PubMed · 11439839
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D Reilly. 2001. Physicians heal thyselves!. https://pubmed.ncbi.nlm.nih.gov/11439839/
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Chiropractors' manual methods of healing have diverse origins. Unlike the older traditions of bonesetters, chiropractors apply their techniques to health problems beyond the musculoskeletal system. The ideas of the Palmers were seminal, but innovation has been a prominent characteristic in the evolution of technique, and borrowing of methods between "brand-name" techniques has been common. Manipulative strategies have also been influenced by various instruments for diagnosing (ie, detecting) putative subluxations. Influences from beyond the profession (eg, from osteopathy) are also apparent; chiropractors have not confined themselves to the high-velocity adjustive procedures that marked the profession's inception. Technique has been a source of controversy within the profession, but little has been done to determine the relative merits of various manual assessment and intervention procedures. The proprietary nature of many chiropractic methods has promoted both innovation and secrecy. Extensive research will be needed to separate the chaff from the wheat.
OBJECTIVE: To evaluate the quality of Recommended Clinical Protocols and Guidelines for the Practice of Chiropractic (ICA guidelines) published by the International Chiropractors Association (ICA), August, 2000. METHODS: The Appraisal Instrument for Clinical Guidelines (Cluzeau instrument) was applied to the ICA guidelines by 10 independent experienced evaluators. An independent, global assessment was also made by each evaluator. RESULTS: Mean scores (with 95% confidence limit) for each of the instrument's 3 dimensions were Rigor of Development, 27% (5.1); Context and Content, 18.3% (9.4); and Application, 2% (3.9). The unanimous global assessment was "not recommended as suitable for utilization in practice." Comparison of the ICA guideline scores with the Council on Chiropractic Practice's Clinical Practice Guideline No. 1, Vertebral Subluxation in Chiropractic Practice (CCP guidelines) scores and Guidelines for Chiropractic Quality Assurance and Practice Parameters (Mercy guidelines) Cluzeau instrument-based scores revealed that the ICA guidelines received slightly higher scores than the CCP guidelines but substantially lower scores than the Mercy guidelines for all dimensions. CONCLUSION: The ICA guidelines were assessed as not suitable for utilization in chiropractic practice.