Published in the British Chiropractic Association’s ‘Contact’ magazine, Winter 2017, Vol. 31, No. 3:

Improving Research Capacity

It’s always a privilege to attend a chiropractic graduation ceremony and see the next generation of chiropractors embark on what is a fantastic career, and the recent AECC University College graduation ceremony in Bournemouth was no exception. The huge impact that we can have on our patients’ lives, making them happier, healthier and able to go about their normal everyday activities, is truly remarkable. So, good luck to all the new chiropractors!

It was a lovely day, and in addition to seeing all the new chiropractors celebrate with their friends and families, it was wonderful to see our founding trustee, Dr Richard Brown, conferred as a Fellow of the AECC UC in recognition of his dedication and commitment to chiropractic. Richard, Secretary General of the World Federation of Chiropractic, has worked tirelessly over the years to develop and promote the chiropractic profession at a national and international level. On receiving this award, Richard said ‘It is an enormous honour to receive this Lifetime Fellowship. As a proud alumnus of AECC University College I am delighted to see how the institution has evolved and is justly regarded as a world leader in chiropractic”.

I was also able to catch up with Dr Dave Newell to find out how he has been getting on in his first couple of months as Visiting Research Fellow at the Department of Primary Care and Populations Sciences (PCPS), Faculty of Medicine, University of Southampton.

Here’s what Dave had to say; “It’s been a hugely busy, but exciting couple of months here at Southampton. Being part of PCPS means I am working alongside some of the top researchers in musculoskeletal medicine, public health and epidemiology. Although we come from a variety of different healthcare professions, I have been astonished by the similarities that we have when it comes to research issues. We hope to be recruiting to PhD students to join us next year. It is hugely exciting work; without the funding and support from the CRC this work really wouldn’t be possible”.

Thinking of the newly graduated chiropractors, just how many of them might consider research as part of their chiropractic career? If the literature is anything to go by, not many! Studies conducted in Europe and North America indicate that less than 5% of the chiropractic profession is engaged in research activities, and that includes those within the research and academic institutions! The majority of chiropractors go on to pursue clinical careers and, why not? After all that is what we’re trained to do and what we’re really good at! However, unless we start to build a sustainable and progressive research foundation, we will really struggle to see the profession progress. It is often said that ‘research is the currency of the profession’ and we need it to gain cultural authority, to build public, patient and professional confidence and trust in what we do.

So this is something that the CRC aims to do: improve the UK research capacity. By supporting those who have a thirst for research in developing and furthering their skills, as well as encouraging chiropractors to be ‘clinical researchers’ by participating in research studies, collecting data as part of their everyday clinical practise and becoming part of a larger research network, we can substantially improve the amount of chiropractic research being produced in the UK.

A question that I’m often asked is why is research so important or relevant to everyday practise? Only the other day someone wrote on social media to ask, ‘just how useful was EBM in chiropractic practice?’  Admittedly, it can sometimes be hard to understand how a small, obscure study has any clinical relevance whatsoever, but how many of us don’t use evidence in our everyday practice? Surely we use it to explain why joints crack, the relative safety of cervical manipulation in skilled hands, or the benefit of exercise and education in addition to manual care? Researchers are becoming much better at ‘knowledge translation’ (making the evidence palatable and applicable for the everyday clinician) and we discerning practitioners are getting better at understanding and using the literature. Clinical guidelines, compiled after thorough review of all the best available evidence, are perhaps the best clinical research tool that we can use to provide the best possible care to our patients, and in these days of blogs, podcasts, social media, webinars and online live debates, access to digestible and applicable research is so much better! (If you don’t already, then please like and follow the CRC Facebook page).

So, in answer to the original question ‘ just how useful is EBM in chiropractic practise?’, what is the alternative? To practice without consideration of the patient’s preference, our clinical expertise or use of the best available evidence? Simply apply a ‘trust me, I’m the doctor’ approach, roll up our sleeves and get stuck in?!

 

Elisabeth Angier

Chair, Chiropractic Research Council