Talk:Chiropractic/Archive 10

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anonymous stroke study

An anonymous editor added the following to the bottom of the chiro page;

Vertebral artery dissection (VAD) has been observed in association with chirotherapy of the neck.However, most publications describe only single case reports or a small number of cases. We analyzed data from neurological departments at university hospitals in Germany over a three year period of time of subjects with vertebral artery dissections associated with chiropractic neck manipulation. We conducted a countrywide survey at neurological departments of all medical schools to identify patients with VAD after chirotherapy followed by a standardized questionnaire for each patient. 36 patients (mean age 40+11 years) with VAD were identified in 13 neurological departments. Clinical symptoms consistent with VAD started in 55% of patients within 12 hours after neck manipulation. Diagnosis of VAD was established in most cases using digital subtraction angiography (DSA), magnetic resonance angiography (MRA) or duplex sonography. 90% of patients admitted to hospital showed focal neurological deficits and among these 11 % had a reduced level of consciousness. 50% of subjects were discharged after 20±14 hospital days with focal neurological deficits, 1 patient died and 1 was in a persistent vegetative state. Risk factors associated with artery dissections (e. g. fibromuscular dysplasia) were present in only 25% of subjects. In summary, we describe the clinical pattern of 36 patients with vertebral artery dissections and prior chiropractic neck manipulation.

J Neurol (2006) 253 : 724–730

This is interesting information and in the right format it could be used in the safety section. It needs to be properly referenced and cannot be original research. So, anonymous editor, please sign in and reintroduce this right here in this discussion section and lets consider this.

BTW I'll be out till sunday. Everyone have a great weekend! --Dematt 18:23, 30 June 2006 (UTC)

Series of copy edits completed to tighten - please check, don't think there's anything controversial in what I've doneGleng 19:45, 2 July 2006 (UTC)

Excellent work Gleng, it's amazing the things (mispelling, grammer, etc.) that you don't see after reading the same thing over and over:) I'm impressed that you actually read the whole thing at least twice! I only saw one change that I question [1], but I can't figure the best way to say it. Have you finally decided that it is USA, not US or U.S.A. or United States or Yanks:) --Dematt 23:20, 2 July 2006 (UTC)

Bonesetting

That was a joke, right! .. ... or was it?--Dematt 23:22, 2 July 2006 (UTC)

Okay, if not, IMO bonesetting is an art that has it's own history and relevance that is seperate from chiropractic. I don't know much about it, but I'm sure there is information out there that needs to be researched in its own right. If it is determined that it's relevance fits with chiropractic in some way, then we can wikilink it then. But, people looking for bonesetting are not looking for chiropractic. They should not be merged.--Dematt 02:56, 3 July 2006 (UTC)

Agreed. They are two divergent disciplines. Levine2112 04:45, 3 July 2006 (UTC)

Alot of principles apply to both, but bone-setting is new to me, chiropractic isn't. That should spell alot. Don't merge. Drdr1989 00:24, 5 July 2006 (UTC)

Ummmm, I think it should have it's own article expanded, not merged with chiropractic. Seperate and distinct.--Hughgr 02:39, 5 July 2006 (UTC)

"Fact" sheet?

I have been reviewing the so-called National Council Against Health Fraud "Fact Sheet" on Chiropractic and noticed that while it starts out with some facts, it quickly morphs into an anti-chiropractic opinion piece. Therefore I have removed the link. Steth 12:43, 4 July 2006 (UTC)

It is a useful external link, and completely harmonious with our external links policy. However, it would be acceptable to call it something other than a fact sheet on the links if you prefer. Jefffire 12:49, 4 July 2006 (UTC)

Uh... yeah, I concur completely with Jeffire. That you disagree with it doesn't seem to be much justification for removing it. Its within the external links policy. --Havermayer 03:27, 25 August 2006 (UTC)

Science section

Hey guys, we have this sentence in the science section.

However a bigger difference is that conventional medical treatments, especially new treatments, often have a stronger scientific foundation, in that their rationale is supported by experiments that analyse their mechanisms of action in detail.

I'm not sure that it is accurate, but I am open to rationale. The reason being that today's chiropractor was educated in the basic sciences along side pre-med students, has a degree in biology and/or human biology that was taught by PhD's in their fields and learned most of his/her rationale from the same sources as MD's, e.g. Physiology, Anatomy, Biochemistry, Human Dissection, etc., etc. Most chiropractors treat based on the same rationale that MD's treatments are based on. DC's read the same peer-reviewed studies that MD's do, though they also read other sources as well. From what I gather, the only difference may be that they do look at the same information from a vitalistic rather than allopathic POV. I think that is all we can realistically say.

Because the subject of chiropractic is so diverse, I think it is necessary to seperate the information into musculoskeletal and organic(for lack of a better word) conditions.

If we consider that there are theories (lets call them that for now) that are based on the musculoskeletal system and treatment of low back pain, neck pain, etc. And considering that most of what DC's treat are back pain, I think we can assume that most of what DC's do is based on science that is just as strong as conventional medicine, and I might even suggest, is the science that medicine now uses as well, i.e. ice instead of heat for acute low back pain. Just take a look at the research that has been going on at National College, Lincoln college, St. Louis College, etc., since they opened and you will find every approach evaluated long before conventional medicine even considered looking at them. DC's have been researching back pain, neck pain, ultrasound, electrical stimulation, ultraviolet, acupuncture, acupressure, radio waves, color therapy, light therapy, diagnostic tests, all types of equipment, etc. since the early 1900's. Most of the research that debunks several of the treatments of the past came from DC's. Certainly, initially, the research was not up to today's standards, but neither was conventional medicine's. The point is, that the research is there, the effort is and has been there, and continues to look for the best way to treat today's problems - and is just as valuable to the treatment of musculoskeletal problems as conventional medicines research into their medications. An unbiased evaluation reveals a system of pain management that conventional medicine strives to meet. We should assume that it is based on good science until proven otherwise rather than the other way around. Considering that, lets show some of the actual research that is out there.

Now, when it comes to the theory that subluxations cause organic (meaning non-psychosomatic)diseases, there is also research. Certainly the quality leaves some question, mostly because it is difficult to prove with current scientific methods, but that does not mean it is not there. IMO, it, too should be noted in the article as well as referenced (key word- referenced)comments about it's weaknesses and strengths.

Any thoughts?--Dematt 04:49, 6 July 2006 (UTC)

I guess that sentence was mine. The rationale for it is as follows; when new conventional treatments are introduced, clinical trials are just the final stage. Before that stage there is now very extensive basic research on animals and cell lines and then on human volunteers. The basic research seeks to validate the principle behind the treatment - so for a new drug, that research might test whether the drug is specific and selective in its actions, usually by showing that it binds competitively and selectively to a particular known receptor, and characterising its action as agonist/antagonist/invers agonist etc. After characterising the ligand there then need to be studies showing a)that disturbance in that receptor system has pathologically involved in the disease process and that interventions at that receptor can ameliorate it. This might be done for instance by human genetics studies looking for mutated alleles in the case of genetic diseases, or by gene microarray studies in the case of other diseasesThese days this is often achieved in part with transgenic animal models where the expression of the receptor (or an endogenous ligan) is genetically engineered to be up regulated or down regulated, and the phenpotype of the transgenic animal is studied. I don't want to go on, but my point is simply that validation of efficacy is generally only the last stage of introducing a new treatment; and that the rationale of the treatment generally will have been extensively tested in lab experiments beforehand. There is a huge amount of basic research behind new drug treatments, and most new drugs never get close to the clinical testing stage. I did not at all mean to denigrate the training or understanding of chiropractors, or suggest that clinical studies by DCs are less good than those by conventional medics. Many conventional medical treatments have not been scientifically validated in this way, and often it is difficult to do this - for example, a bugbear of mine, the current management of labor in maternity wards would not stand up to scientific validation, but it would clearly be potentially unethical to experiment with a mode of management that is known to be safe whatever your reservations, and has been used for 50 years. So many older treatments were introduced and continue to be used solely on the basis of clinical experience. However this is rarely true of new treatments. The analagous investigation for chiropractic would be studies on the anatomy and functional role of spinal nerves and of their involvement in specific disease processes. Again, this type of experiment could certainly be done in animal models - but I don't think has been. Gleng 16:31, 6 July 2006 (UTC)

I believe that the sentence could be reworked to be made more accurate and less denigrating. To say that there is less experimentation in existence for chiropractic's rationale than conventional medical treatment is rather unfair. Wilk has shown us that chiropractic has really only had but 20 years of funded and scientifically recognized research. What we do know clinically about chiropractic is certainly limited, but the rationale is certainly supported scientifically to some extent. My fear is that there are a lot of anti-chiros out there who claim chiropractic is no different that a faith-based medicine. I think we can all agree that it is not. They might see a sentence like the one in question and jump all over it.

Yesterday, I happened across a piece of research on reflex effects of vertebral subluxations at JMPT. It's not the best piece of research I've seen, but it does look at human and animal models and suggests that vertebral subluxations may modulate activity in afferent nerves. Anyhow, I thought Gleng might find it interesting based on his last paragraph above. Levine2112 18:30, 6 July 2006 (UTC)

No problem Gleng. In fact, I bring this up because it was you that made the statement and I know you would look at it objectively. My point is that if we think of chiropractic as two pronged; 1)treatment of back pain and 2)treatment of subluxation, then we have to compare apples to apples.

The science for 1) back pain is the same science that conventional medicine uses as we both use the same information. Whether it was performed by MD's, DC's or PhD's.
The science for 2) subluxation cannot be compared to science done by conventional medicine, because they have never performed science in an effort to test the subluxation hypothesis. If they had tried, I would venture to say that their methods would be no better than that presented by DC's as the difficulty in testing is the problem.

