Last year, I spent positively hours and hours researching issues of child safeguarding in osteopathy for the Centre for Reviews and Summaries, set up by the National Council for Osteopathic Research. At the end of it all I had personally learnt an awful lot about how to spot emotional abuse, when it was mandatory to report female genital mutilation, what Victoria Gillick’s legacy to the legal world was, and whether step-parents can give consent to treatment. It was designed to be a user-friendly resource for osteopaths. Instead of you having to wade through Andrew Maddick’s IJOM articles, the Osteopathic Practice Standards and the NICE Guidelines – fascinating as all those resources are, I say without sarcasm – the idea was that you could take a quick look at a “snapshot summary” on the NCOR website, and get up to speed in less than 5 minutes per piece.
While mine never got published, for reasons too dull to go into, I wasn’t deterred from offering to be involved in the next round of NCOR’s “Snapshot Summaries”, on the basis that it was good to have a project to get my teeth into, it was fun being involved in the NCOR group – our convivial Skype meetings were organized by the very personable and social person of Austin Plunkett – and it all adds to the growing and necessary research culture in our profession.
Now it seems there is something of an appetite for this kind of thing, as the project this year has been oversubscribed (20+ expressed interest, with a good showing from the Sutherland Cranial College), and the number has currently been whittled down to about a dozen – quite impressive considering nobody is getting paid. Speaking of being impressed, I was rather humbled by the company I was in. In our little Skype subgroup alone was an ex-research scientist, an ex-Chairman of a Research Committee, and a lecturer in sports rehab who used to work at NCOR.
We should be doing 3 -4 days of work in total on this, (in a team of two or three if you prefer not working alone), but that is over a few months with considerable flexibility, and there is always the understanding and supportive attitude of Austin to reassure us and smooth our worried brows. All we have to do is keep him posted and tune into regular Skypes.
Now these are not systematic reviews, or exhaustive meta-analyses. They are brief summaries of selected recent papers, drawing mostly on NICE Guidelines, Cochrane Reviews and NHS Clinical Knowledge Summaries (CKSs). But they are fantastically concise and to the point. If a whole five-minute paper is even too much for you, they begin with a few key messages which can be absorbed in less than 60 seconds. It really couldn’t be easier for us to get a bit more evidence-based in our practice. In the past few minutes, I have learnt, for example, that
- Mindfulness-based interventions can positively influence how people cope with pain, but evidence that they alter the experience of pain itself is weak – thanks to Maria Robinson’s summary of Acceptance and mindfulness in the management of persistent pain,
- For frozen shoulder, exercise should only be recommended once movement can be tolerated after the acute phase – thanks to Elena Ward’s Exercise Therapy in the management of Shoulder Pain,
- For patients with rotator cuff tendinopathy, there is low to moderate quality evidence supporting the use of manual therapy to reduce pain, but not to improve function – thanks to Jonathon Spadaccini’s Manual therapy in the management of tendinopathy.
There are several other very useful summaries, from the days when Carol Fawkes was shouldering the burden alone, for example
- Pharmacological pain management
- Straight leg raising test
- Evaluation of the hip joint and thigh musculature
I’m planning to have a quick look at these right now, as I’ve ten minutes to spare before lunch. This is evidence-based medicine without tears.
Thanks for reading. The motivational interviewing blog is still on the list! Coming one day soon…