Chiropractic case reports: a review and bibliometric analysis

Abstract

Objective: To determine publication trends, gaps, and predictors of citation of chiropractic case reports (CRs).

Methods: A bibliometric review was conducted by searching PubMed, Index to Chiropractic Literature (ICL), and Google Scholar to identify PubMed-indexed CRs, which were screened according to selection criteria. Case reports were categorized by International Classification of Disease (ICD-10) code, patient age, topic describing case management or adverse effects of care, focus being spinal or non-spinal, journal type, integrative authorship, title metrics, and citation metrics. Binary logistic regression was used to identify independent predictors of citations per year and total citations greater than the median values.

Results: The search identified 1176 chiropractic CRs meeting selection criteria. There was an increasing trend of CRs having a case management topic, non-spinal focus, non-chiropractic journal, neuromusculoskeletal-focus, diagnosis of vascular pathology, and a decreasing trend of adverse effect vascular pathology CRs. Independent predictors of greater total citations (or citation rate) included ICD-10 categories of perinatal conditions, infections, "case" in title, case management topic, and physical therapy, integrative, and dental journal type. Predictors of fewer citations included diseases of the blood, neoplasms, other findings not elsewhere classified, a title > 11 words, and multidisciplinary authorship. ICD-10 categories describing non-musculoskeletal diseases and special populations such as pediatrics, pregnancy, and perinatal conditions had few CRs.

Conclusion: Chiropractic CRs are diversifying from spine-related topics. Chiropractors are encouraged to publish objective, structured CRs within defined research gaps. Published CRs can inform the design of future research studies with a higher level of clinical relevance and evidence.

Keywords: Bibliometrics; Case reports; Chiropractic; Information science; Literature review; Musculoskeletal diseases; Spine.

Fig. 1

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart

Fig. 2

Case report volume indexed by EBSCOhost according to special interest on August 25th, 2020. Select interest groups are shown. Nursing language / classification, case management, nursing administration, nursing education, informatics, and quality assurance are not shown, which had fewer CRs than chiropractic, while evidence-based practice, advanced nursing practice, palliative/hospice care, and social work are also not shown, which had a greater number of CRs than chiropractic

Fig. 3

Volume of chiropractic case reports by ICD-10 category

Fig. 4

Yearly number of adverse effect or case management case reports. Data from 2020 are de-emphasized as it may not be accurate (see Limitations)

Fig. 5

The trend in spine-related case reports, starting at the first year of consecutive publications without zero points (gaps). Data from 2020 are de-emphasized as it may not be accurate (see Limitations)

Fig. 6

Medical and chiropractic (also including alternative and complementary medicine) journal types shown as a percentage of total publications by year, starting at the first year without zero points / gaps. Data from 2020 are de-emphasized as it may not be accurate (see Limitations)

Fig. 7

Journal types with the largest positive slope, as a percentage of total CR volume. Data from 2020 are de-emphasized as it may not be accurate (see Limitations)

Fig. 8

Incidences of non-chiropractic authors in chiropractic CRs. Note that some CRs had more than one type of non-chiropractic author, which was included within the count

Fig. 9

Total number of chiropractic case reports with an integrative authorship team per five-year period