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Monthly Archives: April 2014

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The Comparative Effect of Episodes of Chiropractic and Medical Treatment on the Health of Older Adults

By |April 29, 2014|Low Back Pain, Medicare|

The Comparative Effect of Episodes of Chiropractic and Medical Treatment on the Health of Older Adults

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther 2014 (Mar); 37 (3): 143–154

Paula A Weigel, Jason Hockenberry, PhD,
Suzanne E. Bentler, PhD, Fredric D. Wolinsky, PhD

Candidate for PhD,
Department of Health Management and Policy,
College of Public Health,
The University of Iowa,
Iowa City, IA.


OBJECTIVES:   The comparative effect of chiropractic vs medical care on health, as used in everyday practice settings by older adults, is not well understood. The purpose of this study is to examine how chiropractic compares to medical treatment in episodes of care for uncomplicated back conditions. Episodes of care patterns between treatment groups are described, and effects on health outcomes among an older group of Medicare beneficiaries over a 2-year period are estimated.

METHODS:   Survey data from the nationally representative Survey on Assets and Health Dynamics among the Oldest Old were linked to participants’ Medicare Part B claims under a restricted Data Use Agreement with the Centers for Medicare and Medicaid Services. Logistic regression was used to model the effect of chiropractic use in an episode of care relative to medical treatment on declines in function and well-being among a clinically homogenous older adult population. Two analytic approaches were used, the first assumed no selection bias and the second using propensity score analyses to adjust for selection effects in the outcome models.

RESULTS:   Episodes of care between treatment groups varied in duration and provider visit pattern. Among the unadjusted models, there was no significant difference between chiropractic and medical episodes of care. The propensity score results indicate a significant protective effect of chiropractic against declines in activities of daily living (ADLs), instrumental ADLs, and self-rated health (adjusted odds ratio [AOR], 0.49; AOR, 0.62; and AOR, 0.59, respectively). There was no difference between treatment types on declines in lower body function or depressive symptoms.

There are more articles like this @ our:

Maintenance Care, Wellness and Chiropractic Page

(more…)

Reading Pain in a Human Face

By |April 29, 2014|Computers|

Source Jan Hoffman NY Times

 

How well can computers interact with humans? Certainly computers play a mean game of chess, which requires strategy and logic, and “Jeopardy!,” in which they must process language to understand the clues read by Alex Trebek (and buzz in with the correct question).

But in recent years, scientists have striven for an even more complex goal: programming computers to read human facial expressions.

pain

Take a quiz on the New York Times website and see how well you do recognizing  real pain.

The practical applications could be profound. Computers could supplement or even replace lie detectors. They could be installed at border crossings and airport security checks. They could serve as diagnostic aids for doctors.

Researchers at the University of California, San Diego, have written software that not only detected whether a person’s face revealed genuine or faked pain, but did so far more accurately than human observers.

Read more…

 

 

 

ICD-10 Guidelines for DCs

By |April 20, 2014|Diagnosis, ICD-10 Coding|

ICD-10 Guidelines for DCs

The Chiro.Org Blog


SOURCE:   ACA News ~ April 2014

By Evan M. Gwilliam, DC


The ICD-10 codes that will soon be used on CMS-1500 claim forms have many pages of guidelines that explain the rules and conventions necessary to apply them correctly. Depending on the publisher, they take up about 30 pages in the ICD-10-CM code set. Some explain items like the definition of “Excludes2” and the meaning of the semicolon or slanted brackets (see Sections 1.A and 1.B). The bulk of these guidelines, around 20 pages, are found in Section 1.C and are chapter specific. The ICD-10-CM code set is divided into 21 chapters, each one for a distinct body system or condition.

Chiropractic physicians typically use codes from just four or five of the 21 chapters available in ICD-10-CM. These include, but are not necessarily limited to, the codes from Chapter 6, diseases of the nervous system; Chapter 13, diseases of the musculoskeletal system and connective tissue; Chapter 18, symptoms, signs and abnormal clinical findings, not elsewhere classified; Chapter 19, injury, poisoning and certain other consequences of external causes. Most doctors of chiropractic (DCs) do not employ certified coders to research all of the coding changes that are specific to their specialty. They are compelled to learn coding while running a small business and continuing to focus on the clinical needs of their patients. A thorough understanding of all the guidelines in ICD-10-CM is wise, but listed below are a handful of guidelines that should be the focus.


