Researching the Appropriateness of Care in the Complementary and Integrative Health Professions Part 5: Using Patient...

Area of Science:

• Health Services Research
• Clinical Data Management
• Chiropractic Research

Background:

• Acquiring large-scale patient data from multiple chiropractic practices presents significant logistical and methodological challenges.
• Standardized data abstraction is crucial for reliable analysis of chiropractic patient records.

Purpose of the Study:

• To describe a 4-step process (consent, selection, protection, abstraction) for acquiring a large sample of chiropractic patient records.
• To detail the methods used for data acquisition and abstraction from 99 chiropractic practices.

Main Methods:

• A prospective and retrospective sampling strategy was employed, collecting records from patients with chronic back or neck pain.
• Clinic staff were trained for record collection, scanning, and transfer, utilizing an online data collection tool for abstraction.
• Protocols for patient confidentiality were established, and Doctors of Chiropractic were trained as abstractors.

Main Results:

• 3603 patient records were scanned, with 19% deemed unusable due to poor quality or relevance.
• Interrater reliability for appropriateness of care decisions was fair to moderate (κ .38-.48).

Conclusions:

• The acquisition and abstraction of chiropractic patient records is complex, requiring adaptive strategies.
• Incomplete provider documentation was a significant issue, underscoring the need for improved record-keeping standards in chiropractic research.