Defining the landscape of patient harm after osteopathic manipulative treatment: synthesis of an adverse event model. Unger, M. D., Barr, J. N., Brower, J. A., Kingston, J. C., Heller, G. R., & Palmer, J. L. BMC Complementary Medicine and Therapies, 23(1):407, November, 2023. Paper doi abstract bibtex Abstract Background In the United States, osteopathic manipulative treatment (OMT), is a popular complementary physical health approach for the treatment of neuromusculoskeletal disorders. However, post-OMT adverse events (AEs) are poorly defined in terms of frequency, severity, and temporal evolution. To date, no benchmark for patient safety exists. To improve understanding in this field, we set out to model the landscape of patient harm after OMT. Methods We conducted a comprehensive search of all available primary clinical research studies reporting on the occurrence of post-OMT AEs in nonpregnant, adult outpatients treated by an osteopathic physician in the United States. The methodology of eligible studies was then reviewed to select those containing the minimum required dataset to model the post-OMT AEs. The minimum required dataset consisted of four model parameters: ‘post-OMT interval’, ‘OMT encounters with post-OMT interval assessment’, ‘AEs preceded by an OMT encounter’, and ‘AE severity.’ We used the dataset extracted from selected studies to calculate a patient safety benchmark defined as the incidence rate of AEs per 100 post-OMT interval-days. Results From 212 manuscripts that we identified, 118 primary clinical research studies were assessed for eligibility. A total of 23 studies met inclusion criteria for methodological review, of which 13 studies passed and were selected for modeling. Mild AEs were the most frequent, accounting for n = 161/165 (98%) of total AEs observed in the literature. The cumulative incidence of mild AEs was also significantly greater ( P = 0.01) than both moderate and severe grades. The benchmark incidence rate was 1.0 AEs per 100 post-OMT interval-days. Conclusions The majority of post-OMT AEs observed in the primary clinical literature were of mild severity. Modeling of the combined dataset on post-OMT AEs allowed for the derivation of a patient safety benchmark that, to date, has not been established in the field of osteopathic manipulative medicine. Additional research is needed to improve model resolution during the post-OMT period. This work conceptualized a model for identifying and grading post-OMT AEs, which should facilitate future comparisons between institutions in order to continually improve patient safety standards in the field of osteopathic manipulative medicine.
@article{unger_defining_2023,
title = {Defining the landscape of patient harm after osteopathic manipulative treatment: synthesis of an adverse event model},
volume = {23},
issn = {2662-7671},
shorttitle = {Defining the landscape of patient harm after osteopathic manipulative treatment},
url = {https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/s12906-023-04230-2},
doi = {10.1186/s12906-023-04230-2},
abstract = {Abstract
Background
In the United States, osteopathic manipulative treatment (OMT), is a popular complementary physical health approach for the treatment of neuromusculoskeletal disorders. However, post-OMT adverse events (AEs) are poorly defined in terms of frequency, severity, and temporal evolution. To date, no benchmark for patient safety exists. To improve understanding in this field, we set out to model the landscape of patient harm after OMT.
Methods
We conducted a comprehensive search of all available primary clinical research studies reporting on the occurrence of post-OMT AEs in nonpregnant, adult outpatients treated by an osteopathic physician in the United States. The methodology of eligible studies was then reviewed to select those containing the minimum required dataset to model the post-OMT AEs. The minimum required dataset consisted of four model parameters: ‘post-OMT interval’, ‘OMT encounters with post-OMT interval assessment’, ‘AEs preceded by an OMT encounter’, and ‘AE severity.’ We used the dataset extracted from selected studies to calculate a patient safety benchmark defined as the incidence rate of AEs per 100 post-OMT interval-days.
Results
From 212 manuscripts that we identified, 118 primary clinical research studies were assessed for eligibility. A total of 23 studies met inclusion criteria for methodological review, of which 13 studies passed and were selected for modeling. Mild AEs were the most frequent, accounting for
n
= 161/165 (98\%) of total AEs observed in the literature. The cumulative incidence of mild AEs was also significantly greater (
P
= 0.01) than both moderate and severe grades. The benchmark incidence rate was 1.0 AEs per 100 post-OMT interval-days.
