Virtual Conference
Spine 2023

Derek Farmen

National Spine Management Group, USA

Title: Examining Clinical Opinion and Experience Regarding Utilization of Plain Radiography of the Spine: Evidence from Surveying the Chiropractic Profession


Plain Radiography of the spine (PROTS) is utilized in many forms of healthcare including the chiropractic profession; however, the literature reflects conflicting opinions regarding utilization and value. Despite being an essential part of Evidence-Based Practice (EBP), few studies assess Doctors of Chiropractic (DCs) clinical opinions and experience regarding the utilization of (PROTS) in practice. In this study, DCs were surveyed regarding utilization of PROTS in practice. The survey was administered to an estimated 50,000 licensed DCs by email. A total of 4301 surveys were completed, of which 3641 were United States (US) DCs. The Clinician Opinion and Experience on Chiropractic Radiography (COECR) scale was designed to analyze survey responses. This valid and reliable scale demonstrated good internal consistency using confirmatory factor analysis and the Rasch model. Survey responses show that 73.3% of respondents utilize PROTS in practice and 26.7% refer patients out for PROTS. Survey responses show that, among US DCs, 91.9% indicate PROTS has value beyond identification of pathology, 86.7% indicate that PROTS is important regarding biomechanical analysis of the spine, 82.9% indicate that PROTS is vital to practice, 67.4% indicate that PROTS aids in measuring outcomes, 98.6% indicate the opinion that PROTS presents very low to no risk to patients, and 93.0% indicate that sharing clinical findings from PROTS studies with patients is beneficial to clinical outcomes. The results of the study indicated that based on clinical experience, the majority of DCs find PROTS to be vital to practice and valuable beyond the identification of red flags.


Dr. Derek Farmen graduated Cum Laude with his Doctor of Chiropractic degree from Palmer College of Chiropractic in 2018 at the age of 28. He holds qualifications in Spinal Trauma and Interprofessional Hospital Communication through Cleveland University – Kansas City and is credentialed in Spinal MRI Interpretation through University at Buffalo Jacobs school of Medicine and Biomedical Sciences.  Dr. Farmen is currently in private practice and is undergoing fellowship training in Spinal Biomechanics and Trauma where he is scheduled to graduate in September to become a Spine Management Physician. Dr. Farmen’s interest of study is the diagnosis, management and prevention of mechanical spine pain with a collaborative approach between specialists.