By 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. The dedicated volunteers of the Commission who are compiling the literature strive to be as thorough as possible. The sheer volume of research gathered to date is very impressive and will no doubt result in reliable evidence-based treatment options for all types of clinicians who want to serve their patients in an appropriate manner. This initiative focuses on the “process of care” instead of arbitrary treatment recommendations found in ordinary guidelines. This article will attempt to answer the most common questions CCGPP has been receiving concerning the development of the best practice initiative. For further information please visit our website at www.ccgpp.org.
Q: How did CCGPP members (aka Council) get chosen?
A: Members were appointed by the respective organizations that founded CCGPP. Those organizations are: American Chiropractic Association; Association of Chiropractic Colleges; Congress of Chiropractic State Associations; Consortium for Chiropractic Research (founding member but not current member); Council on Chiropractic Education (founding member but not current member); Federation of Chiropractic Licensing Boards; Foundation for Chiropractic Education and Research; Foundation for Chiropractic Tenets and Science (founding member but not current member); International Chiropractors Association (founding member but not current member); National Association of Chiropractic Attorneys; and National Institute of Chiropractic Research.
Q: How did researchers (aka Commission) get chosen?
A: Chiropractic colleges provided the majority of researchers. CCGPP solicited from all schools; team leaders also selected others according to experience, education and needed skill sets.
Q: Is this “Mercy” all over again?
A: No, CCGPP was appointed to look at all protocols, guidelines, parameters and research related, applicable and useful for the chiropractic profession, including information from outside the US.
Q: How many previous participants from “Mercy” are involved?
A: Eight out of 82 CCGPP council and commission participants were members of the “Mercy Conference” commission. Four others submitted opinions to Mercy but were not part of the commission. It is inevitable that some researchers from one project will overlap into our project as it is a small profession and necessary skill sets to perform all tasks required are in need.
Q: “I disagree with the presence of Dr. _____ on CCGPP. He/she is too far from my philosophical perspective.”
A: CCGPP has carefully tried to stay away from philosophical conflicts. The Congress of Chiropractic State Associations (COCSA), the organization responsible for commissioning CCGPP, is well-known for its apolitical nature and one-third of our council members derive from this organization. Our job is to build a database of information for chiropractic, and to effectively do that, we need to steer clear of potential political issues. Since our creation, CCGPP research commission chairpersons have come from diverse philosophic environments.
Q: What kind of studies will be considered valid?
A: In order to be considered valid, studies will have to be able to pass scrutiny by those within the chiropractic profession as well as outside the chiropractic profession. This means that standardized, widely adopted international instruments of examination and review of literature will be used, of course, and all studies will have to pass through these filters. An added advantage of this necessary process is that undoubtedly some studies which have been critical of chiropractic care but were constructed using faulty methodology will be identified as such for the first time in a widely distributed publication for many outside the chiropractic profession to contemplate.
Q: Will subluxation be included?
A: Yes, all research material pertaining to subluxation is being examined for publication.
Q: What best practices models are being used?
A: A variety of models, since this is the first time this has been written for the chiropractic profession. David Sackett is the leading international authority on best practices and certainly he has had a major impact on everyone’s consideration of this subject.
Q: Why is the document condition-based?
A: The document is condition-based because CCGPP was formed largely, but not only, to address problems revolving around issues of reimbursement and this industry is currently in a condition-based format.
Q: How will CCGPP address techniques?
A: It will not address technique because of the exceptionally small amount of information available in the literature.
ABOUT THE AUTHOR: Eugene A. Lewis, DC, MPH, is a graduate of Logan College of Chiropractic and has practiced in Greensboro, North Carolina since 1979. He earned his Master of Public Health from the University of North Carolina at Greensboro. Dr. Lewis has served as president of the North Carolina Chiropractic Association, president of the Southeastern Chiropractic Federation and has been a member of the North Carolina State Board of Chiropractic Examiners. He has served as a Commissioner of the North Carolina State Radiation Protection Commission and as a benefits advisor to the North Carolina Health Planning Commission. Dr. Lewis was a member of the Commission for Chiropractic Quality Assurance and Practice Parameters, which published Guidelines for Chiropractic Quality Assurance and Practice Parameters in 1993. He has been a member of the Council on Chiropractic Guidelines and Practice Parameters since 1997 and has been chairman since 2002. Dr. Lewis is a Fellow of the International College of Chiropractors. He can be reached through the CCGPP office at PO Box 2054, Lexington, SC 29071, 803-808-0640, or firstname.lastname@example.org