In 1995, the Council on Chiropractic Practice (CCP) was
established with the express purpose of "developing
evidence-based guidelines, conducting research and performing
other functions that will enhance the practice of chiropractic for
the benefit of the consumer."
As its first project, the CCP created a multidisciplinary
panel, supported by staff and led by a project director. This
panel analyzed available scientific evidence relating to the
vertebral subluxation and directed a critical review of numerous
studies and other evidence.
The panel solicited input from representatives of more than 35
technique developers in order to determine the degree to which
their techniques could be expressed in an evidence-based format
and to obtain any evidence they could supply to substantiate their
protocols.
In order to ensure that the guidelines best met the practice
needs of field doctors, the CCP held an "open forum" and
invited all interested doctors, consumers and attorneys to
participate. Written as well as in-person submissions were
included.
Following a thorough review of the available evidence, a draft
guideline was developed and submitted to 195 peer reviewers in 12
countries. After considering and incorporating suggestions from
these reviewers, a final draft was presented to the panel for
approval.
The final document, "Council on Chiropractic Practice
Clinical Practice Guideline Number 1, Vertebral
Subluxation in Chiropractic Practice," was published in
1998. It has been distributed to all known doctors of chiropractic
in the United States and Canada, as well as the health ministers
of 191, and is available online. It was also the first
chiropractic guideline to qualify for inclusion in the National
Guideline Clearinghouse.
In view of the procedures and protocols employed in the
development of this document, its reliance on scientific
literature, and its focus on the vertebral subluxation, the World
Chiropractic Alliance (WCA) fully supports and endorses this
document and urges its use by all doctors of chiropractic.
Practice guidelines are not -- and should not be viewed as -- a
standard of care which dictates how doctors should practice, or as
a substitution for clinical expertise and judgment. However, the
CCP Guideline provides the scientific evidence which helps D.C.s
reliably make those judgments. It also is a powerful tool in
validating the use of chiropractic to analyze and correct
vertebral subluxation to patients and for insurance companies and
courts of law.
Doctors of chiropractic whose practice decisions have been
judged on the basis of other, non-subluxation-based guidelines can
use the CCP Guideline to provide validation for their care,
particularly in regards to subluxation correction for children and
asymptomatic patients.
The full text of the CCP
Guideline is available for download on the WCA website.
See also the WCA Position Paper on the
"The Guidelines for Chiropractic Quality Assurance and
Practice Parameters" (Mercy Guidelines).