A Careful, Steady Approach to Guidelines

LAS VEGAS -- The demand for practice guidelines in health care has not subsided. Most payer organizations are using existing clinical guidelines to establish their own "in-house" versions. But as research and clinical experience march on, there is an ever-increasing need to update existing guidelines to better reflect the most effective forms of care.

That is why the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) was created, and why they met March 14, 1998 in Las Vegas.

After the publication of the Mercy guidelines, there was a call from the profession to not only review those guidelines, but to involve field practitioners to a much greater degree in the guidelines. To that end, the Congress of Chiropractic State Associations (COCSA) formed the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) in early 1995, set by-laws and elected officers. COCSA was the logical body to establish the council, because the Congress managed a coalition of 50 chiropractic state associations.

The goal was to include every major organization in chiropractic, with a strong emphasis on field practitioners. The CCGPP was charged with the responsibility to oversee all issues pertaining to chiropractic practice guidelines in the United States. Those responsibilities included responding to requests from federal, state and other guidelines organizations on matters relevant to chiropractic practice. Recent examples include the nomination (and subsequent acceptance) of a reviewer for an evidence report on the diagnosis and treatment of chronic headache pain conducted by Duke University; and sponsorship of two chiropractic teams at the recent low-back pain conference sponsored by the Institute for Healthcare Improvement (please see "Chiropractic Featured at IHI Conference" in the March 23, 1998 issue).

In addition to being the contact point for the chiropractic profession, the CCGPP must continue to insure that the chiropractic guidelines accurately reflect current chiropractic practice.

Before the current chiropractic guidelines are revised, a careful review must be made, along with a survey of the profession. The review will be published in the form of a monograph. The survey is still being developed.

"Guidelines assist practitioners in making decisions about appropriate health care, assuring quality of care and improved outcomes," noted Council President Rick McMichael, DC. "The CCGPP is proceeding carefully in this area. Our goal is to insure chiropractic's involvement in all guidelines processes. To do this, we are seeking input from the profession. We will move toward revisions of the chiropractic guidelines in a careful, methodical manner."

The CCGPP is comprised of these board members and the chiropractic organizations they represent:

The Council on Chiropractic Guidelines and Practice Parameters welcomes comments relative to clinical guidelines and their development. Please address all comments to CCGPP, P.O. Box 6070, Huntington Beach, CA 92615.