Each year for the past two years, Arlan Fuhr, D.C., executive director of the National Institute for Chiropractic Research has been asked to testify about the chiropractic profession before the U.S. Congressional Subcommittee on Labor, Health and Human Services, Education and Related Agencies. The results of Dr. Fuhr's presentation last year (please see "Dr. Arlan Fuhr Addresses U.S. House Subcommittee" in the June 21, 1991 issue) were seen in a recent report of the House and Senate Appropriations' Committees:
Item
Chiropractic Treatment
1. House (Report 102-121 p. 119) "The Committee has again heard testimony on the need to study the effectiveness of chiropractic treatment. We were encouraged to learn from the Department's fiscal year 1991 report to us that research on the effectiveness of chiropractic spinal manipulation is expected to be part of a Patient Outcomes Research Team on low back pain. We encourage the agency to include an evaluation of chiropractic treatment in other studies of the prevention and treatment of neuromusculoskeletal disorders and ask that the Department be prepared to present further testimony on this topic during the fiscal year 1993 hearings."
Action Taken or to be Taken
1. At the University of Washington, the Patient Outcomes Research Team (PORT) on low back pain has initiated a pilot comparative study of the treatment of low back problems by means of physical therapy or chiropractic spinal manipulation provided under the auspices of the Group Health Health Maintenance Organization (HMO) in Seattle. The pilot may lead to a full-scale clinical trial. This is a direct response to AHCPR's interest in evaluating chiropractic treatment and the participation of chiropractors on the advisory committee of the low back pain PORT.
AHCPR also awarded in FY 1991 a grant to study the treatment of low back problems in the outpatient setting. This study, led by Timothy Carey, M.D., of the University of North Carolina at Chapel Hill, will evaluate patient outcomes and costs involved in treatment by primary care physicians, surgical specialists, and chiropractors. Both urban and rural chiropractors are included. The low back pain PORT and this second study are collaborating on the design of telephone surveys and cost-effectiveness analysis. AHCPR staff involved in medical effectiveness research will continue to identify and work with prospective applicants to help promote new outcomes research on chiropractic care.
Chiropractors are also included in the new clinical practice guideline panel on chronic low back pain.
This year, Dr. Fuhr is scheduled for a 10 a.m. address to the Congressional Subcommittee on Labor, Health and Human Services, Education and Related Agencies in Washington D.C., Wednesday, May 13, 1992. Dr. Fuhr will be coordinating his address with both the American Chiropractic Association and the International Chiropractors Association as well as members of the research community.
One of the exciting aspects of Dr. Fuhr's presentation this year will be his inclusion of copies of the Mercy Center Conference Practice Guidelines document. This will establish chiropractic practice guidelines as part of the congressional record, along with Dr. Fuhr's testimony.
Dr. Fuhr's report to the Congressional Subcommittee will be published in Dynamic Chiropractic as soon as it is available.
