cite

The Global Spine Care Initiative: World Spine Care executive summary on reducing spine-related disability in low- and middle-income communities.

Journal Article Eur Spine J · September 2018 PURPOSE: Spinal disorders, including back and neck pain, are major causes of disability, economic hardship, and morbidity, especially in underserved communities and low- and middle-income countries. Currently, there is no model of care to address this issu ... Full text Link to item Cite

The Global Spine Care Initiative: model of care and implementation.

Journal Article Eur Spine J · September 2018 PURPOSE: Spine-related disorders are a leading cause of global disability and are a burden on society and to public health. Currently, there is no comprehensive, evidence-based model of care for spine-related disorders, which includes back and neck pain, d ... Full text Link to item Cite

Opioid Use Among Veterans of Recent Wars Receiving Veterans Affairs Chiropractic Care.

Journal Article Pain Med · September 1, 2018 OBJECTIVE: To examine patient sociodemographic and clinical characteristics associated with opioid use among Veterans of Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND) who receive chiropractic care, and to explore the relationship between ... Full text Link to item Cite

Chiropractic Integration into Private Sector Medical Facilities: A Multisite Qualitative Case Study.

Journal Article J Altern Complement Med · August 2018 OBJECTIVES: Chiropractic care may have value in improving patient outcomes and decreasing opioid use, but little is known about the impetus for or process of incorporating these services into conventional medical settings. The purpose of this qualitative s ... Full text Link to item Cite

Effect of Usual Medical Care Plus Chiropractic Care vs Usual Medical Care Alone on Pain and Disability Among US Service Members With Low Back Pain: A Comparative Effectiveness Clinical Trial.

Journal Article JAMA Netw Open · May 18, 2018 IMPORTANCE: It is critically important to evaluate the effect of nonpharmacological treatments on low back pain and associated disability. OBJECTIVE: To determine whether the addition of chiropractic care to usual medical care results in better pain relief ... Full text Link to item Cite

Patients receiving chiropractic care in a neurorehabilitation hospital: A descriptive study

Journal Article Journal of Multidisciplinary Healthcare · May 3, 2018 Objectives: Individuals rehabilitating from complex neurological injury require a multidisciplinary approach, which typically does not include chiropractic care. This study describes inpatients receiving multidisciplinary rehabilitation including chiroprac ... Full text Cite

Interdisciplinary Practice Models for Older Adults With Back Pain: A Qualitative Evaluation.

Journal Article Gerontologist · March 19, 2018 PURPOSE: Older adults seek health care for low back pain from multiple providers who may not coordinate their treatments. This study evaluated the perceived feasibility of a patient-centered practice model for back pain, including facilitators for interpro ... Full text Link to item Cite

Chiropractic Integrated Care Pathway for Low Back Pain in Veterans: Results of a Delphi Consensus Process.

Journal Article J Manipulative Physiol Ther · February 2018 OBJECTIVE: The purpose of this study was to develop an integrated care pathway for doctors of chiropractic, primary care providers, and mental health professionals who manage veterans with low back pain, with or without mental health comorbidity, within De ... Full text Link to item Cite

Integration of Doctors of Chiropractic Into Private Sector Health Care Facilities in the United States: A Descriptive Survey.

Journal Article J Manipulative Physiol Ther · February 2018 OBJECTIVE: The purpose of this study was to describe the demographic, facility, and practice characteristics of doctors of chiropractic (DCs) working in private sector health care settings in the United States. METHODS: We conducted an online, cross-sectio ... Full text Link to item Cite

Effect of high-dose oral multivitamins and minerals in participants not treated with statins in the randomized Trial to Assess Chelation Therapy (TACT).

Journal Article Am Heart J · January 2018 IMPORTANCE: In a prespecified subgroup analysis of participants not on statin therapy at baseline in the TACT, a high-dose complex oral multivitamins and multimineral regimen was found to have a large unexpected benefit compared with placebo. The regimen t ... Full text Link to item Cite

Be good, communicate, and collaborate: a qualitative analysis of stakeholder perspectives on adding a chiropractor to the multidisciplinary rehabilitation team.

