The World
Chiropractic Alliance
Position Paper on Research Policy
The World
Chiropractic Alliance is committed to the highest standards of the
professional practice of chiropractic and to the highest standards of
ethical research conduct.
The World
Chiropractic Alliance encourages research by chiropractic colleges,
universities and research institutions, and practice‑based studies
conducted by individual doctors of chiropractic, e.g., case reports and
other health outcomes studies, as part of a continuing learning process
that will ultimately result in better practitioners and patient care.
Research conducted
across these many fronts, including collaborative interdisciplinary
studies with experts from a variety of other health fields, will
contribute to the ever‑growing body of knowledge and to a better
understanding of the benefits of chiropractic care.
It is expected
that each member of the World Chiropractic Alliance will support research
and other scholarly activities and be guided by the principles of best
practices and evidence‑based health care delivery. In particular, the
latter includes precisely defining a patient problem and what information
is required to resolve the problem; conducting an efficient search of the
literature; selecting the best of the relevant studies, and applying rules
of evidence to determine their validity. Since evidence‑based health
delivery involves skills of problem definition, searching, evaluating, and
applying original scientific literature, it is incumbent on members of the
chiropractic profession to apply these skills to their practice.
Strict codes of
conduct govern the use of humans in research and these guidelines in the
United States are set forth by the Office for Human Subjects Research (OHSR)
at the National Institutes of Health, by state law where applicable, and
the Privacy Rule as part of the Health Information Portability and
Accountability Act (HIPAA) of 1996, administered by the Department of
Health and Human Services. Under this act, Doctors of Chiropractic are
considered "covered entities" and must comply with all HIPAA provisions.
For covered entities, compliance with these regulations, known as the
Privacy rule, was required as of
April 14, 2003.
The Privacy Rule
does not prohibit the publication of patient finding, but it does provide
very specific guidelines for using patient material for research purposes.
Health professionals must understand fully their obligations under the
Privacy rule before disclosing patient data to others or before initiating
research themselves.
Moreover, the
World Chiropractic Alliance cautions it members that it regards the
practice of utilizing research programs for the specific purpose of
patient solicitation to be an unacceptable and possibly illegal method of
patient inducement that will ultimately damage the credibility of
chiropractic as a whole and, in particular, damage the credibility of
chiropractic research.
However, when
research does result in care rendered by a doctor of chiropractic, a
disclaimer, patient privacy disclosure statement, and a proper informed
consent document must be signed. This is the research volunteer's
acknowledgment that they fully understand the research project complies
with all relevant federal and/or all international research guidelines
and, as part of this document, they fully disclose any financial conflict
of interests.
The World
Chiropractic Alliance recognizes that a normal part of the everyday
chiropractic practice involves communication in some form that will allow
members of the public to better understand the benefits of chiropractic
care and to recognize the services available from a specific doctor of
chiropractic.
Being able to
present to colleagues, patients and the public in a succinct fashion the
content of the scientific literature, and its strengths and weaknesses,
and the ability to extract the clinical message and its application to
patient care are considered evidence of successful "critical appraisal,"
best‑practice skills in evidence‑based health delivery.
This communication
can take many forms including research, advertising and marketing.
Ultimately, this communication is governed by applicable federal and state
laws as well as specific chiropractic codes of ethical conduct.