Friday, November 1, 2013 - 20:49 Christopher Kent DC, JD
Searching the Literature for Intellectual Ammunition

Plenty of Research on Subluxation Exists - If you are willing to look for it

The phone rang, asking that I call a DC on his cell phone immediately. He asked if I could supply him with an article regarding the forces associated with a chiropractic adjustment. He informed me that he was in the middle of a malpractice trial, and needed the information immediately. I referred him to a DC who has lectured on this topic and who was likely to have the information readily available. Another chiropractor called who had made some rather bold claims regarding the effectiveness of chiropractic for a specific condition. He had an MD patient in his office asking for supporting evidence. He said that the physician was on the table and wondered if I could "fax it over right away." The claim was one for which I could not recall any literature support, and if I had, I certainly could not make the paper magically appear by snapping my fingers.

It is not uncommon for well-meaning chiropractors to make statements regarding the effectiveness of chiropractic care without having supportive documentation available should it be requested. Your credibility, as well as that of the profession, rests on your ability to make claims responsibly. My advice is simple: Before you make any claims, have the documentation in hand.

Scholarly responsibility is one characteristic of a profession. As one author has noted, "Professions are based on scientific and philosophical facts acquired through scholarly endeavour. Individuals who enter a profession do so for reasons that distinguish them from other work or vocations. They understand that their work renders a unique public service with a scientific or philosophical basis and/or body of knowledge that requires an extended period of academic and hands-on preparation. Professions are also based on specialized skills necessary for the professional to perform the public service."1

The purpose of this article is to provide you with a resource to enable you to easily access scholarly literature in chiropractic. Let's begin with databases. Databases allow users to search the included literature using a variety of criteria, such as journal, author, topic, title words, etc. Databases often include online abstracts (summaries) that may be viewed free of charge.

Databases

Index Medicus, MEDLINE and PubMed. The granddaddy of the indexes, the printed Index Medicus was published for 125 years until it was supplanted by the online service, MEDLINE.2 Checking today, there were 5,893 journal indexed in Index Medicus, and 618 additional journals included in MEDLINE,3 the latter of which may be accessed free of charge through PubMed.

PubMed allows the user to search 20 million citations for biomedical literature from MEDLINE, life science journals, and online books.4 To get started, just go to www.ncbi.nlm.nih.gov/pubmed. There is a quick-start guide and tutorials available on the site. Alternatively, you can just start playing with it. Entering the word chiropractic yielded 5,091 results. Since most peer-reviewed chiropractic journals are not included in PubMed, it is a good place to see what those outside the profession have written. However, don't depend on it to find chiropractic publications; most are not included.

Index to Chiropractic Literature (ICL). This free database is a service of the Chiropractic Library Consortium. This excellent resource includes current and past peer-reviewed chiropractic journals, and non-peer-reviewed newspapers and magazines. It does not include non-chiropractic sources, and complements PubMed. Point your browser to www.chiroindex.org.

MANTIS. The Manual, Alternative, and Natural Therapy Index System addresses "alternative medicine literature," including chiropractic, osteopathy, homeopathy and manual medicine, and includes over 400,000 records from more than 1,000 journals. You can access the MANTIS database at www.healthindex.com.

CINAHL (Cumulative Index to Nursing and Allied Health Literature) is a paid subscription service available to educational institutions, hospitals, medical institutions, corporations and libraries. CINAHL searches may be available through a medical or chiropractic college library. The Web address is www.ebscohost.com/cinahl.

Google Scholar provides a search of scholarly literature across many disciplines and sources, including theses, books, abstracts and articles. A beta version is currently available at http://scholar.google.com and search tips are available at http://scholar.google.com/intl/en/scholar/refinesearch.html

ICPA (International Chiropractic Pediatric Association) has a compilation of references online. Although not a searchable database, articles cited are arranged alphabetically by condition. Go to http://icpa4kids.org/Chiropractic-Research

Journals

If you are seeking a specific journal article or wish to search a specific journal, you can go directly to the journal's Web site. Abstracts are usually available at no charge. Here is a selection of peer-reviewed chiropractic journal Web sites. For an up-to-date, comprehensive list, you may wish to visit the Index to Chiropractic Literature, as described above. The journals are listed alphabetically.

Winning the debate, enhancing cultural authority and building credibility are great reasons for learning to search the literature. But the best reason is to provide the best possible care for your patients.

References

1. Quality Research International. Analytic Quality Glossary: Profession.
2. "Index Medicus to Cease as Print Publication." NLM Technical Bulletin, 2004 May-Jun;(338):e2.
3. U.S. National Library of Medicine, National Institutes of Health. Number of Titles Currently Indexed for Index Medicus and MEDLINE on PubMed.
4. www.ncbi.nlm.nih.gov/pubmed

On Purpose