What is the Clinical Compass?
Written by Editor   
Monday, March 06, 2017 12:55 PM

News bite: Learn more about the Clinical Compass, a resource that researches and rates evidence, compiles it in a summary document for the chiropractic profession and other related stakeholders.

What is the Clinical Compass and How is it Valuable to Your Practice?By William Doggett DC FACO FICC - COCSA District 4 CCGPP Representative

The Clinical Compass was formed in 1995 and initially named the “Council on Chiropractic Guidelines and Practice Parameters” (CCGPP).  It was founded at the behest of the Congress of Chiropractic State Associations (COCSA) and assistance from nine national chiropractic associations.

  • American Chiropractic Association, 
  • Association of Chiropractic Colleges, 
  • Council on Chiropractic Education, 
  • Federation of Chiropractic Licensing Boards, 
  • Foundation for the Advancement of Chiropractic Sciences, 
  • Foundation for Chiropractic Education and Research, 
  • International Chiropractors Association, 
  • National Association of Chiropractic Attorneys 
  • National Institute for Chiropractic Research.

The Clinical Compass’ mission is to provide consistent and widely adopted chiropractic practice information, to perpetually distribute and update this data so that consumers and others have reliable information on which to base informed health care decisions.

The Clinical Compass was delegated to examine all existing guidelines, parameters, protocols and best practices in the United States and other nations with a chiropractic lens. Participation and process has been transparent and a major goal is to represent a diverse cross-section of the profession on the projects in which Clinical Compass has been involved.  Clinical Compass researches and rates evidence, which is compiled in a summary document for the chiropractic profession and other related stakeholders. 

Such information can make a difference in clinical practice, such as the chiropractic malpractice case that involved the treatment of a patient injured in a motor vehicle accident 15 years prior, the insurance company sued the treating chiropractor. Their position was that the patient had been treated in excess of the professional standards and should have been referred to a different, non-chiropractic, provider after just 2-4 visits. They contended that, based on the absence of specific or significant improvement in the patient’s condition, the failure to refer the patient at that early time was a violation of practice standards by the treating chiropractor and thus malpractice. The defense used the acute care algorithm developed by the Clinical Compass and published in the Journal of Manipulative Physiological Therapeutics (JMPT) in 2015, and explained to the jury that these guidelines were developed for the treatment of acute back pain and were considered professional standards. The jury took less than one hour to decide that the treatment was indeed within professional standards and that there had been no malpractice by excessive treatment. 

You can access the chapters of the literature synthesis on line at www.clinicalcompass.org  under the resources tab drop down at clinical guidelines. While you’re at the site look into the topics under the rapid resource response center (R3C). It has much valuable information that can benefit the doctor in the field regarding the standards in treating many other conditions.  

One tab over in the drop downs is the donation tab. The work that the members of the Clinical Compass do is funded by donations from state and national chiropractic associations and individuals such as you. Consider making a donation, or ask your state association to donate so that Clinical Compass can continue to inform and protect DC’s as they have since 1995.

The Clinical Compass is a steering organization comprised of 21 individuals. 16 are chiropractors with one in education, one in research and 14 in full-time private practice. There is a vendor representative, a representative from chiropractic colleges and attorneys representing the National Association of Chiropractic Attorneys, as well as a public member. A research commission with several dozen members reports to and is supervised by the Clinical Compass members.

The information contained in the eight clinical chapters covered in this project, being assembled by Clinical Compass, is a literature synthesis. A literature synthesis is an academically rigorous analysis of all the available scientific literature on a specific topic. Reviewers use internationally accepted tools to rate each article according to specific criteria. These include the type of study (randomized controlled trial, case series, etc), the quality of the study, size of the study and many other factors which influence the credibility and strength of the study’s conclusions. 

Each reviewer independently rates all the available articles, and the ratings are compared among the members of the review team. When there is disagreement among the reviewers regarding the conclusions, a formal consensus process is followed to arrive at an overall conclusion upon which all reviewers can agree. The resulting conclusions do not represent the reviewers’ own beliefs but rather what the literature actually supports. 

A literature synthesis is a starting point. It indicates only what we can conclude with supportable, scientific evidence. Appropriate therapeutic approaches will consider the literature synthesis as well as clinical experience, coupled with patient preferences in determining the most appropriate course of care for a specific patient.  

After Clinical Compass teams with specific skills review and rate all information gathered from multiple databases (synthesis), this information is then translated into easily usable tools. The synthesis is not the Compass©, it is merely evidence stratification for the most common conditions seen by chiropractic doctors. Clinical Compass recognizes that information in this format is difficult to digest and implement. To assist comprehension and ease of application, the synthesis will be translated for use in the treatment room via a DIER (Dissemination, Implementation, Evaluation, and Revision) This process will ultimately produce the Chiropractic Clinical Compass©. In addition, in today’s ever-changing health care environment, the literature synthesis can be used for many purposes and Clinical Compass is flexible and responsive to rapidly changing trends and needs.

When the Clinical Compass was started by COSCA many were afraid that this was going to be perceived as just another guideline to be used by the insurance industry as they had the Mercy Guidelines to limit and restrict chiropractic practice. Now the validity and relevance of the Clinical Compass documents has been upheld in a court of law and demonstrates that the hard work of those members of Clinical Compass is valuable and useful to all chiropractors who treat patients suffering from injury or disease.

Source: http://clinicalcompass.org