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OCA Evidence-based Framework Advisory Council 

In November 2019, the Ontario Chiropractic Association (OCA) asked members to participate in our Evidence-based Framework Advisory Council to help the OCA with the process of developing a comprehensive understanding of evidence-based chiropractic care, within the universally accepted three pillars of the evidence-based framework: best available evidence, clinical expertise and patient preference ensuring exceptional care for patients.

With over 90 applicants, the OCA selected 13 chiropractors reflecting a range of practice modes and one patient.

Much has happened since the OCA Evidence-based Framework Advisory Council first met on a snowy weekend on January 19, 2020. Despite the COVID-19 pandemic, the advisory council is dedicated to advancing its mandate to help the OCA develop a comprehensive and inclusive understanding of chiropractic care.

With the advice of our council, we are creating the future of chiropractic care in Ontario.

Here are the outstanding members of the OCA Evidence-based Framework Advisory Council and our communications update on their dedicated leadership of the work.

Dr. Sean Batte
Dr. Sean BatteLogan University graduate | Practises in the London area
Dr. Ken Brough
Dr. Ken BroughPalmer College of Chiropractic graduate | Practises in Ottawa
Dr. Anita Chopra
Dr. Anita ChopraNew York Chiropractic College graduate | Pactises in Brampton, Oakville & Etobicoke
Dr. Marco De Ciantis
Dr. Marco De CiantisCMCC graduate | Practises in North York
Dr. Peter Emary
Dr. Peter EmaryNew York Chiropractic College graduate | Practises in Cambridge
Dr. Brian Gleberzon
Dr. Brian GleberzonCMCC Graduate | Practises in Toronto
Sheila Gregory
Sheila GregoryPatient Member
Dr. Glen M. Harris
Dr. Glen M. HarrisCMCC graduate | Practises in midtown Toronto
Dr. Deborah Kopansky-Giles
Dr. Deborah Kopansky-GilesCMCC graduate | Practises in the Greater Toronto Area
Dr. Keshena Malik
Dr. Keshena MalikM.Sc., Rehabilitation Sciences, McMaster University | Advanced Practice Provider, Hamilton Health Sciences
Dr. Bernadette Murphy
Dr. Bernadette Murphy CMCC graduate | Practises in the Greater Toronto Area
Dr. Paul Nolet
Dr. Paul NoletCMCC Graduate| Practises in Guelph
Dr. Antonio 'Tony' Ottaviano
Dr. Antonio 'Tony' OttavianoLife University Graduate | Practises in the Niagara area
Dr. Rod Overton
Dr. Rod OvertonCMCC graduate | Practises in the London area
OCA Evidence-based Framework Advisory Council Profiles

Members’ Communication Updates

To learn more about the OCA’s work with the Evidence-based Framework Advisory Council, contact Caroline Brereton, CEO, at 416-860-4155 or by email at cbrereton@chiropractic.on.ca

July 2021


In the last update to you on the outstanding work of the OCA Evidence-based Framework  Advisory Council, members are making significant strides in their mandate help to the OCA develop a comprehensive understanding and inclusive description of chiropractic care.

“The council is a very diverse group representing many different practice styles, and yet after every meeting, I am impressed by how much we have in common, how much we respect each other’s opinions and how much our goals for the project align.” – Dr. Rod Overton

Dr. Rod Overton, June 2021

“The task force individuals included researchers, field chiropractors, and patient advocates. The diversity of perspectives gives me confidence that we are creating a framework that will be really helpful to field practitioners in applying an evidence-based approach to the way they practice.” – Dr. Bernadette Murphy

Dr. Bernadette Murphy, June 2021

“The truly magical aspect, subjectively, of working in this group is the opportunity to share and develop poignant ideas with prominent members of the field and personal mentors of mine. Objectively, I feel humbled, honoured and thrilled to create a framework that will aid so many practitioners, touching the lives of hundreds of thousands of patients in such a positive way.” – Dr. Marco De Ciantis

Dr. Marco De Ciantis, June 2021

“The opportunity to support our profession working on the Evidence-based framework has been extraordinary. The dedication to a common goal has been an example of unity and cooperation that I hope can be an example to all of us. I personally have been energized by the work, and am so gratified to serve with such an impressive group of people in the interests of chiropractic.” – Dr. Sean Batte

Dr. Sean Batte, June 2021

“Working with such a diverse group of individuals has been such a rewarding experience! To learn that our end-goal is the same, create an Evidence-Based Framework for the Chiropractors of Ontario, with very different backgrounds goes to show what determination, hard-work, and cooperation can do.”
– Dr. Anita Chopra

Dr. Anita Chopra, June 2021

What’s New
We’ve completed our engagement with other organizations to obtain feedback on our Patient Preference White Paper. This is but one of several foundational research investigations that comprise the three pillars of evidence-based practice: Clinical Expertise, Best Available Evidence and Patient Preference.

