• Owens EF Jr
• Hoiriis KT
• Pfleger B

• Manipulation, Cervical
• Outcome Assessment, Health Care / methods
• Subluxation
• Surveys and Questionnaires

Upper cervical based practitioners often look at the correction of cervical subluxations as the ultimate goal of patient care. Patients, government agencies, and third-party payers on the other hand, are more interested in the outcomes of the care in terms of relief of symptoms, improvement in general health, and cost-effectiveness. While it is certainly the goal of practitioners to satisfy these outcome-based criteria, there have been few studies to demonstrate how effective upper cervical care can be from this perspective.

Outcome-based research is less involved with the mechanics of the subluxation and more devoted to evaluating the effectiveness of care on the health of patients. This kind of research has become particularly popular with government agencies, such as the Agency for Health Care Policy and Research, and a host of tools for measuring the outcome of patient care have been developed over the past few years.

Outcome-based research is most often carried out through the use of questionnaires that patients fill out at the initiation and termination of a course of care. The data collected in this way, although subjective, are well accepted as reliable and valid indicators of the effectiveness of care. Various questionnaires have been developed and tested for reliability in detecting specific conditions, such as chronic low back pain, as well as for general health assessment.

There have been several large-scale outcome-based research studies of chiropractic effectiveness and cost-effectiveness. Most recently, Dickholtz, Wallace, and Woodfield have presented outcomes studies using RAND questionnaires in populations of patients from one practice. However, there have not been any large-scale efforts to demonstrate the effectiveness fo specific upper cervical chiropractic care. We are proposing that the Sid E. Williams Research Center act as the coordinating site for such a large-scale study.

The research department will provide a set of questionnaires and train practitioners in their proper use. We will also act as the collecting point for the completed surveys. Pooling the results from several practices will serve two purposes: the larger number of patients wull add power to the statistical analysis of the results, and there will be a greater degree of anonymity and confidentiality for the patients as well as the contributing practitioners.

Author Keywords: Chiropractic, subluxation, practice-based research, upper cervical.

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