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Report from the SBM Conference

On July 9th we held our first Science Based Medicine conference in Las Vegas. The event was definitely a success – we filled our room to capacity (150 attendees) and almost everyone stayed until the end. It also appeared that most attendees were actually awake, a rarity for a full-day medical conference. The Q&A session at the end was lively and interesting.

Kimball Atwood and I covered the history of science-based medicine and explored the differences between EBM and SBM. David Gorski discussed cancer quackery, including specific cases to illustrate the potential harm of pursuing worthless therapies for serious diseases. Harriet Hall gave us an overview of the the pseudoscience endemic in chiropractic. Mark Crislip discussed the chronic Lyme disease controversy. And Val Jones discussed health information online.

Based upon the feedback from those attending the conference, as well as the general enthusiasm, it seems that there is a hunger for this type of information. The audience was split about even between health care professionals and interested lay public. Many people asked if we plan on giving the conference again, and the answer is definitely yes. We have no plans set as of yet, and will certainly announce any future conferences here.

The list of editors and authors at SBM is deep and growing, so we have more than enough speakers to draw from. Also, the list of potential topics to cover is likewise long – we barely scratched the surface at this conference.

There were two broad themes in the questions we were asked, both during the Q&A and after the conference. The first is if we plan to make the content of the conference available for wider distribution. The answer to that question is definitely yes. We, of course, all have our slide presentations and written descriptions of each lecture. But also the entire conference was recorded on video, which gives us the option of releasing it in either DVD or podcast format. We have not yet decided which and how many of these formats we will use, and of course will make any announcements here. We are also exploring the possibility of attaching CME to the content if possible.

The other type of question we received was how to get involved in promoting SBM. There were many excellent suggestions, most of which were things we have already considered but simply lack the resources to put into effect. For example, several people suggested that we add new kinds of content to the SBM site – such as a page dedicated to each major topic with a description and list of resources. We have, in fact, already started to write an index of our SBM posts by topic, but this is a great deal of work and we all are most limited in our most precious resource – time.

The comments of this post can also serve as a place to share with us your suggestions as to what kinds of resources would be most useful – where should we focus our efforts? But I also made the point that we need volunteers as well as suggestions. While we are all dedicated to working toward improving and expanding this site, new projects require new resources. So if you have a suggestion, be prepared to be asked to chip in. Many people did step up and volunteer their help, which is greatly appreciated.

There are many ways people can help promote quality science-based medicine. In addition to submitting guest entries for this blog, you can stay alert to political activity in your state. Is someone trying to pass a bill to water down the standard of care? Let us know, and also make your voice heard by writing to your representatives and governor. If you has a skill you think might be useful, let us know and we will discuss how you can help. And any new projects we take on will certainly go faster if the workload is spread out.

For example – indexing all the posts at SBM by topic, and collecting relevant links and references. Many people asked if there was one place they could go to learn everything they need to know about the vaccine autism controversy. What a wonderful resource that would be, and we could host it right here at SBM – all it takes is time.

What the SBM conference taught me is that there is a growing network of people who are concerned about the quality of science in medicine. SBM and the standard of care have been systematically attacked over the last two decades and significant damage has been done at every level – political, academic, institutional, and regulatory. SBM is more than a blog – it is a rallying call. We need to re-dedicate the medical profession to quality science, and put an end to tolerating pseudoscience simply because it is called by a pleasant euphamism.

Posted in: Science and Medicine

Leave a Comment (61) ↓

61 thoughts on “Report from the SBM Conference

  1. Draal says:

    Have you considered giving lectures academic society conferences? I’m unfamiliar with the health related ones but just for example ACS. The conferences are primarily for people talking about their research and stuff but they do host special interest seminars. I went to an engineering one where a gentlemen talked about how he went about reducing his carbon foot print in his personal life and home. So many grad students attend the conferences; they’d be an ideal audience, in my opinion. You would just need to advertise the seminar effectively since I don’t know how familiar the general academic community is with the skeptic movement.

  2. nobs says:

    It is my observation that 25% of the conference was devoted to chiropractic, AND that this blog devotes a considerable amount of attention to chiropractic. Yet there is NO DC on the editorial or contributor list. Why?

  3. nobs – 1/6 is not 25%.

    There are many specialties not yet represented on our contributor list. Give us time.

  4. nobs says:

    >>”# Steven Novellaon 15 Jul 2009 at 9:03 am
    nobs – 1/6 is not 25%. “<<

    This source, which I am using as my reference, only lists 4(four parts) which indeed equals 25%.

    http://lippard.blogspot.com/2009/07/science-based-medicine-conference-part.html

  5. Or, I suppose, you could have used my description of the conference above as a source.

  6. nobs says:

    I did not see any breakdown in your description above. I gave you my reference for 25% and it appears you want to argue 25% vs 17%?

    >>”There are many specialties not yet represented on our contributor list. Give us time.”<<

    Can you give us a bit of info as to what efforts are being pursued to accomplish this?

