Journal of Manipulative and Physiological Therapeutics
Volume 31, Issue 6 , Pages 412-418 , July 2008

Adherence to Radiography Guidelines for Low Back Pain: A Survey of Chiropractic Schools Worldwide

  • Carlo Ammendolia, DC, PhD

      Affiliations

    • Clinical Epidemiologist, Rehabilitation Solutions, University Health Network, Toronto, Ontario, Canada; Scientist, Centre for Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network, Toronto, Ontario Canada; Adjunct Scientist, Institute for Work and Health, University of Toronto, Toronto, Ontario, Canada
    • Professor and Coordinator of Diagnostic Imaging, New York Chiropractic College, Seneca Falls, New York; Doctor of Chiropractic Program, D'Youville College, Buffalo, New York
    • Senior Clinical Research Project Manager, Institute for Work and Health, University of Toronto, Toronto, Ontario, Canada
    • Corresponding Author InformationSubmit requests for reprints to: Carlo Ammendolia, DC, PhD, Centre for Research Expertise in Improved Disability Outcomes, Toronto Western Hospital–University health Network, Fell Pavilion 4-132399 Bathurst St, Toronto, Ontario, Canada M5T 2S8
    • ,
  • John A.M. Taylor, DC

      Affiliations

    • Scientist, Centre for Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network, Toronto, Ontario, Canada; Institute for Work and Health, University of Toronto, Toronto, Ontario, Canada; Associate Professor, Department of Public Health Sciences Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
    • ,
  • Victoria Pennick, RN, MHSc

      Affiliations

    • Senior Clinical Research Project Manager, Institute for Work and Health, University of Toronto, Toronto, Ontario, Canada
    • ,
  • Pierre Côté, DC, PhD

      Affiliations

    • Professor and Coordinator of Diagnostic Imaging, New York Chiropractic College, Seneca Falls, New York; Doctor of Chiropractic Program, D'Youville College, Buffalo, New York
    • Senior Clinical Research Project Manager, Institute for Work and Health, University of Toronto, Toronto, Ontario, Canada
    • Senior Scientist, Institute for Work and Health, University of Toronto, Toronto, Ontario, Canada; Assistant Professor, Department of Public Health Sciences Faculty of Medicine, University of Toronto, Ontario, Canada
    • ,
  • Sheilah Hogg-Johnson, PhD

      Affiliations

    • Senior Clinical Research Project Manager, Institute for Work and Health, University of Toronto, Toronto, Ontario, Canada
    • Senior Scientist, Institute for Work and Health, University of Toronto, Toronto, Ontario, Canada; Assistant Professor, Department of Public Health Sciences Faculty of Medicine, University of Toronto, Ontario, Canada
    • ,
  • Claire Bombardier, MD

      Affiliations

    • Senior Clinical Research Project Manager, Institute for Work and Health, University of Toronto, Toronto, Ontario, Canada
    • Senior Scientist, Institute for Work and Health, University of Toronto, Toronto, Ontario, Canada; Professor, Faculty of Medicine University of Toronto, Division of Rheumatology, University of Toronto, Ontario, Canada; Director, Clinical Decision-Making and Health Care Division, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
    • Clinical Decision-Making and Health Care Division, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada

Received 1 November 2007 ,Revised 3 January 2008 ,Accepted 7 January 2008.

