Research Report

Funding Source: NIH/NCCIH UG3/UH3AT009761  

Award Amount: $7,087,730 + 2024 Administrative Supplement ($480K ) + Administrative Supplements for 4 DCs to participate as trial Fellows ($900K)

Performance Period: 9/20/2017 – 8/31/2025

Principal Investigators: Cynthia Long, Ph.D.; Christine Goertz, D.C., Ph.D.

PCCR Co-Investigators: Stacie Salsbury, Ph.D., R.N.; Robert Vining D.C., DHSc

External Co-Investigators: Erin Krebs, M.D., M.P.H.; Thad Abrams, M.D., M.S.; Anthony Lisi, D.C.; Jon Lurie, M.D., M.S.; Paul Shekelle, M.D., Ph.D.; Robert Wallace, M.D., MSc; Richard Branson D.C.; Kei Hoi Cheung, Ph.D.

PCCR Clinical Research Specialist: Elissa Twist, D.C., M.S., FIAMA, CCRP , CIP

PCCR Clinical Project Managers: Amy Minkalis, D.C., M.S., CCRP; Anna Walden-Steward, D.C., M.S., CCRC

PCCR Data Coordinating Center Members: Sujatha Kelidaya, B.Sc.; Jacob McCarey, M.S.

Sites: VA Connecticut Health Care System; Minneapolis VA Health Care System; Iowa City VA Health Care System; VA Greater LA Healthcare System

Description: VERDICT is a large-scale, randomized, pragmatic trial conducted as part of the Pain Management Collaboratory; it enrolled 766 Veterans with chronic low back pain from 2/22/2021 to 5/10/2024 to evaluate the effectiveness of varied number of dosage levels of chiropractic care for the management of low back pain. Data collection was completed on 5/20/2025 and data analysis is underway. Stay tuned.

Read More: Chiropractic Care for Veterans: A Pragmatic Randomized Trial Addressing Dose Effects for cLBP (VERDICT)

Performance Period: 8/6/2022 – 3/31/2026 

Principal Investigators: Robert Vining, D.C., DHSc; Maranda Kleppe, D.C. 

Co-Investigators: Maranda Kleppe, D.C.; Jacob McCarey, M.S. 

Site: Palmer College of Chiropractic, Davenport IA 

Description: Quality indicators are standardized, evidence-based measures of health care quality that offer key information about the care patients receive and outcomes that can be expected. Prior to this set of studies, there are no standard set of quality indicators for chiropractic care published in the peer-reviewed literature. A series of studies are being conducted in this research program to develop, validate, and study quality indicators for chiropractic care, with the overall goal of enhancing the capacity of providers and health care organizations to regularly assess and inform the delivery of high-value chiropractic care.

Read more: Quality Indicators of Chiropractic 

Performance Period: 8/07/2022 – 6/30/2028

Principal Investigators: Stacie Salsbury, Ph.D., R.N.; Lisa Killinger, D.C.

Co-Investigators: Elissa Twist, D.C., M.S., FIAMA, CCRP , CIP; Judy Bhatti, D.C., M.S., DHEd

Site: Palmer College of Chiropractic, Davenport IA

Description: Healthy ageing is the goal of empowering individuals and communities to maintain their functional abilities, sense of well-being, and engagement in society throughout the lifespan. Midlife and older adults aged 55 years and older comprise 1 in 3 chiropractic patients. Chiropractors have an essential role in recognizing barriers to healthy ageing, providing evidence-based chiropractic care, and facilitating self-management in this patient population. This program of research seeks to integrate current models of healthy ageing, such as the 4Ms of Age-Friendly Health Systems, the Geriatrics 5Ms, and Integrated Care for Older People (ICOPE), into chiropractic education, clinical practice, and health care systems and policies.

Read More: Models of Healthy Ageing with Chiropractic Care

Funding Source: NIH Loan Repayment Program

Grant Number: L30AT013015 

Performance Period: 7/1/2024-6/30/2026

Principal Investigator: Zacariah Shannon, D.C., M.S., Ph.D.

Primary Mentor: Cynthia Long, Ph.D.

