Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 15187
  Title Chiropractic quality assurance: standards and guidelines
URL http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505001/
Journal J Can Chiropr Assoc. 2001 Mar;45(1):11-17
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Peer Review Yes
Publication Type Article
Abstract/Notes Chiropractic quality assurance involves development of both clinical guidelines and standards. Confusion generated by poor differentiation of guidelines from standards contributes to mistrust of the guideline development process. Guidelines are considered to be recommendations that allow for flexibility and individual patient differences. Standards are more binding and require a high level of supporting evidence. While guidelines serve as educational tools to improve the quality of practice, standards that outline minimum competency are used more as administrative tools on which to base policy. Barriers to development of clinical guidelines and standards include fear that they will create prescriptive “cookbook” practice, and the distrust that guidelines are developed primarily for cost containment. Clinicians also criticize guidelines developed by academics that don't relate to practice, and those based on evidence that lacks clinical relevance. Conflicting guidelines perceived to be based on strong bias or conflict of interest are also suspect. To reduce barriers to acceptance and implementation, guidelines should be inclusive, patient-centered, and based on a variety of evidence and clinical experience.

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