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Health Services Research Related to Chiropractic: Review and Recommendations for Research Prioritization by the Chiropractic Profession (Letter)
HEALTH SERVICES RESEARCH RELATED TO CHIROPRACTIC: REVIEW AND RECOMMENDATIONS FOR RESEARCH PRIORITIZATION BY THE CHIROPRACTIC PROFESSION (LETTER) To the Editor: The purpose of this letter is to provide information concerning the Council on Chiropractic Practice (CCP). I feel that Mootz et al1 incorrectly characterized Clinical Practice Guideline Number I, Vertebral Subluxation in Chiropractic Practice (CCP Guideline) as ban update of a previous guideline from the World Chiropractic Alliance.Q The CCP is an apolitical, nonprofit, 501 (c) organization and is not affiliated with the American Chiropractic Association, International Chiropractors Association, World Chiropractic Alliance, Federation of Straight Chiropractors and Organizations, Congress of Chiropractic State Associations, Federation of Chiropractic Licensing Boards, or any state association. The first edition of the CCP Guideline was completed in 1998 and revised in 2003. It represents an original work, not a revision of any previous guideline. A third revision is in progress and is scheduled for completion in 2008. Furthermore, the authors suggest that the recommendations do not incorporate patient condition or diagnosis into management decisions. This is patently false. The CCP Guideline provides for clinical decision-making based upon history, physical examination, diagnostic imaging, and instrumentation findings to determine the safety and appropriateness of chiropractic care. Persons wishing to download and read the CCP Guideline may do so without charge at http://www.ccp-guidelines.org, and a summary is available at http://www.ngc.gov. Finally, the authors cite an article by Cates et al2 that is critical of the first edition of the CCP Guideline yet fail to cite my letter to the editor3 in response to the Cates et al2 article. I encourage readers seeking a balanced view to read this and other letters to the editor before accepting these conclusions at face value. Christopher Kent, DC, JD President Council on Chiropractic Practice Ramsey, NJ, USA 0161-4754/$32.00
Copyright D 2007 by National University of Health Sciences doi:10.1016/j.jmpt.2007.06.004
REFERENCES 1. Mootz RD, Hansen DT, Breen A, Killinger LZ, Nelson C. Health services research related to chiropractic: review and recommendations for research prioritization by the chiropractic profession. J Manipulative Physiol Ther 2006;29: 707 - 25.
2. Cates JR, Young DN, Guerriero DJ, et al. Evaluating the quality of clinical practice guidelines. J Manipulative Physiol Ther 2001;24:170 - 6. 3. Kent C. Evaluating the quality of clinical practice guidelines. J Manipulative Physiol Ther 2001;24:612 - 6 (letter).
HEALTH SERVICES RESEARCH RELATED TO CHIROPRACTIC: REVIEW AND RECOMMENDATIONS FOR RESEARCH PRIORITIZATION BY THE CHIROPRACTIC PROFESSION In Reply: We appreciate the interest Dr Kent has in our summary of health services research literature conducted relative to chiropractic practice since 19951 and acknowledge his interest in providing additional information regarding the Council on Chiropractic Practice (CCP). The purpose of our article was to offer brief summaries to illustrate the state of health services research activity in chiropractic since 1995 to assist in prioritization of topics for future health services research. It was not intended to provide a detailed assessment of each of the primary publications mentioned, let alone detailed critiques of any non–peer-reviewed correspondence. However, we welcome the opportunity to address the assertions raised. It may be correct that the 1998 and 2003 CCP guideline2,3 should be considered an boriginalQ work rather than an bupdateQ of the 1993 World Chiropractic Alliance (WCA) practice guidelines.4 However, the assertion of nonaffiliation between the CCP and the WCA is an interesting one. Most (9/ 16) members of the Board of Directors of CCP listed at the time of this reply on the WCA web site (http://www.worldchiropracticalliance.org/about/leadership.htm and http:// www.worldchiropracticalliance.org/councils/councils.htm) hold active Board of Director and leadership positions in the WCA (not simply members).2-4 Also, 4 of the 6 members of the WCA Board of Directors listed at the time of this reply were members of the CCP Board of Directors in the 2003 CCP guideline update. Of additional interest, the street address for the CCP printed on the back cover of the original publication (Library of Congress: 98-073514, ISBN: 0-9666598-0-5) is identical to that for the WCA, in Chandler, Ariz.2 The cover is omitted from the online version of the document currently at the CCP web site; therefore, some readers may not know this information. We have no criticism that most WCA leaders are also majority principals in the CCP. However, it seems understandable given the considerable overlap in leadership and participants of the 2 organizations and their respective guideline efforts that observers might reasonably conclude a link between the original WCA guideline and subsequent CCP efforts. Dr Kent states that we suggested that the CCP brecommendations do not incorporate patient condition or
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Copyright D 2007 by National University of Health Sciences doi:10.1016/j.jmpt.2007.06.004
REFERENCES 1. Mootz RD, Hansen DT, Breen A, Killinger LZ, Nelson C. Health services research related to chiropractic: review and recommendations for research prioritization by the chiropractic profession. J Manipulative Physiol Ther 2006;29: 707 - 25.
2. Cates JR, Young DN, Guerriero DJ, et al. Evaluating the quality of clinical practice guidelines. J Manipulative Physiol Ther 2001;24:170 - 6. 3. Kent C. Evaluating the quality of clinical practice guidelines. J Manipulative Physiol Ther 2001;24:612 - 6 (letter).
HEALTH SERVICES RESEARCH RELATED TO CHIROPRACTIC: REVIEW AND RECOMMENDATIONS FOR RESEARCH PRIORITIZATION BY THE CHIROPRACTIC PROFESSION In Reply: We appreciate the interest Dr Kent has in our summary of health services research literature conducted relative to chiropractic practice since 19951 and acknowledge his interest in providing additional information regarding the Council on Chiropractic Practice (CCP). The purpose of our article was to offer brief summaries to illustrate the state of health services research activity in chiropractic since 1995 to assist in prioritization of topics for future health services research. It was not intended to provide a detailed assessment of each of the primary publications mentioned, let alone detailed critiques of any non–peer-reviewed correspondence. However, we welcome the opportunity to address the assertions raised. It may be correct that the 1998 and 2003 CCP guideline2,3 should be considered an boriginalQ work rather than an bupdateQ of the 1993 World Chiropractic Alliance (WCA) practice guidelines.4 However, the assertion of nonaffiliation between the CCP and the WCA is an interesting one. Most (9/ 16) members of the Board of Directors of CCP listed at the time of this reply on the WCA web site (http://www.worldchiropracticalliance.org/about/leadership.htm and http:// www.worldchiropracticalliance.org/councils/councils.htm) hold active Board of Director and leadership positions in the WCA (not simply members).2-4 Also, 4 of the 6 members of the WCA Board of Directors listed at the time of this reply were members of the CCP Board of Directors in the 2003 CCP guideline update. Of additional interest, the street address for the CCP printed on the back cover of the original publication (Library of Congress: 98-073514, ISBN: 0-9666598-0-5) is identical to that for the WCA, in Chandler, Ariz.2 The cover is omitted from the online version of the document currently at the CCP web site; therefore, some readers may not know this information. We have no criticism that most WCA leaders are also majority principals in the CCP. However, it seems understandable given the considerable overlap in leadership and participants of the 2 organizations and their respective guideline efforts that observers might reasonably conclude a link between the original WCA guideline and subsequent CCP efforts. Dr Kent states that we suggested that the CCP brecommendations do not incorporate patient condition or
479