Journal Article Chiropr Man Therap · 2018 BACKGROUND: While chiropractors are integrating into multidisciplinary settings with increasing frequency, the perceptions of medical providers and patients toward adding chiropractors to existing healthcare teams is not well-understood. This study explore ... Full text Link to item Cite

Association Among Opioid Use, Treatment Preferences, and Perceptions of Physician Treatment Recommendations in Patients With Neck and Back Pain.

Journal Article J Manipulative Physiol Ther · 2018 OBJECTIVE: The purpose of this study was to explore the relationship between self-reported use of opioids by patients with neck and back pain and their demographics, pain characteristics, treatment preferences, and recollections of their physicians' opinio ... Full text Link to item Cite

Patient-centered professional practice models for managing low back pain in older adults: a pilot randomized controlled trial.

Journal Article BMC Geriatr · October 13, 2017 BACKGROUND: Low back pain is a debilitating condition for older adults, who may seek healthcare from multiple providers. Few studies have evaluated impacts of different healthcare delivery models on back pain outcomes in this population. The purpose of thi ... Full text Link to item Cite

Ineffective Policies to Address the Opioid Epidemic.

Journal Article JAMA Psychiatry · September 1, 2017 Full text Link to item Cite

Association of lumbar spine stiffness and flexion-relaxation phenomenon with patient-reported outcomes in adults with chronic low back pain - a single-arm clinical trial investigating the effects of thrust spinal manipulation.

Journal Article BMC Complement Altern Med · June 9, 2017 BACKGROUND: Spinal manipulation (SM) is used commonly for treating low back pain (LBP). Spinal stiffness is routinely assessed by clinicians performing SM. Flexion-relaxation ratio (FRR) was shown to distinguish between LBP and healthy populations. The pri ... Full text Link to item Cite

The effect of chiropractic treatment on the reaction and response times of special operation forces military personnel: study protocol for a randomized controlled trial.

Journal Article Trials · September 20, 2016 BACKGROUND: Chiropractic care is commonly used to treat musculoskeletal conditions and has been endorsed by clinical practice guidelines as being evidence-based and cost-effective for the treatment of patients with low back pain. Gaps in the literature exi ... Full text Link to item Cite

Effect of Spinal Manipulation of Upper Cervical Vertebrae on Blood Pressure: Results of a Pilot Sham-Controlled Trial.

Journal Article J Manipulative Physiol Ther · June 2016 OBJECTIVE: The purpose of this pilot sham-controlled clinical trial was to estimate the treatment effect and safety of toggle recoil spinal manipulation for blood pressure management. METHODS: Fifty-one participants with prehypertension or stage 1 hyperten ... Full text Link to item Cite

Similar Effects of Thrust and Nonthrust Spinal Manipulation Found in Adults With Subacute and Chronic Low Back Pain: A Controlled Trial With Adaptive Allocation.

Journal Article Spine (Phila Pa 1976) · June 2016 STUDY DESIGN: A three-arm controlled trial with adaptive allocation. OBJECTIVES: The aim of this study was to compare short-term effects of a side-lying, thrust spinal manipulation (SM) procedure and a nonthrust, flexion-distraction SM procedure in adults ... Full text Link to item Cite

Cross-Sectional Analysis of Per Capita Supply of Doctors of Chiropractic and Opioid Use in Younger Medicare Beneficiaries.

Journal Article J Manipulative Physiol Ther · May 2016 OBJECTIVE: The purpose of this study was to determine whether the per-capita supply of doctors of chiropractic (DCs) or Medicare spending on chiropractic care was associated with opioid use among younger, disabled Medicare beneficiaries. METHODS: Using 201 ... Full text Link to item Cite

Assessment of chiropractic treatment for active duty, U.S. military personnel with low back pain: study protocol for a randomized controlled trial.

Journal Article Trials · February 9, 2016 BACKGROUND: Low back pain is highly prevalent and one of the most common causes of disability in U.S. armed forces personnel. Currently, no single therapeutic method has been established as a gold standard treatment for this increasingly prevalent conditio ... Full text Link to item Cite

The Association Between Use of Chiropractic Care and Costs of Care Among Older Medicare Patients With Chronic Low Back Pain and Multiple Comorbidities.

Journal Article J Manipulative Physiol Ther · February 2016 OBJECTIVE: The purpose of this study was to determine whether use of chiropractic manipulative treatment (CMT) was associated with lower healthcare costs among multiply-comorbid Medicare beneficiaries with an episode of chronic low back pain (cLBP). METHOD ... Full text Link to item Cite

Effects of spinal manipulation on sensorimotor function in low back pain patients--A randomised controlled trial.