  7. “It is my observation that 25% of the conference was devoted to chiropractic…”

    No, if you had observed the conference, you’d know that to be incorrect. It was your UNDERSTANDING that the 25% conference was devoted to chiropractic, and that understanding was based on incomplete, second hand information

    Additionally, to put the numbers game of whether it was 17% or 25% aside, one speaker’s presentation (out of six) was on the topic of unscientific practices endemic in chiropractic.

    In addition to no chiropractors, this site also does not have any homeopaths, naturopaths, acupuncturists, reiki or craniosacral practitioners, or antivactionists as contributors.

    If Dr. Novella ever manages to find a completely woo-free, chiropractor using scientifically supported methods willing to contribute to this site, I am sure he will welcome them with open arms.

  8. “I did not see any breakdown in your description above. ”

    Reread the second paragraph in the post and do the math.

    “I gave you my reference for 25% and it appears you want to argue 25% vs 17%?”"

    You’re the one who started the numbers game. In order to better sell your point, you used a percentage figure rather than simply saying that one presenter talked about chiropractic

    Playing the numbers game, your number was 8 points higher than the true number; or looked at differently, your number was 47% higher than the true number.

  9. Newcoaster says:

    Steven

    I really enjoyed the SBM conference, as did my wife who chose to attend that with me rather than the workshops that were being offered as part of TAM7. It was one of the more enjoyable, interesting and entertaining medical conferences I’ve ever been to. I really do hope this will be a regular event. Actually, it was better than the rest of TAM7, so kudos to all of the SBM regulars.

    Though most of the topics were familiar to me, I did learn new things from each the presenters. What was interesting in talking afterwards to some of the other physicians who attended, as well as to some of my colleagues back home, was how little most doctors really know about the background of various sCAM claims. ( For example, I talked to an internist from WA who routinely referred people to chiropractors for low back pain because he thought “there must be something to it” and had no idea of the origins of the philosophy. He was appalled, and said his practice will now change.)

    I also do appreciate all the effort the SBM bloggers put into their blogs, the time and research and the fact that you are doing this for no money, on your own time. There were many suggestions of how to grow SBM, and I think it really is becoming a “go to resource“ for sCAM information, similar to how the JREF has become the gold standard for general skeptical information.

    Besides refreshing my skeptical batteries, and re-inspiring me to make more of an effort at educating my shruggie or woo friendly colleagues locally, I am also trying to think of ways that I could help out with SBM.

    It might be useful to have a link on SBM to all the ideas and suggestions that were generated by the speakers and in the Q&A session, so that those of us who would like to help out can see what needs to be done, and see if any of our skill sets would be useful to SBM.

  10. Newcoaster says:

    And oh yeah, Val Jones….the nicest person in the world.

  11. nobs says:

    # Karl Withakayon 15 Jul 2009 at 10:23 am
    “It is my observation that 25% of the conference was devoted to chiropractic…”

    >>”No, if you had observed the conference, you’d know that to be incorrect. It was your UNDERSTANDING that the 25% conference was devoted to chiropractic, and that understanding
    was based on incomplete, second hand information”<>”Additionally, to put the numbers game of whether it was 17% or 25% aside, one speaker’s presentation (out of six) was on the topic of unscientific practices endemic in chiropractic.”<>”…..If Dr. Novella ever manages to find a completely woo-free, chiropractor using scientifically supported methods willing to contribute to this site, I am sure he will welcome them with open arms.”<<

    Do you speak for Mr.Novella? You do not define your personal definition of “woo-free, however, finding a DC “using scientifically supported methods”, is readily findable and accessible. Anyone proclaiming otherwise is intentionally ignoring the evidence. I fail to comprehend an honest obstacle to that end. However, Mr. Novella, unfortunately, did not elaborate on his efforts to remedy that…. And what would accomplish that? Qualifications? Published studies? Academic background? He did not qualify or quantify his declaratrion. There are MANY DCs that would qualify as “scientific-based”. Has he contacted any? If so- whom? What has been the replies?

  12. Draal says:

    a completely woo-free, chiropractor using scientifically supported methods

    I’m under the impression that such a person isn’t a rare endangered species. My mother sees a chiropractor regularly for spinal alignment therapy to alleviate her back pain due to scoliosis. It has worked for her better than anything else; pain medicine had only minimal impacts or the side affects were to great for her. So I’m convince that chiropractors are useful for certain therapies.

  13. Joe says:

    @nobs on 15 Jul 2009 at 8:57 am “It is my observation that 25% of the conference was devoted to chiropractic, AND that this blog devotes a considerable amount of attention to chiropractic. Yet there is NO DC on the editorial or contributor list. Why?”

    Ooh Ooh I know I know! !! It is because most chiros are idiots and have nothing of consequence to offer.

    Nobs, prove me wrong.

  14. nobs says:

    Joe:>>”Ooh Ooh I know I know! !! It is because most chiros are idiots and have nothing of consequence to offer.

    Nobs, prove me wrong.”<<

    Joe- My observation is that you find it SO neccessary to respond to any/every chiropractic post, is evidence that you do not consider it “nothing of consequence”.

  15. lippard says:

    nobs: You incorrectly assumed that I have finished posting my summary of the conference. I’ve been making a couple of posts a day and should finish today or tomorrow. There are two speakers and a Q&A panel left to write about.

