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Chiropractic care and the risk of vertebrobasilar stroke: results of a case–control study in U.S. commercial and Medicare Advantage populations

Overview of attention for article published in Chiropractic & Manual Therapies, June 2015
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • One of the highest-scoring outputs from this source (#6 of 519)
  • High Attention Score compared to outputs of the same age (98th percentile)

Mentioned by

news
4 news outlets
blogs
1 blog
twitter
75 tweeters
facebook
46 Facebook pages
wikipedia
1 Wikipedia page
googleplus
4 Google+ users
video
4 video uploaders

Citations

dimensions_citation
20 Dimensions

Readers on

mendeley
138 Mendeley
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Title
Chiropractic care and the risk of vertebrobasilar stroke: results of a case–control study in U.S. commercial and Medicare Advantage populations
Published in
Chiropractic & Manual Therapies, June 2015
DOI 10.1186/s12998-015-0063-x
Pubmed ID
Authors

Thomas M Kosloff, David Elton, Jiang Tao, Wade M Bannister

Abstract

There is controversy surrounding the risk of manipulation, which is often used by chiropractors, with respect to its association with vertebrobasilar artery system (VBA) stroke. The objective of this study was to compare the associations between chiropractic care and VBA stroke with recent primary care physician (PCP) care and VBA stroke. The study design was a case-control study of commercially insured and Medicare Advantage (MA) health plan members in the U.S. population between January 1, 2011 and December 31, 2013. Administrative data were used to identify exposures to chiropractic and PCP care. Separate analyses using conditional logistic regression were conducted for the commercially insured and the MA populations. The analysis of the commercial population was further stratified by age (<45 years; ≥45 years). Odds ratios were calculated to measure associations for different hazard periods. A secondary descriptive analysis was conducted to determine the relevance of using chiropractic visits as a proxy for exposure to manipulative treatment. There were a total of 1,829 VBA stroke cases (1,159 - commercial; 670 - MA). The findings showed no significant association between chiropractic visits and VBA stroke for either population or for samples stratified by age. In both commercial and MA populations, there was a significant association between PCP visits and VBA stroke incidence regardless of length of hazard period. The results were similar for age-stratified samples. The findings of the secondary analysis showed that chiropractic visits did not report the inclusion of manipulation in almost one third of stroke cases in the commercial population and in only 1 of 2 cases of the MA cohort. We found no significant association between exposure to chiropractic care and the risk of VBA stroke. We conclude that manipulation is an unlikely cause of VBA stroke. The positive association between PCP visits and VBA stroke is most likely due to patient decisions to seek care for the symptoms (headache and neck pain) of arterial dissection. We further conclude that using chiropractic visits as a measure of exposure to manipulation may result in unreliable estimates of the strength of association with the occurrence of VBA stroke.

Twitter Demographics

The data shown below were collected from the profiles of 75 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 138 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Italy 1 <1%
Australia 1 <1%
United Kingdom 1 <1%
Canada 1 <1%
United States 1 <1%
Unknown 133 96%

Demographic breakdown

Readers by professional status Count As %
Other 31 22%
Student > Master 19 14%
Student > Doctoral Student 18 13%
Researcher 15 11%
Student > Bachelor 9 7%
Other 28 20%
Unknown 18 13%
Readers by discipline Count As %
Medicine and Dentistry 65 47%
Nursing and Health Professions 24 17%
Neuroscience 6 4%
Agricultural and Biological Sciences 5 4%
Sports and Recreations 5 4%
Other 11 8%
Unknown 22 16%

Attention Score in Context

This research output has an Altmetric Attention Score of 123. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 April 2022.
All research outputs
#253,247
of 21,419,046 outputs
Outputs from Chiropractic & Manual Therapies
#6
of 519 outputs
Outputs of similar age
#3,039
of 245,830 outputs
Outputs of similar age from Chiropractic & Manual Therapies
#1
of 1 outputs
Altmetric has tracked 21,419,046 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 519 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.6. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 245,830 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them