The National Guideline Clearinghouse (NGC) is "a comprehensive database of evidence-based clinical practice guidelines and related documents produced by the Agency for Health Care Policy and Research (AHCPR)." The government website features over 500 health care guidelines, including a utility for comparing the attributes of two or more guidelines in a side-by-side comparison.
NGC's mission, according to the website, is to "provide physicians, nurses, and other health professionals, health care providers, health plans, integrated delivery systems, purchasers and others an accessible mechanism for obtaining objective, detailed information on clinical practice guidelines and to further their dissemination, implementation and use." To fulfill that mission, the website features links to the major recommendations of each of the guidelines.
The NGC has now added to their website the Guidelines for Chiropractic Quality Assurance and Practice Parameters (popularly called the Mercy Guidelines).
"Aspen Publishers was approached by the National Guideline Clearinghouse for permission to list the recommendations from the Guidelines for Chiropractic Quality Assurance Conference on their website," explained Amy Martin,MHS, acquisitions' editor for allied health. "They (NGC) have apparently received many inquiries wondering why they weren't listed. The (Mercy) Guidelines continue to be one of our most popular publications and it only makes sense that they should be accessible through the NGC, as it is geared toward being a comprehensive public resource for consumers and health care professionals."
Readers may access the chiropractic guidelines on the NGC website at: http://www.guideline.gov/index.asp . Once on the NGC home page, type "chiropractic" in the search field and hit the "Submit" button. You'll be taken to a page that displays the names of five guidelines that contain information on chiropractic. It is on this page that the reader can select the relevant guidelines for comparison.
To compare the Mercy Guidelines and the AHCPR's back pain guidelines, you simply select the box for Guidelines for Chiropractic Quality Assurance and Practice Parameters and the box for Acute Low Back Problems in Adults. You then click the "Add to Guideline Collection" button to proceed. The next page lists the "Guidelines in your Collection." On this page you click on the "Compare Selected Guidelines" button. You can now compare the two guidelines side-by-side.
The most striking difference between these two guidelines is the funding sources:
Congress of Chiropractic State Associations
American Chiropractic Association
International Chiropractic Association
Canadian Chiropractic Association
Federation of Chiropractic Licensing Boards
Association of Chiropractic Colleges
Southeastern Chiropractic Federation
Texas Chiropractic Association
Foundation for Chiropractic Education and Research
National Upper Cervical Chiropractic Association
Activator Methods
The Chiropractic Report
Foot Levelers, Inc.
Leander Technologies
Motion Palpation Institute
National Chiropractic Mutual Insurance Company
Nutri-West
OUM Group Inc.
Superfeet
World Wide Chiropractic Placement Service
Funding for the distribution of the guidelines to all members of the chiropractic profession:
National Chiropractic Mutual Insurance Company
Foot Levelers, Inc.
OUM Group
California Chiropractic Association
Leander Health Technologies
Activator Methods
The Practice Resource Group
Motion Palpation Institute
Parker Chiropractic Resource Foundation
Synergy
Visual Odyssey
Another important difference is the "Target Population":
AHCPR Guidelines:
Adults with acute low back problems defined as activity limitations due to symptoms in the low back and/or back-related leg symptoms of less than 3 months' duration.
Guidelines for Chiropractic Quality Assurance and Practice Parameters:
Patients who are candidates for chiropractic care.
This is just one example of the comparisons possible. You can next choose to "View Major Recommendations" or go back to the "Search Results" page and generate another comparison of the chiropractic guidelines against less rigorous or less specific guidelines.
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