The Center will focus on the development of a method for determining appropriateness of care for the investigation of CAM. It will significantly advance a previously developed method by the RAND Corporation by including patient preferences, patient centered outcomes and economic aspects along with professional judgments based on efficacy, effectiveness and safety in determining appropriateness. The Center will have four Projects: The Appropriateness of Manipulation and Mobilization in Chiropractic for the Treatment of Chronic Cervical Pain;Chiropractic Patient-Reported Outcomes for Chronic Cervical Pain;Decision- Making of Patients in Using Chiropractic for Chronic Cervical Pain;Incorporating Economics into the Appropriateness ofthe Use of Chiropractic Care for Chronic Cervical Pain. It is Expected outcomes from each of the Projects, and the overall center, are that there will be impacts on the methods for investigating CAM and for providing evidence about appropriate use of M/M for cervical problems, patient preferences for care, patient based outcome measures for cervical care and the cost implications of inappropriate care which can contribute to determining the magnitude of the problem. Each of the projects uses multiple methods. This Core will ensure that the studies and methods are built upon the best existing data and the best research methods. The studies also all use data gathered using a range of qualitative and quantitative methods, including focus groups and cognitive interviews, surveys, structured interviews, and chart reviews. The Center has assembled a uniquely qualified team. The research team that has been assembled also has extensive and overlapping research expertise. Apart from their contribution to the specific Projects they can also contribute to all the Projects. To ensure that this expertise is brought to bear on each of the Projects we are proposing to develop, in the Core, a Research Methods Assessment and Evaluation Core. This will contribute directly to the cross fertilization between the Projects. It will also contribute to the methods in each project, assure they are rigorous and that they are implemented. The Core will also be responsible for documenting and reporting the methodologies used and publishing them, as the objective is the advancement of methods.

National Institute of Health (NIH)
National Center for Complementary & Alternative Medicine (NCCAM)
Research Program--Cooperative Agreements (U19)
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Special Emphasis Panel (ZAT1)
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Rand Corporation
Santa Monica
United States
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Herman, Patricia M; Kommareddi, Mallika; Sorbero, Melony E et al. (2018) Characteristics of Chiropractic Patients Being Treated for Chronic Low Back and Neck Pain. J Manipulative Physiol Ther 41:445-455
Hays, Ron D; Spritzer, Karen L; Sherbourne, Cathy D et al. (2018) Group and Individual-level Change on Health-related Quality of Life in Chiropractic Patients with Chronic Low Back or Neck Pain. Spine (Phila Pa 1976) :
Coulter, Ian D; Crawford, Cindy; Hurwitz, Eric L et al. (2018) Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. Spine J 18:866-879