Clinical Compass

Clinical Compass The Clinical Compass (CCGPP) exists to translate existing knowledge into effective, evidence - based chiropractic practice.

The Clinical Compass is powered by the Council on Chiropractic Guidelines and Practice Parameters (CCGPP). Our mission is to gather and evaluate existing evidence-based practice information; to facilitate the development of new information where existing evidence is lacking; and to distribute and assist in implementation of evidence-based practice information that is relevant to the chiropractic profession.

Recruiting participants into clinical trials is often one of the biggest barriers to generating real-world evidence. Thi...
06/22/2026

Recruiting participants into clinical trials is often one of the biggest barriers to generating real-world evidence. This new study from the VERDICT trial offers valuable insight into how we can improve that process—especially within integrated healthcare systems like the VA.

Researchers enrolled 766 veterans with chronic low back pain across four VA facilities and compared different recruitment strategies to determine what worked best.

Here’s what they found:
• Existing chiropractic referrals were the most efficient recruitment method, with a median time to enrollment of just 23 days.
• Email invitations outperformed postal mail alone, cutting response times nearly in half (16 days vs. 30 days).
• Virtual baseline visits improved accessibility, with 83% of participants completing this step remotely.
• Existing referrals recruited the highest proportion of racial and ethnic minority veterans, while EHR prescreening identified the greatest proportion of female veterans.
• Despite these successes, limited chiropractic clinic capacity meant that nearly 1 in 5 eligible veterans could not be enrolled.

Why does this matter?
Pragmatic clinical trials are designed to answer questions in real-world healthcare settings. Understanding how to recruit participants efficiently—and in ways that improve diversity and access—helps ensure the evidence we generate better reflects the patients we serve.

The takeaway? Thoughtful, flexible recruitment strategies aren't just administrative details—they're essential to conducting meaningful, representative research.

Read it here: https://pubmed.ncbi.nlm.nih.gov/41857686/

🔍 What was the purpose of this review?Researchers conducted an updated systematic review to evaluate the efficacy of spi...
06/17/2026

🔍 What was the purpose of this review?

Researchers conducted an updated systematic review to evaluate the efficacy of spinal manipulative therapy (SMT) for chronic spinal conditions in adults aged 55 years and older.

The review included studies involving:
✔ Chronic low back pain
✔ Chronic neck pain
✔ Lumbar spinal stenosis
✔ Combined neck and back disability

The goal was to determine whether SMT improves outcomes such as pain, physical function, quality of life, and activities of daily living in older adults.

As populations age and musculoskeletal disorders become increasingly common, high-quality evidence is essential for informed clinical decision-making.

📖 Schielke et al. JCCA 2026

New research is adding an important layer to our understanding of vascular health and autoimmune disease.A large retrosp...
06/15/2026

New research is adding an important layer to our understanding of vascular health and autoimmune disease.

A large retrospective cohort study of more than 143,000 patients found that individuals with autoimmune thyroiditis had a higher risk of cervical artery dissection (CeAD) compared to matched euthyroid controls. While the absolute risk remains very low (0.040% vs. 0.025%), the relative risk was significantly increased.

The study also found:
• A 58% increased relative risk of cervical artery dissection
• More than double the relative risk of carotid artery dissection
• A 67% increased relative risk of stroke

What does this mean clinically? Not that people with autoimmune thyroiditis should be alarmed—but that thyroid health may be one piece of the puzzle when assessing vascular risk and taking a thorough patient history.

As always, association does not equal causation. More research is needed to better understand the role of thyroid antibodies, hormone levels, medications, and other factors that may influence this relationship.

It's a reminder of how interconnected our body systems truly are—and why individualized, evidence-informed care matters.

Read it here: https://pubmed.ncbi.nlm.nih.gov/42022661/

🌎 Low back pain remains a major global health challenge.According to the review, low back pain is the leading cause of y...
06/10/2026

🌎 Low back pain remains a major global health challenge.

According to the review, low back pain is the leading cause of years lived with disability worldwide, with both prevalence and disability increasing with age and peaking between ages 80 and 84.

Older adults are more likely to experience:
• Persistent symptoms
• Reduced mobility
• Loss of independence
• Greater healthcare utilization

These realities highlight the importance of identifying effective, evidence-informed, nonpharmacologic treatment options for managing chronic spinal pain in aging populations.

📖 Schielke et al. JCCA 2026

🏥 What role can chiropractic care play in Federally Qualified Health Centers (FQHCs)?A recent publication explores how c...
06/08/2026

🏥 What role can chiropractic care play in Federally Qualified Health Centers (FQHCs)?

A recent publication explores how chiropractors may help address one of the most significant challenges facing primary care today: providing effective, accessible care for spinal and musculoskeletal (MSK) conditions.

Why does this matter?
Spinal and MSK disorders are among the leading causes of disability worldwide and remain a major contributor to healthcare utilization and opioid prescribing.

