Gotlib Allan, Rupert Ron
Canadian Chiropractic Association, Toronto, Ontario.
Paediatr Child Health. 2005 Mar;10(3):157-61.
To review the biomedical literature up to and including 2003, and determine the extent of the evidence related to the therapeutic application of chiropractic manipulation for paediatric health conditions. No critical appraisal of the evidence is undertaken.
The indexed manual therapy sector including medical, chiropractic, physiotherapy, naturopathic and osteopathic literature was searched. This included PubMed; the Manual, Alternative, and Natural Therapy Index System; the Cumulative Index to Nursing and Allied Health Literature; the Index to Chiropractic Literature; the Paediatric Economic Database Evaluation Project; the Cochrane Library; the Canadian Coordinating Office for Health Technology Assessment database; and the Agency for Healthcare Research and Quality database. Other resources included research conference and symposium proceedings, and the references of identified studies.
The search identified 1731 articles, of which 166 met the eligibility criteria. Two reviewers determined by consensus each citation's appropriate level on the strength of evidence scale. There was one systematic review, nine randomized controlled trials, one observational study, 141 descriptive case studies and 14 conference abstracts.
Health claims made by practitioners regarding the application of chiropractic manipulation as a health care intervention for paediatric health conditions are, for the most part, supported by low levels of scientific evidence. Chiropractors, in particular, employ manipulation for the treatment of a wide variety of paediatric health conditions. The evidence rests primarily with clinical experience, descriptive case studies and a few randomized controlled trials. There is a need for more rigorous scientific inquiry to examine the value of manipulative therapy in the treatment of paediatric conditions. To advance the health interests of paediatric patients, health care decisions made on the basis of expert opinion or clinical experience must integrate the best research evidence available from high-quality, scientific studies.
回顾截至2003年（包括2003年）的生物医学文献，确定与脊椎按摩疗法在儿科健康状况治疗应用方面相关证据的程度。未对证据进行批判性评价。
检索了包括医学、脊椎按摩疗法、物理治疗、自然疗法和整骨疗法文献在内的索引手动治疗领域。这包括PubMed；手动、替代和自然疗法索引系统；护理及相关健康文献累积索引；脊椎按摩疗法文献索引；儿科经济数据库评估项目；Cochrane图书馆；加拿大卫生技术评估协调办公室数据库；以及医疗保健研究与质量局数据库。其他资源包括研究会议和研讨会论文集，以及已识别研究的参考文献。
检索到1731篇文章，其中166篇符合纳入标准。两名评审员根据证据强度量表通过共识确定每篇引文的适当级别。有1篇系统评价、9项随机对照试验、1项观察性研究、141篇描述性病例研究和14篇会议摘要。
从业者关于将脊椎按摩疗法作为儿科健康状况的医疗干预措施应用的健康声明，在很大程度上得到了低水平科学证据的支持。特别是脊椎按摩师，采用手法治疗多种儿科健康状况。证据主要基于临床经验、描述性病例研究和一些随机对照试验。需要进行更严格的科学探究，以检验手法治疗在儿科疾病治疗中的价值。为了促进儿科患者的健康利益，基于专家意见或临床经验做出的医疗决策必须整合来自高质量科学研究的最佳研究证据。
