Self-reported recognition of undiagnosed life threatening conditions in chiropractic practice: a random survey

BACKGROUND The purpose of this study was to identify the type and frequency of previously undiagnosed life threatening conditions (LTC), based on self-reports of chiropractic physicians, which were first recognized by the chiropractic physician. Additionally this information may have a preliminary role in determining whether chiropractic education provides the knowledge necessary to recognize these events. METHODS The study design was a postal, cross-sectional, epidemiological self-administered survey. Two thousand Doctors of Chiropractic in the US were randomly selected from a list of 57878. The survey asked respondents to state the number of cases from the list where they were the first physician to recognize the condition over the course of their practice careers. Space was provided for unlisted conditions. RESULTS The response rate was 29.9%. Respondents represented 11442 years in practice and included 3861 patients with a reported undiagnosed LTC. The most commonly presenting conditions were in rank order: carcinoma, abdominal aneurysm, deep vein thrombosis, stroke, myocardial infarction, subdural hematoma and a large group of other diagnoses. The occurrence of a previously undiagnosed LTC can be expected to present to the chiropractic physician every 2.5 years based on the responding doctors reports. CONCLUSION Based on this survey chiropractic physicians report encountering undiagnosed LTC's in the normal course of practice. The findings of this study are of importance to the chiropractic profession and chiropractic education. Increased awareness and emphasis on recognition of LTC is a critical part of the education process and practice life.