Journal Article Man Ther · February 2016 BACKGROUND: Low back pain (LBP) is a major health problem in industrialized societies. Spinal manipulation (SM) is often used for treating LBP, though the therapeutic mechanisms remain elusive. Research suggests that sensorimotor changes may be involved in ... Full text Link to item Cite

Characteristics of US Adults Who Have Positive and Negative Perceptions of Doctors of Chiropractic and Chiropractic Care.

Journal Article J Manipulative Physiol Ther · 2016 OBJECTIVE: The purpose of this study was to compare characteristics, likelihood to use, and actual use of chiropractic care for US survey respondents with positive and negative perceptions of doctors of chiropractic (DCs) and chiropractic care. METHODS: Fr ... Full text Link to item Cite

The McAndrews Leadership Lecture: February 2015, by Dr Scott Haldeman. Challenges of the Past, Challenges of the Present

Journal Article Journal of Chiropractic Humanities · December 1, 2015 The McAndrews Leadership Lecture was developed by the American Chiropractic Association to honor the legacy of Jerome F. McAndrews, DC, and George P. McAndrews, JD, and their contributions to the chiropractic profession. This article is a transcription of ... Full text Cite

Public Perceptions of Doctors of Chiropractic: Results of a National Survey and Examination of Variation According to Respondents' Likelihood to Use Chiropractic, Experience With Chiropractic, and Chiropractic Supply in Local Health Care Markets.

Journal Article J Manipulative Physiol Ther · October 2015 OBJECTIVES: The purpose of this study was to determine whether general perceptions of doctors of chiropractic (DCs) varied according to likeliness to use chiropractic care, whether particular demographic characteristics were associated with chiropractic ca ... Full text Link to item Cite

Report of the NIH task force on research standards for chronic low back pain

Journal Article International Journal of Therapeutic Massage and Bodywork: Research, Education, and Practice · September 1, 2015 Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients’ lives. Such cLBP is often ter ... Full text Cite

Development of an attention-touch control for manual cervical distraction: a pilot randomized clinical trial for patients with neck pain.

Journal Article Trials · June 5, 2015 BACKGROUND: Manual cervical distraction (MCD) is a traction-based therapy performed with a manual contact over the cervical region producing repeating cycles while patients lie prone. This study evaluated a traction force-based minimal intervention for use ... Full text Link to item Cite

Methods for Developing Patient-Reported Outcome-Based Performance Measures (PRO-PMs).

Journal Article Value Health · June 2015 OBJECTIVE: To recommend methods for assessing quality of care via patient-reported outcome-based performance measures (PRO-PMs) of symptoms, functional status, and quality of life. METHODS: A Technical Expert Panel was assembled by the American Medical Ass ... Full text Link to item Cite

Clinician proficiency in delivering manual treatment for neck pain within specified force ranges.

Journal Article Spine J · April 1, 2015 BACKGROUND CONTEXT: Neck pain is a common musculoskeletal complaint responsive to manual therapies. Doctors of chiropractic commonly use manual cervical distraction, a mobilization procedure, to treat neck pain patients. However, it is unknown if clinician ... Full text Link to item Cite

Benefits, Challenges, and Culture Change Related to Collaborations Between Complementary and Alternative Medicine and Traditional Research-Intensive Institutions

Journal Article Medical Science Educator · March 1, 2015 Background: This project assessed the nature of collaboration between complementary and alternative medicine (CAM) and traditional, research-intensive (TRI) institutions among the nine National Center of Complementary and Alternative Medicine (NCCAM)-funde ... Full text Cite

Report of the NIH Task Force on research standards for chronic low back pain.

Journal Article Phys Ther · February 2015 UNLABELLED: Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP ... Full text Link to item Cite

Comparing Propensity Score Methods for Creating Comparable Cohorts of Chiropractic Users and Nonusers in Older, Multiply Comorbid Medicare Patients With Chronic Low Back Pain.