So, my contention at this point is that the statement;

However a bigger difference is that conventional medical treatments, especially new treatments, often have a stronger scientific foundation, in that their rationale is supported by experiments that analyse their mechanisms of action in detail.

does not compare apples to apples. Make sense? or am I off the deep end? How can you say one is better than the other?--Dematt 19:24, 6 July 2006 (UTC)

The House of Lords committee report covers all CAM not just chiropractic - chiropractic is Group 1 and comes off well generally in the report, but the report seemed to make some apt points: "The Department of Health summed up their opinion of the evidence base "Evidence for CAM in the form of research has been criticised as being inadequate, and there is some justification in this claim" the Department of Health [acknowledged] that the same could be said for some conventional medicine. It is our view that most modern conventional therapies are backed by scientific evidence. ...There are two notable weaknesses of the evidence base for CAM. One is that in most of these areas little research is being done, and the second is that the few studies which have been completed are given disproportionate weight. ..All the therapies .. in Group 1 either have done, or are working on, rigorous trials to test their claims. However, one or two studies with positive results in support of their claims for efficacy are not enough. ..... Evidence for the efficacy of the treatment itself is not the only important factor .. evidence of the validity of diagnostic procedures is as important as evidence supporting efficacy of a treatment.....Diagnostic procedures must be reliable and reproducible and more attention must be paid to whether CAM diagnostic procedures as well as CAM therapies, have been scientifically validated."

I accept that physical therapies may be just as empirically driven as chiropractic. Any implication that chiropractic practices are faith based is unintended. I also agree that much conventional medicine is validated in a very similar way to chiropractic. Validation of a medical treatment is multi-facetted, Clinical trials are not the whole answer -in all trials there are non-responders, so even when a trial validates the general effectiveness of a treatment, this is not the same as declaring its universal effectiveness. The key to rational medicine is identifying in advance which patients will respond to a treatment, and this means understanding the differing aetiologies of disease and diagnising them accurately. The role of basic science is to establish the mechanisms of disease in a way that translates into diagnosis and treatment, and in a way open to scientific test and falsification or verification. Chiropractic has a strength in seeking to understand the "whole patient" and seek individualised treatment. I think the chiropractor uses his or her experience and the collective empirical experience of chiropractors to come to a diagnosis and recommend a treatment. However these circumstances are precisely those when the influences collectively called the placebo effect will be most influential, so part of the effectiveness of chiropractic seems certain to be accounted for by a strong placebo effect. To refine and improve treatment it is important to identify where the effects of treatment go beyond this. This I think is where the scientific basis of chiropractic looks weak because of a shortage of research. I think the theory needs to be elaborated with more detailed functional and anatomical studies, (studies exactly like those found by Levine above - thanks for finding this Levine; obviously there are people on the case here). However, that's my opinion; what I was trying to do here was to characterise the nature of the evidence for the effectiveness of chiropractic while acknowledging areas of relative weakness - in the sense that the scientific foundations are deficient because more research is needed, not because the foundations are implausible or dogma based.Gleng 11:46, 7 July 2006 (UTC)

So, can we agree that we could contend that- for back pain related research - the body of science for physical therapies and conventional medicine is essentially on the same footing as chiropractic, though all may lack some quality? It is the claim for health related benefits of chiropractic that lacks sufficient evidence, as the body of quality science available is insufficient to draw conclusions about specific diagnostic or treatment methods. --Dematt 13:06, 7 July 2006 (UTC)

I think that's fair, though I'm conscious that we're getting into OR and our interpretations here, so it would be best to agree that this seems a fair reflection and find some authoratative statement backing it - one reason I've been stressing the report above is to see if we can use this as authority for what is said here. Personally I think this report was a well informed and balanced overview, might be a bit out of date now, and not specific enough about chiropractic, but it's the clearest and most responsible acount of the confounding effects of the placebo effect that I've seen. Overall it's sympathetic to chiropractic while keeping an objective distance, and not shy of stating where the potential problems areGleng 14:07, 7 July 2006 (UTC)

Okay, thanks Gleng, just had to get it straight in my head as we work our way though this. I appreciate your knowledge as well as your candor. Feel free to keep me on track during this process as I am sure my bias will occasionally rear it's head:) --Dematt 18:11, 7 July 2006 (UTC)

"Adjustment" claim

The following self-glorifying (?) claim in the article is problematic:

"The chiropractic adjustment differs from other manipulative techniques in its precision and accuracy in correcting vertebral subluxations."

It makes an undocumented claim:

... that it is more precise and accurate than "other manipulative techniques," when in fact an adjustment can be performed precisely or imprecisely, accurately or sloppily, and other manipulations performed by other professionals can be performed just as precisely or imprecisely. Skills vary among chiros and among other professionals, but only chiros call it an "adjustment," regardless of whether they've done it well or not. This does not deny that it should naturally be the case that more chiros are skilled at it than the number of those skilled at it in other professions, since it is the hallmark skill of chiropractic.

It does not differ for the reason claimed, but for another reason:

... it is performed for another reason than other manipulations - it is performed to correct vertebral subluxations. Other manipulations performed by other professions (and reform chiros) are performed for other reasons. Only those who believe in vertebral subluxations perform "adjustments" to correct them.

The defining difference is the intent. The sentence should be reworded or deleted. I favor rewording it, since this difference in intent is crucial to an understanding of chiropractic, and should not be left unsaid. -- Fyslee 14:42, 8 July 2006 (UTC)

I beg to differ. Historically, manipulations were given to a general area, where as the adjustment was given to a single, specific vertebrae.--Hughgr 18:42, 8 July 2006 (UTC)

I understand what you're saying, but the facts (not the same as "intention") say otherwise. Historically that may be so, but nowadays manipulation can and often is directed at a specific movement segment (I assume you are referring to such), at very specific angles, but in fact it is impossible to limit the effects of an adjustment or manipulation only to that segment, although an attempt to do so will help to limit it to the local area. A failure to attempt such limitation will result in a general mobilization of the area (which will still do the job in most cases.....;-). -- Fyslee 22:33, 8 July 2006 (UTC)

Wow, this is basically the same conversation we are having on the VS page[2]. Down to the minute:) I'm moving it here so we can work on it together;

Hey guys, Fyslee made a much needed edit;

It could be said the one thing that separates the chiropractic adjustment from other manipulative techniques is the aim toward specificity.

It could be said the one thing that separates the chiropractic adjustment from other manipulative techniques is the aim toward specific treatment of subluxations.

When I read the original sentence, I thought it was talking about the difference between what is claimed to be the more generalized osteopathic manipulative techniques that "crack" them all vs the claim to adjust just the specific subluxation necessary. This new sentence seems to say that they only treat subluxations. Is that what we meant? And is that what we want? And if so, maybe we can add the comparison with the osteopath. --Dematt 22:33, 8 July 2006 (UTC)

My edit summary:

"undocumented assumption reworded to accurate description"

I attempted to resolve a problematic wording by replacing it with something that was at least accurate, even if it might have changed the originally intended (and undocumented) assumption (meaning). Maybe I interpreted it incorrectly. I hoped to create a wording that could stand up to scrutiny. The original was lacking - in my opinion. -- Fyslee 22:44, 8 July 2006 (UTC)

I have to agree with Fyslee. Either his statement should stay or we need to document that the DC's technique is different and more specific. Otherwise, we state that DC's think that their technique is different and allow appropriate discussion to the contrary. Is this a fallacy that DCs are led to believe by their instructors; is it a fallacy that DCs lead their patient's to believe for some reason; is it a fallacy that DCs want other professionals to believe as a proprietary or legal protection; or is it true.

I think there are times when it is accurate to say that the adjustment is more specific. For instance, with HIO that only adjusts the atlas or Gonstead technique that only adjusts the major subluxation in the specific direction of fixation there is no doubt about specific adjustments to specific vertebra. I would imagine that the actual statement came after BJ narrowed treatment to HIO. However, by that time, diversified technique had already been circulating (Langworthy incorporated lots of techniques at ASC), the adjustments tend to be more generalized and will move more than the intended vertebra. We can say DD noted that the difference was using the short lever for the adjustment, but even he began to adjust different vertebra with different methods, probably a lot borrowed from osteopathic and bone-setting techniques.

So maybe it's a little of all these things. If we use one sentnence, it would be more accurate to use Fyslee's version. Or we have to expound and document. If there are some facts out there, lets see them.--Dematt 03:47, 9 July 2006 (UTC)

In regard to Dematt's first paragraph above, I think we could answer "All of the above." It can be very precise, it can also be a delusion, and it can also be a sales gimmick. It depends on the situation, the chiropractor, the school, etc. All of the above are definitely true at times, but just as certainly not always.

One can make a rock solid case for one thing: the (only?) absolutely defining difference between the chiropractic "adjustment" and joint manipulation is the intention - to correct vertebral subluxations (VS). Only chiropractors have a patent on this concept, as well they should.

One cannot make a solid case for degree of accuracy or precision, since that depends on the skill of the one doing it. This is true among chiros themselves. There are MDs, DOs, and PTs who are just as skilled at doing precision manipulating as any DC. Certainly not as many, but they do exist. Yet they don't do it to correct VS, and they do it only in the presence of symptoms, whereas many DCs perform adjustments based solely on the DCs own determination of the presence of a subluxation. It is this type of asymptomatic treatment that raises the hackles of skeptics, and is specificially singled out by many insurance companies as non-coverable. It lessens the credibility of the whole profession, to the detriment of many sincere and highly skilled DCs.

I originally saw the first version of the sentence in question as a blatant attempt at putting one-upmanship into the article, but I let it ride for awhile. When I saw that it was still there without being dealt with as a clearly POV sales trick, I decided to attempt to at least make the statement accurate in some sense, without starting a debate over the original intent. Better to let it die a quiet death....;-)

I certainly would have no problem with an added sentence explaining that chiropractors are trained to perform specific adjustments with great accuracy, but it shouldn't be written *as if* they are the only ones who can do it specifically and accurately. That is actually becoming less true all the time, in keeping with the increased training many PTs are receiving in manipulative techniques. Since the article is about chiropractic, and not about MDs or PTs, they don't need to be mentioned, or any comparison made. That would avoid any one-upmanship problems. It goes without saying that the greatest number of skilled joint manipulators are to be found in the chiropractic profession.

