- Email: [email protected]
A breath of fresh air
Clinical Chiropractic (2005) 8, 111—112
intl.elsevierhealth.com/journals/clch
EDITORIAL
A breath of fresh air The articles in this issue of Clinical Chiropractic run the full gamut from case reports, once more detailing treatments hitherto unreported in the chiropractic literature, to large scale trials and systematic reviews; from experienced ‘‘professional’’ researchers to clinicians writing for the first time. This sits well with the aims and the philosophy of the journal,1 not only informing and educating the clinician and, as a result, improving patient care but allowing clinicians to stimulate the research process by identifying the future questions that need to be asked.2,3 One article that particularly encapsulates this approach is Amy Gibbs’ Chiropractic co-management of medically treated asthma: a case series (pp. 140—144) and it does so for several reasons. This article actually began life as an attempt at a clinically based randomized controlled trial. As such, it was an ineffectual attempt to investigate an indeterminate condition using inappropriate methodology. Most editorial boards would have rejected the article outright; most referees — making the unlikely assumption that the article got as far a peer review — would have sent the author packing. It is a tribute to the constructivism of both bodies and their desire to help new authors bridge the gap to publication standard that they spotted within the data, a small scale investigation that offered serious consideration as to the best way to investigate what is essentially a symptom in a clinical setting. This builds on previously published single case studies4,5 that employed both hard and soft outcome measures and is, perhaps, the second step on
the road to identifying what question we should be asking of which patient sub-set and how we should be collecting and analysing the data. I have lost count of the number of redrafts the author went through before reaching acceptance but this was, in turn, a reflection both of her own determination to see her clinical observations reach her peers and the constructive support she received as the article evolved from trying to ‘‘prove’’ efficacy of chiropractic intervention in asthma by means of a randomized controlled trial (RCT) to the realization that the other data inadvertently employed offered a range of more suitable methodologies for future investigation: proof, no; food for thought, inspiration for a paradigm change, yes. In a profession that still measures its development by decades and finds research funds by digging into the pockets of its students, graduates, academics and patients the emphasis should be on the safety and integrity of patient care–—that is what will generate an evidence base for future practice. Proof is unnecessary; improvement is the professional requirement–—and the requirement for the profession.
References 1. Young M, Bolton J, Young A. Pushing back the frontiers, pushing back the boundaries: a new journal, a new paradigm. Clin Chiropractic 2003;6(1):1—3. 2. Young M. The write stuff. Clin Chiropractic 2003;6(3/4): 89—91.
1479-2354/$30.00 # 2005 The College of Chiropractors. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.clch.2005.07.003
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3. Young M. Writing for the peer-reviewed biomedical literature: Part I. The why and the wherefore. Clin Chiropractic 2003;6(3/4):144—50. 4. Worrill N. Asthma: a descriptive case study. Br J Chiropractic 1998;2(1):4—5. 5. Green A. Chronic Asthma and chiropractic manipulation: a case study. Br J Chiropractic 2000;4(2):32—5.
Editorial Martin Young (Editor)* Yeovil Chiropractic Clinic, 142, Sherborne Road, Yeovil, Somerset BA21 4HQ, UK *Tel.: +44 1935 423138; fax: +44 1935 424983 E-mail addresses: [email protected]. [email protected].
intl.elsevierhealth.com/journals/clch
EDITORIAL
A breath of fresh air The articles in this issue of Clinical Chiropractic run the full gamut from case reports, once more detailing treatments hitherto unreported in the chiropractic literature, to large scale trials and systematic reviews; from experienced ‘‘professional’’ researchers to clinicians writing for the first time. This sits well with the aims and the philosophy of the journal,1 not only informing and educating the clinician and, as a result, improving patient care but allowing clinicians to stimulate the research process by identifying the future questions that need to be asked.2,3 One article that particularly encapsulates this approach is Amy Gibbs’ Chiropractic co-management of medically treated asthma: a case series (pp. 140—144) and it does so for several reasons. This article actually began life as an attempt at a clinically based randomized controlled trial. As such, it was an ineffectual attempt to investigate an indeterminate condition using inappropriate methodology. Most editorial boards would have rejected the article outright; most referees — making the unlikely assumption that the article got as far a peer review — would have sent the author packing. It is a tribute to the constructivism of both bodies and their desire to help new authors bridge the gap to publication standard that they spotted within the data, a small scale investigation that offered serious consideration as to the best way to investigate what is essentially a symptom in a clinical setting. This builds on previously published single case studies4,5 that employed both hard and soft outcome measures and is, perhaps, the second step on
the road to identifying what question we should be asking of which patient sub-set and how we should be collecting and analysing the data. I have lost count of the number of redrafts the author went through before reaching acceptance but this was, in turn, a reflection both of her own determination to see her clinical observations reach her peers and the constructive support she received as the article evolved from trying to ‘‘prove’’ efficacy of chiropractic intervention in asthma by means of a randomized controlled trial (RCT) to the realization that the other data inadvertently employed offered a range of more suitable methodologies for future investigation: proof, no; food for thought, inspiration for a paradigm change, yes. In a profession that still measures its development by decades and finds research funds by digging into the pockets of its students, graduates, academics and patients the emphasis should be on the safety and integrity of patient care–—that is what will generate an evidence base for future practice. Proof is unnecessary; improvement is the professional requirement–—and the requirement for the profession.
References 1. Young M, Bolton J, Young A. Pushing back the frontiers, pushing back the boundaries: a new journal, a new paradigm. Clin Chiropractic 2003;6(1):1—3. 2. Young M. The write stuff. Clin Chiropractic 2003;6(3/4): 89—91.
1479-2354/$30.00 # 2005 The College of Chiropractors. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.clch.2005.07.003
112
3. Young M. Writing for the peer-reviewed biomedical literature: Part I. The why and the wherefore. Clin Chiropractic 2003;6(3/4):144—50. 4. Worrill N. Asthma: a descriptive case study. Br J Chiropractic 1998;2(1):4—5. 5. Green A. Chronic Asthma and chiropractic manipulation: a case study. Br J Chiropractic 2000;4(2):32—5.
Editorial Martin Young (Editor)* Yeovil Chiropractic Clinic, 142, Sherborne Road, Yeovil, Somerset BA21 4HQ, UK *Tel.: +44 1935 423138; fax: +44 1935 424983 E-mail addresses: [email protected]. [email protected].