Journal Article J Manipulative Physiol Ther · 2015 OBJECTIVE: Patients who use complementary and integrative health services like chiropractic manipulative treatment (CMT) often have different characteristics than do patients who do not, and these differences can confound attempts to compare outcomes acros ... Full text Link to item Cite

Inter-examiner reliability of the interpretation of paraspinal thermographic pattern analysis

Journal Article Journal of the Canadian Chiropractic Association · January 1, 2015 Introduction: A few spinal manipulation techniques use paraspinal surface thermography as an examination tool that informs clinical-decision making; however, interexaminer reliability of this interpretation has not been reported. The purpose of this study ... Cite

Randomized effectiveness trial of a brief course of acupuncture for posttraumatic stress disorder.

Conference Med Care · December 2014 BACKGROUND: Initial posttraumatic stress disorder (PTSD) care is often delayed and many with PTSD go untreated. Acupuncture appears to be a safe, potentially nonstigmatizing treatment that reduces symptoms of anxiety, depression, and chronic pain, but litt ... Full text Link to item Cite

Focus article: report of the NIH Task Force on Research Standards for Chronic Low Back Pain.

Conference Eur Spine J · October 2014 UNLABELLED: Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP ... Full text Link to item Cite

Report of the National Institutes of Health task force on research standards for chronic low back pain.

Journal Article J Manipulative Physiol Ther · September 2014 OBJECTIVES: Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP ... Full text Link to item Cite

Study protocol for patient response to spinal manipulation - a prospective observational clinical trial on physiological and patient-centered outcomes in patients with chronic low back pain.

Journal Article BMC Complement Altern Med · August 8, 2014 BACKGROUND: Low back pain (LBP) is a major health issue due to its high prevalence rate and socioeconomic cost. While spinal manipulation (SM) is recommended for LBP treatment by recently published clinical guidelines, the underlying therapeutic mechanisms ... Full text Link to item Cite

Report of the NIH Task Force on research standards for chronic low back pain.

Journal Article Pain Med · August 2014 OBJECTIVE: Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP i ... Full text Link to item Cite

Report of the NIH Task Force on Research Standards for Chronic Low Back Pain.

Journal Article Spine J · August 1, 2014 UNLABELLED: Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP ... Full text Link to item Cite

Focus article report of the NIH task force on research standards for chronic low back pain.

Journal Article Clin J Pain · August 2014 BACKGROUND: Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP ... Full text Link to item Cite

EDTA chelation therapy alone and in combination with oral high-dose multivitamins and minerals for coronary disease: The factorial group results of the Trial to Assess Chelation Therapy.

Journal Article Am Heart J · July 2014 BACKGROUND: Disodium ethylenediaminetetraacetic acid (EDTA) reduced adverse cardiac outcomes in a factorial trial also testing oral vitamins. This report describes the intent-to-treat comparison of the 4 factorial groups overall and in patients with diabet ... Full text Link to item Cite

Quality-of-life outcomes with a disodium EDTA chelation regimen for coronary disease: results from the trial to assess chelation therapy randomized trial.

Journal Article Circ Cardiovasc Qual Outcomes · July 2014 BACKGROUND: The National Institutes of Health.funded Trial to Assess Chelation Therapy (TACT) randomized 1708 stablecoronary disease patients aged .50 years who were .6 months post.myocardial infarction (2003.2010) to 40 infusions ofa multicomponent EDTA c ... Full text Link to item Cite

Report of the NIH task force on research standards for chronic low back pain.

Journal Article Spine (Phila Pa 1976) · June 15, 2014 UNLABELLED: Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP ... Full text Link to item Cite

Report of the NIH Task Force on research standards for chronic low back pain.

Journal Article J Pain · June 2014 UNLABELLED: Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP ... Full text Link to item Cite

The effect of an EDTA-based chelation regimen on patients with diabetes mellitus and prior myocardial infarction in the Trial to Assess Chelation Therapy (TACT).

