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Biomedical subjects

Ronald J Feise

Publications and source records attributed to Ronald J Feise.

5 recordsLinked to original sources
PubMed2006

Effectiveness of an evidence-based chiropractic continuing education workshop on participant knowledge of evidence-based health care.

BACKGROUND: Chiropractors must continue to learn, develop themselves professionally throughout their careers, and become self-directed and lifelong learners. Using an evidence-based approach increases the probability of optimal patient outcomes. But most chiropractors lack knowledge and interest in evidence-based approaches. The purpose of this study was to develop and measure the effectiveness of evidence-based training for chiropractic practitioners in a continuing education setting. METHODS: We developed and evaluated a continuing education workshop on evidence-based principles and methods for chiropractic practitioners. Forty-seven chiropractors participated in the training and testing. The course consisted of 12.5 hours of training in which practitioners learned to develop focused questions, search electronic data bases, critically review articles and apply information from the literature to specific clinical questions. Following the workshop, we assessed the program performance through the use of knowledge testing and anonymous presentation quality surveys. RESULTS: Eighty-five percent of the participants completed all of the test, survey and data collection items. Pretest knowledge scores (15-item test) were low (47%). Post intervention scores (15-item test) improved with an effect size of 2.0. A 59-item knowledge posttest yielded very good results (mean score 88%). The quality of presentation was rated very good, and most participants (90%) would "definitely recommend" or "recommend" the workshop to a colleague. CONCLUSION: The results of the study suggest that the continuing education course was effective in enhancing knowledge in the evidence-based approach and that the presentation was well accepted.

Journal Article↗
PubMed2006

Chiropractic manipulation in adolescent idiopathic scoliosis: a pilot study.

BACKGROUND: Adolescent idiopathic scoliosis (AIS) remains the most common deforming orthopedic condition in children. Increasingly, both adults and children are seeking complementary and alternative therapy, including chiropractic treatment, for a wide variety of health concerns. The scientific evidence supporting the use chiropractic intervention is inadequate. The purpose of this study was to conduct a pilot study and explore issues of safety, patient recruitment and compliance, treatment standardization, sham treatment refinement, inter-professional cooperation, quality assurance, and outcome measure selection. METHODS: Six patients participated in this 6-month study, 5 of whom were female. One female was braced. The mean age of these patients was 14 years, and the mean Cobb angle was 22.2 degrees. The study design was a randomized controlled clinical trial with two independent and blinded observers. Three patients were treated by standard medical care (observation or brace treatment), two were treated with standard medical care plus chiropractic manipulation, and one was treated with standard medical care plus sham manipulation. The primary outcome measure was Cobb, and the psychosocial measure was Scoliosis Quality of Life Index. RESULTS: Orthopedic surgeons and chiropractors were easily recruited and worked cooperatively throughout the trial. Patient recruitment and compliance was good. Chiropractic treatments were safely employed, and research protocols were successful. CONCLUSION: Overall, our pilot study showed the viability for a larger randomized trial. This pilot confirms the strength of existing protocols with amendments for use in a full randomized controlled trial. TRIAL REGISTRATION: This trial has been assigned an international standard randomized controlled trial number by Current Controlled Trials, Ltd. http://www.controlled-trials.com/isrctn/. The number is ISRCTN41221647.

Journal Article↗
PubMed2005

Construction and validation of the scoliosis quality of life index in adolescent idiopathic scoliosis.

STUDY DESIGN: A prospective cross-sectional design was used to evaluate the Scoliosis Quality of Life Index (SQLI). SQLI is a 22-item self-reporting health-related quality-of-life questionnaire for idiopathic scoliosis patients. OBJECTIVE: The goal of this study was to evaluate the psychometric qualities of SQLI. SUMMARY OF BACKGROUND DATA: SQLI, a modification of the Scoliosis Research Society-22 (SRS-22) questionnaire, is intended to be more applicable to patients with adolescent idiopathic scoliosis (AIS) between 10 and 18 years of age. METHODS: Eighty-four subjects with a mean age of 14.9 years participated. We determined reliability, validity, distribution of scores, and clinical utility of SQLI in a hospital setting. Seventy patients were AIS patients (16 postsurgical, 30 braced, 24 unbraced) with a mean Cobb angle of 30.7 degrees, and 14 patients were sibling controls. RESULTS: Reliability: Intraclass correlation coefficient for test-retest reliability of the global index was very good (ICC 2,1 = 0.80); Spearman's rho correlations between items and domains was 0.39 to 0.89 and between domains and global index was 0.55 to 0.78; Cronbach's alpha scores were more than 0.80 (0.82-0.89). VALIDITY: construct validity was established by correlations between SQLI's global index and Quality of Life Profile for Spine Deformities (QLPSD) global index (Spearman's rho, 0.79) and between SQLI domains and QLPSD domains (0.46-0.81); discriminate validity was established by SQLI's global index successfully partitioned controls and AIS subjects (Kruskal-Wallis test, P = 0.0013). Time required by the patient averaged 2.5 minutes per administration. CONCLUSIONS: SQLI is reliable and valid and demonstrates satisfactory distribution of scores. SQLI is a promising instrument in the assessment of AIS patients.

Adolescent↗
PubMed2002

Do multiple outcome measures require p-value adjustment?

BACKGROUND: Readers may question the interpretation of findings in clinical trials when multiple outcome measures are used without adjustment of the p-value. This question arises because of the increased risk of Type I errors (findings of false "significance") when multiple simultaneous hypotheses are tested at set p-values. The primary aim of this study was to estimate the need to make appropriate p-value adjustments in clinical trials to compensate for a possible increased risk in committing Type I errors when multiple outcome measures are used. DISCUSSION: The classicists believe that the chance of finding at least one test statistically significant due to chance and incorrectly declaring a difference increases as the number of comparisons increases. The rationalists have the following objections to that theory: 1) P-value adjustments are calculated based on how many tests are to be considered, and that number has been defined arbitrarily and variably; 2) P-value adjustments reduce the chance of making type I errors, but they increase the chance of making type II errors or needing to increase the sample size. SUMMARY: Readers should balance a study's statistical significance with the magnitude of effect, the quality of the study and with findings from other studies. Researchers facing multiple outcome measures might want to either select a primary outcome measure or use a global assessment measure, rather than adjusting the p-value.

Clinical Trials as Topic↗