Swiss Chiropractic Cohort (Swiss ChiCo) Study: A Nationwide Practice-Based Research Network Project

The Swiss chiropractic cohort (Swiss ChiCo) practice-based research network (PBRN) is nationwide research project with the aim to develop a musculoskeletal focused PBRN within the Swiss chiropractic setting and describe the characteristics of clinicians recruited. Development of the PBRN has been guided through participatory engagement of multiple stakeholders including patients, clinicians, scientists, and policymakers.

Study Overview

• Status: Completed
• Conditions: Musculoskeletal Pain

Detailed Description

Management of musculoskeletal (MSK) conditions is moving away from traditional medical treatments such as pain medication and towards more physical and preventative approaches. As a result, there is a need to describe manual care approaches to make informed decisions on how best to use this capacity in the current health care system. While this literature is emerging, very little is collected from clinical settings where the large majority of MSK care occurs. The lack of clinically collected data creates gaps in patient-centred research and difficulties with knowledge implementation in treatment settings.

To help bridge this divide, countries such as the United Kingdom, Canada, Sweden, and Australia have established MSK-focused practice-based research networks (PBRNs). PBRNs are sustained collaborations between practitioners and academicians. This collaboration allows patient recruitment from diverse clinical settings and allows practitioners to be more actively involved in the research process. As a result data collected, and subsequent recommendations may have greater clinical utility than that which comes from more traditional research-only settings.

This study aims to develop a MSK focused PBRN within the Swiss chiropractic setting and describe the characteristics of clinicians recruited. It represents a collaborative effort of international researchers, Swiss chiropractic clinicians, and the chiropractic patient and clinical associations in Switzerland (Pro Chiropractic Switzerland and ChiroSuisse). Clinicians will endorse participation in the PBRN by completing an electronic study form. Once established, nested sub-studies will be conducted within this new clinical research environment. Through stakeholder engagement and institutional support, the Swiss ChiCo PBRN can serve as an important resource to advance chiropractic and MSK health services research.

• Study Type: Observational
• Enrollment (Actual): 151

Contacts and Locations

Study Locations

• Switzerland
  • Zurich, Switzerland, 8008
    • Balgrist University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

All active chiropractors in Switzerland

Description

Inclusion Criteria:

• Active clinician members of the Swiss Chiropractic Association (ChiroSuisse)

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Cross-Sectional

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Chiropractic clinicians; Swiss chiropractic clinicians

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self-confidence in clinical management of patients with low back pain	Assessment via practitioner self-confidence scale (PCS, 4-20). The PCS contains four items with a total score of 20 where 4 represents greatest self-confidence and 20 represents the lowest self-confidence towards clinical management of patients with low back pain.	Baseline
Biomedical versus biopsychosocial treatment orientation	Assessment via pain attitudes and beliefs scale musculoskeletal version (PABS-MSK). The PABS-MSK contains two domains, a higher score on the biomedical domain (PABS-MSK-BM, score range 10-60) represents a higher biomedical orientation. A higher score on the biopsychosocial domain (PABS-MSK-BPS, score range 10-60) represents a higher biopsychosocial orientation.	Baseline
Participation proportion (feasibility outcome)	Proportion of eligible clinicians who participate	Baseline
Motivation for clinician participation in a PBRN sub-study (feasibility outcome)	Assessment via visual analog scale (VAS, 0-100). A higher score reflects higher motivation for clinician participation in a PBRN sub-study.	Baseline

Collaborators and Investigators

• Sponsor: Balgrist University Hospital
• Collaborators: University of Zurich, Epidemiology, Biostatistics and Prevention Institute; University of Southern Denmark, Department of Sports Science and Clinical Biomechanics; Swiss Chiropractic Association (ChiroSuisse); Swiss Chiropractic Patient Association (Pro Chiropractic Switzerland)
• Investigators: Principal Investigator: Cesar A Hincapié, DC PhD, Balgrist University Hospital and University of Zurich

Publications and helpful links

General Publications

• Lalji R, Hofstetter L, Kongsted A, von Wyl V, Puhan MA, Hincapie CA. Swiss chiropractic practice-based research network and musculoskeletal pain cohort pilot study: protocol of a nationwide resource to advance musculoskeletal health services research. BMJ Open. 2022 Jul 13;12(7):e059380. doi: 10.1136/bmjopen-2021-059380.
• Lalji R, Hofstetter L, Kongsted A, von Wyl V, Puhan MA, Hincapie CA. The Swiss chiropractic practice-based research network: a population-based cross-sectional study to inform future musculoskeletal research. Sci Rep. 2023 Apr 6;13(1):5655. doi: 10.1038/s41598-023-32437-3.

Helpful Links

• Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Project webpage
• Musculoskeletal Epidemiology Research Group, Balgrist University Hospital, Project webpage

Study record dates

Study Major Dates

• Study Start (Actual): September 9, 2021
• Primary Completion (Actual): December 19, 2021
• Study Completion (Actual): December 19, 2021

Study Registration Dates

• First Submitted: September 8, 2021
• First Submitted That Met QC Criteria: September 8, 2021
• First Posted (Actual): September 16, 2021

Study Record Updates

• Last Update Posted (Actual): April 26, 2023
• Last Update Submitted That Met QC Criteria: April 25, 2023
• Last Verified: April 1, 2023

More Information

Terms related to this study

• Keywords: Chiropractic; Health care quality; Musculoskeletal health; Manual medicine
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Musculoskeletal Diseases; Muscular Diseases; Musculoskeletal Pain
• Other Study ID Numbers: SwissChiCo-PBRN

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Data may be made available for research purposes. Requests, including a synopsis of the study plan, can be addressed to the central contact person.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No