Practicing Chiropractors’ Committee on Radiology Protocols (PCCRP) announced today that the PCCRP Radiographic Guideline was 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. NGC is an initiative of the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services.
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 numerous Chiropractic political associations, organizations and leaders of Chiropractic Technique Methods:
International Chiropractors Association
World Chiropractic Alliance
Federation of Straight Chiropractors and Organizations (FSCO)
Council on Chiropractic Practice (CCP)
Norway Chiropractic Association,
Ukraine Chiropractic Association
State and Provincial Associations
Arizona Chiropractic Society
Chiropractic Awareness Council of Ontario
Chiropractic Diplomatic Corps
Chiropractic Fellowship of Pennsylvania
Connecticut Chiropractic Council
Massachusetts Chiropractic Society
Michigan Association of Chiropractors (MAC)
Nevada Chiropractic Association
Virginia Society of Chiropractic
Washington State Chiropractic Association
Wyoming Chiropractic Society
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.
To learn more about PCCRP, the principle investigators, the esteemed committee members and the international panel of reviewers assembled to guide and facilitate the creation of the guidelines, please visit the PCCRP website at http://www.pccrp.org/.