In the past the focus of incident analysis has tended to be on the events immediately surrounding an adverse incident and, in particular, the acts or omissions of the people involved. A report from the UK Department of Health in 2000, An Organisation with a Memory, acknowledges that individuals must be accountable for their actions but stresses that serious errors are often caused by wider defects in systems latent conditions ; which lie dormant until they combine, possibly with human error, to precipitate a serious incident. Identification of these defects and conditions through active management of patient safety and effective reporting systems enables them to be removed before they can cause harm to patients. 356. Chiropractic Treatment of Lower Extremity Conditions: a Literature Review - Hoskins W., McHardy A., Pollard H. et al. [W. Hoskins, PhD candidate, Macquarie Injury Management Group, Department of Health and Chiropractic Australia] - J. MANIP. PHYSIOL. THER. 2006 29 8 ; - summ in ENGL Objective: The purpose of this study was to document the quantity and type of research conducted on the chiropractic management of lower extremity conditions. Methods: A review of the literature was conducted using the CINAHL, MEDLINE, MANTIS, and Science Direct databases each from inception to December 15, 2005 ; . Search terms included chiropractic, hip, knee, ankle, foot, with Medical Subject Heading terms for each region. Inclusion criteria included studies with a lower extremity diagnosis, and the treatment was performed by doctors of chiropractic. Articles were excluded if pain was referred from spinal sites and if there was a duplicate publication; articles published in non-peer-reviewed literature and abstracts in conference proceedings were also excluded. Of the articles identified, an analysis was conducted assessing those including peripheral and or spinal treatment. Clinical trials were assessed for quality using the Physiotherapy Evidence Database scale. Results: There was a total of 1652 citations. Of these, 76 were deemed relevant; 24 were related to the foot, 10 to the ankle, 25 to the knee, and 17 to the hip. Twenty-nine citations included spinal treatment, 47 solely peripheral, and 2 solely spinal. Ten citations were clinical trials and scored on the Physiotherapy Evidence Database scale. Conclusions: Literature on the chiropractic management of lower extremity conditions has a large number of case studies level 4 evidence ; and a smaller number of higher-level publications level Section 19 vol 50.2, for example, tenormin 25mg.
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