References 

  1. Chapman-Smith DA. In: The chiropractic profession. West Des Moines (Iowa): NCMIC Group Inc; 2000;p. 45–64
  2. World Federation of Chiropractic [home page on the Internet]. Canada: Ontario. [cited 2005 May 8]. Available from: http://www.wfc.org.Accessed March 1, 2007
  3. Beck RW, Holt KR, Fox MA, Hurtgen-Grace KL. Radiographic anomalies that may alter chiropractic intervention strategies found in a New Zealand population. J Manipulative Physiol Ther. 2004;27:554–559
  4. Ernst E. Chiropractor's use of x-rays. BMJ. 1998;71:248–251
  5. Haas M, Taylor JAM, Gillette RG. Commentary. The routine use of radiographic spinal displacement analysis: a dissent. J Manipulative Physiol Ther. 1999;22:254–259
  6. Phillips RB. Plain film radiology in chiropractic. J Manipulative Physiol Ther. 1992;15:47–50
  7. Yochum T. Diagnostic imaging in its first century. J Manipulative Physiol Ther. 1995;18:618–625
  8. Ammendolia C, Bombardier C, Hogg , Johnson S, Glazier R. Views on x-ray use in patients with acute low back pain among chiropractors in an Ontario community. J Manipulative Physiol Ther. 2002;25:511–520
  9. Ammendolia C. Radiographic anomalies that may alter chiropractic intervention strategies found in a New Zealand population. J Manipulative Physiol Ther. 2005;28:375–376
  10. Phillips RB, Frymoyer JW, MacPherson BV, Newburg AH. Low back pain: a radiographic enigma. J Manipulative Physiol Ther. 1986;9:183–187
  11. Coulter ID, Shekelle PG. Chiropractic in North America: a descriptive analysis. J Manipulative Physiol Ther. 2005;28:83–89
  12. Hurwitz EL, Coulter ID, Adams AH, Genovese BJ, Shekelle PG. Use of chiropractic services from 1985 through 1991 in the United States and Canada. Am J Public Health. 1998;88:771–776
  13. Waalen JK, Mior SA. Practice patterns of 692 Ontario chiropractors (2000-2001). J Can Chiropr Assoc. 2005;49:21–32
  14. Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(Suppl 2):S192–S300
  15. Bigos SJ, Bowyer OR, Braen GR, Brown K, Deyo R. Acute low back problems in adults. Clinical practice guidelines no. 14. Rockville (Md): Agency for Health Care Policy and Research, Public Health Service, US Dept. of Health and Health Services; 1994;Publication No. 95-0642
  16. Koes B, van Tulder M, Ostelo R, Burton K, Waddell G. Clinical guidelines for the management of low back pain in primary care. Spine. 2001;26:2504–2514
  17. Van Tulder M, Becker A, Bekkering T, et al. European guidelines for the management of acute nonspecific low back pain in primary care. Cost B13 Working Group on Guidelines for the Management of Acute Low Back Pain in Primary Care. 2004;
  18. Deyo RA, Weinstein JN. Low back pain. N Engl J Med. 2001;344:363–370
  19. Liang M, Komaroff AL. Roentgenograms in primary care in low back pain: a cost effectiveness analysis. Arch Intern Med. 1982;142:1100–1112
  20. Marchiori DM, Hawk C, Howe J. Chiropractic radiologists: a survey of demographics, abilities, educational attitudes and practice trends. J Manipulative Physiol Ther. 1998;21:392
  21. Plaugher G. The role of plain film radiography in chiropractic clinical practice. Chiropr J Aust. 1992;22:153–161
  22. Kopansky-Giles D, Papadopoulos C. Canadian Chiropractic Resources Databank (CCRD): a profile of Canadian chiropractors. J Can Chiropr Assoc. 1997;4:155–191
  23. Harger BL, Taylor JA, Haas M, Nyiendo J. Chiropractic radiologists: a survey of chiropractors' attitudes and patterns of use. J Manipulative Physiol Ther. 1997;20:311–314
  24. Harrison DE, Harrison DD, Troyoanovich SJ. Reliability of spinal displacement analysis on plain x-rays: a review of commonly accepted facts and fallacies with implications for chiropractic education and technique. J Manipulative Physiol Ther. 1998;21:252–266
  25. Van Tulder MW, Assendelft WJJ, Koes BW, Bouter LM. Spinal radiographic findings and nonspecific low back pain: a systematic review of observational studies. Spine. 1997;22:427–434
  26. Taylor JAM. Full spine radiography. Review of the literature. J Manipulative Physiol Ther. 1993;16:460–474
  27. Schultz G, Philips R, Cooley J, et al. Diagnostic imaging of the spine in chiropractic practice: recommendations for utilization. Chiropr J Chiropr. 1992;22:141–152