Key takeaways:
✔ FQHCs serve millions of underserved patients across the United States.
✔ Current primary care models often struggle to meet the growing demand for MSK care.
✔ Chiropractors are well positioned to serve as embedded spine and MSK specialists within integrated healthcare teams.
✔ Medicaid reimbursement appears to be a key factor supporting successful chiropractic integration.
✔ Alternative payment models—including value-based care, shared savings, capitation, and grant funding—may create additional opportunities for sustainable implementation.

The authors draw parallels to the successful integration of dentistry, podiatry, and optometry services within FQHCs and suggest chiropractic care may offer a similar pathway to improving access to nonpharmacologic pain management.

As healthcare systems continue to prioritize value-based care, interdisciplinary collaboration, and opioid reduction strategies, this paper provides an important framework for understanding how chiropractic services may contribute to improved outcomes and reduced downstream healthcare utilization.

📖 Reference: https://doi.org/10.1177/27683605261444627

What opportunities do you see for chiropractic integration within primary care and safety-net healthcare settings?

🤝 Friends of Clinical CompassAt Clinical Compass, our mission is to advance evidence-informed chiropractic care through ...
06/05/2026

🤝 Friends of Clinical Compass

At Clinical Compass, our mission is to advance evidence-informed chiropractic care through research, education, and collaboration. We are grateful for the many leaders and organizations who support that mission and recognize the value of rigorous scientific inquiry.

We're honored to share these words from Dr. Lisa Kouzes, Vice President of the Federation of Chiropractic Licensing Boards:
"Clinical Compass played an integral role in demonstrating the safety and efficacy of chiropractic care through rigorously vetted scientific evidence and expert testimony. Their team's responsiveness and dedication to clarity strengthened informed decision-making and ultimately led to service in the best interest of the public."

Partnerships like these help ensure that healthcare decisions are guided by the best available evidence, supporting patients, providers, regulators, and the public alike.

Thank you, Dr. Kouzes, for your leadership and support of evidence-informed chiropractic care.

📚 New PublicationWhat does the evidence say about spinal manipulation for older adults with chronic spinal conditions?A ...
06/03/2026

📚 New Publication

What does the evidence say about spinal manipulation for older adults with chronic spinal conditions?

A newly published systematic review evaluated randomized controlled trials involving adults aged 55 years and older with chronic low back pain, chronic neck pain, and lumbar spinal stenosis.

The authors reviewed 7 randomized controlled trials (9 reports) including more than 1,200 participants to better understand the role of spinal manipulative therapy (SMT) in this growing population.

As the prevalence of spinal pain continues to increase with age, understanding safe and effective nonpharmacologic treatment options is becoming increasingly important.

Over the next few posts, we'll highlight some of the key findings from this review.

💰 What does the evidence say about student loan debt in the chiropractic profession?A recent survey of 1,455 U.S. chirop...
06/01/2026

💰 What does the evidence say about student loan debt in the chiropractic profession?

A recent survey of 1,455 U.S. chiropractors explored educational debt, income, loan relief opportunities, and perceptions of the value of chiropractic education.

Key findings:
📊 Median student loan debt at graduation: $185,000
📈 Median current student loan debt: $240,000
💵 Median gross income: $76,000
❓ 87% reported being ineligible or unsure if they qualified for loan relief programs
📉 More than half disagreed that their chiropractic education provided a positive financial return on investment
🔄 65% reported they would not choose a chiropractic career again

While many respondents reported positive non-financial benefits from their training and careers, the findings highlight ongoing challenges related to educational debt and professional sustainability.

These results raise important questions for educators, institutions, professional organizations, and policymakers:
• How can the profession better address educational debt?
• What strategies may improve financial sustainability for future chiropractors?
• How can we preserve the value of chiropractic education while improving accessibility?

Evidence-informed conversations about the future of the profession are essential.

Read the study: https://pubmed.ncbi.nlm.nih.gov/41973683/

What defines quality care in chiropractic—and can we actually measure it?This national survey of U.S. chiropractors expl...
05/25/2026

What defines quality care in chiropractic—and can we actually measure it?

This national survey of U.S. chiropractors explored both the importance and feasibility of implementing quality measures in real-world practice.

Key takeaways:
✔️ Strong agreement across the profession on what matters most
✔️ Patient safety leads the way (with measures like documenting adverse events ranking highest)
✔️ Quality care isn’t just a concept—it’s measurable and implementable

As healthcare continues to evolve, chiropractic is stepping further into accountability, standardization, and evidence-informed practice.

Read it here: https://pubmed.ncbi.nlm.nih.gov/41904489/

Healthcare costs in the U.S. have surpassed $5 trillion—and a significant portion is tied to inefficiencies and low-valu...
05/18/2026

Healthcare costs in the U.S. have surpassed $5 trillion—and a significant portion is tied to inefficiencies and low-value care.

This article highlights how states like Oregon and Washington are addressing this through evidence-based policy and something equally important: including complementary and integrative health providers (like chiropractors) in coverage decision-making.

Why does this matter?
✔️ More diverse clinical perspectives
✔️ Greater emphasis on prevention and whole-person care
✔️ Smarter, more cost-effective healthcare decisions

Representation at the policy level shapes access to care.

Read it here: https://doi.org/10.1177/27683605261436283

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