Chapter 6 Guidelines

Chapter 6 (diseases of the nervous system) includes codes from G00 to G99, covering the nervous system. DCs frequently treat many conditions of the nervous system, but only a few guidelines are important in the typical chiropractic setting. Some chiropractic patients may suffer from hemiplegia (G81) or monoplegia (G83). The guidelines tell us that the dominant or nondominant side can be affected and should be identified. However, if dominance is not specified, code selection follows these rules:

  • For ambidextrous patients, the default should be dominant;
  • If the left side is affected, the default is non-dominant; and
  • If the right side is affected, the default is dominant.

The general code set guidelines tell us to report only codes for conditions that are being treated or that directly affect the treatment. If a patient presents with hemiplegia (G81) that does not affect the treatment in any way, it will not be reported.

(more…)

Patient with Low Back Pain and Somatic Referred Pain Concomitant with Intermittent Claudication in a Chiropractic Practice

By |April 13, 2014|Intermittent Claudication|

Patient with Low Back Pain and Somatic Referred Pain Concomitant with Intermittent Claudication in a Chiropractic Practice

The Chiro.Org Blog


SOURCE:   Topics in Integrative Health Care 2014 (MAR 27); 5 (1)

Kathryn Hoiriis, D.C., Brent S. Russell, M.S., D.C.


Introduction:   Approximately 12% of older patients in the general population have atherosclerotic disease of the aorta and lower extremity arteries, i.e., peripheral artery disease (PAD). Intermittent claudication is the most common symptom. When a patient with low back pain complains of lower extremity pain that is worsened with mild exercise (e.g. walking), the etiology is often not clear.

Case Presentation:   A 56 year-old male presented with low back pain, left hip and buttock discomfort, numbness in thigh and calf, and left knee weakness while walking.

Intervention and Outcome:   Chiropractic care was provided and the low back pain improved. The patient developed leg weakness. Radiographic evaluation showed calcification of abdominal aorta and common iliac arteries. The patient was referred for medical evaluation and diagnostic ultrasound findings of arterial occlusion lead to surgical referral. The surgeon reported a “significant amount” of blockage of the left external iliac artery. Leg weakness resolved following placement of surgical stents.

Discussion:   Claudication may go undiagnosed because many people consider the pain a consequence of aging, and may therefore just reduce their activity level to avoid the pain. Early diagnosis of PAD/intermittent claudication is important since PAD is a major risk factor for adverse cardiovascular events.

There are more articles like this @ our:

Low Back Pain and Chiropractic Page

(more…)

Current Trends in Chiropractic Research: An Interview with Malik Slosberg, DC

By |April 11, 2014|Chiropractic Research|

Current Trends in Chiropractic Research
An Interview with Malik Slosberg, DC

The Chiro.Org Blog


SOURCE:   Health Insights Today ~ March 2014 ~ FULL TEXT

Interview by Daniel Redwood, DC


Malik Slosberg, DC, lectures throughout the United States and internationally. A professor at Life Chiropractic College West who has received many awards as an outstanding instructor, including “Teacher of the Year,” he has also served on the postgraduate faculty of ten chiropractic colleges and was named “Chiropractor of the Year” by the Parker Resource Foundation.

Dr. Slosberg has been in private practice for thirty years, has published numerous articles in chiropractic journals and is currently a columnist for Dynamic Chiropractic. In addition, he has produced educational materials including videos, wall charts, and patient handouts used by many chiropractic colleges and thousands of chiropractors worldwide.

Slosberg holds a Masters of Science degree from California State University in clinical counseling and a Physicians’ Assistant degree from Dartmouth College.