Conclusions
The majority of post-OMT AEs observed in the primary clinical literature were of mild severity. Modeling of the combined dataset on post-OMT AEs allowed for the derivation of a patient safety benchmark that, to date, has not been established in the field of osteopathic manipulative medicine. Additional research is needed to improve model resolution during the post-OMT period. This work conceptualized a model for identifying and grading post-OMT AEs, which should facilitate future comparisons between institutions in order to continually improve patient safety standards in the field of osteopathic manipulative medicine.},
language = {en},
number = {1},
urldate = {2024-01-13},
journal = {BMC Complementary Medicine and Therapies},
author = {Unger, Mark D. and Barr, Jackilyn N. and Brower, Jacob A. and Kingston, Joseph C. and Heller, Gregory R. and Palmer, Joy L.},
month = nov,
year = {2023},
pages = {407},
}
Downloads: 0
{"_id":"QDtEzSZsJtqFvemnW","bibbaseid":"unger-barr-brower-kingston-heller-palmer-definingthelandscapeofpatientharmafterosteopathicmanipulativetreatmentsynthesisofanadverseeventmodel-2023","author_short":["Unger, M. D.","Barr, J. N.","Brower, J. A.","Kingston, J. C.","Heller, G. R.","Palmer, J. L."],"bibdata":{"bibtype":"article","type":"article","title":"Defining the landscape of patient harm after osteopathic manipulative treatment: synthesis of an adverse event model","volume":"23","issn":"2662-7671","shorttitle":"Defining the landscape of patient harm after osteopathic manipulative treatment","url":"https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/s12906-023-04230-2","doi":"10.1186/s12906-023-04230-2","abstract":"Abstract Background In the United States, osteopathic manipulative treatment (OMT), is a popular complementary physical health approach for the treatment of neuromusculoskeletal disorders. However, post-OMT adverse events (AEs) are poorly defined in terms of frequency, severity, and temporal evolution. To date, no benchmark for patient safety exists. To improve understanding in this field, we set out to model the landscape of patient harm after OMT. Methods We conducted a comprehensive search of all available primary clinical research studies reporting on the occurrence of post-OMT AEs in nonpregnant, adult outpatients treated by an osteopathic physician in the United States. The methodology of eligible studies was then reviewed to select those containing the minimum required dataset to model the post-OMT AEs. The minimum required dataset consisted of four model parameters: ‘post-OMT interval’, ‘OMT encounters with post-OMT interval assessment’, ‘AEs preceded by an OMT encounter’, and ‘AE severity.’ We used the dataset extracted from selected studies to calculate a patient safety benchmark defined as the incidence rate of AEs per 100 post-OMT interval-days. Results From 212 manuscripts that we identified, 118 primary clinical research studies were assessed for eligibility. A total of 23 studies met inclusion criteria for methodological review, of which 13 studies passed and were selected for modeling. Mild AEs were the most frequent, accounting for n = 161/165 (98%) of total AEs observed in the literature. The cumulative incidence of mild AEs was also significantly greater ( P = 0.01) than both moderate and severe grades. The benchmark incidence rate was 1.0 AEs per 100 post-OMT interval-days. Conclusions The majority of post-OMT AEs observed in the primary clinical literature were of mild severity. Modeling of the combined dataset on post-OMT AEs allowed for the derivation of a patient safety benchmark that, to date, has not been established in the field of osteopathic manipulative medicine. Additional research is needed to improve model resolution during the post-OMT period. This work conceptualized a model for identifying and grading post-OMT AEs, which should facilitate future comparisons between institutions in order to continually improve patient safety standards in the field of osteopathic manipulative medicine.","language":"en","number":"1","urldate":"2024-01-13","journal":"BMC Complementary Medicine and