Third Annual Research Agenda Conference

Warning: Chiropractic at Risk of Being Limited to Low Back Care

By Editorial Staff

ARLINGTON, Virginia -- The third annual Research Agenda Conference (RAC3) for the chiropractic profession (June 19-21) was attended by over 140 researchers, a significant number considering there are only about 65 researchers at the chiropractic colleges in North America (out of 1,265 faculty members).

As with the past two conferences, RAC3 was co-sponsored and funded by the U.S. Health and Human Services Bureau of Health Professions (HRSA BHPr), but this year's conference was the first to be conducted in collaboration with the newly established Consortial Center for Chiropractic Research (CCCR). The CCCR, headquartered at Palmer Center for Chiropractic Research, is a consortium of five chiropractic colleges (Palmer, Los Angeles, National, Northwestern, and Western States), and two state universities (University of Iowa and Kansas State University). It was funded in October 1997 by the Office of Alternative Medicine and the National Institute of Arthritis, Musculoskeletal and Skin Diseases (NIAMS) of the National Institutes of Health (please see "Palmer College Will Headquarter Research Consortium" in the March 23, 1998 issue).

This year's conferenced focused on research training, and was a great opportunity for the seasoned and well-known researchers to pass their experience to the new and up-and-coming researchers. The conference focused on developing and expanding chiropractic's research infrastructure through:

encouraging interinstitutional collaborations (both among chiropractic colleges and between chiropractic and other health care professional training institutions); and

providing training in research methods and procedures for chiropractic college faculty.

The joint sponsorship has allowed the conference to double in size and offer research training and collaboration-building opportunities previously unavailable on such a large scale to chiropractic colleges and their faculty.

The two previous conferences began the building process:

Research Agenda Conference #1 (RAC1): The National Workshop to Develop the Chiropractic Research Agenda

The purpose of RAC1 was to convene a national meeting to develop a research agenda for the chiropractic profession targeting the need to increase its research capacity. The emphasis was on clinical, educational, and outcomes research; basic science and health services research were topics also addressed. Groundwork was established through a literature review and creation of position¥ recommendations for the future on the topics of clinical, educational, outcomes, basic science, and health services research and research infrastructure in chiropractic (please see "National Workshop Sets Chiropractic Research Agenda" in the August 15, 1996 issue).

Research Agenda Conference #2 (RAC2)

The objectives of the second "National Workshop to Develop the Chiropractic Research Agenda" (see "Setting the Chiropractic Research Agenda: Conference II" in the October 20, 1997 issue) were:

propose demonstration projects based on the previous year's recommendations;

develop steps to implement such projects;

identify strategies to overcome barriers to advancing chiropractic research;

develop strategies to foster interdisciplinary collaboration;

propose action steps to advance the overall chiropractic research agenda;

Research Agenda Conference #3 (RAC3)

Some of the comments made by this year's opening speakers reflected their insight into the chiropractic profession based on the last two years of interaction:

"I observe indications that chiropractic is gaining its deserved place among health care professions (that are) federally supported." -- Shannon Mulrooney, HRSA

"You are where the rubber meets the road (for) being agents of change." -- Henry Montes,MPH, Director, Div. of Assoc. Dental and Public Health Professions

"We recognize that the trends are very clear. People are going to be managing their health personally. Instead of caretakers, they (health care providers) are going to be coaches." -- Neil Sampson, Acting Associate Administrator for Health Professions, HRSA

The conference included round table discussions and other networking opportunities that brought chiropractic researchers, funding agencies and research journal editors closer together. Some of the more encouraging presentations described the success attained in collaborative research with institutions outside the chiropractic profession:

Joanne Nyiendo,PhD, director of research for Western States Chiropractic College (WSCC), presented the success of developing a research collaboration that has combined the efforts of WSCC, Oregon State University, and local DCs and MDs.

Eric Hurwitz, DC,PhD, of Los Angeles College of Chiropractic (LACC), presented details on LACC's "Web of Collaboration," which includes relationships with other research and health care facilities, including the University of California at Los Angeles (UCLA).

Perhaps the most dramatic presentation in the conference was given by Scott Haldeman, DC,MD,PhD. Dr. Haldeman cut short his presentation on "The Evolution and Importance of Spinal and Chiropractic Research" to issue a warning to the chiropractic research community:

"Chiropractic is at risk right now of being limited to the treatment of low-back pain. You are the only group that has the qualifications, the skills and the desire to advance the scientific qualifications of this profession."

In talking with Dr. Haldeman after his presentation, the details of this most recent threat to chiropractic were made more clear. It seems that there is a move within the medical research community to establish that cervical manipulation is too dangerous and holds to little benefit. The intent appears to be to highlight the potential dangers of the cervical adjustment and thereby raise the public concern to the point that cervical manipulation will no longer be a standard part of chiropractic practice.