One thing to keep in mind - a joint cares not about the intention of the manipulator. As long as the manipulation/adjustment is performed properly, some relief should occur. The chiropractic intention (correcting VS) has its greatest effect on the mind of the patient and on the chiropractor's own sense of having done a good job. Fantastic placebo effect and marketing technique (which is constantly being misused by practice builders to manipulate patient's minds). The joint couldn't care less who did it or why. -- Fyslee 14:48, 9 July 2006 (UTC)

So the who and why only become important when considering when and how much and how often.--Dematt 11:49, 10 July 2006 (UTC)

Well.....taking into account that my statement is rather simplistic, yes. Of course there can be other factors to consider, but from a purely physiologic sense, without the psychological/placebo aspects, a joint in need of a manipulation/adjustment should respond positively. -- Fyslee 16:57, 10 July 2006 (UTC)

And your statement allows for an important philosophical difference among manipulators. If we consider just objective straights, they would manipulate different vertebrae at different times for different reasons and possibly more often than PT's, MD's and even some (or they would argue, most) DC's. So the difference may not be so much the specificity of the manipulation as much as the specific purpose. I.e., if your purpose is to reduce pain, 10 visits with some exercises and IBU might do the job, but if your purpose is to "affect dyspepsia with or without spinal pain" it may take 30 visits and stay away from the IBU. Thus, Fyslee's statement of manipulating the vertebral subluxation is probably more accurate as it encompasses this concept without regard to other manipulators and their skills and purpose.

Just to add my two bits, it has been my understanding that the manipulation was to a general area, whilst the chiro adjustment was to a specific, single vertebra with a specific line of correction. But perhaps that not as accurate now as it once was. I have no problem with the current wording. but I'd just like to show a quote I found that shows why I've thought this.

"Yes, there are osteopaths, a few orthopedist, and some physiotherapists who "manipulate" the body, including the spine. But because of their general dirth of training, because of their tendancy to non-specificity in their manipulations, because they see manipulations limited to musculoskeletal problems, and because they tend to lack a meaningful, practical grasp of the hierarchial arrangement of the body's systems, their manipulations are unable to approach the clinical results of chiropractors. That of course could change with time...The concept of analyzing and correcting the full spine, as a functional unit, would not rest well with allopathic thinking." (vs. only manipulate area with pain) V. Strang, 1984 Essencial Principles of Chiropractic--Hughgr 19:02, 10 July 2006 (UTC)

Putting together all that, how about:

Chiropractic's contribution to the field of manipulative therapies is the concept of applying a precise adjustment to a specific affected vertebra rather than the generalized maneuvers of the early osteopaths. Though other healing arts have recently begun to develop their skills in this area, the use of spinal manipulation in an attempt to correct the theoretical vertebral subluxation remains solely a chiropractic endeavor.

--Dematt 19:38, 10 July 2006 (UTC)

I like it. Levine2112 21:06, 10 July 2006 (UTC)

Very good. -- Fyslee 14:35, 11 July 2006 (UTC)

Cool, I'll put it in and see what happens:) --Dematt 14:43, 11 July 2006 (UTC)

Sorry, I didn't see this discussion before my edit. However, the statement "...other healing arts have recently begun to develop their skills in this area..." presupposes that they need to, which may not be generally accepted. — Arthur Rubin | (talk) 17:32, 11 July 2006 (UTC)

No problem. That's a good point. Keep thinkin' :) --Dematt 18:10, 11 July 2006 (UTC)

I've just tried to salvage the most important point. -- Fyslee 19:03, 11 July 2006 (UTC)

I took the extra mile:) --Dematt 19:35, 11 July 2006 (UTC)

Research funding

Always an issue with research, I figured it best to add at least paragraph describing the nature nature and state of chiropractic research funding. The most info that I could locate was from the Cherkin/Mootz report Chiropractic in the United States Training, Practice, and Research <-- PDF. However, the data presented in this report is only accurate as of 1997. Updates and revisions for encyclopedia accuracy is appreciated as always. Levine2112 17:27, 10 July 2006 (UTC)

Good, thanks Levine! I keep going back and forth trying to decide how to address research funding. I feel like there should be something in the history that mentions the AMA role in restricting research efforts and the monetary effects of schools being private instead of public. If you come up with anything, that would be great as well.--Dematt 21:07, 10 July 2006 (UTC)

I am looking around for this and more current data about the state of chiropractic research funding. Levine2112 21:09, 10 July 2006 (UTC)

Also, from Wilk vs. AMA,

"Evidence at the trial showed that the defendants took active steps, often covert, to undermine chiropractic educational institutions, conceal evidence of the usefulness of chiropractic care, undercut insurance programs for patients of chiropractors, subvert government inquiries into the efficacy of chiropractic, engage in a massive disinformation campaign to discredit and destabilize the chiropractic profession and engage in numerous other activities to maintain a medical physician monopoly over health care in this country." Interesting, eh.--Hughgr 22:01, 10 July 2006 (UTC)

Wow, that says a lot. --Dematt 22:04, 10 July 2006 (UTC)

archive?

Could we archive this, its getting really long. Thanks.--Hughgr 19:45, 11 July 2006 (UTC)

Done, hopefully to everyone's satisfaction. -- Fyslee 20:15, 11 July 2006 (UTC)

Thankyouverymucha :)--Hughgr 23:34, 11 July 2006 (UTC)

Muchos Gracios Amigos! --Dematt 03:41, 12 July 2006 (UTC)

Mange tak! Levine2112 03:50, 12 July 2006 (UTC)

Det var så lidt. Da nada. -- Fyslee 09:45, 12 July 2006 (UTC)

Inappropriate Utilization of cervical manipulation

Hi folks,

I added a few lines discussing Rand's finding that cervical manipulation is used inappropriately. Please review. Abotnick 03:05, 20 July 2006 (UTC)

My first comment is that you wrote: "the Rand corporation reviewed chiropractic usage of neck manipulation", but the reference you are pointing to doesn't specify "chiropractic". Did the actual Rand study only include "chiropractic" usages, or is this one of those case where they are also including a blind masseur and an Indian barber's use of neck manipulation? (See Terrett AGJ: Misuse of the literature by medical authors in discussing spinal manipulative therapy injury. JMPT 1995;18:203) If it was not limited to chiropractic then it isn't really relevant to this article and should be removed.

Second, note that the number may be incorrect or misleading. Here in a summary of the RAND report the numbers are different and you can get a clearer picture of the story. The panel demonstrated clear agreement on 40% of the indications and clear disagreement on 2% of them. Regarding the appropriateness of cervical manipulation or mobilization for the indications 43% of the indications were rated inappropriate for the intervention with 41% ranking as uncertain and 16% considered appropriate. Levine2112 03:21, 20 July 2006 (UTC)

The NCAHF link in the article doesnt' work, and the rand ref is only a cover page, so there's not much info. Do you have the report Abotnick? What needs to be answered with this discussion is whether or not the "whole" spine works as a functional unit, or is it just individual motion segments.--Hughgr 18:06, 20 July 2006 (UTC)

I made some changes. See what you think. I may have changed too much, so feel free to change it back.--Dematt 18:28, 20 July 2006 (UTC)

L>:My first comment is that you wrote: "the Rand corporation reviewed chiropractic usage of neck manipulation", but the reference you are pointing to doesn't specify "chiropractic".

L>Did the actual Rand study only include "chiropractic" usages, or is this one of those case where they are also including a blind masseur and an Indian barber's use of neck manipulation? (See Terrett AGJ: Misuse of the literature by medical authors in discussing spinal manipulative therapy injury. JMPT 1995;18:203) If it was not limited to chiropractic then it isn't really relevant to this article and should be removed.

According to the NCAHF reference it was a multidisciplinary panel which included chiros. I don't see any reason why it would be irrelevant.

>TDiI - The panel included chiros. But was the study only about chiropractic adjustments or did it include other people performing neck manipulation? Levine has a good point - is is the same point that Terrett made in his study - that studies about neck manipulation have been wrongly attributed to chiropractors. If this study wasn't exclusively about the proper usage of neck manipulations as performed by chiropractors, then it is of very little value here other than to mislead readers. This portion of the article asked the question: Is the chiropractic adjustment safe? However, this RAND study doesn't help answer that question. It asks: Are neck manipulations safe? Neck manipulation can be and are unfortunately performed by practioners with less precision skill of a chiropractor. I think Terrett noted that this study included manipulations performed by a Kung Fu healer or something wierd like that! Using this RAND study to answer the question "Is chiro safe?" would be like using a study that included heroine addicts to answer the question "Are syringes safe?" I hope you all see my point. TheDoctorIsIn 20:42, 21 July 2006 (UTC)

L>Second, note that the number may be incorrect or misleading. Here in a summary of the RAND report the numbers are different and you can get a clearer picture of the story. The panel demonstrated clear agreement on 40% of the indications and clear disagreement on 2% of them. Regarding the appropriateness of cervical manipulation or mobilization for the indications 43% of the indications were rated inappropriate for the intervention with 41% ranking as uncertain and 16% considered appropriate. Levine2112 03:21, 20 July 2006 (UTC)

I'm secondary referencing here. Does anyone have access to the original study? The low back pain study they referenced pulled records and I'm assuming that this was done also so it is not just indications. If that is true then it isn't comparable to Levine's 40% study.

The NCAHF link in the article doesnt' work, and the rand ref is only a cover page, so there's not much info. Do you have the report Abotnick? What needs to be answered with this discussion is whether or not the "whole" spine works as a functional unit, or is it just individual motion segments.--Hughgr 18:06, 20 July 2006 (UTC)

Link is fixed.