Journal Article Circ Cardiovasc Qual Outcomes · January 2014 BACKGROUND: The Trial to Assess Chelation Therapy (TACT) showed clinical benefit of an EDTA-based infusion regimen in patients aged ≥50 years with prior myocardial infarction. Diabetes mellitus before enrollment was a prespecified subgroup. METHODS AND RES ... Full text Link to item Cite

Chiropractor interaction and treatment equivalence in a pilot randomized controlled trial: An observational analysis of clinical encounter video-recordings

Journal Article Chiropractic and Manual Therapies · January 1, 2014 Background: Chiropractic care is a complex health intervention composed of both treatment effects and non-specific, or placebo, effects. While doctor-patient interactions are a component of the non-specific effects of chiropractic, these effects are not ev ... Full text Cite

Financial attitudes, knowledge, and habits of chiropractic students: A descriptive survey

Journal Article Journal of the Canadian Chiropractic Association · January 1, 2014 Objective: Our purpose was to describe the financial knowledge, habits and attitudes of chiropractic students. Methods: We designed a cross-sectional survey to measure basic financial knowledge, current financial habits, risk tolerance, and beliefs about f ... Cite

Forces applied during manual assessments of low back pain patients

Conference ASME International Mechanical Engineering Congress and Exposition, Proceedings (IMECE) · January 1, 2014 Doctors of chiropractic (DCs) use manual palpation to subjectively assess the relative "stiffness" (resistance) of spinal articulations to help inform decisions regarding where to focus treatment. The objective of this study was to quantify the forces gene ... Full text Cite

Prevalence of radiographic findings in individuals with chronic low back pain screened for a randomized controlled trial: secondary analysis and clinical implications.

Journal Article J Manipulative Physiol Ther · 2014 OBJECTIVE: The purpose of this study is to measure the prevalence of graded disc degeneration, spondylolisthesis, transitional segmentation, and the distribution of sacral slope in patients 21 to 65 years of age with chronic low back pain (CLBP). METHODS: ... Full text Link to item Cite

Oral high-dose multivitamins and minerals after myocardial infarction: a randomized trial.

Journal Article Ann Intern Med · December 17, 2013 BACKGROUND: Whether high-dose multivitamins are effective for secondary prevention of atherosclerotic disease is unknown. OBJECTIVE: To assess whether oral multivitamins reduce cardiovascular events and are safe. DESIGN: Double-blind, placebo-controlled, 2 ... Full text Link to item Cite

Beyond spinal manipulation: Should Medicare expand coverage for chiropractic services? A review and commentary on the challenges for policy makers

Journal Article Journal of Chiropractic Humanities · December 1, 2013 Objectives: Private insurance plans typically reimburse doctors of chiropractic for a range of clinical services, but Medicare reimbursements are restricted to spinal manipulation procedures. Medicare pays for evaluations performed by medical and osteopath ... Full text Cite

Authors' reply

Journal Article Focus on Alternative and Complementary Therapies · December 1, 2013 Full text Cite

Medicare's demonstration of expanded coverage for chiropractic services: limitations of the demonstration and an alternative direct cost estimate.

Journal Article J Manipulative Physiol Ther · October 2013 OBJECTIVE: The purposes of this study were to examine the direct costs associated with Medicare's 2005-2007 "Demonstration of Expanded Coverage of Chiropractic Services" (Demonstration) and their drivers, to explore practice pattern variation during the De ... Full text Link to item Cite

Perspectives of older adults on co-management of low back pain by doctors of chiropractic and family medicine physicians: a focus group study.

Journal Article BMC Complement Altern Med · September 16, 2013 BACKGROUND: While older adults may seek care for low back pain (LBP) from both medical doctors (MDs) and doctors of chiropractic (DCs), co-management between these providers is uncommon. The purposes of this study were to describe the preferences of older ... Full text Link to item Cite

Military report more complementary and alternative medicine use than civilians.

Journal Article J Altern Complement Med · June 2013 OBJECTIVES: The study objective was to estimate complementary and alternative medicine (CAM) use among active duty military and compare data with civilian use. DESIGN: A global survey on CAM use in the 12 previous months was conducted. Final participants ( ... Full text Link to item Cite

Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: results of a pragmatic randomized comparative effectiveness study.

Journal Article Spine (Phila Pa 1976) · April 15, 2013 STUDY DESIGN: Randomized controlled trial. OBJECTIVE: To assess changes in pain levels and physical functioning in response to standard medical care (SMC) versus SMC plus chiropractic manipulative therapy (CMT) for the treatment of low back pain (LBP) amon ... Full text Link to item Cite

Effect of disodium EDTA chelation regimen on cardiovascular events in patients with previous myocardial infarction: the TACT randomized trial.

