Participants in the CCP Guideline Development Process
The CCP has developed practice guidelines for vertebral subluxation with the active participation of field doctors, consultants, seminar leaders, and technique experts. In addition, the Council has utilized the services of interdisciplinary experts in the Agency for Health Care Policy and Research (AHCPR), guidelines development, research design, literature review, law, clinical assessment, chiropractic education, and clinical chiropractic.
The Council additionally included consumer representatives at every stage of the process and had individuals participating from several major chiropractic political and research organizations, chiropractic colleges and several other major peer groups. The participants in the guidelines development process undertaken by the CCP and their areas of expertise are listed in Appendix 1.
Following the development of the guidelines and the construction of a draft of the final recommendations the guidelines were reviewed by over 250 peer reviewers. These reviewers were chosen based on several characteristics. See Table 2
The Guideline Panel, as well as the various reviewers, were solicited via several announcements for participants in trade journals and/or individuals were directly approached by representatives of the panel and asked to participate. Those who participated in the development and review of the 1998 process were encouraged to participate once again.
Mechanics of the Review
The significant difference for the 2003 update and revision was the use of an on line review process. Considering the sheer number of reviewers, the cost and time involved in copying, mailing and waiting for feedback from this number of reviewers would have prohibitive. This model of on line review worked well and it is hoped that it will serve to assist other guidelines developers who face similar hurdles.
Essentially, the final draft of the guidelines revision was placed in a secure on line Forum where reviewers were required to provide a LOGON and PASSWORD to enter and access the draft. Once the individual reviewed the draft they then filled out an on line form with any recommendations or changes. Their response was immediately routed to the Project Manager for review and any needed action.
Recommendations for additions or changes to the draft based on this review were then circulated electronically to the Panel for feedback. Other than an Assistant to the Project
_________________________________________________________ 20 Council on Chiropractic Practice Clinical Practice Guideline Number 1 Vertebral Subluxation in Chiropractic Practice – 2003 Update & Revision