Abotnick 19:11, 20 July 2006 (UTC)

Abotnick, I'm not sure I'm reading the same thing you are in the referenced article. Am I missing something? --Dematt 19:25, 20 July 2006 (UTC)

Dematt, I found some more information on the Coulter study. They did use clinical scenarios. I don't think that it was a reflection of chiropractors actual practices which since they are subluxation based are probably even worse because they don't rely on a valid diagnosis.

See below.

http://www.ptjournal.org/Jan99/v79n1p50.cfm

"Another approach to evaluating the risks and benefits of MCS is to summarize the opinions of experts in the field of manual therapy. The RAND group evaluated the risks and benefits of MCS by assessing the clinical opinions of a 9-member panel that consisted of 4 chiropractors, a primary care physician, a neurosurgeon, an orthopedic surgeon, and 2 neurologists.11,174,175 Ratings were made on a 9-point ordinal scale (1=inappropriate application of MCS, 9=appropriate application of MCS). For 736 "clinical scenarios," the panel indicated that only 11.1% of the scenarios were appropriate for the application of MCS, whereas 57.6% of the scenarios were ranked as inappropriate.174 Coulter174 noted that for almost all the scenarios evaluated, the use of mobilization was rated more favorably than manipulation." Abotnick 15:30, 22 July 2006 (UTC)

I see what you're saying and I broke the group down into 4MDs, 4DCs and 1 MD/DC because I think it is relevant in this discussion. Because we are trying to use research to back up conjecture, I think we need a good reference for the last sentence, then we got it. Other than that, the paragraph could theoretically use a rebuttal type statement that takes out any particular POV and allows an uneducated reader to draw their own conclusion.--Dematt 13:36, 24 July 2006 (UTC)

My problem still remains that this study was about cervical manipulation performed by other practitioners than just chiropractors. For all we know (this is just a hypothetical), 100% of the manipulations performed by chiropractors were deemed appropriate in this study, while the other practitioners accounted for the misuses. I don't see how this study is really helpful to an article exclusively about chiropractic (and not exclusively about cervical manipulation). I recommend expunging it or making the point clearly within that this study wasn't limited to chiropractic cervical adjustments alone. For a clear snapshot of the implication of what RAND research has shown specifically about chiropractic, check out this link on RAND. Levine2112 15:58, 24 July 2006 (UTC)

I agree with the concern about whether chiros performed the manipulations. I am also concerned that I don't know what the list of conditions were. For instance, perhaps the list of over 700 conditions were things like vaginitis, hemorroids, ingrown toenails and then headaches. Then I would agree cervical manipuation may be appropriate for only 11% of those. Without knowing what was on the list, the numbers are meaningless to those who "really want to know":) If the paragraph stays, the next sentence needs to address these. --Dematt 17:25, 24 July 2006 (UTC)

I performed some editing to this section in question. I still think it should be expunged outright due to its lack of chiropractic specificity and thus being a source of confusion, but if it is going to stay it should be more along the lines of how I edited it to be. As usual, I am open to alternatives. Levine2112 18:20, 24 July 2006 (UTC)

BTW, I have a similar objection to the research behind our footnote #2 which is linked to one of ur intro paragraphs. While this meta-analysis talks about chiropractic, the research is dealing with spinal manipulation in general and includes in his research manipulation performed by other types of practiitoners than just chiropractors. We really can't validly use this research to say anything about chiropractic specifically; certainly we can't use it as scientific evidence that specifically refutes chiropractic. Levine2112 17:04, 24 July 2006 (UTC)

Levine, I find it interesting, given their conclusion, that they say, "We do, however, note that the absence of evidence is not the same as evidence of absence of an effect. None of the reviews conclusively demonstrates that SM is ineffective."

Also, relating to "inappropriate cervical manipulations", does anyone have a comment on evaluating the whole spine as a functional unit, vs. one motion segment?--Hughgr 19:24, 24 July 2006 (UTC)

Conleydc changes

Conleydc, Welcome! It is good to have some new ideas here on the chiropractic page. You had some good input, but got a little carried away:) Please don't take it hard that I reverted your changes. Some of them were not bad, but when you deleted large volumes of text, you inadvertantly deleted other points of view(POVs). While they may not be your POV, they represent months of work by countless numbers of editors that represent as many POVs. Overall the compromised text covers all our POVs. While your POV is important as well, please feel free to add whatever you like (though be prepared for some cross examination), but try not to delete text without discussion. Looking forward to your input!! --Dematt 14:20, 24 July 2006 (UTC)

RfC on National Association of Chiropractic Medicine

I am beginning an RfC on National Association of Chiropractic Medicine, and would lke to get input from others as to whether it should or should not be referenced in the article.

It is my view that it is not a source worthy of reference since it does not publicly reveal it’s membership numbers or names, does not hold elections for officers like real groups and associations do. I could not find any information about regularly held meetings, or any scientific seminars that it sponsors for the chiropractic profession for continuing education credits.

All I could find is a one-page website with three of the four links at the bottom to websites that are privately owned and operated by Stephen Barrett that solicit donations. Therefore I am skeptical about this so-called ‘Association’ and its inclusion in this article.

Even though it is a chiropractic group, Fyslee, who, curiously is a physical therapist, seems to know much about it. I am assuming good faith that he or Artie Rubin can provide this needed data, as they felt strongly enough to ensure the inclusion of the several references to NACM. I had asked for this information in the past, but nothing was produced.

Lacking verifiable data, perhaps we should consider removing it. Would anyone care to comment? Steth 02:29, 26 July 2006 (UTC)

Assuming what you say is accurate - that it does not publicly reveal its membership numbers or names, does not hold elections for officers like real groups and associations do, and that it is not a ligitimate organization with any sort of majority or significant view - I would have to concur that any reference to it should be expunged... and perhaps its own article should face the test of an AfD. Levine2112 05:43, 26 July 2006 (UTC)

I was the one who added it to the "reform section", but those are valid points. All I know is what they (whomever they are) say in their website. If we can't prove that it is a real organization then it shouldn't be included.--Hughgr 05:47, 26 July 2006 (UTC)

I believe what I wrote to be accurate, as I couldn't find any information anywhere about this. In previous talk pages, Fyslee explained that if the names were revealed, it's members would be in great physical danger (presumably from angry chiropractors) and that these attacks have taken place. I asked him to elaborate to prove this, but he was not forthcoming. Either way it should be considered for exclusion from the article.

I think you are right Levine, the article should be brought under scrutiny with an AfD. Maybe others can provide some insight. Steth 10:53, 26 July 2006 (UTC)

I would like to give anyone else an opportunity to provide the data on NACM. Otherwise I will go ahead and remove the references as I think that is the correct thing to do for unverifiable additions. Can anyone provide this information? Thanks Steth 16:59, 26 July 2006 (UTC)

Hi Mccready, I noticed recent changes to the Chiropractic article you have been making lately. Regarding the NACM, I have been seeking information regarding their legitimacy. Do you have some new information that would qualify them as a legitmate "association"? You know, like the list of members, officers, something about elections, seminars, or official recognition. I have been trying to locate this information, but have been unsuccessful in this endeavour. If you have this information, please share it with us so we can evaluate it. Thanks,Steth 11:37, 28 July 2006 (UTC)

Vandalism?

Mccready, take a chill pill. I think you woke on the wrong side of the bed. You know better, please be careful. --Dematt 12:22, 26 July 2006 (UTC)

Vandalism is too strong a word perhaps, but a reasoned approach is always better, with extensive use of the talk page. Jefffire 12:24, 26 July 2006 (UTC)

Deleting things because the "article is too long" is IMO poor justification, and inevitably leads to POVish deletions. Removing otherwise good information from WP is imo a far worse "sin" than exceeding nominal article length. Better to seek consensus and perhaps split the article in such cases. - Jim Butler^(talk) 19:03, 26 July 2006 (UTC)

Here, here. McCready, we finally got this article running smoothly with editors of all POVs. Please respect. Levine2112 06:50, 27 July 2006 (UTC)

Revert war

1. Top should say "vertebral subluxations" and differentiate from subluxations 2. Article too long - the bits I've removed should be on other pages. 3. There is definitely dispute about chiro effectiveness (despite levine's and others religous adherence to the line) and this needs to be flagged. 4. There is good commententary that chiro is a pseudoscience and this needs to be tagged. If you want a solution to this, best to tackle the points one by one, eh? Mccready 07:01, 27 July 2006 (UTC)

Some of your points are good enough, just take it one at a time, and discuss serious and larger edits here first. -- Fyslee 08:01, 27 July 2006 (UTC)

You've reverted good edits. Which points do you disagree with?Mccready 08:17, 27 July 2006 (UTC)

I disagree mostly with (2). Even if the article is too long, and the rest of the editors can be convinced of that, the decision of what to do with the article and the information still needs to be made by the editors working together, not just by one editor who edits too boldly. That only leads to revert warring and bad feelings.

The other points do need looking into, especially the first one about "vertebral subluxations." I'll do that one right now. -- Fyslee 10:37, 27 July 2006 (UTC)

I have no trouble with 3 of the points noted above. However, if we must include such a strong stance on science, then the article will have to be longer due to the necessity to explain the metaphysical, hypothetical and religious aspects of chiropractic. And then you would have to explain that most DC's don't really practice that anyway, because 90% treat low back and neck pain, apparently effectively and with high patient satisfaction. I think we're looking at a vicious cycle that from a philosophical POV appears as pseudoscience, which is what some would like to see, but others see as dogmatic stubborness in an effort to protect a theory until science proves it. That could be argued ad infinitum on this discussion page, but all it will do is continue revert wars for the next ten to thiry years (which is how long it will be until the science is finished). It seems that the only reasonable solution is to either use compromise wording or go ahead and take out all mention of science and flag it now. Any thoughts?--Dematt 15:57, 27 July 2006 (UTC)

The article is long, but it's a big topic. Doesn't matter anyway, not a paper encyclopedia. The "bits" your removing are information that contradicts your POV, but are relevent to the article. Please don't remove them. I doublt someone would be confused about a "subluxation" on the "Chiropractic" page. There is already a disambig. page and the chiro sublux page makes the distinction. And finally, discuss your "bold" changes on the talk page first. --Hughgr 17:24, 27 July 2006 (UTC)

(2) Long articles can be split; that's better than deleting material. Kevin, we had this discussion on talk:acupuncture where (intentionally or not) you kept deleting stuff that was counter to your POV.

