College of Chiropractic and he is the gentleman who developed George's Test. We have all, over the years since that time, been confronted with various tests whether it was DeKlynes Test, or whether it was George's Test, or whether it was [inaudible 00:10:59] or whatever name was given to it, but basically a constellation of procedures to attempt to elicit the quality and the patency of the vertebral artery. It was assumed in those early days after the development of these tests that they were in fact, good and true indicators regarding the health and well-being of a vertebral artery. The fullness of time has indicated that that's not the case. The research since the development of these tests, on the tests themselves has indicated that they provide a very, very high percentage of false positives and a very, very high percentage of false negatives. The truth of the matter is, the testing itself to determine the quality, the patency, and the adjustability if you will, of the vertebral artery is not viable. The conventional wisdom has transitioned from, you must do a screening test, to you shouldn't do a screening test. Now I'm not suggesting that there isn't any use for positional testing, rotational testing, things of that nature. The provocative testing where you attempt to introduce strain to elicit a change in the artery is what is not being recommended at this time. If you look at a patient and there's an obvious [inaudible 00:12:25] and you can see a pulsation in the neck, I'm not suggesting that you don't pay attention to that. I'm not suggesting that if a patient turns their head to one side or the other, and they become dizzy and they move toward passing out, that you not pay attention to that. What I am suggesting is that if you perform a George's Test and the test is negative, that you are free to go about that patient without any worry. That is simply isn't the case. There is an emerging perspective that the performance of the test, and in particular, the test with all of its components where the strains are introduced into the artery for that person who is in progress, may in fact trigger a more severe circumstance. If we go back to the idea that what we do didn't cause the problem, but in fact the patient presented with the problem then we have to look at, is the process of testing aggravating it, irritating, worsening it or complicating it. The conventional wisdom today is, that the use of provocative testing procedures to introduce strains and stresses on the vertebral arteries to use that as a measure of a sufficiency of the artery, to be able to deliver an adjustment is not a viable consideration. The conventional wisdom today is that the practitioner should not perform those provocative tests. Now this- We're going to look at what you as the practitioner needs to know to help ascertain whether this is a high risk patient or not. The other approach is very simply, are the things that we do very well with, and that's listening to and reacting to our gut. The evaluative tools at this point in the discussion, without being a wise guy, are very simply your ears, your eyes, and your gut. Think about and feel what's going on with that patient.
Dr. Stu Hoffman:
Dr. Gerry Clum:
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