The Research Agenda Conference V: Integrating Chiropractic Theory, Evidence, and Practice (RAC V), held in Chicago July 21-23, brought nearly 200 chiropractors and other health care professionals together for high-level academic dialogues on chiropractic research."Many participants told me that they felt this year's conference was a comfortable, safe environment for learning," reported conference director William Meeker,DC,MPH, who is also the director of research for the Palmer Center for Chiropractic Research and principal investigator for the Consortial Center for Chiropractic Research. Dr. Meeker noted an "atmosphere of collegiality, regardless of the participants' experience or political stripe."
"The Funding Window is Open"
RAC V emphasized training and expertise in chiropractic research, rather than funding. "This conference marked a watershed in chiropractic research. The availability of research funding is not our main challenge anymore," explained Dr. Meeker. "Federal research funds are available through the National Institutes of Health's NCCAM (National Center for Complementary and Alternative Medicine), and HRSA (the U.S. Health Resources and Services Administration), and private groups such as the FCER. Now we need to make sure that as research scientists we are producing high-quality proposals that get funded. And we need to remember that the funding window is open now, but it will close in five to 10 years, and we need to take advantage of our opportunities now."
The complex issue of research in subluxation, adjustment, health maintenance care and wellness was given high priority. "The huge topic of maintenance and wellness care was tackled at RAC V," said Cheryl Hawk,DC,PhD, a member of the Conference Planning Committee and associate professor at the Palmer Center for Chiropractic Research. "There is a real need for high-level discussion in this area because of its prevalence in practice and because of the difficulty and many challenges inherent in this type of research."
While significant basic science research projects are underway at various chiropractic institutions, this is another area that needs quality proposals and funding, said conference speakers. "Palmer College is committed to the long, arduous and expensive basic science, biomechanics, and clinical research needed in our profession to fully understand the effects of the subluxation," said Palmer College of Chiropractic President Guy Riekeman,DC. "Subluxation-based research, new techniques and clinical approaches are a high priority for Palmer, and we have committed significant resources to this endeavor."
More Case Reports and Observational Studies Needed
While only eight percent of the attendees at RAC V were field practitioners, the message from speakers to the clinicians and their colleagues was the need for more case reports and observational research. "Too often chiropractors think research means clinical trials," explained Dr. Hawk. "The reality is that to design the best clinical trials, we need more grass-roots-level research from practitioners in the form of case reports and observational studies. This is a great way for DCs to get into research, and we have wonderful resources in the RAC V participants and speakers. We encourage all interested field practitioners to contact the PCCR or the CCCR for information on how to get started."
Practice-based research is another way field practitioners can participate in important studies. "We have an active practice-based research program at Palmer, and other institutions are involved in this type of research as well," Dr. Hawk continued. "It's an easy way for chiropractors to make an important research contribution."
Learning Opportunities
"This was my fourth RAC event," observed Paul Osterbauer,DC,MPH, associate professor and research faculty clinician at Northwestern Health Sciences University. "It was a good opportunity to refocus and get a new perspective so that we can go back to our respective institutions and work on proposals and research projects with renewed energy and increased knowledge. I got some great ideas this weekend."
The RAC V speakers were a list of 'who's who' in chiropractic research and health sciences. Several of the expert presenters had nonchiropractic scientific backgrounds. Speakers included: Dr. Riekeman; Jean Moss,DC,MBA,FICC, president of Canadian Memorial Chiropractic College; Gail Jensen,PT,PhD, professor, faculty associate, Center for Health Policy and Ethics at Creighton University; David Koch,DC, president, Sherman College of Straight Chiropractic; James Mertz,DC,DACBR, president, American Chiropractic Association; Benjamin Crabtree,PhD, professor, director of research, Department of Family Medicine, University of Medicine and Dentistry of New Jersey; Gregory Cramer, DC, PhD, dean of research, National College of Chiropractic; Anthony Rosner,PhD, director of research and education, Foundation for Chiropractic Education and Research; Christine Goertz,DC,PhD, program officer at the NCCAM, National Institutes of Health; Jennifer Hannah, program officer at the Health Resources and Services Administration (HRSA); and Norm Clark,DDS, branch chief, Allied Health and Associated Health Professions, division of Dental and Public Health Professions, Health Resources and Services Administration."RAC V was one of the best experiences I have had since being involved in chiropractic," said Andrew Riddle, a Parker College intern. "It broadened my thoughts on what a DC can do. We are in great need of talented researchers to produce for our profession. It seems that we are exhausting the relatively few researchers we have. Chiropractic students have virtually no practical research exposure during our training. This conference can help develop the chiropractors' affinity to using and contributing to research."
At least 12 chiropractic research journals were represented by their editors at the conference, and there was a great deal of discussion about the efforts of our scientific publications."The research agenda conferences are a terrific forum for some of the best minds in chiropractic and other professions to come together to further the national research agenda for chiropractic," observed HRSA representative Jennifer Hannah. "The level of commitment and enthusiasm exhibited by all of the participants, including Bill Meeker, the RAC planning committee and the Palmer staff, was outstanding and contributes greatly to the success of these conferences."
"It was very exciting for me to look at a room filled with 200 chiropractors who were brought together because of their interest in research," added Dr. Goertz. "I am impressed by the incredible progress that the chiropractic profession has made during the past five years in beginning to develop a research infrastructure and future initiatives. Two of NCCAM's goals are to stimulate submission of high-quality applications in CAM, and to increase the number, quality and diversity of CAM investigators. NCCAM benefits from involvement in these conferences because it gives us an opportunity to better identify how we can best achieve these goals. I think the chiropractic profession benefits from what transpired because moving forward with a significant research agenda will ultimately lead to better quality patient care." "There was a greater emphasis this year on qualitative research, including observational research, studies of the anthropological aspects of the chiropractic clinical encounter, research agenda-setting and editorial review, explained Dr. Meeker. "There will be even more emphasis on this branch of chiropractic research at RAC VI."
Results from RAC V discussion groups and other conference follow-up information will be posted on the websites of CCCR (http://www.c3r.org) and the Palmer College (http://www.palmer.edu).
RAC VI will convene in July 2001.
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