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original document participated and those previously involved were invited to submit additional and/or supplemental material. Over 40 named technique systems were represented at this meeting. A Technique Panel was formed to facilitate the acquisition and review of material related to this topic and this Panel now totals some 125 individuals representing various techniques.

In the spring of 2002 during the annual meeting of the Council, the Guidelines Committee was reconstituted, a Project Manager was appointed and the further structure of the review, updating and revision was discussed and planned. A nearly identical process was used for the updating and revision. The Project Manager, who serves as Chair of the Guidelines Committee, assembled a panel of area experts who assisted in the search for literature, the subsequent gathering of that literature and its critical assessment.

As in the original process an “Abstraction Form” was utilized and suggestions for changes in the Ratings, Recommendations and Commentary were sought from this panel and the Guidelines Committee as a whole. The literature and other evidence utilized in the update spanned the time period between 1996-2003. The literature search was evidenced based and broad in nature adhering to Sackett’s admonition to track down “…the best external evidence with which to answer our clinical questions.” The panel relied heavily on the peer reviewed chiropractic literature as well as the general biomedical literature where applicable.

A detailed search of the guideline development methodology literature published since 1995 was undertaken by members of the guidelines committee and pertinent concepts and procedures incorporated into the process. 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 more clearly its methods of development. Unfortunately, these criticisms were at times based on guidelines development literature published only after the CCP guides were created and distributed. This literature was reviewed carefully and the recommendations incorporated into this revision and updating. 79-81

A significant difference in the process for the updating and revision consisted of easier access to literature due to improvements in electronic searching and the developments of additional electronic databases that index chiropractic peer reviewed literature. The literature was searched utilizing MANTIS, CINAHL, The Index to Chiropractic Literature, Medline, individual electronic journal searches such as the Journal of Manipulative and Physiological Therapeutics and the Journal of Vertebral Subluxation Research. Hand and stack searches were also employed to assure the most extensive gathering of relevant literature. The document is currently scheduled for further updating and revision by August 2008.


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

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