Association between cervical artery dissection and spinal manipulative therapy –a medicare claims analysis - BMC Geriatrics

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Association between cervical artery dissection and spinal manipulative therapy –a medicare claims analysis - BMC Geriatrics
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Cervical spinal manipulation does not appear to be a significant risk factor for cervical artery dissection in older adults, reports a study published in BMCGeriatr

we analyzed the relationship between CSM and CeAD with three different types of controls: a case-control design consisting of cases with CeAD and controls from the general population of Medicare beneficiaries matched by sex, age and calendar year of the CeAD; , a case-control design with the same cases and controls with ischemic stroke from the population of Medicare beneficiaries; and a case-crossover design, in which exposures prior to the CeAD are compared to exposures in the time period 6...

Due to large number of diagnostic covariates we used variable selection methods. To select predictors of CeAD cases versus ischemic stroke controls we employed Least Absolute Shrinkage and Selection Operator for logistic regression to select covariates []. In particular, we selected those covariates that had a nonzero LASSO coefficient. The penalty parameter in the LASSO was determined using 10-fold cross-validation with optimization of the binomial deviance .

All analyses above were repeated for each of the three time frames for exposure to CSM and E&M . That is, we report odds ratios comparing CSM to E&M and neither CSM nor E&M to E&M exposure in each of these time periods.

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