ArticleChiropractic & manual therapies2013
How to proceed when evidence-based practice is required but very little evidence available?
Article in Chiropractic & manual therapies, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effect of chiropractic treatment on primary or early secondary prevention: a systematic review with a pedagogic approach.Chiropractic & manual therapies · 2018Pooled it
- Rectal Stimulation in Premature and Full-Term Newborns: A Narrative Review.Children (Basel, Switzerland) · 2025Review
- The Ontario Chiropractic Association's Evidence-Based Framework Advisory Council: Enhancing patient care through the comprehensive integration of the pillars of evidence-based practice.The Journal of the Canadian Chiropractic Association · 2025Article
- When there is little or no research evidence: a clinical decision tool.The Journal of the Canadian Chiropractic Association · 2025Article
- The accreditation role of Councils on Chiropractic Education as part of the profession's journey from craft to allied health profession: a commentary.Chiropractic & manual therapies · 2020Review
- 'PICO-D Management'; a decision-aid for evidence-based chiropractic education and clinical practice.Chiropractic & manual therapies · 2016Article
- Similarities and differences of a selection of key accreditation standards between chiropractic councils on education: a systematic review.Chiropractic & manual therapies · 2016Review
- Similarities and differences of graduate entry-level competencies of chiropractic councils on education: a systematic review.Chiropractic & manual therapies · 2016Review
- A survey of Australian chiropractors' attitudes and beliefs about evidence-based practice and their use of research literature and clinical practice guidelines.Chiropractic & manual therapies · 2013Article
- Radiophobia Overreaction: College of Chiropractors of British Columbia Revoke Full X-Ray Rights Based on Flawed Study and Radiation Fear-Mongering.Dose-response : a publication of International Hormesis SocietyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAll clinicians of today know that scientific evidence is the base on which clinical practice should rest. However, this is not always easy, in particular in those disciplines, where the evidence is scarce. Although the last decades have brought an impressive production of research that is of interest to chiropractors, there are still many areas such as diagnosis, prognosis, choice of treatment, and management that have not been subjected to extensive scrutiny. DISCUSSION: In this paper we argue that a simple system consisting of three questions will help clinicians deal with some of the complexities of clinical practice, in particular what to do when clear clinical evidence is lacking. Question 1 asks: are there objectively tested facts to support the concept? Question 2: are the concepts that form the basis for this clinical act or decision based on scientifically acceptable concepts? And question three; is the concept based on long-term and widely accepted experience? This method that we call the "Traffic Light System" can be applied to most clinical processes. SUMMARY: We explain how the Traffic Light System can be used as a simple framework to help chiropractors make clinical decisions in a simple and lucid manner. We do this by explaining the roles of biological plausibility and clinical experience and how they should be weighted in relation to scientific evidence in the clinical decision making process, and in particular how to proceed, when evidence is missing.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.