Osteopathic research: the needed paradigm shift.
The purposes of this article are twofold: (1) To assist scientists on the faculties of colleges of osteopathic medicine in the design of research projects relevant to osteopathic medical theory and practice; and (2) to assist clinical investigators in the development of research protocols that are best suited to the assessment of clinical outcomes of osteopathic medical practice. Toward this end, the central osteopathic medical principles are heuristically interpreted and elaborated, with the intention of facilitating the formulation of fundamental questions by researchers in the various biomedical disciplines and the design of clinical research projects by osteopathic physicians. A few of the questions evoked by such elaboration of the osteopathic medical principles and awaiting study are suggested for consideration by researchers. Such research questions require and, in part, compose a research paradigm that differs basically from, yet complements and "completes," the prevailing and highly productive reductionist paradigm. It is, in the original sense of the word, a "holistic" paradigm that places emphasis on the organismic context in which the biological mechanisms exist and operate. Conventional clinical research protocols for the assessment of efficacy of most chemical and physical therapeutic agents are ill-suited for the assessment of osteopathic medical care, of manipulative treatment in particular. It is emphasized that osteopathic medical care must be evaluated as it is practiced and not as a contrived, unreal version; and that it must be tested as a derivative of, and in the context of, that philosophy by criteria consonant with that philosophy.(ABSTRACT TRUNCATED AT 250 WORDS)