Foundation for Vertebral Subluxation Establishes Permanent Best Practices Initiative
Several years ago the Foundation for Vertebral Subluxation (FVS) embarked on an ambitious effort to develop a clinical practice guideline/best practices project that would search, gather, compile and review the scientific literature going as far back as January 2007. The FVS saw a crucial need to develop this project because other practice guidelines that included the management of vertebral subluxation were about to become outdated leaving chiropractors who practice in a subluxation model vulnerable in malpractice claims, regulatory board witch hunts and the insurance industry.
That project involving twelve topic areas is nearing completion and the Guidelines Committee is beginning the next steps of developing Best Practices Recommendations based on that review. The review involves over 4000 research papers and covers the following topic areas:
- History and chiropractic examination
- Instrumentation
- Radiographic and other imaging
- Clinical impression, assessment and recordkeeping
- Reassessment and outcomes assessment
- Modes of adjustive care
- Duration of care for correction of vertebral subluxation
- Chiropractic care for children
- Maternal chiropractic care
- Vertebral subluxation and well being
- Behavioral and mental health issues
- Patient safety, privacy and advocacy
According to FVS President Christopher Kent DC, JD “This was a Herculean task accomplished by a team of dedicated researchers and we are forever grateful for their service in carrying out this project.”
FVS Board Member Veronica Gutierrez DC, who worked on practice guideline development along with Kent and McCoy in the 90’s, praised the work of the team. “They have done an outstanding job and anyone that has ever suffered through guideline development knows all too well the pain and personal sacrifice it brings with it. But they also know the satisfaction that comes with being involved in such important work.”
The bulk of the funding for this project came from the California Chiropractic Association under the leadership of Brian Stenzler DC in his role as President of the CCA at that time. Additional funding was provided by the International Chiropractic Pediatric Association.
As the project came together the FVS realized that this was no longer the way to manage guideline development for subluxation management. Matthew McCoy DC, MPH Vice President of the FVS related his experience in guideline development going back to the early 90’s. “The guideline development projects myself and Dr. Kent had been involved in, along with other efforts, basically involved killing oneself every five years by starting over where the last iteration left off and digging through five years of research all over again. We realized this is not sustainable.”
Over the past several months the FVS has held a series of conference calls and meetings to discuss a long term solution and that has resulted in a plan laid out during this years’ IRAPS at Sherman College to develop a permanent and ongoing best practices initiative. In addition to being FVS President, Dr. Kent is the Director of Evidence Informed Curriculum and Practice at Sherman College. He will provide additional oversight of the project.
At this point in time a team has been established to oversee this ongoing initiative. To accomplish this, several Research Fellowship Scholarships have been developed in order to staff the initial team and their training.
Anquonette Stiles DC, MPH has been granted a Research Fellowship and accepted the role as Project Manager. Dr. Stiles has already begun working with two students from Sherman College of Chiropractic who were awarded Research Fellowships from the FVS for their participation. Those recipients are Kathryn Heidt MS and Hui Zhen Lim. Christie Kwon MS, DC, who was the Project Manager for the initial project that began in 2015 will remain involved and provide oversight and guidance to the developing team.
“We are taking a train the trainers approach moving forward with the intention that we will establish a permanent team with ongoing expertise in best practices work” stated Kwon. “The profession desperately needs people who are committed to the development of these guidelines given the upheaval currently going on in the profession.”
The FVS intends to make all of its work available to the profession and is currently addressing legal and technical issues relate to copyright, reproduction issues, database and website development. Once that is complete the team will produce an ongoing monthly update of all the scientific literature published. This means the FVS will have the most current evidence impacting subluxation management. Then every five years the FVS will update the Recommendations based on the literature. The five year process will be made much easier because the literature is being searched, gathered and reviewed on a regular basis instead of just every five years.ABOUT Foundation for Vertebral Subluxation
The mission of the Foundation is to advocate for and advance the founding principles and tenets of the chiropractic profession in the area of vertebral subluxation through research, education, policy and service.