  16. Alexander Han says:

    What someone seeing patients “has to offer” and “damage they can do” are not the same thing.

  17. If you had attended the SBM conference, or if you have ever listened to any of the Skeptics Guide to the Universe podcasts, you’d know Dr Novella speaks very well for himself, and since it seems you did read my reply, you already know well that I made no claim to speak for Dr Novella beyond my belief in what his response would be should he find a woo-free, scientifically based chiropractor willing to post on this site.

    As to my definition of a woo-free chiropractor, I’ll give it my best shot, and it’s hardly a “personal” definition; it’s probably pretty close to what any of the posters on SBM would say if you asked them.

    Woo-Free Chiropractor: One whose practice is limited to spinal manipulation for uncomplicated lower back pain that does not believe in the theories of subluxations or inate intelligence, and does not offer or recommend treatments that have not been scientifically validated, such as acupuncture, reiki, craniosacral, or hebal supplements that have not been shown to be safe and effective.

    “however, finding a DC “using scientifically supported methods”, is readily findable and accessible. ”

    Maybe, but finding DC’s that EXCLUSIVELY use scientifically supported methods (and underlying theories) with no use of scientifically unsupported or scientifically contradicted methods is a bit more challenging. Anyone proclaiming otherwise is intentionally cherry picking the evidence.

    “There are MANY DCs that would qualify as “scientific-based””

    You have not provided your definition of a “scientific-based” chiropractor (at the same time you complained about me not defining woo-free, ironically enough); please provide your definition so we can see if we agree on what constitutes a scientific-based DC.

  18. Harriet Hall says:

    Karl Withakay said,

    “If Dr. Novella ever manages to find a completely woo-free, chiropractor using scientifically supported methods willing to contribute to this site, I am sure he will welcome them with open arms.”

    I know one chiropractor who subscribes to the SBM approach: Samuel Homola. He hosts the Chirobase website with Stephen Barrett. Although he has not written for this blog, he has read what I have written about chiropractic and he endorses it.

  19. Draal,

    “I’m under the impression that such a person isn’t a rare endangered species. My mother sees a chiropractor regularly for spinal alignment therapy to alleviate her back pain due to scoliosis.”

    The anecdote that your mother’s back pain was alleviated does not even support the hypothesis that the relief was due to the actions of the chiropractor, but for the sake of argument, I will concede that the chiropractor was responsible for your mother’s improvement.

    Offering at least one effective service does not mean that the chiropractor is “woo-free” or limits their practice to scientifically supported practices and theories. Even offering one or more scientifically validated therapies doe not make a chiropractor (or anyone else) science-based.

    Providing a seemingly effective service also does not mean that there is support to say a treatment is effective for the reasons the chiropractor thinks it is.

  20. Harriet & Steven, any chance of Samuel Homola doing a one time guest post on SBM for an enlightening inside perspective?

    Any thoughts on one time guest posts in general to expand the scope of contributors on SBM? Maybe a guest post once a month or once a week?

    Perhaps an occasional guest post form critical thinkers or medical bloggers that are not MD’s or MD’s from other countries to provide a different perspective on science based medicine. (I’m NOT implying myself.)

    I really appreciate the efforts you’ve already taken in this direction with the additions of Kroll, Ramey, and future MD Krieder.

  21. Joe says:

    @ nobs on 15 Jul 2009 at 12:24 pm “Joe- My observation is that you find it SO neccessary to respond to any/every chiropractic post, is evidence that you do not consider it “nothing of consequence”.”

    Must I explain, again. Chiro is consequential in that proponents bilk people for sham treatments. Even your treatments for low back pain are dubious. Your claims are consequential because you defraud people.

    We await your evidence to the contrary.

  22. Woody says:

    Kudos to Dr. Novella and the other speakers for an excellent conference. I definitely plan to attend future conferences if they are held. I was impressed by the fact that former CAM practitioners were also present and were able to provide an “inside scoop” on the topic. A massage therapist openly decried the woo practices of his colleagues. Although they certainly are a minority in their fields, it is encouraging to hear their voices. I would also point out that Dr. F. Steele’s talk on Personalized Medicine in the main TAM conference was outstanding and would be a great topic for further discussion online or at future such events.

  23. Dacks says:

    The best moment of the SBM conference was when the brave and lonely massage therapist rose to make a comment near the end of the Q and A. Speaking as one of the only CAM practioners in the room, he complimented the panel on the high level of discussion and reported unfavorably on the quality of talks at most CAM conferences. If only more “alternative” providers could be persuaded to listen to how orthodox medicine really approaches the issues!

    On the other hand, one of the more depressing conversations I had was with an elderly medical physicist (specialist in radiology?) who had no interest in hearing about the SBM conference, assured me that his clinic practiced only evidence based medicine, then rattled on about how “psychosomatic power” can be used to change brain structure. So there is still plenty of work to be done even in the skeptical community.

  24. nobs says:

    Joe->>”Must I explain, again. Chiro is consequential in that proponents bilk people for sham treatments. Even your treatments for low back pain are dubious. Your claims are consequential because you defraud people.

    We await your evidence to the contrary.”<<

    HUH??? Seriously??? It is YOU making the claims. Therefore it is incumbent upon YOU to provide the evidence for YOUR claims…..Not the other way ’round, sir.