Journal Article JAMA · March 27, 2013 IMPORTANCE: Chelation therapy with disodium EDTA has been used for more than 50 years to treat atherosclerosis without proof of efficacy. OBJECTIVE: To determine if an EDTA-based chelation regimen reduces cardiovascular events. DESIGN, SETTING, AND PARTICI ... Full text Link to item Cite

Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA): study protocol for a randomized controlled trial.

Journal Article Trials · January 16, 2013 BACKGROUND: Low back pain is a prevalent and debilitating condition that affects the health and quality of life of older adults. Older people often consult primary care physicians about back pain, with many also receiving concurrent care from complementary ... Full text Link to item Cite

Intradiscal Pressure Changes during Manual Cervical Distraction: A Cadaveric Study.

Journal Article Evid Based Complement Alternat Med · 2013 The objective of this study was to measure intradiscal pressure (IDP) changes in the lower cervical spine during a manual cervical distraction (MCD) procedure. Incisions were made anteriorly, and pressure transducers were inserted into each nucleus at lowe ... Full text Link to item Cite

Development of force-feedback technology for training clinicians to deliver manual cervical distraction

Conference ASME International Mechanical Engineering Congress and Exposition, Proceedings (IMECE) · January 1, 2013 Objective: Neck pain is a prevalent musculoskeletal (MSK) complaint and costly societal burden. Doctors of chiropractic(DCs) provide manual therapies for neck pain patients to relieve discomfort and improve physical function. Manual cervical distraction (M ... Full text Cite

A pilot study of a chiropractic intervention for management of chronic myofascial temporomandibular disorder.

Journal Article J Am Dent Assoc · 2013 BACKGROUND: Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). ... Full text Link to item Cite

Results of the Trial to Assess Chelation Therapy

Conference CIRCULATION · December 4, 2012 Link to item Cite

The association of complementary and alternative medicine use and health care expenditures for back and neck problems.

Journal Article Med Care · December 2012 BACKGROUND: Health care costs associated with use of complementary and alternative medicine (CAM) by patients with spine problems have not been studied in a national sample. OBJECTIVES: To estimate the total and spine-specific medical expenditures among CA ... Full text Link to item Cite

Patient-centered outcomes of high-velocity, low-amplitude spinal manipulation for low back pain: a systematic review.

Journal Article J Electromyogr Kinesiol · October 2012 Low back pain (LBP) is a well-recognized public health problem with no clear gold standard medical approach to treatment. Thus, those with LBP frequently turn to treatments such as spinal manipulation (SM). Many clinical trials have been conducted to evalu ... Full text Link to item Cite

Neck pain participant's perception of traction forces during chiropractic manual cervical distraction

Conference ASME International Mechanical Engineering Congress and Exposition, Proceedings (IMECE) · January 1, 2012 In this exploratory study, we measured applied traction forces during a chiropractic manual cervical distraction procedure for each of three "treatment" perceptions; (i) beginning to feel a stretch, (ii) stretch feels like it could be a treatment, and (iii ... Full text Cite

Design of the Trial to Assess Chelation Therapy (TACT).

Journal Article Am Heart J · January 2012 TACT is an National Institutes of Health-sponsored, randomized, double-blind, placebo-controlled, 2 × 2 factorial clinical trial testing the benefits and risks of 40 infusions of a multicomponent disodium EDTA chelation solution compared with placebo and o ... Full text Link to item Cite

Effect of spinal manipulation on sensorimotor functions in back pain patients: study protocol for a randomised controlled trial.

Journal Article Trials · June 28, 2011 BACKGROUND: Low back pain (LBP) is a recognized public health problem, impacting up to 80% of US adults at some point in their lives. Patients with LBP are utilizing integrative health care such as spinal manipulation (SM). SM is the therapeutic applicatio ... Full text Link to item Cite

Chiropractic in North America: toward a strategic plan for professional renewal--outcomes from the 2006 Chiropractic Strategic Planning Conference.

Journal Article J Manipulative Physiol Ther · June 2010 OBJECTIVE: This report describes the process, participation, and recommendations of a set of consensus conferences on strategy for professional growth that emphasized elements of public trust and alignment between the chiropractic profession and its stakeh ... Full text Link to item Cite

Collaborative Care for Older Adults (COCOA), Palmer College of Chiropractic.