(3) Re debate over effectiveness, using NPOV, perhaps we can just say something like "most scientists see evidence" and cite it.

(4) On pseudoscience: under NPOV it is fine to say in the article that some people say chiro is pseudoscience. However, using the category advances that POV to the exclusion of others. This has come up with acupuncture and related topics, and I see a real problem with some editors trying to impose the views of skeptical advocacy groups, a/o the deprecated WP:SPOV, and refusing to consider the implications of NPOV violations. Please read WP:CG, which cautions the possible POVishness of using cats and says when in doubt, don't do it. The cat is also misleading to readers, esp. in light of the fact that some scientists find evidence for chiro's efficacy. Even under WP:SPOV, category:pseudoscience is unjustified unless there is scientific consensus that chiro is pseudoscientific. "Good commentary" that chiro is pseudoscience is fine to cite in the article with NPOV wording, but in no way suffices to justify using a category, which by definition is without qualification. Thanks, Jim Butler^(talk) 04:52, 28 July 2006 (UTC)

I think your on the right track. Parts of chiropractic could be considered PS and it may be appropriate to that opinion as such, but there is no consensus on that issue among outsiders much less here on the WP.--Dematt 14:14, 28 July 2006 (UTC)

I must agree. While certain beliefs are clearly considered pseudoscientific by skeptics and the medical and scientific world, labelling chiropractic as a whole, especially using the category tag, is too much. The specific aspects that are pseudoscientific can be mentioned in the article, but spare us for the category tag. Use it on homeopathy! It's only redeeming quality is that it itself can't harm anyone, after all, "Homeopathy is bullshit. Only very, very diluted. It's completely safe to drink." - Peter Dorn. -- Fyslee 14:24, 28 July 2006 (UTC)

Funny quote, and it's gratifying to see that you guys share some reservations about category:pseudoscience. On homeopathy, I'm pretty skeptical, but even there I'm dubious about using cat:pseudoscience. It's a little bit like the example given at Wp:npov#Let_the_facts_speak_for_themselves. We should just report what reviewers say about the evidence, or lack thereof. Some editors seem more interested in affixing the pseudoscience label than in presenting specific arguments from critics, and I think that's a shame. But if consensus is to keep this cat — it did survive a deletion nomination — then we should be careful in using it. Wikipedia:Categorization_of_people has some good stuff to say along these lines. cheers, Jim Butler^(talk) 03:20, 29 July 2006 (UTC)

The stuff I've deleted as too long should go in other articles - so put it there if you wish. You'd have to be a diehard to delete the RAND stuff I put in Paul - talk about good faith!!! I haven't got time to muck around again so I'm reverting. Apologies to anyone whose since made good edits but now you know how it feels. Mccready 08:21, 28 July 2006 (UTC)

Kevin, please engage the issues that editors have raised here. Reverting without discussion is contrary to WP:DR, which is WP policy. Please abide by that and don't escalate. Thanks, Jim Butler^(talk) 08:37, 28 July 2006 (UTC)

Kevin, you know that I agree with the meaning, if not the precise wording, of certain of your edits. The problem is that you make too many edits at one time, so the only practical way to restore things ends up also deleting the good edits. Make smaller edits. Then they can be refined, instead of deleted. Use the talk page more and the edit button less. Editing, in and of itself, isn't necessarily part of collaboration. Using the talk page is where that happens, then your edits have a better chance of becoming a stable part of the article, if that is what you really wish. If not, just keep on going it alone and your hard work will be wasted effort, because even I won't be able to defend you or your edits. -- Fyslee 14:30, 28 July 2006 (UTC)

Section "Changing political and healthcare environment"

The bulk of the verbose section "Changing political and healthcare environment" does not seem to relate to the topic. Only at the end, the section makes a small connection with the topic. I suggest the section be summarized into 2 or 3 sentences, and the irrelevant material removed. Any objections? -Pgan002 00:18, 28 July 2006 (UTC)

McReverts

I have been trying to establish if NACM is a legitmate organization, i.e. does it publish a list of members, elect officers, sponsor seminars, etc. like all real associations do. I asked for comments as suggested by an admin. I politely asked for the data many times. No one produced the data to verify it's legitimacy, yet Fyslee and Macready insist it should be in the article because...??? I

I remove the references, they put it back. Back and forth, back and forth. No discussion. Fyslee says it is notable and I don't need to know more and I should just live with it. Why? Because he says so and they have a one page website so it must be a legitmate organization. After all, he is a physical therapist you know, and chiropractic's foremost historian, so there. Mcreedy? Well Mccready is Mccready. Spreading grief with massive POV McReverts (copyright) throughout WP. So what's an editor to do with? I would gladly solicit suggestions, as I see others are just as frustrated with getting nowhere fast. Steth 23:01, 28 July 2006 (UTC)

Revisions/reverts of Lead

Mccready, this sentence in the lead really bugs you:

"Chiropractors believe that alleged spinal joint misalignments, which they call vertebral subluxations, can interfere with the body's self-regulating mechanisms via the nervous system, resulting in bodily dysfunction."

What legitimate (from a Wiki viewpoint) reason do you have for changing it? It is written very carefully, in a NPOV way. It is true that chiropractors "believe" that unproven idea. That's the facts. If it stated that the belief itself was true, then you'd have a leg to stand on, but you don't. -- Fyslee 16:18, 29 July 2006 (UTC)

parsing ambig. disagree that "belief" modifies self reg crap - which is common to all health interventions anyway. it's weasel alt med, like non invasive surgery etc, to create brand differentiation in the mind of the target Mccready 14:09, 30 July 2006 (UTC)

In other words, you dislike the motivations of those who say it. That's not a valid reason to delete. I'm restoring. thx, Jim Butler^(talk) 16:26, 30 July 2006 (UTC)

OK - that was a bit hasty, sorry - I now understand what you mean by "parsing ambig." It's a valid point, even though I disagree it was really that ambiguous. Moot now given a string of edits to that part. I'll leave it up to better-informed editors to hash out how important this "self-regulating" thing is, and how to present it. You sure are cynical about product differentiation. Agree it's a factor in the promulgation of any meme, but it's also possible that different approaches simply reflect honest differences of opinion. cheers, Jim Butler^(talk) 05:07, 31 July 2006 (UTC)

Use of category:pseudoscience

I've deleting category:pseudoscience. "Not science" in the edit summary doesn't justify using the cat, and doesn't address the comments toward the end of section above. . There are good arg's on both sides, and WP shouldn't enshrine just one side as a cat. Similar to if Chomksky calls Bush a fascist - we don't then put Bush in category:fascists.

Also, this might be of interest to Dematt, Fyslee and others: Temperature is running high at category:pseudoscience and its talk page between editors who with to narrow the category, as I do, and those who wish to continue applying it to anything with a whiff of pseudoscience (e.g. a skeptic said so, so it goes in the cat). As I mentioned above, I think it's more NPOV to present arg's pro and con in the article, and not endorse one side with a category. WP:CG and Wikipedia:Categorization_of_people agree. Because there is significant disagreement over the cat, I added a dispute tag, yet some editors have been removing it because it might "weaken" the category. As if these differences of opinion aren't legitimate, and inviting discussion is bad. We could use some fresh input. Thanks much, Jim Butler^(talk) 17:00, 30 July 2006 (UTC)

No. Thank you, Jim. I appreciate your thoughts on this matter. Levine2112 02:20, 31 July 2006 (UTC)

Thanks Jim! --Dematt 02:32, 31 July 2006 (UTC)

The pseudoscience aspects of chiropractic need more explanation. I will find some clear facts to put in the article. If anyone can help I will be grateful. Hylas Chung 04:51, 31 July 2006 (UTC)

Hi Hylas Chung and all -- yes, it will take some time to iron all this out -- you may find the comments I just posted at Talk:Pseudoscience#Chiropractic relevant, here. Basically it appears that the threshold for using certain categories is significantly higher than for using lists, under NPOV. cheers, Jim Butler^(talk) 05:54, 31 July 2006 (UTC)

The pseudoscience cat applies to notable pseudoscientific subjects. Categories are used in Wikipedia to help readers search related subjects. When comparing pseudoscientific subjects, it will help to place notable pseudoscientific subjects together. Just about every part of chiropractic is pseudoscientific. It is useful for the reader to read about it in terms of pseudoscientific elements. Wikipedia is not a platform for promotion. It is not a soapbox. Science comes first, and any dismissal of science in favor of pseudoscience is tantamount to evangelising. The research should focus on reviews, and on what reliable experts have said about the overall reasearch. OR is not necessary at all. If an expert states that the research shows chiropractic to be pseudoscientific then it can go in the pseudoscience cat. This does not require any time to iron out. There are many sources stating the overall research shows chiropractic is pseudoscientific. Eg, The encyclopedia of pseudoscience has it listed, Beyerstein 1991 says it is right in the middle of pseudoscience, and Eisner 2003 and Lilienfeld 2004 also calls it pseudoscientific. These can all be added to the article in order to clarify the pseudoscientific nature of chiropractic.Librelevate 08:13, 31 July 2006 (UTC) ps. Homola 2002 also considers chiropractic to be pseudoscientific, and he states that most chiropractors promote chiropractic as a primary medical method, or as an alternative medicine. Both groups claim they cure organic disease such as athsma etc. Chiropractic is very pseudoscientific according to certain experts. Librelevate 09:03, 31 July 2006 (UTC)

Welcome Librelevate to the chiropractic page. Thanks for your comments regarding pseudoscience and chiropractic. You certainly sound as though you've made up your mind:) You might even be right! But, more importantly, we need to make sure everything is presented in a NPOV. Your comment above about WP, "It is not a soapbox. Science comes first, and any dismissal of science in favor of pseudoscience is tantamount to evangelising.", sounds a little evangelical itself. Before we all start pushing and shoving our own POVs and creating revert wars, how about we attempt to handle it here on the talk page. I sure hate to see a lot of cooperative work get lost in one fell swoop.

