Variation in use of radiographs in chiropractic care: a cross-sectional study
Notice bibliographique
Résumé
BACKGROUND: There appears to be a substantial variation in the use of radiographs in chiropractic clinics, but the reasons for this variation are not well understood. This study examined the use of radiography over a one-year period in Danish chiropractic clinics and explored its associations with clinic- and chiropractor-level characteristics. METHODS: Data on the number of unique patients consulting a chiropractor and those receiving radiography between 1 January 2022 and 31 December 2022 were obtained from a Danish national registry. Information on clinics including the number of chiropractors, geographical region, multidisciplinary status, and types of other healthcare professionals employed, as well as chiropractor characteristics (age, gender, seniority, and country of education) was collected from clinic websites and a national register of Danish healthcare professionals. The proportion of patients undergoing radiography was calculated for each clinic. Associations with clinic and chiropractic characteristics were tested using chi-square or t-tests, as appropriate. Characteristics were also compared between clinics with and without in-house radiographic imaging facilities. RESULTS: A total of 237 chiropractic clinics and 657 chiropractors were included. The mean age of chiropractors was 47 years (SD 12.8), 53% were women and 61.8% were educated in Denmark. Clinics with radiographic facilities (n = 161, 68%) tended to be larger and more likely to be multidisciplinary than clinics without (n = 76, 32%). Among clinics with radiographic facilities, the proportion of patients receiving radiography was 9.5% (95% CI 8.4-10.6%), ranging from 0 to 39%. No associations were found between radiography use in clinics with in-house radiographic facilities and clinic or chiropractic characteristics. In clinics without radiographic facilities, only 1.1% of patients were referred for radiography via chiropractic service codes, although this is likely an underestimation, as referrals to public hospitals were not captured. CONCLUSION: Although considerable variation in radiography use was observed across Danish chiropractic clinics with radiographic facilities, this was not explained by measured clinic or chiropractic characteristics. The true extent of radiography use in clinics without in-house facilities remains uncertain. Further research into clinical decision-making is needed to support evidence-based, transparent and consistent practice, potentially using qualitative methods to better understand the reasons behind the observed variation.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».