Clinical Compass Update

March 12, 2025
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Systemic Review Honored by Journal, Speakers Bureau Planned

The Clinical Compass board celebrates 30 years of non-profit, professional service by growing its evidence-based resources for the chiropractic profession. With a team of dedicated volunteers, the Clinical Compass research team has over the past five years produced five clinical practice guidelines and contributed to two others, published two systematic reviews, and developed preliminary education competencies for chiropractors in integrated healthcare settings.

Dr. Farabaugh

Our most recent study, “Cost of chiropractic versus medical management of adults with spine-related musculoskeletal pain: a systematic review,” was named the 2024 Best Published by the journal, Chiropractic and Manual Therapies. The paper, which is open access (free), compared the costs of chiropractic versus medical care for the management of spine-related musculoskeletal pain in U.S. adults. The study team, led by investigator Ronald Farabaugh, DC — who is also chair of the ACA Research Advisory Board and ACA’s representative on the Clinical Compass board — identified 44 high/acceptable-quality studies and found that care provided by chiropractors consistently resulted in fewer downstream services related to opioid prescriptions, surgeries, imaging, emergency room use, and hospitalizations. Patients initiating their care with chiropractors experienced substantially lower overall healthcare costs compared to medical management.

The Clinical Compass board has dedicated considerable efforts to improving sustainability and developing strategies to raise awareness and impact of the organization’s dedication to providing resources to the profession, such as this important cost article. Clinical Compass is actively promoting the cost paper and leading an effort to train a speakers bureau to deliver findings of the chiropractic and medical cost comparison evidence to payors. A toolkit is in development to prepare stakeholders for engaging in conversations with decision-makers to promote access to chiropractic services.

Clinical Compass is a non-profit evidence-synthesis think-tank that performs literature synthesis studies and generates best practices through consensus-based research models. In addition, with six published letters to the editor, the research team has been proactively defending the profession against flawed and biased papers that inappropriately malign chiropractic. In addition, Clinical Compass maintains regularly updated evidence centers for 17 different clinical topics, such as dry needling, opioids, and cost-effectiveness.

For details on Clinical Compass papers and letters from the past five years, see below or go to clinicalcompass.org.

 

Best Practices/Clinical Practice Guidelines

  1. Trager R, Daniels C, Hawk C, Taylor D, Price M, Anderson K, Mooring S, Crivelli L, Walters S, Staab C, Oakley C. Chiropractic Management of Adult Patients with Cervicogenic or Tension-Type Headaches: A Systematic Review and Clinical Practice Guideline. (Manuscript in Submission)
  2. Daniels CJ, Cupler ZA, Napuli JG, Walsh RW, Ziegler AL, Meyer KW, Knieper MJ, Walters SA, Salsbury SA, Trager RJ, Gliedt JA, Young MD, Anderson KR, Kirk EJ, Mooring SA, Battaglia PJ, Paris DJ, Brown AG, Goehl JM, Hawk C. Development of Preliminary Integrated Health Care Clinical Competencies for United States Doctor of Chiropractic Programs: A Modified Delphi Consensus Process. Glob Adv Integr Med Health. 2024 Aug 15;13:27536130241275944.
  3. Keating G, Hawk C, Amorin-Woods L, Amorin-Woods D, Vallone S, Farabaugh R, Todd A, Ferrance R, Young J, O’Neill Bhogal S, Sexton H, Alevaki H, Miller J, Parkin-Smith G, Schielke A, Robinson A, Thompson R. Clinical Practice Guideline for Best Practice Management of Pediatric Patients by Chiropractors: Results of a Delphi Consensus Process. J Integr Complement Med. 2024 Mar;30(3):216-232.
  4. Whalen W, Hawk C, Farabaugh R, Daniels C, Taylor D, Anderson K, Crivelli L, Anderson D, Thomson L, Sarnat R. Best Practices for Chiropractic Management of Adult Patients with Mechanical Low Back Pain: A Clinical Practice Guideline for Chiropractors in the United States. Journal of Manipulative Physiological Therapeutics 2022;2022 Oct;45(8):551-565.
  5. Hawk C, Amorin-Woods L, Evans W, Whedon J, Daniels C, Williams R, Parkin-Smith G, Taylor D, Anderson D, Farabaugh R, Walters S, Schielke A, Minkalis A, Crivelli L, Alpers C, Hinkeldey N, Hoang J, Caraway D, Whalen W, Cook J, Redwood D. The Role of Chiropractic Care in Providing Health Promotion and Clinical Preventive Services for Adult Patients with Musculoskeletal Pain: A Clinical Practice Guideline. Journal of Alternative and Complementary Medicine 2021.27(10):850-867.
  6. Hawk C, Whalen W, Farabaugh R, Daniels C, Minkalis A, Taylor D, Anderson D, Anderson K, Crivelli L, Clark M, Barlow E, Paris D, Sarnat R, Weeks J. Best Practices for Chiropractic Management of Patients with Chronic Musculoskeletal Pain: A Clinical Practice Guideline. Journal of Alternative and Complementary Medicine 2020;26(10):884-901.
  7. Whalen W, Farabaugh R, Hawk C, Minkalis AL, Lauretti W, Crivelli L, Wyatt L, Sheppard M, Walters S. Best-Practice Recommendations for Chiropractic Management of Patients With Neck Pain. J Manipulative Physiol Ther. 2019 Nov;42(9):635-650.

Systematic Reviews

  1. Farabaugh R, Hawk C, Noll C, Daniels C, Whedon J, Schneider M, Taylor D, Whalen W, Suiter L, McGowan, Wilcox R, Sarnat R. Cost of Chiropractic Versus Medical Management of Adults with SpineRelated Musculoskeletal Pain: A Systematic Review. Chiropractic and Manual Therapies 2024;32(8).
  2. Hawk C, Minkalis A, Khorsan R, Daniels C, Homack D, Gliedt J, Hartman J, Bhalero S. Systematic Review of Non-Drug, Non-Surgical Treatment of Shoulder Conditions. Journal of Manipulative and Physiologic Therapeutics 2017; 40(5):293-370.

Letters to the Editor

  1. Meyer K, Trager R, Daniels C, Cupler Z. Letter to the Editor: Self-Manipulation Inaccurately Associated with the Chiropractic Profession. American Journal of Forensic Medical Pathology 2024. Article-in-press.
  2. Cupler Z, Trager R, Daniels C. Letter to the Editor: Cervical Spinal Manipulative Therapy Unlikely Cause of Spontaneous Internal Carotid Artery Dissection. Vascular and Endovascular Surgery 2022;0(0):1-2.
  3. Miller J, Trager R, Battaglia P, Daniels C. Letter to the Editor: Missing Information and Bias Confounds Between Manipulation and Atypical Femur Fracture. Case Reports in Orthopedic Research 2021. Case Reports in Orthopedic Research 2021.4:267-269.
  4. Rae L, Daniels C, Trager R. Rapid Response: Misrepresentation of Chiropractic in a Case of Carotid Artery Dissection. BMJ Open Case Reports 2021.
  5. Daniels C, Hawk C. Letter to the Editor: Methodological Limitations and Selection Bias Undermine Certainty of Findings Related Chiropractic to Spontaneous Intracranial Hypotension. The Neurohospitalist 2022;12(2):427-428.
  6. Trager R, Hardison J. Letter to the Editor: Confounding and Misclassification Obscures the Association Between Spinal Manipulation and Spontaneous Intracranial Hypotension. Neurohospitalist. 2022 Apr;12(2):429-430.