Journal Article J Allied Health · 2010 Integrative medicine (IM) is a subset of interprofessional health care that seeks to join the knowledge and practices of various allopathic and complementary and alternative medicine disciplines in an attempt to offer cost-effective and clinically signific ... Link to item Cite

Cost of care for common back pain conditions initiated with chiropractic doctor vs medical doctor/doctor of osteopathy as first physician: experience of one Tennessee-based general health insurer.

Journal Article J Manipulative Physiol Ther · 2010 OBJECTIVE: The primary aim of this study was to determine if there are differences in the cost of low back pain care when a patient is able to choose a course of treatment with a medical doctor (MD) versus a doctor of chiropractic (DC), given that his/her ... Full text Link to item Cite

Characteristics of Veterans Health Administration chiropractors and chiropractic clinics.

Journal Article J Rehabil Res Dev · 2009 Chiropractic services have been delivered on station at select Veterans Health Administration (VHA) medical facilities since late 2004. No published data describing the characteristics of VHA chiropractic physicians (chiropractors) and chiropractic clinics ... Full text Link to item Cite

Erratum: (Liver International (2007) (18))

Journal Article Liver International · April 1, 2007 Full text Cite

Natural products and chronic hepatitis C virus.

Journal Article Liver Int · February 2007 BACKGROUND: Chronic hepatitis C virus (HCV) infection is a significant public health problem, with a worldwide prevalence of approximately 170 million. The standard of care for chronic HCV, a combination of alpha-interferon (IFN) and ribavirin, is only 50% ... Full text Link to item Cite

Stop Hypertension with the Acupuncture Research Program (SHARP): results of a randomized, controlled clinical trial.

Journal Article Hypertension · November 2006 Case studies and small trials suggest that acupuncture may effectively treat hypertension, but no large randomized trials have been reported. The Stop Hypertension with the Acupuncture Research Program pilot trial enrolled 192 participants with untreated b ... Full text Link to item Cite

Auricular acupuncture in the treatment of acute pain syndromes: A pilot study.

Journal Article Mil Med · October 2006 This pilot study used a randomized controlled clinical trial design to compare the effects of standard emergency medical care to auricular acupuncture plus standard emergency medical care in patients with acute pain syndromes. Eighty-seven active duty mili ... Full text Link to item Cite

Assessment of chiropractic outcomes for low back pain and neck pain: a health plan quality incentive model.

Journal Article J Healthc Qual · 2006 Blue Cross and Blue Shield of Minnesota conducted a quality improvement project to quantify and improve the clinical and functional outcomes of low back pain and neck pain patients in a chiropractic network. Improved outcomes were encouraged through a fina ... Full text Link to item Cite

Stop Hypertension with the Acupuncture Research Program (SHARP): clinical trial design and screening results.

Journal Article Control Clin Trials · February 2004 Hypertension is a major public health problem with serious medical and financial consequences. Barriers to successful conventional pharmacological treatment include side effects, out-of-pocket expenses, patient noncompliance and insufficient dosages. Acupu ... Full text Link to item Cite

Drug use management in board and care facilities.

Journal Article Gerontologist · December 1997 The purpose of this study was to describe medication management in board and care facilities throughout Minnesota. A triangulation of data collection methods was used, including mail questionnaires (N = 98 facilities), telephone interviews (N = 64 faciliti ... Full text Link to item Cite

Are all health plans created equal? The physician's view.

Journal Article JAMA · September 17, 1997 CONTEXT: The health care market is demanding increasing amounts of information regarding quality of care in health plans. Physicians are a potentially important but infrequently used source of such information. OBJECTIVE: To assess physicians' views on hea ... Link to item Cite

The Chiropractic Report Card: Patient Satisfaction Study

Journal Article Journal of the American Chiropractic Association · 1997 Cite

The Chiropractic Report Card: Patient Satisfaction Study

Journal Article Journal of the American Chiropractic Association · 1997 Cite

Physicians’ Ratings of Health Plan Performance: Data from a Pilot Survey

Journal Article Journal of General Internal Medicine · 1996 Cite

A Review of Conservative Management Strategies in the Care of Patients with Essential Hypertension.

Journal Article JNMS - Journal of the Neuromusculoskeletal System · 1993 Cite

Summary of the 1995 ACA Annual Statistical Survey on Chiropractic Practice.

Journal Article Summary of the 1995 ACA Annual Statistical Survey on Chiropractic Practice. Cite