article archive
January 2006
Discovering the global burden
of subluxation
by Dr. Terry A. Rondberg
What impact does vertebral subluxation have on the world?
Does it affect human health and well‑being? How does
it alter the mortality and morbidity rate in various population
groups? Can it be a factor in combating pandemics or raising
the wellness level in developing nations?
These are some of
the questions we, as a profession, must answer if we are
to secure a position for chiropractic in the 21st century
health paradigm.
To arrive at the answers, we'll need to approach
the challenge with a massive information‑gathering effort
that can combine the most credible research protocols with
the power of electronic data collection technology.
In many
ways, we have to model the effort on the World Health Organization's "Global Burden of Disease (GBD) project," which
was started in 1993.
Although we always assume there's a mountain
of research to support the medical approach, that isn't the
case. According to the Harvard School of Public Health, "Historically,
there has existed no reliable epidemiological data‑set
sweeping enough to identify priorities for health services
and research." The GBD project ‑‑ sponsored
by WHO and the World Bank ‑‑ was launched as
a worldwide collaboration of about 100 researchers.
Based on
the data those 100 or so researchers compile, the project "series comprehensively quantifies the burdens
of 486 sequelae of 108 major causes of death and disability,
disaggregated by eight geographic regions and ten age‑sex
groups; risk factors are evaluated and projections to the
year 2020 are made."
Thanks to this ambitious project, we know more than ever
about the state of human health throughout the world. Scientists
have quantified the health impact of factors as diverse as
climate change, obesity and clinical depression and have
even been able to estimate how many years each factor takes
off our life. These "Disability Adjusted Life Years," or
DALYs as they're called, combine the time lived with disability
and the time lost due to premature mortality. One DALY can
be thought of as one lost year of 'healthy' life, WHO explains.
What
if the GBD project included vertebral subluxation as one
the criteria it studied? How many DALYs would subluxations
be responsible for? How many more years of healthy life would
be added if we were a subluxation‑free world?
Not surprisingly,
the GBD project did not include subluxations. After all, many
of our own researchers and leaders continue to remind the world
there's little proof that subluxations even exist, let alone
have an impact on health.
For instance, an article written by
Donald R. Murphy, DC, and nine of his colleagues in the Sept.
1, 2005 issue of Dynamic Chiropractic, noted that "the
scientific literature has failed to demonstrate the very existence
of the subluxation."
Likewise, in the January 2004 issue of the "Journal
of Manipulative and Physiological Therapeutics (JMPT) Joseph
Keating, PhD stated: "I cannot recall ever reading a
randomized controlled clinical trial in which putative segmental
indicators of subluxation were monitored alongside clinical
outcomes variables such that correlation between subluxation
correction and improved clinical outcomes could be demonstrated."
Sadly,
they are at least partially correct. (I do dispute their claim
that there is no proof of the subluxation's existence or impact
on health. There have been a number of excellent research papers
in the Journal of Vertebral Subluxation Research and other
chiropractic journals that provide a firm foundation of evidence.)
Still,
they are correct to say that we lack the kind of research data
that would allow us to quantify the global burden of subluxation
and be accepted by the world's medical and scientific communities.
But
we are closer to that goal than ever before, thanks to RCS
(Research & Clinical Science), the private‑sector
project that is engaging in a global data gathering effort
to identify and quantify various factors relating to subluxation
and health.
It's hard to believe that the chiropractic profession
could conduct research on the scale of the World Health Organization
or Harvard. Yet, while the GBD included only about 100 researchers,
RCS is prepared to train and equip thousands of chiropractic
doctors as field researchers, collecting data from hundreds
of thousands ‑‑ and perhaps even millions ‑‑ of
people around the world.
Naturally, RCS doesn't have funding
from the World Bank and can't rely on government grants.
If we wait for that to happen, we'll never get the research
we need. Instead, each doctor involved in the program is
asked to pay a fee (as low as $149/month) to become an Authorized
RCS Clinical Investigator. Many doctors have chosen to become
RCS members solely to be part of this monumental research
effort rather than because their practices could grow significantly
as a result.
It's hard to understand why some chiropractic researchers
haven't enthusiastically jumped on board this project. They
say we need the hard, scientific proof that subluxations
have a negative impact on health and that chiropractic care
can provide specific benefits. Yet, they continue trying
to keep all meaningful research restricted to their own little
exclusive domain, to maintain their elevated position above
the rabble of mere practitioners in the field.
Despite their
initial skepticism, they can no longer have doubts about RCS's
legitimacy. Not only has it earned approval by an independent
Institutional Review Board, but it makes sure every doctor
who participates in the program is approved as well. No other
chiropractic research project ever conducted has been as scrupulous.
Nor
can they have failed to be impressed by the composition of
the RCS International Scientific Advisory Panel, a multi‑disciplinary
group of world‑class scientists with extraordinary
credentials and expertise. As a group, their research papers
have been published in hundreds of major scientific journals
through the world, including:
American Journal of Medical Genetics
American Journal of Physical Anthropology
American Psychologist
Archives of Internal Medicine
Archives of Physical Medicine and Rehabilitation
Brain Research
Cancer Journal
Clinical Neurology Research
International Journal of Integrative Medicine
International Journal of Neuropharmacology
Japanese Orthopaedic Surgeon Association Journal
Journal of Applied Physiology
Journal of Applied Social Psychology
Journal of Biochemistry
Journal of Biomedical Science
Journal of Cell Biology
Journal of Comp Neurology
Journal of Comparative Neurology
Journal of Human Evolution
Journal of Neurobiology
Journal of Neurochemistry
Journal of Neuroscience
Journal of Orthopedic and Sports Physical Therapy
Journal of Psychiatric Research
Journal of Strength and Conditioning Research
Journal of the American Medical Association
Molecular Psychiatry
Nairobi Journal of Medicine
Neurochemistry International
New African Journal of Medicine
Operative Techniques in Orthopedics
Proceedings of the National Academy of Sciences
Society for Neuroscience
It's clear that RCS has the scientific research expertise
and scope to carry out chiropractic's "Global Burden
of Subluxation" project. Thanks to doctors around the
world who are bold enough and dedicated enough to become
RCS Authorized Clinical Investigators, we will finally be
able to answer the important questions about chiropractic
and provide the "proof" that chiropractic is a
key element in health, longevity and well-being.
Whether
you're motivated by the desire to help prove chiropractic works,
expand your practice, or raise the level of your profession's
credibility in your community, you should consider joining
your colleagues as a member of RCS.
To learn more, call RCS
at 800 909 1354 or 480 303 1694,
or visit the RCS website at www.rcsprogram.com. Log on to
the special limited-access area of the site by using
the username DC1 and password RESEARCH.