Quality Control in the Chiropractic Clinical Setting Utilizing Thermography Instrumentation as a Model
WR Boone DC, Ph.D, Mary Strange, Jennifer Trimpi, Jeremy Wills, Christopher Hawkins, Patricia Brickey
Journal of Vertebral Subluxation Research ~ October 12, 2007 ~ Pages 1-6
Objective: To describe a model for quality control in the chiropractic health care setting.
Methods: The study presents one model for monitoring the reliability of reproducing thermal pattern scans using a series of different instruments in different adjusting rooms. The study was comprised of two separate trials (A), and (B). In each trial, one student served as the “subject” while a second student obtained thermogaphic scans. The subject then moved to the next room, and the second student again obtained a thermographic scan on the same subject. The scan from room 1 was then compared to determine percent agreement with the scan from room 2. This procedure was repeated in room 3, etc. Data was then analyzed and interpreted. Trial B also included a recording of the ambient temperature of each adjusting room immediately prior to the scan, and directly after each scan was taken.
Results: Trial A: Comparisons of scans from instruments 1 through 18 fell within a range of 2 standard deviations (84.3 – 59.1 % similarity) around a mean of 71.7 + 6.3. The coefficient of variation for Trial A was 8.8% for the left and 6.6% for the right paraspinal thermographic comparisons. Trial B: The same results were observed as with Trial A, with one exception. One instrument fell outside of 2 standard deviations of the mean, 72.4 + 5.2, by 0.3 % similarity for the right paraspinal thermographic findings. The coefficient of variation for the left paraspinal thermographic comparisons was 8.1% for the left and 7.2% for the right. Pre – Post scan temperature readings taking place for the 16 instruments assessed in Trial B were not significantly different (p 0.24).
Conclusion: Quality control procedures are well documented and employed in many different settings ranging from clinical laboratories to manufacturing enterprises and has direct application to the chiropractic setting.
Key Words: Quality control, chiropractic, chiropractic instrumentation, reliability, clinical validity