Figure 4

Clinical management options in response to case scenario 4. Likelihood of nine given clinical management options being followed in response to Case Scenario 4: An elderly woman complains about immediate chest pain on inspiration after manual treatment directed to her thoracic spine. The dotted lines demarcate a region of the chart outside of which management options were arbitrarily designated as ‘likely’ (upper line) or ‘unlikely’ (lower line) to be undertaken. Swiss and UK chiropractors were likely to re-evaluate, and send for imaging; UK chiropractors were likely to refer to another healthcare professional, Swiss chiropractors were unlikely to continue the treatment until the patient is subluxation-free; Swiss chiropractors were unlikely to stop and invite the patient to return as needed; both groups were unlikely to stop to monitor regularly or stop to apologise and report to the incident reporting system.