It may be difficult to imagine the chiropractic profession without its scientific journals; however, there was a time when they did not exist. This year, we are fortunate to celebrate the 35th anniversary of the Journal of Manipulative and Physiological Therapeutics (JMPT), 24 years of the Journal of Chiropractic Medicine (JCM) and the 21st anniversary of the Journal of Chiropractic Humanities (JCH).
Staking Chiropractic's Place in Evidence-Based Medicine
If a tree falls in the forest and no one is there to hear it, does it make a sound? If research, clinical progress and philosophical debates occur within the profession, but were never documented in journals, would chiropractic be like that tree? Would it lose relevance and risk being invisible to modern health care and society?
According to James F. Winterstein, DC, president of National University of Health Sciences, "We can't afford that chance!" NUHS founded and maintains JMPT, JCM and JCH. "The bottom line is that without peer-reviewed and indexed scientific journals, the academic and clinical reputation of our industry as a whole would suffer," said Dr. Winterstein. "These journals give relevance and significance to our practice because they represent the science that undergirds what chiropractic physicians do. Their presence has both promoted and published research, which in turn has given stature to our researchers who can, because of them, publish in other scientific journals."
One of those researchers is Gregory Cramer, DC, PhD, NUHS dean of research and NIH grant-holder. "My research is related to the spine. Other journals related to the spine are often managed by surgeons and other medical professionals who don't see research on spinal manipulation and other Complementary and Alternative Medicine (CAM) treatments as a priority," he said. "To have a journal like JMPT that's edited by a CAM professional provides a very important venue."
"Our journals are peer-reviewed and have been indexed for many years. I often see papers from JCM and JMPT referenced by researchers in other publications,"he added. "Without such indexing, findings in chiropractic research simply would not show up in searches to be used in this way."
As well, chiropractic researchers and universities receive federal grants for research and educational initiatives in evidence-based practice. Grants are often determined based upon evidence and the publication track records of the primary investigator. Years ago, there was strong bias against chiropractic researchers publishing in mainstream journals, thus developing a track record would have been almost impossible. With the presence of the JMPT, which has been indexed in Medline since 1982, there was a place for chiropractic research to be published. This makes us wonder if these types of federal grants would have happened, or happened to the same degree, without the presence of the three NUHS journals.
Tracking Chiropractic Progress Over Time
If you decided to track the evolution of U.S. biomedicine from leeching and laudanum to antibiotics, it would be fairly easy to do by reviewing past volumes of medical journals. However, there was not such an equivalent in the early years of chiropractic.
Chiropractic medicine is over a century old and the world has changed more in this time than in any other century in history; primarily in response to advances in science and health care. But for many decades, the only chiropractic publications available were magazines and newsletters, since the infrastructure for research and science had not yet been built. Although attempts were made, none of the early reports was truly "scientific" because none met the commonly agreed-upon standards for scientific investigation and reporting. Thus, in the early years of chiropractic, although needed, a scientific journal would not have been sustainable.
However, for the past several decades with the rise of chiropractic research and science, the profession can boast of journals that report scientific studies. We can use these as markers of evolution for the profession. The health care model in the U.S. is evolving, particularly regarding issues of health care access and delivery. It will be our journals that keep the chiropractic world connected and responsive to those changes, providing the evidence-based findings DCs need to "stake their place" in the 21st century health care landscape.
Journals have come and gone, but the three National journals have endured over time and all three are included in PubMed. NUHS has supported these publications with the commitment to the principles of a strong foundation in science and intellectual honesty. Each journal has its own focus to offer the chiropractic profession: science, art and philosophy.
Journal of Manipulative and Physiological Therapeutics
"The importance of JMPT cannot be overstated," according to Dr. Cramer. "When I compare it to other well-known health science journals, this is an extremely high-quality journal. No other chiropractic journal is managed more professionally than JMPT."
Founded in 1978, JMPT was the first of the three National journals. Current Editor in Chief, Dr. Claire Johnson, and Associate Editor Dr. Bart Green, helped to transition the journal successfully into the digital age and are responsible for many of the improvements with all three journals. Currently, JMPT is the official scientific journal of the American Chiropractic Association, and is the only chiropractic journal included in Index Medicus. At present, JMPT is also the only chiropractic journal that has an official Impact Factor.
Dedicated to the advancement of chiropractic health care, JMPT provides the latest information and developments in therapeutics, as well as reviews of clinically oriented research and practical information for use in clinical settings.
"I think JMPT's reputation will keep growing," said Dr. Cramer. "When you look through any issue, there are articles from a wide variety of professions: physical therapists, neurologists, doctors of osteopathy. All disciplines are represented from a myriad of institutions around the world." JMPT can be accessed online at www.jmptonline.org. [Editor's note: Abstracts from each issue of JMPT appear in DC with permission from the journal.]
Journal of Chiropractic Medicine
"Evidence-based practice is the requirement for entry into today's integrative medicine arena," said Dr. Winterstein. "JCM is a publication where practicing DCs can submit case studies and find practical research they can apply to patient care."
"It was exactly those kinds of journals I sought out when I was in practice, although at that time there was no JCM – which is probably one of the factors that caused me to originate this journal," he said. (The journal was founded in 1989 as Journal of Chiropractic Technique and was reborn as the Journal of Chiropractic Medicine in 2002.)
JCM is a peer-reviewed journal indexed in PubMed that provides a forum on the developing primary care emphasis within the chiropractic profession. Articles include case reports; in-depth reviews summarizing scientific literature; and original data reports on topics that impact a DC's practice.
Dr. Cramer added, "I think DCs can learn a great deal about specific treatments in JCM and trends on where we're headed. With the abstracts and table of contents, they can skim each issue very quickly and hone in on articles that directly relate to their practice."
Published quarterly, JCM has the clinical substance chiropractic physicians are looking for in a format that makes it a ready resource. JCM is available online at www.journalchiromed.com.
Journal of Chiropractic Humanities
Prior to 1991, there was no peer-reviewed journal solely dedicated to discussions about philosophy within the chiropractic profession. That's when Dr. Winterstein proposed the creation of Philosophical Constructs for the Chiropractic Profession. In 1993, the journal changed its name and broadened its purpose, becoming the Journal of Chiropractic Humanities. The mission of the JCH is "to foster scholarly debate and interaction within the chiropractic profession regarding the humanities, which includes history, philosophy, linguistics, literature, jurisprudence, ethics, theory, sociology, comparative religions, and aspects of social sciences that address historical or philosophical approaches."
"The objective of JCH is to create an environment that promotes legitimate dialogue in a field where a diversity of opinion exists, even on topics that were once considered taboo," said Dr. Johnson, editor of all three NUHS journals. "JCH is particularly relevant to the chiropractic profession today. It is important for people to have a reliable source to go to for information that they can trust."
Healthy debate that challenges ideas in a scholarly and professional manner is essential. JCH helps support and promote evolution of thought in the profession, and thus is an essential component of our profession's future. The most recent journal to be included in PubMed, JCH can be found online at www.journalchirohumanities.com.
Help us celebrate by reading and contributing to the journals that continue to support the chiropractic profession. "Dr. Johnson encourages "all members of the chiropractic community ... to read the contents and are welcome to submit publications for journal review."
Tracy Litsey has a background in government ethics and consumer advocacy, and has been a writer in alternative health topics for more than 10 years. She currently works with the Communications Department of National University of Health Sciences, and produces educational materials for a publisher in the field of Eastern philosophy. She earned her baccalaureate degree in political science from Wheaton College.