Development Process

In 1999, the Canadian Chiropractic Association (CCA) commenced a review of the 1993 Clinical Guidelines for Practice in Canada (Glenerin Guidelines) under the Chair of Dr. Don Henderson.

In 2001, Dr. Henderson recommended, and the CCA Board agreed, that the Canadian Federation of Chiropractic Regulatory Boards (CFCRB) should be invited to partner in the development of a new Clinical Practice Guidelines development process for the profession. A Task Force was established to guide the process and make sure that the guidelines meet the needs of the public and the profession. A Guideline Development Committee was created with broad representation from the profession as well as the participation of a public and an inter-professional member to develop these new evidence-based chiropractic guidelines.

These are a necessary part of health care in the 21st century. We need to take a leadership role in developing our practice guidelines rather than allow outside agencies, government bodies or other health care professions to do it on our behalf. We have the knowledge of relevant research combined with the clinical expertise in chiropractic to develop guidelines that will best serve Canadian chiropractors and our patients.

Guidelines are developed to assist chiropractors in daily practice and help to collate the massive amounts of research and clinical expertise that exists within the profession. These are not to be confused with standards which would dictate practice parameters, but rather serve as a guide and tool for practitioners and the public we care for.

The new approach will seek greater participation from stakeholder organizations and from the profession in the field. It has included extensive consultation with 30 stakeholder organizations from across Canada on the process to be followed and the subject areas to be covered by the guidelines themselves. Unlike the Glenerin Guidelines, these will be subject specific stand-alone documents, published in the Journal of the Canadian Chiropractic Association and available to the entire profession on the web.

After the creation of the Task Force, with representatives from both the CCA and CFCRB, a paper was commissioned on “The Development of Canadian Clinical Practice Guidelines: A Literature Review and Synthesis of Findings”. This paper, authored by Mr. Costa Papadopoulos, the former Health Policy Manager of the CCA, provided the Task Force with many insights into how other professions are treating guidelines and what can be useful for the chiropractic profession.

When the CCA launched the review of the guidelines in 1999, it developed an extensive list of chiropractic organizations to consult with in order to ensure widespread participation. The list was created assuming that every chiropractor in Canada is a member of at least one, and usually several, of these groups. As a result, chiropractors have the opportunity for multiple points of participation and input through their stakeholder group(s). The goal is to have an inclusive basis for representation and participation.

Representatives from these stakeholder organizations are invited to regular Stakeholder Meetings for updates on the activities of the Guidelines Initiative, and to provide direction to the Task Force and Guidelines Development Committee on all of the important decisions. Initial stakeholder meetings on September 28, 2002 in Saint Andrews By-the-Sea, New Brunswick and November 3, 2002 in Calgary, Alberta approved the Process, Guiding Principles, Guideline Template and List of Topics for the guidelines.

In order to keep the profession abreast of the developments of this project, please visit the CCA web site on a regular basis (www.ccachiro.org). Practitioners are able to provide comment to the Initiative as well as reference finished guidelines. 

The Task Force has been created to guide the development process and make sure that the guidelines meet the needs of the public and the profession. The Task Force is responsible for ensuring continued funding for the Initiative and reporting regularly to the Stakeholder organizations. It is made up of an equal number of members from the CCA and the CFCREAB. The current members of the Task Force are: Dr. Ron Brady – Chair (Saskatchewan), Dr. Wanda Lee MacPhee (Nova Scotia), Dr. Keith Thomson (Ontario), Dr. Dean Wright (Ontario) and Dr. Grayden Bridge (Alberta). Two advisors sit on the Task Force: Mr. Jim Duncan, CAE, Executive Director of the CCA and Mr. Peter Waite, CAE, Executive Director of the CFCREAB. Mr. Wayne Glover, CAE supports the Initiative as General Manager.

The process of developing guidelines is ongoing. There will always be a need to either develop a guideline for a new area, or to update existing guidelines. In order to assist with the many steps involved in developing guidelines, the Task Force appointed a Guidelines Development Committee. The members of this committee are listed as the authors of the guideline. Guidelines must meet with their approval before they are published. Current members of the Committee are: Dr. Roly Bryans – Chair (Newfoundland and Labrador), Dr. Mireille Duranleau (Quebec), Dr. Eleanor White (Ontario), Dr. Henri Marcoux (Manitoba), Dr. Brock Potter (British Columbia), Dr. Martin Descarreaux (UQTR) and Dr. Rick Ruegg (CMCC).

One of the recommendations of stakeholder organizations was that the Guidelines Development Committee should also have public and inter-professional representatives. The Task Force called for nominations and has appointed the following individuals.

The current public member of the Committee is Mr. Robert Watkins. The current inter-professional member of the Committee is Dr. Lynn Shaw.