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102 thoughts on “Science-based Chiropractic: An Oxymoron?

  1. Joe says:

    @EvidenceBasedDC on 07 Apr 2010 at 4:25 pm “I do not believe that the entire profession can be summarily dismissed as a fraud.

    Of course- your business is based on adherence to pre-scientific magical thinking; not fraud.

    As for research (funding), the FCER just ended after 60 years http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=54574 They claim to have “… contributed more than 33,000 articles and helped fund over 152 randomized, controlled trials concerning chiropractic manipulation …” Yet very little in chiro is supported. No chiro has ever been able to explain to me why they should work as if future research will vindicate them.

    If you dig into the Bronfort study you cited, you will find their standards are very low. You will also find that a lot of the positive results are found with PT or massage, not DC.

  2. EvidenceBasedDC says:

    @ Harriet Hall, please don’t misunderestand me. I agree with Dr. Homola on a great many things. I was refering to some of the nastier posters, their vitriol does nothing to further debate or provide information.
    The number of younger chiropractors who wish to purge the nonsense from our profession is steadily growing. I welcome the debate on chiropractic. It should have happened long ago. The peresistance of the “subluxation” is innane. The vast majority of the time I treat sprains, strains or pain that is secondary to an activity the patient is involved in or a medical condition they have. Anyone who says otherwise is selling something.

    @ Joe,
    “Of course- your business is based on adherence to pre-scientific magical thinking; not fraud.”

    You seem to have been to my practice without my knowledge. I apoligize if I didn’t see you. Based on your firsthand experience with this particular chiropractor, one can only assume that you are clarirvoyant, possess the ability to astral project, or some other type of “pre-scientific thinking” based psychic ability.

    On a more serious note, is surprising, that many claims made by chiropractors over the years, based on clinical observation, have not stood up to critical analysis? This can be said of other professions as well. Finding out that a once accepted therapy’s effects are due to placebo or the interaction between doctor and patient itself having a positive effect is not uncommon. This has been true of a number of medical treatments. Allow me to quote Scott Haldeman, MD, DC,

    “A recent Special Issue of The Spine Journal on Evidence Informed Management of Chronic Low Back Pain listed over 200 treatments currently being offered patients with low back pain, most of which are offered by medical physicians. Of these, less than 10% have a reasonable body of support based on high quality clinical trials. The greatest research support was for therapies commonly used by chiropractors including the manual therapies, education and exercise.”

    -3.Haldeman S, Dagenais S: What have we learned about the evidence informed management of chronic low back pain?
    The Spine Journal 2008, 8:266-277

    Your contention that the Bronfort paper’s standards being of low quality doesn’t hold water because, only RCTs were reviewed. No cohort studies, no case studies. Can RCTs be biased? Yes. The reviewers used a scale assessing the risk of bias recommended for use in Cochrane systematic reviews of RCTs. Would you contend that Cochrane’s review system is also poor in quality? Additionally, the system used to grade the studies is the grading system developed by the US Preventive Services Task Force. That evidence grading system is a slight modification of the system used in the 2007 Joint Clinical Practice Guideline on low back pain from the American College of Physicians and the American Pain Society. Does that system have low standards as well? Should their studies be thrown out as well?

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