November 2005

An open letter to chiropractors

by Bob Blanks, PhD, RCS President

I would like to take this opportunity to fill you in on the progress of the past six months, and to tell you about several new and exciting projects to be coordinated by Research & Clinical Science (RCS).

IRB approval and electronic data repository: As you know, RCS is an Electronic Chiropractic Record (ECR) company. Full IRB approval has been obtained to create an interactive electronic data repository to track all patient data from participating chiropractic offices. Note that we will be collecting health outcomes data from chiropractic offices worldwide. This international study may seem large but is necessary to control for the thousands of patient sociodemographic, clinical and other outcome measures.

The system will accommodate data from chiropractors practicing up to 65 different techniques and using any variety of outcome measures (e.g., X‑rays, surface EMG, etc.). The electronic data capture network is HIPAA compliant, and protects patient privacy by using custom software to redact all patient identifiers. Once the data sets are complete they will be made available to any group requesting the information for research purposes, and to members of our scientific panel for their research. The long‑term objective is to promote evidence‑based chiropractic.

The RCS network will create the largest data repository in chiropractic‑ think of it as a practice‑based "Framingham" study.

Training sessions for participating data collection sites: These RCS training sessions cover all required training for research participants (human subjects consent, electronic data capture, data entry, compliance, etc.) in an intense 14‑hour weekend course. Clearly, a multi‑center clinical study of this scope requires tremendous coordination, but we have a great team of individuals experienced in conducting health outcomes studies of this type and others who are well‑connected in the field of chiropractic.

First RCS International Scientific Advisory Panel and Research Symposia: As part of our first International Scientific Board Meeting, we have arranged a mini‑conference to be held in Washington DC, Saturday May 5‑6 in conjunction with the annual World Chiropractic Alliance (WCA) Summit Meetings. I arranged to have some members of our scientific panel speak about their research objectives focusing upon a central theme of "Early Biomarkers for Disease Prevention and Health Promotion." I have scheduled a one‑hour panel discussion, allowing all members of the Panel to address specific questions on brain diseases, child health, elder care, allergic asthma, growth factors and stem cell research, osteology etc.

Future research: RCS will rely heavily on the International Scientific Advisory Panel to provide direction for the next phase of research. Once the current "characterization phase" has been completed, RCS will be able to initiate several clinical trials and other research formats to evaluate chiropractic in relation to general health measures or specific health conditions. RCS will rely on the advise of the ISAP for topic areas, research design, and outcome measures for clinical research, and the types of experiments required for hypothesis driven research underlying the mechanisms of mind‑body communication in chiropractic.

Challenges to working within the profession: Finally, some of you will be aware that there are several major factions within the field of chiropractic. As I understand it, one faction wants to align with medicine and focus on musculoskeletal (low back) pain relief, whereas the other follows the original tenants of chiropractic as a system of care with potential applications across many body systems. These two factions sometimes bring criticism from the biomedical community and from within chiropractic itself. RCS has made it clear that we will work with any and all members of the profession who value scientific, evidenced‑based research because this is our goal. We are conducting legitimate IRB‑approved health outcomes research and we have nothing to hide from those with political agendas. Frankly, as chair of a medical IRB at UCI for many years, the factions in chiropractic almost seem minor compared to some of the hotly contested issues in biomedicine and some of the sponsor‑driven protocols from the pharmaceutical industry.

RCS has launched a major health outcomes research program that will produce much valuable information that should benefit the population, health education, research and hopefully produce sufficient peer‑reviewed research to favorable impact health policy reform.

(Dr. Blanks is Professor in the Department of Biomedical Sciences at Florida Atlantic University and a past Professor of Anatomy and Neurobiology at the University of California, Irvine. Prior to this he spent two years at the Max Planck Institute for Brain Research in Frankfurt, Germany and two years in the Department of Anatomy at Harvard Medical School. Dr. Blanks is on the Advisory Board of the International Spinal Health Institute, is a Board Member of the Council on Chiropractic Practice and is actively involved in chiropractic research.)