BJC I/ol I No 1 Page 8

Your contribution to the Chiro.practic knowledge base.... Nell Osborne, BSc (Hons), DC, Research Director Designate, British College of Chiropractic. Address for correspondance: AECC, 13-15 Parkwood Road, Bournemouth BH5 2DF

Tel +44 (0)1202 436245 Fax +44 (0)1202 436312

A S YOU ARE no doubt aware, from Tim Jay's regular updates in Contact, the role of the Board of

,Education (BoE) of the British Chiropractic Association (BCA) is changing. As the steering group for a British College of Chiropractic (BCC), it is becoming more and more independent of the BCA, and position- ing itself to address the continuing profession- al development (CPD) needs of all factions of the developing profession.

There are the familiar aspects of CPD, such as the regional post-graduate groups, now under the watchful eye of Nigel Hunt, and the Vocational Training Scheme (VTS) committee ensuring high standards of new graduate edu- cation and clinical training. Then there are the less familiar, such as a small group to admin- ister and oversee the newly established Chiropractic Assessment Board (CAB) test - one of the new requirements for entry to the BCA - and, of course, the very item that this article is printed in, The British Journal of Chiropractic - the BCC's replacement for the BoE's Education Supplement. It is one of these new groups that this article aims to introduce - The Research Division of the BCC.

As professions go, chiropractic, at least in Europe, is a small one. Its capabilities and suc- cesses are, to practitioners and patients, with- out question. Its potential is, however, unreal- ized. It has come a long way since the days of DD Palmer and gone in so many different directions that one chiropractor may not recognise the techniques of another, or even understand their terminology. However, for a such a successful profession, it has precious little documentation actually demonstrating its effectiveness.

Whether we like it or not, medicine, and the professions allied to medicine, are noticing a paradigm shift in attitude from consumers and third party payers. There is an 'evidence-based' society developing, demanding high standards of care and quality assurance:

• Would you have a hip operation without knowing its success rate ?

• How many back operations occur today compared with 20 or even 10 years ago, and why ?

This questioning attitude is driving values that apply to us as well as to medicine.

Whilst it is true that, at least in some respects, a reductionist scientific research

methodology is incompatible with a holistic clinical discipline - we cannot use this as a shield to hide behind; as an excuse not to fur- ther our own knowledge base. We must take the good aspects of science and use them to further our own ends• We must also be careful to avoid the trap into which many medical researcher have fallen: that a lack of evidence does not necessarily mean evidence of lacking.

The words of Ian Coulter (past president of Canadian Memorial Chiropractic College) "Whenever we circle the wagons we shoot rewards, are a sad inditement of chiroprac- tors as their own worst enemies. The research division of the BCC will provide an opportu- nity to unite under an umbrella in an effort to help you confirm that what you do is achiev- ing what you think it is. The BCA's audit process is a world professional first in quality assurance initiatives. We can do the same in clinical research initiatives. The Research Division of the BCC has been set up to make quality research methodology available to all practitioners, by providing advice, help with protocol development and help with publica- tion•

! f you...rely on x-ray for bio- mechanical analysis, can you imagine practice without them ?

The power of chiropractic is in its diversity. Every chiropractor has their own way of prac- tising based on their own clinical experience, what they have been taught and what 'works tbr them'. It is this that we intend to find out more about through 'practice-based research'. This basically involves continuing to do what you are already doing - but now documenting. The Research Division aims to listen to what the profession is doing (not telling you what you should be doing), designing the best pos- sible protocol to document and investigate what you do, then help you publish the results.

If you are a chiropractor who relies on x- rays for biomechnical analysis, can you imagine practice without them? What if the National Radiological Protection Board (NRPB) decides to take away your x-ray priv- ilege due to a lack of an acceptable risk/ben- efit ratio - something that has happened in parts of Europe? (see article p.2).

We are evermore moving to a insurance-

based or 'third party payer' medical society. Would medical insurance companies begin only to pay for acute low back pain sufferers, since this is all that is "proven ?" Such things are not to be left to the over-stretched colleges, or the professional "researchers", they are the responsibility of each of us as practitioners, to ensure the survival and direction of the profes- sion as an independent discipline.

The Research Division is in the develop- ment stage at present but has already gained significant international support. Sitting on our advisory panel we have home grown input from Alan Breen, Simon Leyson and Haymo Thiel but we are also very honoured to have Scott Haldeman, Howard Vernon, William Meeker, David Chapman-Smith and Alan Jordan offering their invaluable advice and support. The steering group currently consists of myself and three research consultants; two very well established senior lecturers and researchers from the Anglo-European College of Chiropractic; Jenni Bolton PhD and Peter McCarthy PhD. Additionally, there is Professor Tony Atkinson chairman of the Chiropractic Registration Steering Group's sub-committee on clinical competency and chairman of the Chiropractic Patient's Association (CPA).

The process is currently maturing but it will not succeed without you. So if you:

• Have an idea that you think can be researched

• Want to participate in some research • Want to get involved with helping run the

division, then please contact me at the AECC. There will be regular updates in the British Journal o f Chiropractic on how things are pro- ceeding. []

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