Those who attended Dr. Slosberg’s lecture at Cleveland Chiropractic College’s Homecoming in 2013 know that he is an excellent communicator with a strong grasp of chiropractic-related research. Along these lines, he has recently (1) given a presentation to the clinic directors of all of the chiropractic colleges in the world at the Association of Chiropractic Colleges 2013 meeting, on “Integrating Exercise Training in the Chiropractic Curriculum and Clinical Experience; (2) served as guest editor of a peer-reviewed Journal of Electromyography and Kinesiology special issue on spinal manipulation; and been the first chiropractor invited to be a guest faculty member at the Annual Integrative Holistic Medicine Conference.

Tell us about your background in chiropractic practice and teaching, and as an analyst and interpreter of chiropractic-related research?

Before I was a chiropractor, I was a physician’s assistant. I was trained at Dartmouth Medical School and practiced for three years with an internist-gastroenterologist who was chief of staff at the Naples, Florida hospital. Eventually, I just got sick of prescribing medications so I looked for an alternative that was more natural. Someone recommended chiropractic and I went to school without knowing much about chiropractic. After graduating, I started teaching a course titled “Subluxation Pathology.” I started reading a great deal of the peer-reviewed research, since I hadn’t really been exposed to the scientific literature as a student. Reading the data that was out there, I soon realized that this was information that chiropractors should really know. But I didn’t see that it was well disseminated. So I began to teach this course and then the seminars. I also had a chiropractic practice for just under 30 years. Throughout that time, I was always a faculty member at a chiropractic college, first at Life in Georgia and then at Life-West, out in California.

What do you consider the most significant current trends in chiropractic-related research?

There are several that I think are quite significant. There are the recent high quality randomized trials evaluating the relative efficacy of chiropractic or spinal manipulation versus medical care, that is, versus anti-inflammatories, versus facet joint injections, and versus discectomies. This research has demonstrated that chiropractic is as effective or more effective, and often more cost-effective, than these more widely accepted medical interventions. This is important evidence and is being published in the areas of management of low back pain, neck pain, and also for headaches. Another area that I find really fascinating is the research on the impact of chiropractic on brain, including its influence on the sensory cortex, the motor cortex, and the cerebellum.

(more…)

The Comparative Effect of Episodes of Chiropractic and Medical Treatment on the Health of Older Adults

By |April 10, 2014|Chiropractic Care, Cost-Effectiveness, Evidence-based Medicine|

The Comparative Effect of Episodes of Chiropractic and Medical Treatment on the Health of Older Adults

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2014 (Mar); 37 (3): 143–154

Paula A Weigel, MS, Jason Hockenberry, PhD,
Suzanne E. Bentler, PhD, Fredric D. Wolinsky, PhD

Department of Health Management and Policy,
College of Public Health,
The University of Iowa,
Iowa City, IA.


OBJECTIVES:   The comparative effect of chiropractic vs medical care on health, as used in everyday practice settings by older adults, is not well understood. The purpose of this study is to examine how chiropractic compares to medical treatment in episodes of care for uncomplicated back conditions. Episodes of care patterns between treatment groups are described, and effects on health outcomes among an older group of Medicare beneficiaries over a 2-year period are estimated.

METHODS:   Survey data from the nationally representative Survey on Assets and Health Dynamics among the Oldest Old were linked to participants’ Medicare Part B claims under a restricted Data Use Agreement with the Centers for Medicare and Medicaid Services. Logistic regression was used to model the effect of chiropractic use in an episode of care relative to medical treatment on declines in function and well-being among a clinically homogenous older adult population. Two analytic approaches were used, the first assumed no selection bias and the second using propensity score analyses to adjust for selection effects in the outcome models.

RESULTS:   Episodes of care between treatment groups varied in duration and provider visit pattern. Among the unadjusted models, there was no significant difference between chiropractic and medical episodes of care. The propensity score results indicate a significant protective effect of chiropractic against declines in activities of daily living (ADLs), instrumental ADLs, and self-rated health (adjusted odds ratio [AOR], 0.49; AOR, 0.62; and AOR, 0.59, respectively). There was no difference between treatment types on declines in lower body function or depressive symptoms.

There are more articles like this @ our:

Medicare and Chiropractic Page

(more…)