• Commission members and affiliated investigators were authors or co-authors on a substantial body of peer-reviewed work during the quarter — including letters, commentaries, systematic reviews, observational studies, and clinical trial protocols — placing chiropractic research squarely in mainstream clinical and surgical journals.
• The Clinical Compass Evidence Center grew its membership and continued to provide rapid responses and evidence packages to state regulators and other stakeholders; a timely example: evidence provided to the Oregon Health Evidence Review Commission (HERC) that contributed to approval of chiropractic coverage for headache care.
• The Commission continues to publish rebuttals and critiques of flawed literature — a necessary scholarly practice to prevent misinterpretation of evidence that could restrict access to care.
These are not academic niceties. They are the mechanisms through which coverage decisions, regulatory guidance, and referral patterns change. For Washington State chiropractors, that means access, reimbursement, and the clinical latitude to practice evidence-based care are all affected by the work described in this report.
People Power: Honoring scholars and sustaining capacity
Research requires people — and institutions. The Scientific Commission used this quarter to celebrate leadership and longevity with four Emeritus Awards: Jeffrey Cates, DC, MS; Cheryl Hawk, DC, PhD, LMT; Dana Lawrence, DC, MMedEd, MA; and Michael Schneider, DC, PhD. These recognitions are more than accolades. They acknowledge decades of mentorship, methodology development, and institutional memory that keep new projects from reinventing the wheel. In practical terms, the Commission’s emeriti help maintain continuity across successive guideline efforts, systematic reviews, and interdisciplinary partnerships.
In addition, maintaining an active roster of investigators — with a pluralistic mix of clinicians, PhDs, and allied professionals — strengthens peer review, reduces bias risk, and increases the likelihood that completed projects will be accepted by reputable journals. The memo demonstrates this kind of thoughtful team composition across projects, another signal that the field is professionalizing in ways that matter to external stakeholders.
Project Pipeline: What’s being built and why it matters
Below are summaries of several active projects whose outputs will directly influence clinical practice and policy.
1. Chiropractic safety guideline (CITADEL) Status: In development (Board-approved June 17, 2025)
Why it matters: Safety frameworks are central to professional credibility. The CITADEL project — a collaboration with the World Federation of Chiropractic’s Global Patient Safety Initiative — aims to produce explicit, evidence-informed guidance for patient safety in chiropractic practice. This can influence malpractice standards, inform consent language, and offer regulators concrete expectations of provider behavior. Investigators include Katie Pohlman, DC, MPH, PhD; Stacie Salsbury, RN, PhD; Zachary Cupler, DC, MS; and Clinton Daniels, DC, MS.
Implication for Washington clinics: A robust safety guideline will help practices standardize risk screening, documentation, and communication — reducing liability exposure and helping insurers feel comfortable expanding coverage.
2. Clinical practice guideline for cervicogenic and tension-type headaches
Status: Manuscript in revision (Journal of Integrative and Complementary Medicine; initial submission Jan 20, 2025; revision submitted Aug 8, 2025)
Why it matters: Headache management is a frontier issue. Many state health systems and payers are specifically assessing whether to reimburse nonpharmacologic treatment for cervicogenic and tension-type headaches. A clinical guideline grounded in systematic review and expert consensus provides clinicians with recommended dosages, treatment modalities, and referral thresholds. The project team includes leaders such as Cheryl Hawk (Project Director) and multiple clinician- investigators with complementary expertise.
Implication for Washington clinics: Use this guideline to support treatment plans, justify frequency and duration of care to insurers, and improve documentation for patient outcomes. As more payers ask for evidence-based dosing, a guideline is the profession’s best response.
3. Systematic review — non-drug, non-surgical interventions for shoulder pain
Status: Extraction and risk-of-bias assessments pending
Why it matters: Shoulder pain is common in active working populations and older adults alike. Evidence synthesis that clarifies the relative efficacy of manual therapy, exercise, acupuncture, and other conservative interventions will inform conservative care pathways and interdisciplinary referrals.
Implication for Washington clinics: When employers, workers’ compensation carriers, and primary care partners require pathways for shoulder pain, this synthesis will provide clinically actionable evidence to support chiropractic-centered or collaborative care models.
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