  25. Harriet Hall says:

    Karl Withakay asked,

    “any chance of Samuel Homola doing a one time guest post on SBM for an enlightening inside perspective?”

    I have just e-mailed Sam requesting he write a guest post.

  26. nobs,

    We’re still waiting for your definition of a “scientific-based” chiropractor to help understand what you mean when you claim, “There are MANY DCs that would qualify as “scientific-based””

  27. Draal says:

    The anecdote that your mother’s back pain was alleviated does not even support the hypothesis that the relief was due to the actions of the chiropractor, but for the sake of argument, I will concede that the chiropractor was responsible for your mother’s improvement.

    According to one of Dr. Novella’s blog articles, I made a common mistake of confusing “chiropractic” with “manipulative therapy”.

    What my mom told me was that spinal manipulation of her lower back alleviated her lower back pain caused by sever soliosis. As I understand it, her shoulders are not level and her back muscles are attempting to compensate; the overuse of the back muscles leads to the pain. Spinal manipulation is being used to realign her shoulders and relieve the tension on her lower back muscles.

    Providing a seemingly effective service also does not mean that there is support to say a treatment is effective for the reasons the chiropractor thinks it is.

    Shockingly, that how Dr. Novella explained manipulative therapy http://www.sciencebasedmedicine.org/?p=538#more-538.
    Also, as Dr. Novella put it:

    The chiropractic profession has its roots firmly planted in pure pseudoscience, but despite this there happens to be a plausible role for spinal manipulation for the limited indication of uncomplicated lower back strain.

    She no long takes prescription pain medication (with side affects) after several months of therapy. It’s a hell of a lot cheaper than surgery that may or may not work with the added risk of permanent paralysis. I’d think risk out weighs the reward. And when she stopped taking the pain medication and the side affects ceased, does that mean I can’t assume they were linked too?
    Of course it’s anecdote of treatment; but else you want? A statistical assessment from a double-blinded study?! I did offer what the treatment was, one that has a physical mechanism and not some “magic”. I’m not advocating pseudo-science acupuncture or whatever.

    And shouldn’t sports medicine practitioners be targeted too? Many of them practice acupuncture. Why stop at chiropractors?

    Offering at least one effective service does not mean that the chiropractor is “woo-free” or limits their practice to scientifically supported practices and theories. Even offering one or more scientifically validated therapies doe not make a chiropractor (or anyone else) science-based.

    This just sound like a logical fallacy, maybe a non sequitor. You shouldn’t automatically exclude someone of being science-based because they only practice scientifically supported practices. Or Ad ignorantiam: “The argument from ignorance basically states that a specific belief is true because we don’t know that it isn’t true.” Just because someone calls themselves a chiropractor, should not automatically imply they practice pseudo-science.

  28. To clarify one point – we already take outside submissions. Just send them in and we will decide if they are appropriate and of sufficient quality. We will also edit them and may even peer-review them (although we make no claims to being officially a “peer-reviewed” journal).

    We have solicited many outside contributions from various specialties not currently represented. Some have contributed, some have not (usually citing time constraints). I actually don’t remember which, if any, chiropractors we have solicited, but I agree with Harriet Hall that Sam Homola would be the best place to start.

    Any other science-based chiropractors out there – feel free to send in submissions.

  29. “And when she stopped taking the pain medication and the side affects ceased, does that mean I can’t assume they were linked too?”

    Considering that the side effects of that medication have likely already been scientifically documented, there is very reasonable support for the claim that the disappearance of the side effects is connected with discontinuing the medication.

    “Of course it’s anecdote of treatment; but else you want?”

    I believe I said for the sake of argument that I would accept that the treatment she received from the chiropractor was effective. That was not just a cop out statement. I accept that chiropractic can be effective for lower back pain, and I accept that it likely was such in the case of your mother.

    You made the claim that a completely woo-free, chiropractor using scientifically supported methods wasn’t “a rare endangered species.” You then supplied an anecdote (it wouldn’t matter if it was a double -blinded RCT) about your mother receiving effective treatment from a chiropractor as support. What you supplied was support for a claim that the manipulation provided by the chiropractor was effective, and not support that the chiropractor was completely woo-free. You did not provide any evidence that the chiropractor that your mother sees is woo-free and does not believe in subluxations, innate intelligence, or offer or recommend woo such as reiki, acupuncture, etc. I do not claim that the chiro in question is not completely woo-free, but I do claim that is on the low end of probability that they are.

    “And shouldn’t sports medicine practitioners be targeted too? Many of them practice acupuncture. Why stop at chiropractors?”

    I don’t believe anyone here on the side of SBM has advocated giving any practitioners of medical practices not supported by science a break; we’re pretty equal opportunity with our criticism. We certainly don’t give MD’s (cough, cough -Dr. Jay Gordon- cough, cough) a break when they adopt unscientific practices..

    “This just sound like a logical fallacy, maybe a non sequitor.”