While I am not an expert on pseudoscience, I'm pretty sure parts of chiropractic could fit in that category. I am also pretty sure that other parts are not. To place the entire profession in the category so that wikipedians can find them is really quite elementary. Go ahead and make a list on the pseudoscience page and wikilink them. To have the tag at the bottom serves no purpose but to denigrate. I'm pretty sure that is not what WP is about, lest all articles be categorized by someone elses derogatory list making. See what I mean. I think we can find some neutral ground that makes sense in average readers world rather than our own.

I notice chiropractic vertebral subluxation is on the prescientific systems list. Perhaps that is appropriate as well.

--Dematt 12:59, 31 July 2006 (UTC)

No problem Dematt. The situation is about to change. There can be a lot more clarity on the most pseudoscientific aspects of chiropractic. The category will help readers understand the nature of pseudoscience. As Wikipedia is to be written in a neutral way, adding chiropractic to the category of pseudoscience can in no way denigrate anything. All it does is follow the NPOV recommendation to explain pseudoscience in terms of how scientists have recieved it, and to allow the reader to compare pseudoscientific subjects. Neutral, helpful, encyclopedic. And nothing to do with promoting one's own interests. Librelevate 08:46, 1 August 2006 (UTC)

Some editors may not like the category of pseudoscience. That is beside the point. Chiropractic has multiple pseudoscientific elements. Reliable sources say it is a pseudoscientific subject. The category applies. No matter what, the elements will also be properly expanded in the article. This will clarify why chiropractic is considered pseudoscientific. The category is helpful if you are a neutrally oriented editor. Librelevate 09:51, 1 August 2006 (UTC)

It appears we differ over NPOV. Under NPOV, sure we can present different POV's in the article, or use qualifed lists like the one on pseudoscience that simply require a source like Carroll. But using the cat requires showing scientific consensus, both for NPOV reasons (can't advance one significant view at the expense of another), and WP:V reasons (Carroll isn't a reliable source for what sci-consensus is). What I say is in fact in accordance with WP guidelines on how to apply NPOV to cat's (WP:CG, and Wikipedia:Categorization_of_people. May I ask if you've read these, and if you disagree with my reading of them? That would help me, and others, have a better idea of your logic here. Thanks! Jim Butler^(talk) 16:58, 1 August 2006 (UTC)

To attach a label "pseudoscience" to chiropractic is clearly derogatory and requires strong justification. In WP, we need verifiable reputable sources for opinions as well as for facts; clearly this is not a fact but an opinion, and so needs to be stated clearly whose opinion, and the opinions should be attached to someone particularly notable writing in a notable source. Bernstein writing in the Rational Enquirer may well have a valid point, I'm not going to comment on that, but I do not think that this reaches the threshold of notability as a source for inclusion of a derogatory statement like this attached to a subject like chiropractic, which is continually evolving, and includes a large body of serious research published in reputable peer reviewed journals. Looking at all other entries on the pseudoscience list, my own opinion is that chiropractic simply doesn't belong there. Gleng 11:47, 1 August 2006 (UTC)

Disagree gareth. you need to tackle each of the sources. Not just one. In any case the sources and arguments presented by Librelevate warrant its inclusion. And on science: even if DD Palmer claimed it as science that certainly does not make it so. Dematt, or whoever keeps changing "a chiro.. He/she" pls don't. The formulation I use is neater. Need to quote the "scientists" who say chiro isn't pseudoscience and what parts they say are scientific. What's reason for limiting reform crits of Saint DD? Mccready 15:06, 1 August 2006 (UTC)

I'm not sure that the default position should be that chiro is pseudoscience, and I think I'd have problems even in finding good authorities to say that quantum mechanics isn't pseudoscience (it's not, it's just to illustrate that the default is weak). Certainly in my view chiropractic's origins were very extensively pseudoscientific; but actually so was much medical practice at the time, and pharmacology can be said to have evolved from total and utter quackery; it doesn't do to call pharmacology today a pseudoscience because of it. Chiropractic, to a large extent, at least through the journals in which chiropractors publish and in the policy statements of its governing bodies, observes as far as I can see the conditions and ethos of normal medical science. In this it is unlike anything else on the pseudoscience list. That there are fools rogues and charlatans in this profession, and there are in all, is not a good enough reason to categorise the whole field in this way. I think you're not only denigrating chiro, you're also diluting the language. The opinion that chiro is pseudoscience needs a citation from an accepted reputable authority, or it shouldn't appear.Gleng 16:01, 2 August 2006 (UTC)

Mccready, I think your lead he/she edits were put back along with complete reverts last week when you were changing large chunks of data. Speaking for myself, I have no problem with the lead as it is now with "a chiro" and "they".

I am bewidered by your Wilk deletion, yet you want to add more pseudoscience stuff. I personally think the two go together. One of the stated factors in WP for determining if a subject is PS is whether research has been conducted. Certainly a case has been made by the chiropractic profession that part of the damages from the AMA boycott was that they were unable to procure funding for research and essentially no research was allowed in any "legitimate" research facility. By censoring the Wilk info, you are again essentially perpetuating the AMAs tactic of tying chiropractic's hands behind its back while you ask it to defend itself. The WP experience should be different than anything we've read before. We have people from all POVs here that may actually be able to bring it all to light, including yours. But, you have to agree, your POV is not the correct one. And neither is anyone else's. --Dematt 16:19, 1 August 2006 (UTC)

Wilk vs. AMA and Mcreadys repeated removal

Mcready, would you please explain why you keep removing one of the most important historical facets of chiropractic history. I do no feel that your earlier explanation that "the page is too long" or "there is already a Wilk page" are enough to justify your deletion. It is brief overview of the case, which the Wilk page covers in greater detail.--Hughgr 18:40, 1 August 2006 (UTC)

I strongly agree; the Wilk case is clearly a defining moment both for the chiropractic profession and for the AMA. The warning this page is too long is a guide for the average article - a large topic like this needs room, given the complexities and controversies. Editing it short is bound to introduce edit bias into an already controversial topic.Gleng 15:48, 2 August 2006 (UTC)

Pseudoscientific aspects of chiropractic

I added the Pseudoscientific_aspects_of_chiropractic so we can start to add things there. --Dematt 19:49, 1 August 2006 (UTC)

Okay, I have read through tons of information concerning PS and, though there is some good information out there, some with nice charts and everything, what I am seeing appears very subjective and still controversial. It seems the philosophers and scientists of the last half century have yet to clearly define the term. For what is there, there are elements of chiropractic that, at first glance, could be considered pseudoscientific, but even some of Popper's work gives chiropractic a break, especially when he notes that it is sometimes necessary to protect a young theory until it can be proven.

I think chiropractic is more accurately suited for this. I am going to change the heading for the section and we can work on that. Meanwhile, I think we have still neglected to cover some of the issues skeptics have about chiropractic as well as the self policing or lack thereof of the profession.

--Dematt 17:21, 2 August 2006 (UTC)

I most cetainly agree with your assessment. The scientific skeptical editors have hijacked the pseudoscience article claiming it as their own and are doing everything in their power to make sure chiropractic remains listed as a pseudoscientific article. Because they have found three or four "notable" people who claim chiropractic is pseudoscientific, then they all agree that it must be. I have pointed them to 300+ pieces of scientific research - which apparently they have ignored because it shatters their perfectly constructed world. Maybe I am just venting here, but the hypocrisy within that community is mind-bogglingly ironic. They claim to be skeptics, but yet their are all drinking the Kool-Aid... I see no rational thought there and certainly no open minds. Levine2112 17:32, 2 August 2006 (UTC)

Yes, I think there is a misunderstanding among some of the "skeptical" editors about NPOV and pseudoscience. A lot of it boils down to how to properly apply NPOV in the various namespaces. Cf. the exchange between myself and FeloniousMonk at the end of Talk:Pseudoscience#Setting_the_bar. It's one thing to present various arguments in the article namespace; it's quite another to use the category namespace to advance a single designation when there is controversy. Good work both of you on maintaining NPOV. cheers, Jim Butler^(talk) 20:11, 2 August 2006 (UTC)

Hi all. I added a section of facts explaining why chiropractic is considered pseudoscientific. I kept it as neutrally stated as possible. There is more to add. I believe the section may have other facts placed into it from other parts of the article. As long as it clarifies things. I'll also add that some of the critics are actually chiropractic reformers. Thats only fair. KrishnaVindaloo 10:18, 3 August 2006 (UTC)

Thank you KV! That is a great start. Not too sure about the neutral part, but we can work with it:) I have a feeling a lot will get chopped without the references, though. Can you please provide us with some. Thanks! --Dematt 13:07, 3 August 2006 (UTC)

I.e. KV - this statement- "Florida state university board voted 10 to 3 against the inclusion of a chiropractic school on the basis that it is pseudoscience and would ruin the reputation of their orthopedic school (The Washington Post Jan 28, 2005:28)." It would be nice to have this in quotes to show that those are the exact words. Otherwise, do you have a copy of that article? --Dematt 14:23, 3 August 2006 (UTC)

I.e. KV - this statement- "York univeristy of Canada had the same resons for non-inclusion into their university." same thing. I'll go ahead and take it out till you can put it together. --Dematt 15:03, 3 August 2006 (UTC)

