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Article 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
Author(s)	Gatterman I Dobson TP LeFebvre R
Subject(s)	Practice Guidelines as Topic Quality Assurance, Health Care
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. This abstract is reproduced with the permission of the publisher; click on the above link for free full access.

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