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Practicing Chiropractors’ Committee on Radiology Protocols (PCCRP) Subluxation Based Guideline Accepted for Inclusion at the National Guideline Cleari

It is with great pleasure and humble honor that we inform you, our Chiropractic colleagues, that the PCCRP Radiographic Guideline has been accepted for inclusion at the National Guideline Clearinghouse (NGC). The NGC is a comprehensive database of evidence-based clinical practice guidelines that are accessible via the internet. On Wednesday, July 29^th, we received the following letter from the National Guideline Clearing house:

“NGC- 7250: Practicing chiropractors' committee on radiology protocols (PCCRP) for biomechanical assessment of spinal subluxation in chiropractic clinical practice. The guideline has been accepted for inclusion in the National Guideline Clearinghouse.”--- Christina Latzko, MSc (Health Services Research Analyst, National Guideline Clearinghouse www.guideline.gov)

According to Dr. Deed Harrison (Chair of PCCRP), “The PCCRP guideline is the most comprehensive evaluation of the chiropractic and biomedical literature on the topic of the utilization of X-ray in a Chiropractic setting. PCCRP Contains a thorough review of the reliability, validity, clinical utility and risk-benefit ratio of numerous radiographic views, including all standard views and specialty Chiropractic views like the Nasium, Vertex, and Base Posterior.”

Also, according to Dr. Harrison, “The extent of evidence contained in the PCCRP (nearly 2000 references) robustly refutes the contention that radiography in the Chiropractic profession should be used for Red Flag conditions only (suspected tumor, infection, fracture, etc).”

Some of the key topics that are reviewed in the PCCRP Guideline include:

· Guidelines for the use of radiography in the assessment of subluxation of adults and children;

· Biomechanical definitions for 6 subluxation displacement categories with supporting evidence from the literature;

· Discussion of the risk benefit ratio associated with the use of radiography in Chiropractic practice, including the radiation hormesis vs. the linear no threshold (LNT) theory;

· Comprehensive reviews of the literature on the reliability and validity of measurement of the biomechanical component of the subluxation through line drawing mensuration, as well as the reproducibility of patient positioning for radiographic views;

· Evidence based foundation for video fluoroscopy and digital motion X-ray;

· Reviews and rates the evidence on post-treatment use of radiography, in addition to follow-up radiography to assess the effectiveness of the Chiropractic methods employed and the long-term stability of the improvements achieved;

· Legal issues of Chiropractic radiography usage as determined by the existing State Law.

The PCCRP serves as a clinical guide, specifically for Chiropractors, on the utilization of X-ray, versus adopting/supporting the guidelines written for the use of X-ray in a medical setting. It is anticipated that the PCCRP document will provide supporting evidence which may assist Chiropractors using methods that rely upon X-ray analysis to determine appropriate management and to assess the effectiveness of the care plan for a variety of patient populations.

Although, the PCCRP is officially a sub-committee of the International Chiropractors Association (ICA), the guideline committee members were a diverse group and included individuals such as Dr. Christopher Kent (one of the 5 Principle Investigators) and Dr. Dan Murphy. Of importance, the PCCRP was reviewed and endorsed by several major Chiropractic political associations and organizations:

1. The International Chiropractors Association (ICA),

2. The World Chiropractic Alliance (WCA),

3. The Federation of Straight Chiropractors Organizations(FSCO),

4. Council on Chiropractic Practice (CCP),

5. Norway Chiropractic Association,

6. Ukraine Chiropractic Association

If you would like a copy of the PCCRP Guideline you will be able to access these at http://www.ngc.gov/ in the coming weeks or you can contact the ICA at www.chiropractic.org for a printed bound copy.

Written On Behalf of the PCCRP Guideline Committee Members and the ICA,

Deed E. Harrison, DC--
Chair PCCRP Radiographic Guidelines;

Clinic Director- Ruby Mtn. Chiropractic Center, Inc.;
CBP Seminars, Inc.;
Vice President CBP NonProfit, Inc.;
Editor- American Journal of Clinical Chiropractic