Hi Dematt. I was working from memory on those refs. I will dig them up. KrishnaVindaloo 05:26, 4 August 2006 (UTC)

I even had to take out the Keating and Homala part about reformers. We really don't know that. I think it's a secret. --Dematt 15:07, 3 August 2006 (UTC)

Again, memory. I know Homola is considered a reformer in some books on chiropractic. I don't think its that important though. KrishnaVindaloo 05:26, 4 August 2006 (UTC)

I agree. No big deal. Just for accuracy, as there are a lot of sensitive POVs here, and then there's everybody elses:) --Dematt 14:08, 4 August 2006 (UTC)

I don't recall if he ever calls himself a reformer, and I'm not sure Luther ever did either. "By their deeds ye shall know them." They are considered reformers by others, and their actions were directed at reform, so I guess that makes them reformers. (Of course there are those here who would deny that reformers exist, and if they exist their existence must be suppressed here, and that there is no need for reform. To them chiropractic is perfect. They may be right. After all, DD Palmer had a direct line to "the other world"......;-) -- Fyslee 19:18, 5 August 2006 (UTC)

Wrong Fyslee, DD said he had a line to the other world. :) Big difference! hehe Personally, I think he just wanted attention. LOL--Hughgr 19:41, 5 August 2006 (UTC)

Good point,Fyslee. I think we can certainly say he is advocating reform without making any assumptions. But, (I know I may be splitting hairs here), do you think Homala is advocating reform, or do you think he is just writing about what he sees and could care less whether chiropractic reforms?

Hughgr, you're just too funny. LOL:)

--Dematt 20:03, 5 August 2006 (UTC)

Hughgr, good you sensed the sarcastic humor there. Although DD said it, whether he really believed it or not I can't be sure. Never met the guy...;-) He was an active spiritualist, so he probably did believe he had contact with the spirit of Dr. Jim Atkinson. Spiritual self-delusion can do some weird things to people, including warping their sense of honesty, so the ends justify the means. It's quite easy to compare his statements through the years to see the self-serving evolution of the history of the first adjustment. (BJ developed the lie even further.) Rather than calling him deliberately and flagrantly dishonest, I choose to believe his self-delusion caused him to carelessly play with the truth, without necessarily being all that conscious of it.

Dematt, I have to just take what Homola writes and assume good faith. Privately I have never heard (read) him say anything to the contrary. It also makes sense, since he continually defends sensible chiropractic. He just criticizes abuses and improper use of manipulation. I don't remember right now if he still has any hopes for reforms actually taking effect before it's too late. -- Fyslee 20:27, 5 August 2006 (UTC)

Pseudoscientific characteristics

I've moved this to the talk page to get input from everyone here. The battle on the pseudoscience page appears to be highly POV and the more I learn, the less I think chiro is pseudoscience. I do think it has some things that are on the list, but I don't know enough to know if the WP list is tainted with POV information. I need your help to decide. --Dematt 23:34, 4 August 2006 (UTC)

Beyerstein(1996:7), Keating (1997:40), and Homola (2002:311) consider chiropractic to have pseudoscientific characteristics. They allege that these include:

Poor quality research and overinterpretation of results
Masquerading as science
Providing false confidence about the value of various chiropractic techniques (The emphasis on confirmation rather than refutation)
There is resistance to criticism
There is a use of marketing slogans in lieu of scientifically testable hypotheses (such as "chiropractic works") which lack specificity and are not amenable to experimental testing.
The use of uncritical empiricism
The use of selective review
The use of testimonial rather than reliable scientific testing
The use of dogma and belief in chiropractic education, rather than healthy skepticism and scientific thinking.

Keating goes on to state, "the existence of a science of chiropractic seems unmistakable, as evidenced in the pages of several periodicals. Although the volume of research in chiropractic remains minimal, there is legitimate scientific activity, the scientists "right stuff.""

--Dematt 04:08, 6 August 2006 (UTC)

Poor quality research and overinterpretation of results

Is this a fact? Across the board? This is just an allegation.

Masquerading as science

Pure opinion.

Providing false confidence about the value of various chiropractic techniques (The emphasis on confirmation rather than refutation)

Who says the confidence is false? Whose emphasis is on confirmation? All chiropractic researchers? Seem highly speculative.

There is resistance to criticism

Speculative. One could say that the critics are resistant to criticism.

There is a use of marketing slogans in lieu of scientifically testable hypotheses (such as "chiropractic works") which lack specificity and are not amenable to experimental testing.

"In lieu of" is not true. Speculative. Perhaps some say "it works" because of all of the positive results in experimental testing.

The use of uncritical empiricism

Speculative and untrue.

The use of selective review

Speculative and untrue. What constitutes "selective"? Chiropractic research goes out of its way to include more than chiropractors in peer-reviewed journals. A lot of MDs and PhD are involved.

The use of testimonial rather than reliable scientific testing

"rather than" is specualtive and untrue. Chiropractic uses whatever scientific research that is available.

The use of dogma and belief in chiropractic education, rather than healthy skepticism and scientific thinking.

Again, "rather than" is speculative and untrue. My experience is that there is a lot of healthy skepticism and scientific think in chiropractic.

Levine2112 00:14, 5 August 2006 (UTC)

That was pretty much what I was thinking. I know Gleng has suggested that we need to address the controversial subjects and I have no problem doing that. After spending some time on the pseudoscience article, IMO elements of chiropractic may exhibit or has exhibited in the past several of the factors on the so-called Pseudoscience list. However, I really feel that the concept of PS is indefensible. Apparently once someone notable has put you on the list, you're there for good. And I don't know if you've seen the list, but anything could make the list. And the only people that can put you on the list are in the scientific community, and if you complain about it, that makes you even more suspect. The concept is too subject to corruption. Reminds me of the days of the Salem witch trials. In other words, the likelihood that any alternative medicine is going to make it off "the list" anytime soon is very, very slim. At this point, IMO, there does not seem to be a consensus that chiropractic is on the sPS list. For that reason, I think we would be improperly classifying any discussion of the controversies in chiropractic as pseudoscience. --Dematt 04:08, 6 August 2006 (UTC)

Well said, Dematt! Not to be a broken record, but if you feel that strongly about it, you may want to keep an eye on category:pseudoscience, which in its current incarnation is a gross NPOV violation. (Note some POV-pushing editors even removing dispute-tags, to prevent discussion that might change the status quo.) I don't mind including sig minority views via a list or whatever, but am appalled by the idea that if something lacks scientific evidence in some respect and has been called PS in some respect by a critic, then it must be considered PS by the scientific community — and thus deserves being asserted categorically on WP. We oughta be presenting arg's, not asserting them.... cheers, Jim Butler^(talk) 06:17, 6 August 2006 (UTC)

You put it well, Jim. The use of categories must be done very carefully. -- Fyslee 10:12, 6 August 2006 (UTC)

I believe people are at risk of losing a valuable set of facts here. I see nothing wrong with writing, "Keating and Homola consider Chiropractic also to have key elements that are scientifically supported, and Beyerstein considers chiropractic to have weak support in some areas". These are the facts. They are reliable and verifiable, all 3 authors have the title of Dr, and all have published extensively. It is not a matter of us as editors believing whether or not Chiro is psuedo or science. It is up to the reader to decide. This is about verifiability not truth. KrishnaVindaloo 01:51, 7 August 2006 (UTC)

Hey KrishnaVindaloo, thanks for stopping back in. Please feel free to read the article:) I think you'll see that we won't be losing any facts. You will find that most of the points that you made on the list have been covered thoroughly and agreed upon in NPOV already. The only thing we're losing seems to be a WP:subjectively applied (I made that up:) classification of pseudoscience. Chiropractic has not been labeled as pseudoscience by anyone in the scientific community, so there is no need to place the label on it. Homala is a chiropractor. If we use him, then all chiropractors can be considered part of the scientific community. It wouldn't be hard to find one that will disagree, so we would just be starting an edit war for no reason. Keating is a psychologist who worked in a chiropractic college and studied the history extensively. He could be considered a good source(you'll notice him referenced several times throughout the article). But, the paper that is referenced is a discussion about the elements of chiropractic that are scientific, antiscientific and pseudoscientific. The article appears to be a constructive criticism with suggestions for direction. To take a sentence out of context to call chiropractic pseudoscience from this text would be misleading to our readers. In fact, he does make reference to good "scientific stuff" somewhere in that article. Robert Carroll does not call chiropractic pseudoscience on his list and even makes reference to the fact that chiropractic was repressed by the AMA (chiropractors assert this squelched any research funding until 1980's). I don't see WP:Verifiability or WP:R. And I'm afraid others are using WP:OR to make make a POV look like NPOV.

It looks like you might be close to some sort of solution on the PScat:talk page and we can revisit any other options you might have for introducing your readers to appropriately labeled articles such as chiropractic. But I don't see how the label pseudoscience would be an accurate characterization of chiropractic. In essence, we run the risk of misleading your readers, similar to perhaps calling the medical profession reckless for using Vioxx with shabby science. We all know that would be wrong and WP:OR. Perhaps, this subject would be a good representation of category:prescientific systems.

