Evidence map›Paper›PMID 28924697›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2018

Chiropractic spinal manipulation and the risk for acute lumbar disc herniation: a belief elicitation study.

Cesar A Hincapié, J David Cassidy, Pierre Côté, Y Raja Rampersaud, Alejandro R Jadad, George A Tomlinson

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In one paragraph

Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Chiropractic care and risk for acute lumbar disc herniation: a population-based self-controlled case series study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2018
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 1 country.

Cesar A HincapiéInjury Prevention Research Office, Division of Neurosurgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada. cesar.hincapie@utoronto.ca.ORCID http://orcid.org/0000-0002-7257-8122
J David CassidyDivision of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Pierre CôtéFaculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.
Y Raja RampersaudDivision of Orthopaedic Surgery, Toronto Western Hospital, Toronto, Canada.
Alejandro R JadadInstitute for Global Health Equity and Innovation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
George A TomlinsonDepartment of Medicine, Toronto General Research Institute, University Health Network, Toronto, Canada.
University Health Network · CAOntario Tech University · CASt. Michael's Hospital · CAToronto Western Hospital · CAUniversity of Toronto · CA

Funding

CIHR 200902KPD-205299-111612
6 · The paper itself

Abstract

purposeChiropractic spinal manipulation treatment (SMT) is common for back pain and has been reported to increase the risk for lumbar disc herniation (LDH), but there is no high quality evidence about this. In the absence of good evidence, clinicians can have knowledge and beliefs about the risk. Our purpose was to determine clinicians' beliefs regarding the risk for acute LDH associated with chiropractic SMT.

methodsUsing a belief elicitation design, 47 clinicians (16 chiropractors, 15 family physicians and 16 spine surgeons) that treat patients with back pain from primary and tertiary care practices were interviewed. Participants' elicited incidence estimates of acute LDH among a hypothetical group of patients with acute low back pain treated with and without chiropractic SMT, were used to derive the probability distribution for the relative risk (RR) for acute LDH associated with chiropractic SMT.

resultsChiropractors expressed the most optimistic belief (median RR 0.56; IQR 0.39-1.03); family physicians expressed a neutral belief (median RR 0.97; IQR 0.64-1.21); and spine surgeons expressed a slightly more pessimistic belief (median RR 1.07; IQR 0.95-1.29). Clinicians with the most optimistic views believed that chiropractic SMT reduces the incidence of acute LDH by about 60% (median RR 0.42; IQR 0.29-0.53). Those with the most pessimistic views believed that chiropractic SMT increases the incidence of acute LDH by about 30% (median RR 1.29; IQR 1.11-1.59).

conclusionsClinicians' beliefs about the risk for acute LDH associated with chiropractic SMT varied systematically across professions, in spite of a lack of scientific evidence to inform these beliefs. These probability distributions can serve as prior probabilities in future Bayesian analyses of this relationship.

Indexed as

Attitude of Health PersonnelHealth PersonnelHumansIntervertebral Disc DisplacementLow Back PainLumbar VertebraeManipulation, ChiropracticRiskBayesian approachBelief elicitationChiropracticIntervertebral disc displacementRiskSpinal manipulation

Identifiers

PMID28924697
OpenAlexW2755844036

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.