Site: Palmer College of Chiropractic, Davenport IA

Description: During the Assessment of Chiropractic Treatment trial (ACT 1) of 750 active military personnel, participants were still in deployment cycles and initial follow-up data was only collected for 12 weeks. As these deployment cycles diminished, 1-year of follow-up was added for the final 154 participants. This secondary analysis of ACT 1 data will assess the effectiveness of chiropractic care plus usual medical vs. usual medical alone for LBP-related outcomes that include disability, physical, mental, and social health measures for this subgroup of participants. 

Read More: Assessment of Chiropractic Treatment in Active Duty Military Personnel Studies (ACT)

Support: RAND Corporation Technology Incubator; Palmer Center for Chiropractic Research Seed Grant 

Performance Period: 3/1/2023-6/30/2030 

Principal Investigators: Robert Vining, D.C., DHSc; Robert Rudin, Ph.D. 

Co-Investigator: Patricia Herman, N.D., Ph.D. 

Collaborating Institution: RAND Corporation 

Description: There are specific types of low back pain (LBP), but most patients receive a nonspecific diagnosis that does not facilitate evidence-based, individualized care. The research team first developed a practical diagnostic process which includes an exam and checklist to guide clinical evaluation and demonstrate evidence for working diagnoses in clinical settings. They then designed a LBP diagnosis and treatment clinical decision support (CDS) web-based tool with an initial focus on chiropractic. The tool records key exam findings, generates evidence-based working diagnoses, and offers treatment and patient education information for non-pathological LBP. The research team is now refining implementation strategies for the CDS tool, employing user-centered design methods to improve and evaluate the CDS tool and implementation strategy.

 Read More: Evidence-Based Diagnosis and Clinical Decision Making

Principal Investigator: Brian Anderson D.C., M.P.H., M.S., Ph.D.

Description: Low back pain affects nearly 17% of the U.S. population and is among the leading causes of disability, with annual healthcare costs of low back and neck pain totaling US$134 billion. An important contributor to these costs is low-value care, defined as interventions that offer minimal clinical benefit, may harm patients, and contribute to excessive healthcare expenditures. This research program evaluates the utilization of guideline-discordant, low-value procedures for people with low back pain using administrative and secondary data sources, such as private insurance and Medicare claims, and the NIH All of Us Research Program.

Read more: Evaluating Spine-Related Low-Value Services in Administrative and Secondary Data Sources

The Inter-Institutional Network for Chiropractic Research is a collaborative effort between the Palmer Center for Chiropractic Research (PCCR), Yale University Section of Biomedical Informatics and Data Science, and the Osher Center for Integrative Health (jointly based at Harvard Medical School and Brigham and Women’s Hospital).

Co-Directors: Cynthia Long, Ph.D.; Anthony Lisi, D.C.; Peter Wayne, Ph.D.

Steering Committee Members: Matt Kowalski, D.C.; Robert Vining, D.C., D.H.Sc.

Program Manager: Zachary Almquist, M.A.

Funding Source: Palmer College Foundation

Read More: Inter-Institutional Network for Chiropractic Research

Funding Source: NIH/NCCIH
Performance Period: 7/31/2023-6/30/2026
Principal Investigators: Peter Wayne, Ph.D.; Pamela Rist, Sc.D.; Jason Sico, M.D., M.H.S.
PCCR Co-Investigators: Cynthia Long, Ph.D.; Robert Vining, D.C., D.H.Sc.

Sites: Osher Clinical Center; West Haven, VA Connecticut Hospital

Description: A 2-site pilot randomized trial of 60 patients (men and women) diagnosed with episodic migraines (R01 multisite pilot clinical trial) has launched recruitment.

Funding Source: NIH/NCCIH
Performance Period: 9/12/2022-5/30/2026
Principal Investigator: Peter Wayne, Ph.D.
PCCR Co-Investigators: Cynthia Long, Ph.D.; Robert Vining, D.C., DHSc
PCCR Post-doctoral Research Scholar: Maranda Kleppe, D.C.

Sites: Osher Center for Integrative Health at Harvard/BWH; Chiropractic and Tai Chi community clinics/centers in Boston, MA

Description: A 3-armed mixed methods pilot randomized trial of 48 patients with chronic neck pain with care from community-based Tai Chi instructors and chiropractors (R34 clinical trial planning grant application). Enrollment and the primary endpoint are complete. Data analysis is underway.