During the initial meeting, the panel focused on defining the scope
of the guidelines, establishing necessary committees to facilitate the
process, and discussing the topics for literature review.
The panel gathered in a second meeting to interview technique
masters to ascertain the degree to which their procedures could be
expressed in an evidence-based format. Individuals representing over
thirty-five techniques were invited to participate.
Representatives of techniques not represented in the initial
invitation were also welcome, and the CCP actively solicited their
participation. The technique masters were invited to present evidence
substantiating their protocols and assessment methods.
Since the primary goal of the panel was to stimulate and encourage
field practitioners to adapt their practices to enhance patient
outcomes, it was considered important to involve as many practitioners
as possible in the development of workable guidelines.
To achieve this objective, an "open forum" was held for
practitioners to offer their opinions and insight in regard to the
progress of the panel and the product that would be emerging. Opinions
were solicited by the panel, and all information that improved the
process was considered for incorporation. Field practitioners who were
unable to attend the "open forum" session were encouraged to make
written submissions.
The panel convened for a fourth time to assess comments received
through the "open forum" process and determine how the evolving
guidelines should be modified. A working draft of the document was
developed and submitted to peer reviewers for commentary and
additional editing.
The last stage before final review of the document was pilot review
by practitioners for clinical utility and "user friendliness."
The final document, "Council on Chiropractic Practice Clinical
Practice Guideline Number 1, Vertebral Subluxation in Chiropractic
Practice," was published in 1998. It was distributed to all known
doctors of chiropractic in the United States and Canada, as well as
the health ministers of 191, and made available online.