Chiropractor's use of radiography in Switzerland

Aroua, A.; Decka, Ina; Robert, J Gillies; Vader, John‐Paul; Valley, J.-F.

doi:10.1067/mmt.2003.10

Cited by 10 publications

(3 citation statements)

References 5 publications

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“…These are considered to be low levels of single exposure, comparable to less than 1 year of exposure to natural background radiation [ 89 ]; however, cumulative exposure also needs to be considered, with some chiropractors’ advocating repeat spinal X-rays to monitor spinal change from the care provided [ 15 ]. The collective dose from spinal imaging is high and chiropractors’ have been shown to have a relatively high contribution to that collective dose [ 19 ], without corresponding high levels of demonstrated patient benefit.…”

Section: Introductionmentioning

confidence: 99%

Current evidence for spinal X-ray use in the chiropractic profession: a narrative review

et al. 2018

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The use of routine spinal X-rays within chiropractic has a contentious history. Elements of the profession advocate for the need for routine spinal X-rays to improve patient management, whereas other chiropractors advocate using spinal X-rays only when endorsed by current imaging guidelines. This review aims to summarise the current evidence for the use of spinal X-ray in chiropractic practice, with consideration of the related risks and benefits. Current evidence supports the use of spinal X-rays only in the diagnosis of trauma and spondyloarthropathy, and in the assessment of progressive spinal structural deformities such as adolescent idiopathic scoliosis. MRI is indicated to diagnose serious pathology such as cancer or infection, and to assess the need for surgical management in radiculopathy and spinal stenosis. Strong evidence demonstrates risks of imaging such as excessive radiation exposure, overdiagnosis, subsequent low-value investigation and treatment procedures, and increased costs. In most cases the potential benefits from routine imaging, including spinal X-rays, do not outweigh the potential harms. The use of spinal X-rays should not be routinely performed in chiropractic practice, and should be guided by clinical guidelines and clinician judgement.

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Section: Introductionmentioning

confidence: 99%

Current evidence for spinal X-ray use in the chiropractic profession: a narrative review

et al. 2018

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“…In the year 2000, only 25% to 30% of chiropractic patients were radiographed in the United Kingdom 102 and Switzerland. 103 Limited access to radiology facilities possibly explains why fewer radiographs are taken throughout several other European countries. Chiropractors in Belgium, France, Germany, Greece, Italy, Spain, and Sweden do not have the legislation necessary to allow taking or ordering radiographs.…”

Section: Type Of Practicementioning

confidence: 99%

Diagnostic Imaging Practice Guidelines for Musculoskeletal Complaints in Adults—An Evidence-Based Approach: Introduction

Bussières

Peterson

Taylor

2007

Journal of Manipulative and Physiological Therapeutics

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“…This low utilization rate may be partly explained by the fact that many common red flags are nonpathologic, such as age over 50, decision regarding career or athletics, and pain worst lying down and/or at night in bed. 23 Current utilization rates observed in community practice are estimated at approximately 25% in Switzerland 6 and 37% in Canada. 27 It is envisioned that adherence to imaging guidelines in professional practice will continue to improve in the upcoming years as new graduates enter practice and more effective educational intervention strategies are implemented.…”

Section: Figure 3 Scores Obtained In the Pretest (1) And In The Finamentioning

confidence: 99%

Diagnostic Imaging Guidelines Implementation Study for Spinal Disorders: A Randomized Trial with Postal Follow-ups*

Bussières

Laurencelle

Peterson³

2010

Journal of Chiropractic Education

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Louis Laurencelle, PhD, Université du Québecà Trois-Rivières, and Cynthia Peterson, DC, RN, MMedEd, Swiss Academy for Chiropractic Purpose: Implementation strategies of imaging guidelines can assist in reducing the number of radiographic examinations. This study aimed to compare the perceived need for diagnostic imaging before and after an educational intervention strategy. Methods: One hundred sixty Swiss chiropractors attending a conference were randomized to either receive a radiology workshop, reviewing appropriate indications for diagnostic imaging for adult spine disorders (n D 80), or be in a control group (CG). One group of 40 individuals dropped out from the CG due to logistic reasons. Participants in the intervention group were randomly assigned to three subgroups to evaluate the effect of an online reminder at midpoint. All participants underwent a pretest and a final test at 14-16 weeks. A posttest was administered to two subgroups at 8-10 weeks. Results: There was no difference between baseline scores, and overall scores for the pretest and the final tests for all four groups were not significantly different. However, the subgroup provided with access to a reminder performed significantly better than the subgroup with whom they were compared (F D 4.486; df D 1 and 30; p D .043). Guideline adherence was 50.5% (95% CI, 39.1-61.8) for the intervention group and 43.7% (95% CI, 23.7-63.6) for the CG at baseline. Adherence at follow-up was lower, but mean group differences remained insignificant. Conclusions: Online access to specific recommendations while making a clinical decision may favorably influence the intention to either order or not order imaging studies. However, a didactic presentation alone did not appear to change the perception for the need of diagnostic imaging studies. (J Chiropr Educ 2010;24(1):2-18)

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Chiropractor's use of radiography in Switzerland

Cited by 10 publications

References 5 publications

Current evidence for spinal X-ray use in the chiropractic profession: a narrative review

Current evidence for spinal X-ray use in the chiropractic profession: a narrative review

Diagnostic Imaging Practice Guidelines for Musculoskeletal Complaints in Adults—An Evidence-Based Approach: Introduction

Diagnostic Imaging Guidelines Implementation Study for Spinal Disorders: A Randomized Trial with Postal Follow-ups*

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