Therapies","author":[{"propositions":[],"lastnames":["Unger"],"firstnames":["Mark","D."],"suffixes":[]},{"propositions":[],"lastnames":["Barr"],"firstnames":["Jackilyn","N."],"suffixes":[]},{"propositions":[],"lastnames":["Brower"],"firstnames":["Jacob","A."],"suffixes":[]},{"propositions":[],"lastnames":["Kingston"],"firstnames":["Joseph","C."],"suffixes":[]},{"propositions":[],"lastnames":["Heller"],"firstnames":["Gregory","R."],"suffixes":[]},{"propositions":[],"lastnames":["Palmer"],"firstnames":["Joy","L."],"suffixes":[]}],"month":"November","year":"2023","pages":"407","bibtex":"@article{unger_defining_2023,\n\ttitle = {Defining the landscape of patient harm after osteopathic manipulative treatment: synthesis of an adverse event model},\n\tvolume = {23},\n\tissn = {2662-7671},\n\tshorttitle = {Defining the landscape of patient harm after osteopathic manipulative treatment},\n\turl = {https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/s12906-023-04230-2},\n\tdoi = {10.1186/s12906-023-04230-2},\n\tabstract = {Abstract\n \n Background\n In the United States, osteopathic manipulative treatment (OMT), is a popular complementary physical health approach for the treatment of neuromusculoskeletal disorders. However, post-OMT adverse events (AEs) are poorly defined in terms of frequency, severity, and temporal evolution. To date, no benchmark for patient safety exists. To improve understanding in this field, we set out to model the landscape of patient harm after OMT.\n \n \n Methods\n We conducted a comprehensive search of all available primary clinical research studies reporting on the occurrence of post-OMT AEs in nonpregnant, adult outpatients treated by an osteopathic physician in the United States. The methodology of eligible studies was then reviewed to select those containing the minimum required dataset to model the post-OMT AEs. The minimum required dataset consisted of four model parameters: ‘post-OMT interval’, ‘OMT encounters with post-OMT interval assessment’, ‘AEs preceded by an OMT encounter’, and ‘AE severity.’ We used the dataset extracted from selected studies to calculate a patient safety benchmark defined as the incidence rate of AEs per 100 post-OMT interval-days.\n \n \n Results\n \n From 212 manuscripts that we identified, 118 primary clinical research studies were assessed for eligibility. A total of 23 studies met inclusion criteria for methodological review, of which 13 studies passed and were selected for modeling. Mild AEs were the most frequent, accounting for\n n\n = 161/165 (98\\%) of total AEs observed in the literature. The cumulative incidence of mild AEs was also significantly greater (\n P\n = 0.01) than both moderate and severe grades. The benchmark incidence rate was 1.0 AEs per 100 post-OMT interval-days.\n \n \n \n Conclusions\n The majority of post-OMT AEs observed in the primary clinical literature were of mild severity. Modeling of the combined dataset on post-OMT AEs allowed for the derivation of a patient safety benchmark that, to date, has not been established in the field of osteopathic manipulative medicine. Additional research is needed to improve model resolution during the post-OMT period. This work conceptualized a model for identifying and grading post-OMT AEs, which should facilitate future comparisons between institutions in order to continually improve patient safety standards in the field of osteopathic manipulative medicine.},\n\tlanguage = {en},\n\tnumber = {1},\n\turldate = {2024-01-13},\n\tjournal = {BMC Complementary Medicine and Therapies},\n\tauthor = {Unger, Mark D. and Barr, Jackilyn N. and Brower, Jacob A. and Kingston, Joseph C. and Heller, Gregory R. and Palmer, Joy L.},\n\tmonth = nov,\n\tyear = {2023},\n\tpages = {407},\n}\n\n","author_short":["Unger, M. D.","Barr, J. N.","Brower, J. A.","Kingston, J. C.","Heller, G. R.","Palmer, J. L."],"key":"unger_defining_2023","id":"unger_defining_2023","bibbaseid":"unger-barr-brower-kingston-heller-palmer-definingthelandscapeofpatientharmafterosteopathicmanipulativetreatmentsynthesisofanadverseeventmodel-2023","role":"author","urls":{"Paper":"https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/s12906-023-04230-2"},"metadata":{"authorlinks":{}}},"bibtype":"article","biburl":"https://api.zotero.org/groups/2149284/items?key=Tc2D7xMBOC0VRcc11br4cQZZ&format=bibtex&limit=100","dataSources":["Mbi95emQ5h7aP3sGL"],"keywords":[],"search_terms":["defining","landscape","patient","harm","osteopathic","manipulative","treatment","synthesis","adverse","event","model","unger","barr","brower","kingston","heller","palmer"],"title":"Defining the landscape of patient harm after osteopathic manipulative treatment: synthesis of an adverse event model","year":2023}