CHIRO Study Wins Best Paper Award
By Editorial Staff
The Bishop, et al., "Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) Study: A Randomized Controlled Trial on the Effectiveness of Clinical Practice Guidelines in the Medical and Chiropractic Management of Acute Mechanical Lower Back Pain," has been selected by The Spine Journal, the official journal of the North American Spine Society, to receive the 2010 Outstanding Paper Award for Medical & Interventional Science. In a letter to Dr. Bishop notifying him of the award, Spine Journal Editor-in-Chief Eugene Carragee, MD, noted that the paper will be published in an upcoming issue of the journal and requests that Dr. Bishop present the paper from the main podium during the NASS 25th Annual Meeting, Oct. 5-9, 2010 in Orlando, Fla. Outstanding Paper presentations will take place on Oct. 7.
Dr. Bishop outlined the CHIRO study model in our November 2008 issue, explaining that the project is "a series of gold-standard, research-methodology clinical trials designed to evaluate the chiropractic assessment and treatment of patients with acute or chronic cervical, thoracic or lumbosacral spine pain stratified by underlying spine pathology. These studies are being carried out in a hospital-based, tertiary-care Orthopaedic and Neurosurgical Spine Program at Canada's National Spine Institute (ICORD) in the Faculty of Medicine at the University of British Columbia in Vancouver. All chiropractors have full hospital privileges [a first, according to Bishop] and work in a continuum-of-care model that involves related medical and surgical disciplines."
Several CHIRO studies have been completed thus far, including the one honored with the NASS Outstanding Paper Award. This study was designed to determine if evidence-based clinical practice guidelines (CPG) care is more effective than usual care (UC) in the treatment of acute mechanical lower back pain. Patients were randomized to CPG care (reassurance, avoidance of passive treatments, acetaminophen, four weeks of lumbar chiropractic spinal manipulative therapy, and return to work within eight weeks) or family physician-directed UC. Outcome measures included differences in Roland Morris Disability scores at 16 weeks (primary outcome measure) and differences in bodily pain and physical functioning SF-36 domain scores, also at 16 weeks.
Patients randomized to CPG care improved to a significantly greater degree (RDQ scores) than patients receiving UC; bodily pain and physical functioning scores also significantly improved in the CPG group compared to the UC group.
In an interview following the award announcement, Dr. Bishop summed up the guiding rationale for the CHIRO research: "to improve spine patient care," adding that it is no longer good enough to treat patients just because "that's how it's been traditionally done."
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