    I think you’re making the non sequitor or straw man here. I said, “offering one or more scientifically validated therapies does not make a chiropractor (or anyone else) science-based.” I stand by that statement. To be science based, one must be BASED in science. If one is a science based practitioner, everything you practice should be based on science and scientifically validated practices. Having SOME scientifically based methods/treatments does not automatically make your practice as a whole based in science.

    “Just because someone calls themselves a chiropractor, should not automatically imply they practice pseudo-science.”

    I never made such a claim. I did imply that if they call themselves a chiropractor, they are much more likely than not to have pseudo-scientific practices and/or underlying theories. There is a difference in those two statements.

  30. Steven/ Dr. Novella,

    Funny that I asked my questions about guest posters while I had the contributors page up where it clearly states:

    “Please note that we are always on the lookout for medical bloggers with an interest in the topics discussed on Science-Based Medicine and a track record in writing about them. Anyone interested in contributing to this blog should contact either Dr. Gorski or Dr. Novella.”

    I guess I was thinking more along an outreach line, and it is good to know that you already actively solicit outside contributors.

  31. nobs says:

    HH->>”I know one chiropractor who subscribes to the SBM approach: Samuel Homola. He hosts the Chirobase website with Stephen Barrett. Although he has not written for this blog, he has read what I have written about chiropractic and he endorses it.”<>”We’re still waiting for your definition of a “scientific-based” chiropractor to help understand what you mean when you claim, “There are MANY DCs that would qualify as “scientific-based””<>”We have solicited many outside contributions from various specialties not currently represented. Some have contributed, some have not (usually citing time constraints). I actually don’t remember which, if any, chiropractors we have solicited, but I agree with Harriet Hall that Sam Homola would be the best place to start.”<<

    I am obliged to disagree and really am a bit disappointed that he would be considered, especially in light of the long list of DCs who represent “science-based” chiropractic – A short list of DCs to get you started—Among them:

    *Greg Kawchuk, BSc, DC, MSC, PhD(University of Alberta Canada Research Chair in Spinal Function) , *John J. Triano, DC, PhD(Texas Back Institute and Research Professor in the University of Texas Southwestern Medical Center Arlington, Joint Biomedical Engineering Program.), *Cheryl Hawk, DC, PhD, CHES(appointed to the Iowa Board of Health, the State Preventive Health Advisory Committee and the Director’s Council of Scientific and Health Advisors of the Iowa Department of Public Health), *Dr. Mark Erwin DC, PhD
    (University of Toronto-Toronto Western Hospital), *Dr. Jill Hayden DC, PhD(Department of Health Policy, Management & Evaluation-University of Toronto), *Donald Murphy,DC(Clinical Faculty at Brown University School of Medicine), *Gert Bronfort, DC, PhD( Associate Editor for the Cochrane Back Review Group and a reviewer for the National Institutes of Health, Advisory Committee for the Department of Veteran Affairs and reviewer and consultant for the CCGRP Chiropractic Best Practices Initiative)…………

  32. Draal says:

    You made the claim that a completely woo-free, chiropractor using scientifically supported methods wasn’t “a rare endangered species.”

    What I said was that I was “under the impression”, specifically meaning, until a few hours ago, my opinion/interpretation of what a chiropractor is is someone that essentially cracks backs to alleviate pain. Seriously, I thought that was it, not a group of crank wankers. And not surprisingly, about 7% of Americans visit chiropractors so I have had no direct associations with a chiropractor. So I was like, “wtf, why is everyone here trashing chiropractors when my mom swears by hers.” I’m sufficiently happy to support my mother in her decision to continue therapy, even with pseudo-science baggage.

    I never made such a claim. I did imply that if they call themselves a chiropractor, they are much more likely than not to have pseudo-scientific practices and/or underlying theories. There is a difference in those two statements.

    Unstated Major Premise logical fallacy? :P

  33. Harriet Hall says:

    Nobs,
    I wonder how many of those DCs follow the guidelines listed at http://www.chirobase.org/13RD/chiroguidelines.html

    Draal,
    For an excellent overview of what a rational chiropractor can do for you, see http://www.chirobase.org/07Strategy/goodchiro.html

  34. Draal says:

    Thank you very much Harriet.

  35. pmoran says:

    “We, of course, all have our slide presentations and written descriptions of each lecture. But also the entire conference was recorded on video, which gives us the option of releasing it in either DVD or podcast format. ”

    Please make sure it is also available as text. There will presumably be hours of material through which some of us will wish to rummage in a more non-linear fashion than video allows.

  36. Dan Warren says:

    I would like to congratulate you all on a wonderful conference. It exceeded my expectations and made me anxious to be involved next year. It was a pleasure to meet those of you whom I encountered. Thank you all for the work that you do on this site!

  37. wertys says:

    I’m really annoyed that I couldn’t come. I think what the SBM movement needs is a parallel approach of providing discussion and education at a level which will qualify for CME, but is also accessible to the interested allied health or lay listener. Allowing any serious observer to peek ‘behind the veil’ at some of the inner workings of the ‘medical industrial complex’ can only be beneficial to both sides. The SBM bloggers already perform this juggle to a high standard, and doing so in a conference environment would be an awesome contribution for skeptics, health practitoners and non-skeptics alike. Who knows, you might even get a few science journalists along too !!

