Council on Chiropractic Guidelines & Practice Parameters
Council on Chiropractic Guidelines & Practice Parameters
12100 Sunset Hills Rd, Suite 130 -Reston, VA 20190 - Phone: (703) 437-4377 - Fax: (703) 435-4390 | www.ccgpp.org | firstname.lastname@example.org
Wayne Whalen, DC, DACAN
Mark Dehen, DC
Ronald Farabaugh, DC
Jonathan Griffiths, DC, FICC
Eugene A. Lewis, DC, MPH
Mario Spoto, DC
David O’Bryon, CAE, JD
Leonard Suiter, DC
Thomas Augat, DC, MS
David Radford, DC
Kathryn Webb, DC
Jeff Askew, DC
Wayne Bennett, DC, DACBO
John Triano, DC, PhD
COMMISSION VICE CHAIR
Alan Adams, DC, MA
George McClelland, DC
David Taylor, DC, DABCN
Arlan Fuhr, DC
D. H. Leavitt
MEMO TO: Stakeholders
FROM: Dr. Mark D. Dehen, CCGPP Vice Chairman
DATE: December 1, 2005
From the attached article you will see that the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) is about to launch its Best Practices initiative. As you may already know, this is being done at the direction of the Congress of Chiropractic State Associations (COCSA).
Starting in February 2006, all stakeholders will have the opportunity to systematically voice their opinion on the individual chapters of the Best Practices Chiropractic Clinical Compass. Each chapter will be available electronically and open for comment for 60 days with the various chapters being released successively, as they are completed to the draft stage for review. The CCGPP looks forward to your comments. However, for this to be effective we suggest you begin organizing your review teams now.
Having experienced the process necessary to collect, rate and review the literature following recognized standards, as a courtesy the Council offers the following suggestions to interested groups or individuals to anticipate the timeline/action steps that may be helpful in achieving a constructive commentary:
(1) identify volunteers willing to read it and respond in a timely manner.
(2) obtain and disseminate draft copies of the chapters subsequent to their release notice from the CCGPP at www.ccgpp.org and distribute to individuals or a subcommittee within your organization, as may be appropriate (3 days).
(3) have volunteers read the draft copies thoroughly (7 days).
(4) establish relationships with an internet search engine (PubMed,
Chirolars, Ebsco, Cinah, or other) and/or a chiropractic college to assist you in obtaining information/evidence as corroborating documentation for the comments you intend to submit (14 days).
(5) set meeting dates to coalesce those opinions into an organizational consensus, where appropriate. (Information on how to construct a formal Delphi and Nominal Group Processes can be obtained from a Google search on the internet, should you desire.) (14 days).
(6) vote internally to accept those opinions/comments (14 days).
(7) for comments to represent organizations, please be sure to identify the organization and how the comments were concluded (vote, formal consensus, delegated representative single opinion, single opinion)
(8) send those comments back to CCGPP electronically (1 day).
In summary, the CCGPP tenders the following “Recommended Action Plan (RAP)":
(1) generate a list of potential reviewers from within your organization and assure their support
(2) create an email alert to inform them of the chapter availability
(3) create a forum to discuss the opinions and reach a representative consensus
The CCGPP welcomes and desires your comments on the completed drafts. We recognize this is a substantial task, which is why we are alerting you in advance We request your cooperation and assistance in order to create the most representative best practices document we can for the entire chiropractic profession.
Thank you for your help. If you have questions, please contact us at email@example.com.
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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 firstname.lastname@example.org
ACC – David O'Bryon, CAE at email@example.com
COCSA District I: - Dr. Tom Augat at firstname.lastname@example.org
COCSA District II:- Dr. David Radford at email@example.com
COCSA District III:- Dr. Kathryn Webb at firstname.lastname@example.org
COCSA District IV:- Dr. Jeff Askew at email@example.com
COCSA District V – Dr. Wayne Bennett at firstname.lastname@example.org
FCER - Dr. George (Mac) McClelland at email@example.com
FCLB – Dr. David Taylor at firstname.lastname@example.org
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 email@example.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.
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.
Diana Statzula, CN
New Mexico Chiropractic Association