Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, 5230, Odense M, Denmark.
Chiropr Man Therap. 2020 Mar 30;28(1):16. doi: 10.1186/s12998-020-00305-w.
The Danish Authorisation Act sets out the chiropractic scope of practice. Under this legislation the scope of practice is diagnostics, prevention and treatment of biomechanical disorders of the spine, pelvis and extremities. Despite this and an international movement toward a scientifically active, evidence-based profession with a focus on treatment of musculoskeletal disorders, a large proportion of chiropractors still offer treatment of non-musculoskeletal disorders. This study aimed to investigate the content and characteristics of website claims by chiropractors in Denmark on non-musculoskeletal conditions and to assess whether these were aligned with the Danish Authorisation Act of the chiropractic scope of practice.
In this cross-sectional study data on a representative sample were collected from chiropractic clinic websites in Denmark. Information on non-musculoskeletal conditions from the websites was categorised. For each non-musculoskeletal condition, it was noted whether a clarifying explanation justifying the presence of the diagnosis was available and what it said. These explanations were assessed and categorised according to agreement or disagreement with the chiropractic scope of practice as defined by the Danish Authorisation Act. In addition, data on geographic location, clinic size, reimbursement coverage, country of education and special clinical focus (children, athletes, etc) were collected. Differences in characteristics of the clinics and the frequency of reporting non-musculoskeletal conditions were tested using Pearson's chi-squared or Fisher's exact test.
A geographically stratified, random sample of 139 (57%) websites was included from chiropractic clinics in Denmark. In total, 36 (26%) of the sampled websites mentioned conditions of non-musculoskeletal origin that was not accompanied by a clarifying explanation in agreement with the chiropractic scope of practice. A positive association between advertising infant or children's care and advertising treatment for non-musculoskeletal disorders (without adequate explanation) was observed.
A total of 36 (26%) of the sampled chiropractic websites in Denmark mentioned diagnoses or symptoms of non-musculoskeletal origin on their websites without presenting an adequate clarifying explanation in agreement with the chiropractic scope of practice as defined by the Danish Authorisation Act. This could be misleading for patients seeking care for non-musculoskeletal conditions and consequently lead to inappropriate treatment.
丹麦授权法案规定了整脊的执业范围。根据该法规，整脊的执业范围包括脊柱、骨盆和四肢生物力学障碍的诊断、预防和治疗。尽管如此，并且国际上也在朝着以科学为基础、以证据为基础的专业方向发展，重点是治疗肌肉骨骼疾病，但仍有很大一部分整脊医生提供非肌肉骨骼疾病的治疗。本研究旨在调查丹麦整脊医生在非肌肉骨骼疾病网站上的内容和特征，并评估这些内容是否符合丹麦授权法案规定的整脊执业范围。
在这项横断面研究中，从丹麦整脊诊所的网站上收集了具有代表性的样本数据。对网站上的非肌肉骨骼疾病信息进行了分类。对于每一种非肌肉骨骼疾病，都记录了是否有明确的解释来证明该诊断的存在，并记录了解释的内容。根据与丹麦授权法案规定的整脊执业范围的一致性，对这些解释进行了评估和分类。此外，还收集了地理位置、诊所规模、报销覆盖范围、教育国家和特殊临床重点（儿童、运动员等）的数据。使用 Pearson 卡方检验或 Fisher 确切检验测试诊所特征和报告非肌肉骨骼疾病的频率的差异。
从丹麦的整脊诊所中抽取了一个地理分层的随机样本，共 139 个（57%）网站。在抽样的网站中，共有 36 个（26%）网站提到了非肌肉骨骼来源的疾病，但没有提供与整脊执业范围一致的明确解释。在广告婴儿或儿童护理和广告非肌肉骨骼疾病治疗（无充分解释）之间观察到正相关。
在丹麦抽取的整脊网站中，共有 36 个（26%）网站在其网站上提到了非肌肉骨骼来源的诊断或症状，但没有提供与丹麦授权法案规定的整脊执业范围一致的充分澄清解释。这可能会误导寻求非肌肉骨骼疾病治疗的患者，并导致不适当的治疗。
