My reaction to reading the paper discussed herein, were I a handsome Spaniard.
Bleh. I turned from a short trip to the city of angles with a bad man cold that just isn’t going away. Those who do primary care all tell me that whatever is going around lasts 2-3 weeks. Great. I am not sick enough to get out of work but I am not well enough to have any enthusiasm to do anything. I look at the key board and sigh. I just want to binge watch something mindless.
I know Harriet covered “Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation” last week. But it is one thing to read the evaluation of a paper and quite another to evaluate a paper on your own. It is the latter process where you, and by you I mean me, actually learn something. I write mostly for my edification, not yours. Sorry. It is all about me. I will likely read Harriet’s post this weekend.
The issue at hand is whether chiropractic manipulation can cause a stroke. (more…)
Old bad studies: Fantastical autopsy results
I found the following quote at “Chiropractic care can treat more than just bad backs” (FYI. Chiropractic can’t):
Luse references a study published in The Medical Times authored by Dr. Henry Windsor [sic], M.D. that showcases the correlation of spinal health to overall wellness. Windsor dissected 75 human cadavers to investigate their causes of death. The study showed that 138 of the 139 diseases of the internal organs that were present were in connection to the misalignments of the vertebrae.
But I was intrigued. So I went to the video tape. Well, the PDF.
It is an interesting read by a physician who was looking for an association between curvature of the spine and visceral pathology.
He had 50 corpses, age unknown, that he dissected, looked at the spine for curvature and then looked for pathology in organs in the same distribution of sympathetic nervous system as the level of the spine curvature.
Can neck manipulation cause strokes? Most MDs and many chiropractors agree that it can, but some chiropractors disagree. The subject has been covered on SBM before: here, here, here, here, here, here, here, here, and here. We keep returning to the subject not because it is a common problem (it isn’t), but because it is such a devastating one, and because the general public is still not aware of the risk.
A 2012 study published in the International Journal Of Clinical Practice “Assessing the risk of stroke from neck manipulation: a systematic review” concluded:
Conclusive evidence is lacking for a strong association between neck manipulation and stroke, but is also absent for no association.
Despite the uncertainty, they thought the association was strong enough to recommend informed consent be obtained and patients be warned that neck manipulation “may” increase the risk of a rare type of stroke.
A new study in the same journal, “Chiropractic and Stroke: Association or Causation?” applies Hill’s criteria of causation to the evidence and concludes that causality has not been determined. The author is Peter Tuchin, a senior lecturer in chiropractic at Macquarie University in Australia, and a known apologist for chiropractic. I agree with him that the existing evidence is inadequate to conclusively determine causality, but I think it supports a high probability of causality, and the alternate explanations he offers to exonerate chiropractors are questionable. And other factors should be considered, like the many “smoking gun” cases and whether there is any conclusive evidence of benefit to set against the possibility of risk. (more…)