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International Chiropractors Association's Best Practices and Practice Guidelines
Chiropractors Association members, contained herein, are evidence-based suggestions for appropriate care of patients seeking chiropractic care. While no guideline can replace the clinical decisions made by a chiropractic practitioner in the course of caring for an individual patient’s health problem, the suggestions contain herein, are based on the best available published evidence. Any approach, by a practitioner, that is different from these ICA-BPPG Guidelines, does not necessarily mean that the approach in question was below the standard of care. However, any chiropractic practitioner, who adopts a course of action different from these ICA-BPPG Guidelines, is advised to keep sufficient patient records to explain why such an action was undertaken.
The Council on Chiropractic Guidelines and Practice Parameters (CCGPP), was formed in 1995 at the behest of the Congress of Chiropractic State Associations (COCSA) and with assistance from numerous national associations to create an equitable chiropractic practice document. CCGPP was delegated to examine all existing guidelines, parameters, protocols and best practices in the United States and other nations in the construction of this document. Their first mission was to describe the difference between “Guideline” and “Best Practice”.
International Chiropractors Association Position
on the CCGPP “Best Practices” Draft
International Chiropractors Association ~ June 21, 2007
The ICA finds that although the CCGPP limited review of the literature addresses the general
use of physical medicine modalities in the treatment of general conditions frequently
associated with low back pain, it does not adequately address those specific interventions that
are unique to the chiropractic profession or the specific conditions most frequently seen by
doctors of chiropractic, and it should be rejected in its entirety.
What's Up With the CCGPP?
Dr. Mark D. Dehen ~ Vice Chair of the CCGPP ~ April 26, 2007
The Introductory Chapter has been reviewed and revised, per our discussion with COCSA. This was done to improve its clarity and readability without amending the existing research or conclusions, as necessitated maintaining the editorial independence of the project. Currently, the CCGPP is in the process of hiring a healthcare editor to further revise the "evidence synthesis" to make it more user-friendly to the profession at large. Dr. Bill Meeker and Dr. Dana Lawrence, team leads for the low back evidence synthesis chapter, are completing the review and synthesis of the commentary received. Once that commentary has been collated, it will be reviewed by the team for consideration as part of the expert opinion process. That commentary and the team response will then be included in the final version of the low back evidence synthesis.
Evidence-Based Care, Certainty, and the Doctor's Duty of Care
J Manipulative Physiol Ther 2004 (May); 28 (4): 215-216 ~ FULL TEXT
Like most social trends, evidence-based care, originally conceived as a method to inform clinicians and improve patient outcomes, has been propelled beyond its original intent. It has now become evidence-based policy making. In debate, the vanguard of its proponents and its opponents often use stereotypical descriptions that further polarize as they express their views.
The “Best Practice” Initiative: What is it?
Ronald J. Farabaugh, D.C. ~ CCGPP Board Member
A rumor has it that the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) is developing a new guideline. I say rumor, because like all rumors the information released so far has been filled with a combination of fact, fiction, and at times outright misinformation. I intend on producing a series of short articles over the next six months explaining the facts in an effort to help the Chiropractic profession understand the process, and the difference between a “Best Practice” initiative and a “Guideline”. Did you know there is a major difference?
Common Questions and Answers ~ Part 1 and
Part 2
Eugene A. Lewis, DC, MPH, CCGPP Chairman
The best practice initiative undertaken by the Chiropractic Guidelines and Practice Parameters is progressing at a steady pace, with the Introduction and first completed chapter of the document (lumbar spine disorders) scheduled for release in early 2005.
Best Practice Initiative: How Valid Is This Process?
Jeffrey R. Cates, DC, MS, DABCO, DABCC
So, how can DCs use the new CCGPP best practice document to their advantage? Read it! Understand it! It tells you how to document the necessity of supportive care, how to document exacerbations and so much more. If we as a profession don’t adopt the CCGPP’s fair and valid best practice guide, the insurance companies will use their own guidelines to assess our work, and it is very unlikely that they will be as balanced and fair as those put forth by our own scholars.
The Process of Selecting Relevant Research
John J. Triano, DC, PhD
The pace at which information is being published is almost too intensive to conceive. Critical appraisal of the literature is a skill unto itself. It has been estimated that if an individual attempted to keep up with all the literature related to his or her own discipline by reading one article per day, by the end of one year, they would be 99 years behind. The AHCPR guidelines, the first governmentally sanctioned review leading to the recognition of the value of high-velocity, low-amplitude procedures for acute, adult low back pain, located over 10,317 articles. When articles relevant for the task were culled, 3,918 were left.
Best Practice: The Chiropractic Clinical Compass™
Mark Dehen, D.C.
One important reason for moving to a best practice approach and away from a “guidelines” approach is the unfortunate tendency for guidelines to be used as care end points rather than as suggestions for typical cases. Best practices documents like the Compass recognize the individuality of the patient, his or her physician and the circumstances of care.
The Chiropractic Clinical Compass
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