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The literature and other information gathered during this process was then reviewed by a panel of experts who submitted critical review using an “Abstraction Form.” The reviews included questions on:

  • Interventions

  • Outcomes

  • Harms

  • Instrumentation & Analysis

  • Spinal Analysis

  • Study Findings

  • Study Design Flaws

After sorting and evaluating the evidence gathered in the literature search, technique forum, leadership forum, written comments, open forum and the review process, the panel rated and categorized the evidence. After sorting, evaluating, rating and categorizing the evidence (rating and categorizing criteria is discussed later in this document) an initial draft of the guidelines was prepared and distributed to the panel for review and criticism. A revised draft was prepared based upon this input.

International input from the field was obtained when the working draft guidelines document was submitted to 195 peer reviewers in 12 countries. After incorporation of the suggestions from these reviewers, a final draft was presented to the panel for approval. This document was then submitted for proofreading and typesetting and was subsequently published.

Guidelines Development Process & Methodology

Since the original 1998 version of the CCP Guidelines, much has been written on the subject of guidelines methodology and more information for guideline development has been made available. The Guidelines Panel made a concerted effort to review the literature on guidelines development and methodology prior to beginning the actual revision of the 1998 CCP Guides.

A detailed search of the guideline development methodology and implementation literature published since 1995 was undertaken by members of the guidelines committee and pertinent concepts and procedures incorporated into the process.18-59 Particularly, the panel sought to more explicitly describe its methodology. While the methodology followed for the 1998 process was clearly described in various trade journals as well as amongst the participants, the CCP Guides were criticized for not describing its methods of development more clearly.


_________________________________________________________ Council on Chiropractic Practice Clinical Practice Guideline Number 1 Vertebral Subluxation in Chiropractic Practice – 2003 Update & Revision

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