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Council on Chiropractic Guidelines & Practice Parameters
May 3, 2006

Dear Chiropractic Leaders and Colleagues:

The Council on Chiropractic Guidelines and Practice Parameters (CCGPP) has released the long-awaited initial draft of their Best Practice document. The culmination of more than two years of work, the draft is intended to provide clinicians, patients, payors, regulators and others with a tool to incorporate careful analysis of the current state of the scientific literature with clinical expertise and patient care options.

As a stakeholder, we value your input into the process. Production of this document has followed a carefully designed, scientifically based set of procedures intended to comply with the most rigorous and up-to-date international standards of best practice document development. Part of that process involves a carefully designed, pre-established search strategy of the scientific literature, with papers rated for scientific validity and utility. Areas of inconclusive or contradictory evidence were subjected to accepted consensus methodology, and the entire document is intended to be as transparent as possible, allowing users to determine the bases of recommendations and relevant source data for conclusions.

The draft can be accessed at www.CCGPP.org, and lay users can access an abbreviated version at www.spine-health.com

Stakeholders, including chiropractic providers, patients, third party payers, students, and others, are being asked to provide feedback regarding the draft document through a survey mechanism on the CCGPP or Spine.com websites. Stakeholder organizations, including state associations, national associations, chiropractic colleges, and other interested organizations, are being asked to provide specific comments, preferably by organizing a committee of interested members to review and comment on the document. Comments should be sent electronically to the organization's CCGPP representative as noted below.

ACA – Dr. Mario Spoto at maspoto@aol.com
ACC – David O'Bryon, CAE at obryonco@aol.com
COCSA District I: - Dr. Tom Augat at dr.augat@verizon.net
COCSA District II:- Dr. David Radford at dcr8888@aol.com
COCSA District III:- Dr. Kathryn Webb at kwebb@kwebb.com
COCSA District IV:- Dr. Jeff Askew at askew@gcentral.net
COCSA District V – Dr. Wayne Bennett at drbennett@cableone.net
FCER - Dr. George (Mac) McClelland at macdc@usit.net
FCLB – Dr. David Taylor at drtaylordc@comcast.net
NACA – Mike Schroeder at Mikejschroe@aol.com
NICR – Dr. Arlan Fuhr at AWFurh@aol.com

Other national organizations should submit their organization's comments electronically to the CCGPP office at ccgpp@sc.rr.com. An outline for your comments is provided at the conclusion of this letter. All organizations should also direct their individual member doctors to submit comment through the survey posted at www.ccgpp.org. A press release that can be used for this purpose is also included at the end of this publication. Other non-chiropractic stakeholders can be referred to the survey on www.spine-health.com.

This document is a draft and subject to revision based on specific criteria. While one important standard of best practice development is transparency, another equally important trait is editorial independence. Any substantive changes in conclusions or recommendations will be made solely by the independent CCGPP Commission based only on submission of relevant documentation sufficient to support a change in conclusion. All organizations and individuals should submit relevant supporting literature (electronically as a WORD or PDF file) with their comments.

We appreciate your patience and generous support of the Council's important work, and look forward to your participation in this worthwhile and historic effort. Comments will be accepted through June 30, 2006.

If you or your organization has any questions, I would be happy to address them. I can be reached at (619) 258-1144 or by email at DrWWhalen@aol.com.

Sincerely,

Wayne M. Whalen, D.C., DACAN
Chair, Council on Chiropractic Guidelines and Practice Parameters




OUTLINE FOR ORGANIZATIONAL COMMENTS

Indicate whether you (a) strongly agree, (b) agree, (c) agree somewhat, (d) are neutral, (e) disagree somewhat, (f) disagree, or (g) strongly disagree with the following statements:

1) The document addresses the clinical issues most commonly seen in my practice.

2) The document provides me with information to form a rational basis for my clinical case management decisions providing testing/treatment options that guide the direction of patient care, to the extent available within the literature.

3) The document addresses specific clinical issues that target various patient populations (age, sex, acute, chronic, co-morbidities, etc.) of my practice, to the extent available within the literature.

4) The document appears to have had adequate broad-based chiropractic representation.

5) The process used to gather and rate the evidence appeared to be thorough and appropriate for the stated objectives.

6) The process used to develop the actual conclusions from the evidence appeared to be appropriate for the stated objectives.

7) I find the language and format of the document to be clear, easily comprehended and easy to use.

8) Given my understanding of the process used and the organizations and individuals involved, I believe the recommendations are consistent with scientific principles and made independent of any outside influence.

9) I have confidence that the literature-based recommendations reflect conclusions based on the available evidence, rather than beliefs or opinions of individuals within or outside of the process.

10) I have confidence that in the absence of adequate evidence, the consensus process identified in the document was fair and independent.

Respond to the following questions:

11) Within the scope of this best practice chapter, are there any related disorders/conditions or diagnostic procedures commonly used by doctors of chiropractic that were not included in this review? If so, what?

12) Do you have any other comments/concerns?

13) If you rated any of the above statements at a level of disagreement ("Disagree somewhat," "Disagree," or "Strongly disagree") and if you have documentation or evidence in support of that disagreement that you would like to submit for review, please explain and submit documentation electronically, if possible. Evidence/literature supporting your comments can also be sent to: CCGPP, PO Box 2542, Lexington, SC, 29071. The scope of disagreement without basis may be reported in the final document, but may not, by nature of the absence of information, be able to specifically influence the conclusions that are reached. Please be specific and include the page number and specific conclusion/recommendation you wish to comment upon.


PRESS RELEASE FOR NOTIFICATION TO YOUR MEMBERS OR CONSTITUENTS

For Immediate Release
May 3, 2006

Best Practice Document Released for Comment:
Stakeholder Input Requested
By Wayne M. Whalen, D.C., DACAN, Chair, CCGPP

The Council on Chiropractic Guidelines and Practice Parameters (CCGPP) is pleased to announce the release of the initial draft of the Low Back best practices document. The culmination of more than two years of work, the draft is intended to provide clinicians, patients, payors, regulators and others with a tool to incorporate careful analysis of the current state of the scientific literature with clinical expertise and patient care options. While they are emphatically not guidelines per se, we hope they will serve all stakeholders interested in research-informed chiropractic best practices.

Production of this document has followed a carefully designed, scientifically based set of procedures intended to comply with the most rigorous and up-to-date international standards of best practice document development. Part of that process involves a carefully designed, pre-established search strategy of the scientific literature, with papers rated for scientific validity and utility. Areas of inconclusive or contradictory evidence were subjected to scientifically accepted consensus methodology, and the entire document is intended to be as transparent as possible, allowing users to determine the bases of recommendations and relevant source data for conclusions.

Part of this process requires the assistance of our stakeholders. This document is a draft and subject to revision based on specific criteria. While one important standard of best practice development is transparency, another equally important trait is editorial independence. We welcome your feedback regarding this draft document, but readers are cautioned that any substantive changes in conclusions or recommendations will be made solely by the independent CCGPP Commission, and based only on submission of relevant documentation sufficient to support a change in conclusion.

We invite you to review the draft at www.ccgpp.org, and to complete the brief survey provided at the web site. Instructions for submission of comments and supporting documentation can also be found on the web site. Comments will be accepted through June 30, 2006. We look forward to hearing from you.

Jaeni Aarden
Executive Director
New Mexico Chiropractic Association
P. O. Box 21100
Albuquerque, NM 87154
505-280-0689
Fax 505-828-1128
jaeni13@aol.com
www.nmchiroassoc.org

 

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