  28. Aker P, Bombardier C, Jansz G, Bressler H. Chiropractic management of low back pain: a survey of Ontario chiropractors. In: Paper presented at: Second International Forum for Primary Care Research on Low Back Pain; May 30-31. 1997;The Hague, The Netherlands
  29. Carey TS, Garrett J. North Carolina back pain project. Patterns of ordering diagnostic tests for patients with acute low back pain. Ann Intern Med. 1996;125:807–813
  30. Childs AW, Hunter ED. Non medical factors influencing use of diagnostic x-ray by physicians. Med Care. 1972;10:323–335
  31. Pedersen P. A survey of chiropractic practice in Europe. J Manipulative Physiol Ther. 1995;18:124–125
  32. Cherkin CD, MacCornack FA, Berg AO. Managing low back pain—a comparison of the beliefs and behaviours of family physicians and chiropractors. Western J Med. 1988;149:475–480
  33. Ammendolia C, Bombardier C, Hogg-Johnson S, Pennick V, Glazier R. Implementing evidence-based guidelines for x-ray use in acute low back pain. A chiropractic community intervention. J Manipulative Physiol Ther. 2004;27:170–179
  34. Dillman DA. Mail and Internet surveys: The tailored design method. 2nd Ed.. New York (NY): John Wiley & Sons; 2000;
  35. Ammendolia C, Taylor J, Pennick V, Hogg-Johnson S, Bombardier C. Survey of plain film radiography protocols taught at chiropractic schools for acute low-back pain. Ottawa: Cochrane Collaboration Colloquia abstract; 2004;
  36. Rosner B. Fundamentals of biostatistics. 4th Ed.. Wadsworth Publishing Company; 1995;
  37. In:  Haldeman S,  Chapman-Smith D,  Petersen DM editor. Guidelines for chiropractic quality assurance and practice parameters. Mercy Conference Center; 1992;
  38. Hutchinson A, Waddell G, Feder G, Breen A. Burton K. Clinical guidelines for acute low back pain, The Royal College of General Practitioners. 1996;
  39. Deyo RA, Diehl AK. Lumbar spine films in primary care: current use and effects of selective ordering criteria. J Gen Intern Med. 1986;1:20–25
  40. Ammendolia C, Côté P, Hogg-Johnson S, Bombardier C. Do chiropractors adhere to guidelines for back x-rays? A study of chiropractic teaching clinics in Canada. Spine. 2007;32:2509–2514
  41. Assendelft WJ, Pfeifle CE, Bouter LM. Chiropractic in the Netherlands: a survey of Dutch chiropractors. J Manipulative Physiol Ther. 1995;18:129–134
  42. Plamindon RL. Summary of 1994 ACA statistical study. J Am Chiropr Assoc. 1995;32:57–63
  43. Kerry S, Hilton S, Dundas D, Rink E, Oakeshott P. Radiography for low back pain: a randomised controlled trial and observational study in primary care. Br J Gen Pract. 2002;52:469–474
  44. Staiger TO, Paauw DS, Deyo RA, Jarvik JG. Imaging studies for acute low back pain. Postgrad Med. 1999;105:161–162
  45. Deyo RA, Diehl AK, Rosenthal M. Reducing roentgenography use. Arch Intern Med. 1987;147:141–145
  46. Ammendolia C. Adherence to clinical practice guidelines for radiography use in acute low-back pain: a study of chiropractic teaching clinics. PhD Thesis, University of Toronto; 2005.
  47. Hillman BJ, Joseph CA, Mabry MR, Sunshine JH, Kennedy SD, Noether M. Frequency and costs of diagnostic imaging in office practice—a comparison of self-referring and radiologist-referring physicians. N Engl J Med. 1990;323:1604–1608
  48. Berrington de Gonzalez A, Darby S. Risk of cancer from diagnostic x-rays: estimates for the UK and 14 other countries. Lancet. 2004;363:345–351
  49. Owens JP, Rutt G, Keir MJ, Spencer H, Richardson D, Richardson A, et al. Survey of general practitioners' opinions on the role of radiology in patients with low back pain. Br J Gen Pract. 1990;40:98–101
  50. Halpin SF, Yeoman L, Dundas DD. Radiographic examination of the lumbar spine in a community hospital: an audit of current practice. BMJ. 1991;303:813–815
  51. Russo R, Cook P. Diagnosis of low back pain: role of imaging studies. Occup Med State Art Rev. 1998;13:83–97

PII: S0161-4754(08)00173-5

doi: 10.1016/j.jmpt.2008.06.010

Journal of Manipulative and Physiological Therapeutics
Volume 31, Issue 6 , Pages 412-418 , July 2008

Article Tools