Globe Gary A, Morris Craig E, Whalen Wayne M, Farabaugh Ronald J, Hawk Cheryl
Cleveland Chiropractic College Los Angeles, Los Angeles, CA, USA.
J Manipulative Physiol Ther. 2008 Nov-Dec;31(9):651-8. doi: 10.1016/j.jmpt.2008.10.006.
Although a number of guidelines addressing manipulation, an important component of chiropractic professional care, exist, none to date have incorporated a broad-based consensus of chiropractic research and clinical experts representing mainstream chiropractic practice into a practical document designed to provide standardized parameters of care. The purpose of this project was to develop such a document.
Development of the document began with seed materials, from which seed statements were distilled. These were circulated electronically to the Delphi panel until consensus was reached, which was considered to be present when there was agreement by at least 80% of the panelists.
The panel consisted of 40 clinically experienced doctors of chiropractic, representing 15 chiropractic colleges and 16 states, as well as both the American Chiropractic Association and the International Chiropractic Association. The panel reached 80% consensus of the 27 seed statements after 2 rounds. Specific recommendations regarding treatment frequency and duration, as well as outcome assessment and contraindications for manipulation were agreed upon by the panel.
A broad-based panel of experienced chiropractors was able to reach a high level (80%) of consensus regarding specific aspects of the chiropractic approach to care for patients with low back pain, based on both the scientific evidence and their clinical experience.
尽管存在一些涉及整脊专业护理重要组成部分——手法治疗的指南，但迄今为止，尚无一份指南将代表主流整脊疗法的整脊研究和临床专家的广泛共识纳入一份旨在提供标准化护理参数的实用文件中。本项目的目的就是制定这样一份文件。
文件的制定始于种子材料，从中提炼出种子声明。这些声明通过电子方式分发给德尔菲小组，直至达成共识，当至少80%的小组成员达成一致时，即视为达成共识。
该小组由40名临床经验丰富的整脊医生组成，代表15所整脊学院和16个州，以及美国整脊协会和国际整脊协会。经过两轮，小组对27条种子声明达成了80%的共识。小组就治疗频率和持续时间、结果评估以及手法治疗的禁忌症达成了具体建议。
一个由经验丰富的整脊医生组成的广泛小组，能够基于科学证据和他们的临床经验，就整脊疗法治疗腰痛患者的具体方面达成高水平（80%）的共识。
