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).