To fulfill its mission, the Council on Chiropractic Practice created a multidisciplinary panel, supported by staff and led by a project director. This panel analyzed available scientific evidence relating to the vertebral subluxation and directed a critical review of numerous studies and other evidence.
The panel solicited input from representatives of more than 35 technique developers in order to determine the degree to which their techniques could be expressed in an evidence-based format and to obtain any evidence they could supply to substantiate their protocols.
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.