August 2006

Independent group publishes proposed x-ray guidelines

A group of 25 independent practicing chiropractors has developed a set of guidelines for the “Routine Utilization of Radiography in Clinical Chiropractic Practice.” The guidelines are now available on www.pccrp.org for comment from groups as well as individuals, according to Deed Harrison, DC, chairperson of the project.

According to Harrison, the Practicing Chiropractors Committee for Radiology Protocols (PCCRP) Guidelines were developed independent of any organization, although the International Chiropractors Association (ICA) was the first to adopt them.

The preamble to the guidelines identify nine objectives of the document:

1. To provide evidence from the literature, identifying if the routine use of radiography in chiropractic practice, as mandated by state and provincial laws, is valid practice,

2. To determine the health risk of spinal radiography use,

3. To identify the radiographic views utilized in most chiropractic technique systems,

4. To determine the clinical utility of common radiographic views for chiropractic clinical practice,

5. To determine the reliability, validity, and efficacy of common radiological views utilized in chiropractic clinical practice,

6. To identify, with evidence, if the routine use of radiography in pediatric cases is valid,

7. To define chiropractic spinal subluxation from a structural/displacement view point and provide spinal radiographic normal values for alignment,

8. To review spinal radiographic guidelines from other professions, and

9. To provide chiropractic college instructors with the actual, updated, evidence on x-ray usage in chiropractic clinical practice, in order that the current information be shared with prospective chiropractors

The guidelines were authored by Drs. Deed Harrison (chair); Christopher Kent, Joseph Betz, Don Harrison, and Paul Oakley (principle investigators); and committee members Drs. Liz Anderson-Peacock, Stanley N. Bacso, John W. Baird, Robert Berry, Christopher J. Colloca, Edward E. Cremata, Charles Davis, Joseph R. Ferrantelli, Jason W. Haas, Josh Haggard, Sanghak O. Harrison, Scott J. Heun, Bruce K. Makos, Donald W. Meyer, Erin Molyneux, Daniel Murphy, Brian Paris, Jennifer Peet, Lenny Siskin, and Michael Underhill.

In an e-mail, Terry Rondberg, DC, WCA president, explained that the guidelines were developed as a direct response to “red flags only” x-ray guidelines written by others in the profession.

Harrison explained that the guidelines are undergoing a five-phase external review that includes comments by international experts, chiropractic colleges, associations, and the profession at large.

Chiropractors who would like to comment can access the guidelines at www.pccrp.org. Instructions for commenting are given on the Web site.

Sources: Deed E. Harrison, DC; Terry A. Rondberg, DC

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