August 2004

See also: WCA issues position paper on research

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.

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