The Chiropractic Research Agenda Conference: After 10 Years, Where Are We?

By Dana Lawrence, DC, M. Med. Ed., MA

Ten years ago, I was privileged to be both a member of the planning committee and a participant in the first Chiropractic Research Agenda Conference. That conference invited 35 researchers and faculty members to participate in a consensus process in which a number of papers describing the state of chiropractic research were assessed, analyzed, debated, revised, and finally published in the Journal of Manipulative and Physiological Therapeutics about 16 months later. There were, I recall, a total of perhaps 55 attendees.

What came out of that first conference was an overview of the state of chiropractic research. The topic areas assessed included basic science research,1 clinical science research,2 educational research,3 outcomes research,4 and health services research.5 In addition, an introductory paper examined the steps that had been taken to get to the point at which such a program could take place.6

We are coming now to the 10th anniversary of that initial conference. At the 9th conference, held in Las Vegas in March of 2004, in concert with the Association of Chiropractic Colleges' annual meeting (thus the acronym ACC/RAC), there were over 400 attendees, and well over 50 people made plenary presentations; a substantially larger number also made presentations in the various scientific sessions.

We can take justifiable pride in the growth of chiropractic research, but not for a single moment should we sit and rest on our laurels. With the 10th anniversary program coming up, we plan on revisiting the original papers. I would like to describe here the process we will use, before I return to discussing the challenges we face.

We have invited four individuals to take the lead in coordinating efforts to revisit the "white papers." The individuals, and their topic areas, are:

  • Gregory Cramer, DC, PHD - basic science;
  • Gert Bronfort, DC, PHD - clinical science (including outcomes research);
  • Robert Mootz, DC - health services research; and
  • John Mrozek, DC - educational research.

Each individual is responsible for putting together a team to work with in gathering information about new research since the program of 10 years ago, summarizing its recommendations and action steps (presented as "expectations met"), updating the original paper by adding in discussions of "milestone" papers from the past decade, and then discussing where we are, as well as offering new recommendations and action steps. So, the new paper will effectively describe where we were, where we are, and where we should go.

But the story hardly ends there. Once a first draft is received, it will be sent to a board of external reviewers for review. Suggestions for revisions and additions will be made and returned to the writing group, and a second draft will then be prepared, incorporating those recommendations. These second drafts will posted on the RAC Web site (www.c3r.org/accrac05) approximately two months prior to the program, which is scheduled for March 17-19, 2005. All registrants to ACC/RAC will have access to these papers and will be invited to make comment. At the next ACC/RAC, a series of breakout sessions will be held and coordinated for each topic area. The paper will be presented, and the authors will collect written comments and respond to questions from the audience. Each meeting will be recorded. It is important to note that these will not be "word crafting" meetings; they will be devoted to content and substance. From all of these comments and concerns, a final draft of each paper will be prepared. All papers will ultimately be published in JMPT, as per agreement.

We will again be able to see the extent of our accomplishments, as well as the new challenges we face. Finally, a paper will accompany the new "white papers," in which the conference coordinator, Dr. Bill Meeker, working with a few other individuals, will discuss research capacity within the chiropractic profession. This has changed radically over the past decade, with significant accomplishments (for example, the creation of the Palmer Center for Chiropractic Research as a result of federal funding) and significant challenges (for example, the decrease in dedicated researchers arising from the continual decline in chiropractic student enrollment across the profession).

From my perspective, and without any hard proof, I also foresee some challenges, which I have spoken of in past settings. The astute reader will note that, in the main, the people who were involved in preparing the papers 10 years ago remain active and public within the chiropractic research community, notwithstanding the retirement of a few. To be blunt, we are aging, yet we do not have coming up behind us, at least as yet, a new generation of researchers, administrators and support personnel to take over once we leave this wonderful profession. While efforts are indeed underway, they are limited at present; however, the overall theme of the program for March 2005 is "Emerging Training and Research Opportunities." The ability to gain the skills to become an effective researcher is present in ever growing amounts, yet few of us have the knowledge of what the full gamut includes. This program will give the attendee the opportunity to see what options exist, what options are suitable for you, and how each of us may gain new and needed skills.

I am looking forward to my 10th RAC (I omit the ACC part here since the two were separate for a period of time). Having stepped down as the JMPT editor, indicating once again the aging of the profession, I remain eager to see what our newer or younger faculty are bringing to the table, what skills they have, and what research they are involved in. I certainly hope readers will consider attending, to see exactly how far we've come, how much we have to be proud of, and yet how much more we have to do.

References

  1. Brennan PC, Cramer GC, Kirstukas SJ, Cullum ME. Basic science research in chiropractic: the state of the art and recommendations for a research agenda. J Manipulative Physiol Ther 1997;20:150-168.
  2. Sawyer C, Haas M, Nelson C, Elkington W. Clinical research within the chiropractic profession: status, needs and recommendations. J Manipulative Physiol Ther 1997;20:169-178.
  3. Adams AH, Gatterman M. The state of the art of research on chiropractic education. J Manipulative Physiol Ther 1997;20:179-184.
  4. Nyiendo J, Haas M, Hondras MA. Outcomes research in chiropractic: the state of the art and recommendations for the chiropractic research agenda. J Manipulative Physiol Ther 1997;20:185-200.
  5. Mootz RD, Coulter ID, Hansen DT. Health services research related to chiropractic: review and recommendations for research prioritization by the chiropractic profession. J Manipulative Physiol Ther 1997;20:2201-216.
  6. Hawk C, Meeker W, Hansen D. The National Workshop to Develop the Chiropractic Research Agenda. J Manipulative Physiol Ther 1997;20:147-149.

Dana J. Lawrence, DC
Associate Professor,
Palmer Center for Chiropractic Research


Dana Lawrence, DC, M. Med. Ed., MA, is the senior director for the Center for Teaching and Learning at Palmer College of Chiropractic and interim senior director for continuing education and events.

Dr. Lawrence is past editor for several professional scientific journals for the chiropractic profession, and has published a number of textbooks. He serves on numerous editorial boards. He was a member of the Alternative Medicine Program Advisory Council of NCCAM.

In addition to his DC degree, Dr. Lawrence has earned master's degrees in medical education (M. Med. Ed.), and bioethics and health policy (MA). He is a co-investigator on Palmer College's R25 grant, "Expanding Evidence-Based Medicine Across the Curriculum," for which he has helped coordinate faculty training designed to enhance the use and understanding of evidence-based practice by both faculty members and students. In addition, he also teaches a course in evidence-based chiropractic practice.

In 2013, Dr. Lawrence was named "Academician of the Year" by the American Chiropractic Association for his service to the profession.



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