  38. Joe says:

    @ nobs on 15 Jul 2009 at 3:09 pm “Joe->>Your claims are consequential because you defraud people.”<< “HUH??? Seriously??? It is YOU making the claims. Therefore it is incumbent upon YOU to provide the evidence for YOUR claims……”

    Seriously!! You are too clever by a half- I cannot prove you are not supported by evidence. You must prove that what you offer is supported. The British Chiro Ass’n. recently failed at doing so. Also, you should study http://www.chirobase.org

  39. nwtk2007 says:

    There are plenty of science based chiro’s about Joe, you just choose to lump all into one category.

    As to providing evidence , much has been provided and you have proven you will not read it but are willing to comment on it despite that.

    I see no science there.

  40. nwtk2007 says:

    Pretty much a waste of time Nobs.

  41. Grimreapor says:

    I’m bummed I couldn’t be there, but unfortunately, being a student in England I doubt I will be able to afford it for quite a few years.

    Also, after reading David Gorski’s post ‘The clinician-scientist: Wearing two hats’, just reminds me at how busy you guys must be.

    And I still find it amazing how Chiropractic is a sacred cow for so many people.

    Also I can think of one Chiropractor who may fit to your criteria; David Seaman, DC. He was interviewed on the SGU, and sounded like a very reasonable person. But honestly couldn’t do much digging to see if he is interested in any woo.

  42. Kawchuk and Triano: mostly interested in back pain but also co-authors of a monograph claiming that cervical spine manipulation (CSM) doesn’t cause stroke. Rather, apparently, patients who are evolving strokes are more likely than otherwise to consult a chiropractor. Hmmm: doesn’t really explain the young ones, and you’d think chiropractors oughtta be able to recognize a stroke in progress before wringing a neck, no? Nor do K and T seem to question the indications for CSM. Oh well, at least they recommend calling 911.

    Hawk: abstracts on PubMed suggest that she supports chiros as ‘primary care practitioners,’ but worries a bit that they need to be more pro-active about some recommendations, such as advising patients to stop smoking.

    Murphy: seems to limit his practice to back and neck pain. Good, but ‘neural mobilization’ looks a little fishy.

    I didn’t look closely at the rest, but if similar to Kawchuk they seem to be interested primarily in back pain. Also good, but what do all of them think about ‘subluxations’, ‘applied kinesiology’, and immunizations, for example? For SBM blogging purposes it isn’t enough to call yourself a ‘science-based’ chiropractor merely because you are a physical therapist by another name. You gotta be willing and able to take on the overwhelming woo of the field as a whole.

  43. grendel says:

    I know that one of the local universities teaches a course in ‘Chiropractic Science’ and indeed many of the subjects within the course program are excellent science-based approaches to health. I worry hoever that even a large degree of science content within the context of chiropractic can exist but be essentially meaningless to the practice of chiropracty.

    For example the course structure contains subjects such as:

    Diagnosis and Chiropractic Skills
    Processes in Human Disease
    Primary Practice I: Clinical Science and Diagnosis
    Clinical Orthopaedics and Neurology
    Immunology, Genetics and Microbiology
    Chiropractic Skills and Principles II
    Evidence-based Practice

    which would be similar in some respects to other science-based medicine 3rd year programs (minus the specialty areas), however the entire program is prefaced by this:

    “Chiropractors, also known as Chiropractic Physicians, diagnose and treat patients whose health problems are associated with the body’s muscular, nervous, and skeletal systems, especially the spine. Chiropractors believe that interference with these systems impairs the bodys normal functions and lowers its resistance to disease. They also hold that spinal or vertebral dysfunction alters many important body functions by affecting the nervous system and that skeletal imbalance through joint or articular dysfunction, especially in the spine, can cause pain.”

    ‘believe’ and ‘they hold that’ are critical points in that paragraph as they point to an acknowledged (in an honest institution) lack of evidence for the ‘belief’ parts.

  44. Harriet Hall says:

    I have a copy of a chiropractic textbook entitled “Somatovisceral Aspects of Chiropractic: An Evidence-Based Approach.” There is nothing in it that would be considered evidence-based, much less science-based. It mostly cites case reports and small uncontrolled studies. Some chiropractors claim to be science-based practitioners but have no real understanding of the scientific method. This was vividly demonstrated by the British Chiropractic Association’s pathetic list of studies they presented as a response to Simon Singh.

  45. OZDigger says:

    Considering Harriet, that you have no scientific credibility, you just “read a lot”, those comments are a bit anachronistic.

  46. Tim Kreider says:

    Would SBM benefit from a forum? One of the great things about this site is the comment section. But sometimes a thread gets hijacked by an important yet tangential debate… Moving lengthy discussions to an organized forum page might make them easier to read and refer to.

  47. Basiorana says:

    I like how nobs believes that if you cold-call random chiropractors– or any practitioner– and say to them, “We have a website devoted to SBM and we’d like you to make posts about how to get all the crazy woo out of your profession” they’d jump to.

    Of your list, nobs, even assuming all of them are, in fact, practitioners of science-based chiropracty, it’s likely none of them have heard of this site, they aren’t particularly passionate about fighting woo in their profession, they are worried about making professional enemies, they are not particularly good writers, they don’t have a subject in mind, or they do not have the time to post.

