• McGregor M
• Triano JJ

• Association of Chiropractic Colleges / congresses

Methods: Professional abstractions were defined by analysis of word use, word influence, clustering and resonance between representative examples of professional text. Two sources of text were chosen. Expert opinion was surveyed among attendees at the 2000 World Federation of Chiropractic/Association of Chiropractic Colleges Conference on Philosophy in Chiropractic Education. Attendees answered: “In your words, please describe the types of health problems addressed by chiropractors”. Response representativeness was assessed by group membership and comparison with similar literature constructs. Responses were categorized by similarity into six groups and randomly presented to a blinded three-judge panel. Judges independently assigned each response to a group. Disagreements were resolved by majority vote. Results were assessed via centering resonance analysis (CRA), translating text into networks and evaluating word influence according to hierarchical position. Cluster analysis evaluated group interrelationships. The second source came from published articles. The Journal of Manipulative and Physiologic Therapeutics (JMPT), 1978 –2004, and Journal of Vertebral Subluxation Research (JVSR), 1996 – 2004, abstracts were electronically scanned. Text was assessed independently by source and year via CRA. Cluster analysis evaluated relationships. Influence of word use was similarly gauged for both text sources, as the ratio of the sum of positive and negative terms to neutral terms.

Results: A total of 64 usable expert opinion responses, representing 15 countries, were received. The majority of responses reflected biomechanical/somatic pain. Two subgroups, one describing only general health issues (11%), the other, only subluxation-related optimal health (17%) were identified. Expert opinion cluster analysis showed two groups. One contained the four subgroups describing biomechanical/somatic pain. Common influential word pairs were “neck pain”, “lbp, neck” and “effect health”. The other contained the two subgroups. One subgroup focused on general health alone. The other used phrases on subluxation and optimal health. Common influential word pairs were “subluxation, vertebral”, “health problem” and “interference vertebral”. Greater intensity (positive + negative words: neutral words) was found for the subluxation/optimal health group (t=4.61, p=0.01). Article cluster analysis also resulted in two clusters: JMPT (1989 - 2004) and JMPT (1978 – 1988) + JVSR (1996 – 2004). Influential words and pairs for the first were “chiropractic”, “patient”, and “interpedicular sensation”. The second used “care chiropractic”, “back pain”, and “back low”. Comparative coherence was statistically significant (t=4.07, p<0.01) favoring the JMPT 1989-2004 cluster, as was the measure of intensity (t=2.09, p=0.05).

Discussion: Expert opinion indicated a majority of chiropractic abstraction related to biomechanical/somatic pain, with additional general health concerns. One minority subgroup considered general health problems-only and the other, subluxation-only. Cluster analysis verified the distinction between the groups. Word intensity was greater for the smaller group. Articles clustered, early JMPT+JVSR versus later JMPT, based on similarity in characteristic word use. Coherence for later JMPT was the strongest. Influence words and pairs, in contrast to expert opinion, involved somatic concerns for all groups.

Conclusion: The clusters found present an interesting challenge. Opinion-related responses showed stronger polarization over inclusion of somatic/biomechanical problems as professional domain whereas the abstract-based text did not. Rhetoric within the profession regarding professional domain may be different from the written materials upon which abstractions and, ultimately, jurisdictional control are based.

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