Editorial  |   March 2016
Research Into Osteopathic Manipulative Medicine: Steps on the Evidence Pyramid
Author Notes
  •  *Address correspondence to Leslie M. Ching, DO, Oklahoma State University College of Osteopathic Medicine, Department of Osteopathic Manipulative Medicine, 1111 W 17th St, Tulsa, OK 74107-1898. E-mail: leslie.ching@okstate.edu
     
Article Information
Emergency Medicine / Neuromusculoskeletal Disorders / Osteopathic Manipulative Treatment / Pain Management/Palliative Care / Low Back Pain / OMT in the Laboratory
Editorial   |   March 2016
Research Into Osteopathic Manipulative Medicine: Steps on the Evidence Pyramid
The Journal of the American Osteopathic Association, March 2016, Vol. 116, 133-134. doi:10.7556/jaoa.2016.029
The Journal of the American Osteopathic Association, March 2016, Vol. 116, 133-134. doi:10.7556/jaoa.2016.029
An evidence pyramid comprises various sources of information. Although the pyramid can vary depending on the source, in general, the bottom of the evidence pyramid includes ideas and expert opinion (weakest evidence); the middle steps of the pyramid include case reports followed by cross-sectional studies, case control studies, cohort studies, and randomized controlled trials; and at the top are systematic reviews and meta-analyses (strongest evidence). In biomedical research, the pyramid represents a logical, stepwise progression toward the ultimate goal of providing high-quality evidence to guide clinical practice. 
Osteopathic manipulative medicine has traditionally had an empirical basis rather than a research basis. Rigorous studies of concept or efficacy for osteopathic manipulative treatment (OMT) have not been robust. However, this tradition is beginning to change. In the current issue of The Journal of the American Osteopathic Association (JAOA), 7 articles1-7 at different steps in the evidence pyramid—and across varied populations—highlight important areas of osteopathic research. 
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