    Why don’t you send each a link to this site, and chirobase so they know what the site is looking for in a SB-Chiropractor, and ask them to look into it and contribute if interested? I doubt any will respond, but at least then you could know it was not for lack of harassing them.

  48. BenAlbert says:

    Is there an audio or video recording? I would be very keen for either, personally I would pay to see a DVD of this conference.

    Dr Ben

  49. CW says:

    “( For example, I talked to an internist from WA who routinely referred people to chiropractors for low back pain because he thought “there must be something to it” and had no idea of the origins of the philosophy. He was appalled, and said his practice will now change.)”

    Sounds interesting. I’ve wiki’d “origins of chiropractic” and read a bit about its start. I’m guessing that there are other more dire anecdotes of its origin?

  50. Versus says:

    Adding my thanks to all the SBM organizers and speakers. Looking forward to written materials and to the next conference. You guys are great!!!!!

    One more suggestion for speaking venue — the American Public Health Association annual meeting. APHA now has a Chiropractic Section and an Alt Med interest group. I happened to be at another conference in San Diego last year at the same time as the APHA annual meeting was going on, so I joined the APHA and attended the chiro section meeting. There were a few young DCs with MPHs who seemed science-based, some who limited themselves to musculoskeletal conditions (but were not necessarily science-based) and also lots of woo. One DC told me that the influenza virus doesn’t cause death, pneumonia does. (Go figure.) Others go on chiro “mission trips” to India and other countries where vaccine preventable diseases are prevalent without getting vaccinated.

    @ nobs and nwtk2007: If you and others are interested in promoting science-based chiropractic, I suggest you go to your respective state legislatures and urge them to change the chiropractic practice acts to do away with subluxation-based chiropractic and define what DCs are allowed to do in science-based terms.

    @ Tim Kreider: Great idea, but with requirement that arguments must be supported with citations.

  51. Harriet Hall says:

    OzDigger said,

    “Considering Harriet, that you have no scientific credibility, you just “read a lot”, those comments are a bit anachronistic.”

    I have plenty of scientific credibility in most circles, although perhaps not among those who don’t want to believe what science says. The textbook was published in 2001 and the BCA response to Simon Singh just happened, so I don’t understand what is “anachronistic” about my comments.

    Most commenters try to contribute to a rational, courteous discussion rather than insulting the commenter. Next time, please try to respond to the content of the comments.

  52. nobs says:

    >>”# Basioranaon 16 Jul 2009 at 6:39 am
    I like how nobs believes that if you cold-call random chiropractors– or any practitioner– and say to them, “We have a website devoted to SBM and we’d like you to make posts about how to get all the crazy woo out of your profession” they’d jump to.”<>…” it’s likely none of them have heard of this site, they aren’t particularly passionate about fighting woo in their profession, they are worried about making professional enemies, they are not particularly good writers, they don’t have a subject in mind, or they do not have the time to post. “<>”Why don’t you send each a link to this site, and chirobase so they know what the site is looking for in a SB-Chiropractor, and ask them to look into it and contribute if interested? “<>”I doubt any will respond, but at least then you could know it was not for lack of harassing them.”<<

    Oh Really? How do you know that? Quite frankly, I do not know how to respond to this intentionally inflammatory, arrogant, declaration. I will just leave it as is, as I do not care to engage in meaningless assumptions or unsubstantiated accusations.

  53. nobs says:

    Please ignore the above incomplete post- Why it posted garbled….????? It happens here quite frequently and I do not know why. I am going to attempt again, but since there is no preview(if there is-please advise), I do not have any way of knowing ahead of time.

    >>”# Basioranaon 16 Jul 2009 at 6:39 am
    I like how nobs believes that if you cold-call random chiropractors– or any practitioner– and say to them, “We have a website devoted to SBM and we’d like you to make posts about how to get all the crazy woo out of your profession” they’d jump to.”<>…” it’s likely none of them have heard of this site, they aren’t particularly passionate about fighting woo in their profession, they are worried about making professional enemies, they are not particularly good writers, they don’t have a subject in mind, or they do not have the time to post. “<>”Why don’t you send each a link to this site, and chirobase so they know what the site is looking for in a SB-Chiropractor, and ask them to look into it and contribute if interested? “<>”I doubt any will respond, but at least then you could know it was not for lack of harassing them.”<<

    Quite frankly, I do not know how to respond to this intentionally inflammatory declaration. I will just leave it as is, as I do not care to engage in meaningless assumptions or unsubstanitated accusations

  54. nobs says:

    Basiorana16 Jul 2009 at 6:39 am

    >>I like how nobs believes that if you cold-call random chiropractors– or any practitioner– and say to them, “We have a website devoted to SBM and we’d like you to make posts about how to get all the crazy woo out of your profession” they’d jump to.”<>…” it’s likely none of them have heard of this site, they aren’t particularly passionate about fighting woo in their profession, they are worried about making professional enemies, they are not particularly good writers, they don’t have a subject in mind, or they do not have the time to post. “<>”Why don’t you send each a link to this site, and chirobase so they know what the site is looking for in a SB-Chiropractor, and ask them to look into it and contribute if interested? “<>”I doubt any will respond, but at least then you could know it was not for lack of harassing them.”<<

