Survey of Primary Contact Medical and Chiropractic Clinicians on Self-Reported Knowledge and Recognition of Mild Traumatic Brain Injuries: A Pilot Study

Abstract

Objective: The purpose of this study was to assess the self-reported knowledge of concussion recognition and treatment with first-contact family medical and chiropractic practitioners by means of a pilot study of the need, construct validity, and feasibility for further investigation of mild traumatic brain injury (MTBI) knowledge base. Methods: Two hundred forty-eight practicing chiropractic and 120 medical physicians in the south and northeastern sections of the United States were contacted by e-mail, telephone, and postal mail to answer an 18-item survey on knowledge, diagnosis, and common practice with respect to traumatic brain injury patients. Descriptive analysis was used to assess common trends. Results: Twenty-three chiropractic and 11 medical primary care practitioners returned completed surveys, making this a low-power pilot study. The majority claimed confidence in diagnosis of MTBI, but a lack of knowledge of many of the assessment tools and the international guidelines. Chiropractic and medical clinicians revealed similar competencies and differing deficiencies. Both groups admitted infrequent diagnosis of MTBI in practice. There was recognition of major TBI signs, but lack of recognition or inquiry for subtle MTBI signs. Conclusions: There is a need and feasibility for further study of the knowledge transfer to the chiropractic physician with a larger population. These findings correlate with similar medical practitioner studies, and may also support previous findings of underreporting of the prevalence of MTBI. The survey instrument appears to provide valid data on knowledge of MTBIs, with some modifications. (J Chiropr Med 2017;16:19-30)

Survey of chiropractic clinicians on self-reported knowledge and recognition of concussion injuries

“…The purpose of this paper was to investigate the recognition, knowledge, and common procedures of chiropractic physicians when a potential mild traumatic brain injury patient presents to their office. This was done through implementation of a self-reported survey instrument utilized by a previous pilot study [ 17 ]. The study population consisted of only chiropractic physicians in general practice and specialty board certification and/or practice.…”

“…An earlier pilot study [ 17 ] of 23 chiropractic and 11 medical physicians assessed the utilization of a survey instrument. In this pilot study the survey was reviewed for face validity by the 2nd and 3rd authors and by 2 additional educator/clinicians knowledgeable with TBI.…”

“…In this pilot study the survey was reviewed for face validity by the 2nd and 3rd authors and by 2 additional educator/clinicians knowledgeable with TBI. A standardized set of survey items was developed through a literature search, tested through content experts at TCC and published in the pilot study [ 17 ].…”

“…According to the symposium registration, most of the doctors were Texas Chiropractic College graduates and practiced in Texas or Louisiana. Although an earlier study [ 17 ] attempted to look at both medical and chiropractic physicians, this study was intended to evaluate only chiropractic physicians.…”

“…An earlier study by Taylor et al investigated the use of a survey to assess the MTBI knowledge of chiropractic and medical practitioners. This was a small pilot study of the survey instrument which appeared to indicate no difference between the medical and chiropractic practitioners in recognition of MTBI, [ 17 ] with mutual gaps in MTBI knowledge present. Review of the survey instrument demonstrated possible confusion and/or misinterpretation of the survey items.…”