We’ve developed a white paper exploring the evolution and interpretations of the evidence pyramid in reflecting the modern understanding of Best Available Evidence. Council members are exploring leading frameworks reflecting evolved thinking about Dr. Sackett’s model of evidence-based medicine that best reflects and supports the chiropractic profession.

Council members are also working on a white paper on Clinical Expertise.

Why it Matters
This Council is building the critical foundation about how the three pillars intersect in the delivery of patient care, and how a description of chiropractic that embraces the continuum of care can be developed and communicated.

From that foundation, we are developing clinical decision-making tools and will be partnering with organizations to build practical resources for our members.

We will use this comprehensive understanding of chiropractic to advocate for the profession with the governments, other health professions and partners to make chiropractic care the trusted first choice for Ontarians and position chiropractors’ place in Ontario’s broader health ecosystem.

What’s Next
Council outputs will be peer-reviewed and published.
We will be engaging with you to share the results of this work and elaborate on its potential to advance the understanding of chiropractic care in Ontario.

We will collaborate with partners to develop practical tools, education and resources to support our members and the profession in Ontario.

December 2020


Much has happened in the last months since the OCA Evidence-based Framework Advisory Council first met on a snowy weekend January 19, 2020. Despite the COVID-19 pandemic, the advisory council has been dedicated to advancing its mandate to help the OCA develop a comprehensive understanding and inclusive definition of chiropractic care.
With the advice of our council, we are creating the future of chiropractic care in Ontario.
That work is based on the universally accepted three pillars of the evidence-based framework:

  1. Patient Preference
  2. Best Available Evidence
  3. Clinical Expertise

Join us on our journey of creating the future of chiropractic care in Ontario
Council members met three additional times (virtually) to focus on two of the three pillars of the framework, Patient Preference and Best Available Evidence. Meeting in May, June and September, council members achieved key milestones, which were approved by the OCA Board of Directors. The work of council is dynamic and complex with significant impact to our profession in Ontario.

Patient Preference
To start, the Council reviewed and accepted research on the universal expectations of patients from their health providers, in support of Patient Preference. Specifically, Council members reviewed three areas of focus of patient expectations:

  1. Partnership: mutual respect, choice and personalization
  2. Active listening, genuine interest and clarity
  3. A Human Touch: compassion, connection and empathy
From the beginning, all advisory council members recognized that the three pillars of the framework, Patient Preference, Best Available Evidence and Clinical Expertise are not separate, parallel paths, but are interdependent.

Council recommended to the Board of Directors that the first output should be a white paper on Patient Preference, recognizing the significant research supporting the correlation between applying patient preference in care planning and patients’ compliance with their chiropractic care plan.

Council members also supported the Getting to Outcomes (GoT) methodology to guide the work of the OCA in supporting members to enhance their practice by applying the Patient Preference principles. This research-based change management methodology will address the gap between research and practice by ensuring the OCA has sustainable processes and program supports in place for members.

A new lexicon of terms found consensus to support shared understanding.

Best Available Evidence
At the same time, the advisory council embarked on a series of discussions and deep analysis of the latest research on Best Available Evidence, beginning with the evolution of interpretations on the evidence pyramid today.

Setting aside the labels of evidence-based and evidence-informed practice, council members identified the common components that guide clinical decision-making and the use of evidence inpatient care.

  • Explored possible key elements of clinical decision-making
  • Explored factors that may impact the weighting of best available evidence in each situation
  • Recognized that integration of all three pillars (best available evidence, clinical expertise and patient preference/values) is important in clinical decision-making
Council members are laying the groundwork about how the three pillars intersect in the delivery of patient care, and how a description of chiropractic that embraces the continuum of care can be developed and communicated.

Evidence Pyramid
In a rigorous discussion of research behind the evolution of the evidence pyramid, council members investigated the importance of the research question in determining research study design.
As council members knew from their inaugural meeting in January 2020, a discussion on a framework for clinical decision-making would include direction on how to proceed with care when there is little or no evidence.
Given the council’s strong support that it is the integration of the three pillars (Best Available Evidence, Clinical Expertise and Patient Preference) that enables good clinical decision-making, council members investigated how to best support the integration of Best Available Evidence in clinical practice.

Next steps
The Evidence-based Framework Advisory Council continues its mandate to help create the future of chiropractic care in Ontario by helping the OCA develop a comprehensive understanding and inclusive definition of chiropractic care.
Join us on this journey as this crucial work develops.