    Quite frankly, I do not know how to respond to this intentionally inflammatory declaration. I will just leave it as is, as I do not care to engage in meaningless assumptions or unsubstanitated accusations

  55. Sam Homola says:

    Those who have inquired about my views and my background might be interested in an online, open access article I wrote for The Journal of Manual and Manipulative Therapy, the official journal of the American Academy of Orthopedic Manual Physical Therapists. This journal is not to be confused with the Journal of Manipulative and Physiological Therapeutics, which is “dedicated to the advancement of chiropractic health care.”

    http://jmmtonline.com/documents/HomolaV14N2E.pdf

    I have been an advocate of science-based manipulation and a critic of chiropractic vertebral subluxation theory since publication of my 1963 book Bonesetting, Chiropractic, and Cultism, which can be seen in its entirety online at

    http://www.chirobase.org/05RB/BCC/00c.html

    Samuel Homola

  56. BenAlbert says:

    Geez, sorry I only flicked through the initial post. I apologise for the stupid question. Suffice to say I would buy the DVD and be pleased to have it in my library. Also, I would probably still consider buying the DVD even if the content was made free online – considering it a donation to the cause.

    -Ben

  57. Basiorana says:

    nobs, it’s not supposed to be inflammatory, it’s supposed to point out the obvious thing that people seem to be missing– in order to want to post here, you need to know about the site (so you can post at all), be passionate about the subject matter (even most SBM doctors don’t actually care enough about fighting woo to write or speak about it), feel confident in your writing skills and have a strong topic in mind, have the time or desire to make the time to post, and not be worried that speaking about such issues will make you enemies in the field (not a problem for doctors, usually, but a potential concern for chiropractors who would be criticizing the majority of their colleagues). The idea that it would be easy to get a chiropractor as a contributor assumes that they would either financially or personally benefit from writing here (doubtful), or that posting here is easy– clearly not, considering the research involved.

    This is not a slight against chiropractors. There are far more doctors who might come across this site and want to/be able to contribute than there are chiropractors who might do the same; thus, demanding a science-based chiropractor as a contributor to discuss subluxations is like demanding they MUST have a proctologist to discuss coffee enemas, or they MUST have a heptologist to discuss Hulda Clark’s liver flukes.

  58. Dr Benway says:

    SBM ought to write to Bernard and Barbro Sachs-Osher offering to explain how “integrative medicine” has resulted in corrupted evidential standards within academic medicine.

    On the plus side, the problematic definition of “integrative medicine” allows for some shift in its meaning over time.

    There’s presently an opportunity to change the very generous Osher legacy into something of lasting value to future doctors and patients. As it stands however, the Osher name is in danger of becoming associated with an anti-science wrong-turn in the history of medicine.

  59. The Blind Watchmaker says:

    Steve,
    I enjoyed the conference. I look forward to attending again at future TAMS.

    One of the commenters above said this…”If Dr. Novella ever manages to find a completely woo-free, chiropractor using scientifically supported methods willing to contribute to this site, I am sure he will welcome them with open arms.”

    I think that they are called physical therapists. My apologies to physical therapists.

  60. Larry Sarner says:

    I find it interesting that “Nobs” (whomever that might be) managed to turn this discussion from the true topic of the blog entry — the first SBM Conference — to chiropractic. He did it with a simple non sequitur with the *second* comment: “Yet there is NO DC on the [SBM] editorial or contributor list. Why?”

    I have seen this sort of thing happen before. Indeed, it has happened to me and colleagues (in spades). A troll comes on with the purpose of changing the subject, and once succeeding in that, keeping the discussion from ever getting back to the original. It is not possible to satisfy the troll, or “get the last word”. And, as we’ve seen here, the discussion just keeps getting further and further afield.

    The purpose of the trolls (they often come in packs, or different guises for the same individual) invariably is either to sabotage the subject/site, or to make every discussion address the trolls’ pet peeves, or both. It’s a trap.

    In my experience, the only way to deal with the trap effectively is to moderate the discussions, and for the moderator to have zero-tolerance for irrelevancy (deflection). Of course, the accusation will come back that this is “censorship”, but that accusation is itself a non-sequitur.

    I suppose I could be accused of committing a non sequitur myself with this comment. But after 59 comments, only a handful of which have been reactions or supplements to the original blog, I’ll have to take my chances there.

    Meantime, is there anyone willing to add their impressions to Dr. Novella’s about the conference itself? Was there anything left out (of either the conference or Dr. Novella’s account) that should have been there?

  61. I’m really disappointed that I couldn’t get to the SBM event and I look forward to watching or listening to a recording.

    And a note to “nobs” – you complain that there is no DC among the SBM crew even though 25% of the conference was devoted to chiroquactic. Do you think they should recruit some homeopaths, naturopaths, energy healers, Tijuana cancer “curers”, reflexologists, iridologists and other SCAM practitioners to cover the other 75%?

    I did a three-day course to become a Reiki master once. Perhaps I could be SBM’s expert on remote attunement over the telephone.

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