--Dematt 03:54, 7 August 2006 (UTC)

Yes Dematt, I'm currently more interested in treating pseudoscience as it should be treated: As an inclusive issue. As the research on chiropractic is actually pretty darned scathing, I suggest you hold onto the above refs, as they are pretty nice to chiropractic on the whole, and more importantly, they treat the subject of chiropractic and pseudoscience pretty fairly. KrishnaVindaloo 04:09, 7 August 2006 (UTC)

I think if you go around on an inclusive witchhunt, you'll soon find that every known discipline of science has elements pseudoscience that can be verifiably cited and added to your list. Bottomline, is that despite all of the scientific discoveries and acheivements ever made, nobody can conclusively prove anything to be an unequivocal fact. There are very few scientific laws and even those can get shakey given the right universal circumstances and varying frames of reference. The EPR paradox shows us that you can't observe anything without altering it. And thus no matter how controlled you may think a clinical study is, it actually really isn't. In the end, all we can rely on is what we all individually deem to be reliable science. The keyword there is "individually". Everyone has a unique point of view as subjective as the universe is infinite. Thus, I have suggested and continue to endorse populating any pseudoscience list with disciplines that are so obviously considered a pseudoscience that the subjectivity of said label is reduced to sheer and utter overwhelming mass majority worldwide global popular opinion (i.e. Astrology... though we should beware as Mercury is currently in retrograde ;-). Even then - being inclusive of only the most obvious - we'll still have to regard this list as a pile of lumber soaked in gasoline. It can sit there inoccuously forever, but all it takes is that one spark of controversial opinion to set the whole thing aflame. I'm not sure how long you've been editing on the pseudoscience page, but I assure you it's history is scarred with burn wounds and the scorched language of flame wars. Now you know how to keep the peace. Put away your matches and just let it be. Whisper words of wisdom. Levine2112 08:41, 7 August 2006 (UTC)

Did you just seriously try to apply quantum dynamics to chiropractic? Jefffire 11:52, 7 August 2006 (UTC)

Sure. The implications of quantium dynamics is applicable to everything. However, I wasn't speaking of chiropractic specifically; just about the use of the label pseudoscience. My point is that every discipline (whether it be astonomy, pharmacology, chemistry, et cetera) is based on at least one assumption; something that it might hold to be true but deep down its adherents must recognize that there are no absolutes. Thus, if one was collecting a list of disciplines that claim to be science-based but really aren't (which seems to be the working definition of a pseudoscience here), then this list may be as endless as the list of all human scientific endeavors. Thus it just seems to make a discipline less false when it can recognize its own shortcomings in terms of what is theory and what is assumption (i.e. Atomic Theory, Theory of Relativity, et cetera). Levine2112 16:49, 7 August 2006 (UTC)

Levine2112, you would be wise to consider the - assume good faith recommendation of Wikipedia. I am interested in fair representation. I've not been edit warring here, or vandalizing, or spreading false rumour. I've supplied fair and verifiable sources. It is inevitable that this article will at some time have clear explanation of how science recieves some of its pseudoscientific aspects. As far as the category goes, well, its ongoing. I can only say that considering the ongoing research stream, chiropractic is going to look pretty good standing next to Chi Machine and Dianetics. The category description has already clarified that the category is not a list of pseudosciences. A reader will make a comparison, and read that chiropractic as a subject that is under some kind of reform and scientific research program. There is no need to be defensive at all. KrishnaVindaloo 08:58, 7 August 2006 (UTC)

KV, you're one of the last guys I'd ever assume to act in bad faith around here; I just don't think you understand the particular NPOV issues relevant to categories, which just sit there, without annotation, at the bottom of the page. WP guidelines explicitly say that this creates NPOV problems, so we must use cat's with care. The idea that a field is PS is still an opinion, not a fact. Using categories tends to assert rather than present this idea.

Cross-posting from Category talk:Pseudoscience: What if category:terrorists were rewritten per your recent rewrite of category:pseudoscience [3]? Of course I'm not suggesting this, per WP:POINT; just pretend for a moment:

Wikipedia takes no stance on whether a person is a terrorist or or not. This category is to enable readers to browse pages that involve terrorist ideas and activities, that contain issues that clarify terrorist ideas and activities, and to help understand how terrorist ideas and activities are received by civilized societies. It is completely up to the reader to decide whether subjects such as Hamas, the Contras or George Bush etc, are terrorists, or not.

Then, continuing our thought experiment, we'd populate that list with everyone whom every notable commentator ever suggested had to do with terrorism. Arafat, Sharon, Truman, Reagan -- all of them go in, as long as someone said so. Now please read WP:CG and WP:Categorization of people again and tell me if there might be some NPOV problems with that approach! Would you seriously keep arguing "there is no problem. It is all just to inform the readers?" :-) cheers, Jim Butler^(talk) 16:28, 7 August 2006 (UTC)

I've been diverted by real life so apologise for butting in without being fully up on the discussions. Chiropractic's roots are pseudoscientific, but Levine is right: the history of medical science is the history of pseudoscientific origins emerging into a quantifiable objective verifiable body of knowledge; I think that including chiropractic in this category now is just a dilution of the category. However, the criticisms are not going to go away, and the article won't have stability until there is a section on criticisms. The job of this section is not to present criticisms to endorse or rebut them, but to characterise the debate in a way that enables a reasonably minded reader to make his or her own mind up. I don't see a problem in writing that "Some critics of chiropractic (ref) have attacked chiropractic as 'pseudoscientific', alleging that.. , and then displaying key facts relevant to the allegation. However, I don't think it's sensible to list and deal with all criticisms in this way -it would be too long and tedious, but I think that there are three recurrent themes:

1) The use of advertising - claims made without objective justification 2) Poor quality control - unwillingness to seek out and exclude malpractice 3) A rationale based in part on dogma/belief

In each of these areas there has been cause for criticism in the past, and attempts by the profession to address each of these areas. I think that the article will gain stability by characterising these criticisms fairly. The argument that chiropractic science is weak and that the jounals are poor is I think unfair, I see a lot of clinical science, and wouldn't say the standards are very different; the volume of clinical science is much greater and the funding much heavier so of course there is a layer of 'cream' that medical science has that chiropractic lacks, but I don't see objective reasons for disparaging chiropractic research by comparison with most clinical research. The field has journals with peer review that adhere to conventions indistinguishable from mainline journals. I think it is worth reporting criticisms where there are relevant verifiable facts that illuminate the criticism, but if an opinion is just an opinion, that cannot be substantiated concisely by facts, then perhaps leave it out. For example, I don't see what facts would support or refute a statement about the quality of the journals, but their existence and policies are evidence of a committment of the profession to evolving towards evidence based practice, and thus are facts relevant to 3).Gleng 16:42, 7 August 2006 (UTC)

Okay guys, KV et al. on the category:Pseudoscience page, have revamped their description describing the subjects on the list for Pseudosciences:

This category comprises articles pertaining to pseudoscience, to fields of endeavor or bodies of knowledge that critics have characterized as being pseudoscientific or having pseudoscientific aspects, or subjects which a significant portion of the scientific community fault as failing to meet the norms and standards of scientific practice in one way or another. Some of these fields, or parts of them, may be the subject of scientific research and may not be wholly dismissed by the scientific community. The term itself is contested by a number of different groups for a number of different reasons — see the main article for more information.

Stated this way, most of my concerns are handled. I still have yet to see a verifiable and reliable source labeling chiropractic as a pseudoscience, so I agree with Gleng and Levine and don't think that it would be a fair assessment to assert that it is a Pseudoscience per se. But, there are things that chiropractic illustrates very well and of which chiropractic has been accused, especially in its history. Anything else can be handled here on the chiropractic page. It is up to us to do the research and make the appropriate edits while discussing the pseudoscience concerns. We can then discuss the AMA and research and advertising and self-criticism here on our page. I agree that this is the final hurdle to get over. This is what will bring this article into the present and is an opportunity for us to state chiropractic's case, and the reader can decide whether it is a pseudoscience, or whether it matters if it is.

Additionally, the category:Pseudoscience list appears to be very inclusive of other concepts that are considered PS placed alongside subjects that once were PS and now are "real" science, and potentially (I assume good faith on KV's part) will include other fields that have pseudoscientific histories (i.e. osteopathy, pharmacology, psychology, etc.) with their examples of advertising and grandiose claims, then it is a very good idea to be included in such company. However, if it seems that the category is being manipulated by those whose purpose is perjorative, we can deal with it on the category level by assuring that those sciences are listed as well.

Any thoughts? --Dematt 21:14, 7 August 2006 (UTC)

I am certainly against using it merely as a pejorative label. So if it is going to be used at all and applied to chiropractic, then it must also be applied to osteopathy, pharacology, psychology, immunology, and all of modern medicine... just to name a few disciplines. I still hold that this label is so subjective and covers such a wide specturum of grey, that once it is applied to something that is only controversially considered pseudoscience then the floodgates open wide for inclusion of everything... and I mean everything. I maintain that the PS list should be strictly limited to only the most obvious and globally agreed upon examples. Levine2112 21:32, 7 August 2006 (UTC)

I agree. Right now chiropractic is not on the Pseudoscience list and that is the way it should stay unless the list includes all the "grey" area fields. This is about the category:Pseudoscience list. As long as they include all things that have pseudoscientific elements (past or present) then the category is performing its stated purpose - to illustrate pseudoscientific aspects of subjects for its readers. But, I'm telling you KV, the problem would go away if you could create a subcategory and label it something like category:Pseudoscientific elements. --Dematt 22:00, 7 August 2006 (UTC)

Hi Dematt. If you dig around, you will probably find scientific views that state many specific so called pseudosciences are grey areas. Useful books and articles that cover the subject of pseudoscience rarely state that a field is a pseudoscience. They display a set of fields, and point out the pseudoscientific characteristics of those fields. They may possibly state it as; this field displays pseudoscientific characteristics. As with those informed books and articles, they tend to be written in a way that leaves it up to the reader to decide if a subject is "a pseudoscience". That is how Wikipedia works also. I am not at all interested in making any subject in the category of PS to conclude that a subject is definitively a pseudoscience. If a reliable author states it, then it can be added, but it is up to the reader to place the "therefore............". KrishnaVindaloo 09:32, 8 August 2006 (UTC) PS. You may like to read the astrology article. Even there, it is left up to the reader to decide whether it is a pseudoscience or not. The same should be true of all items in the category. KrishnaVindaloo 09:59, 8 August 2006 (UTC)

As long as you are not asking us to make a blanket statement that chiropractic is pseudoscientific, we can deal with the rest. Also, I am not comfortable with a list format as it tends to look like stated facts and there is no way to balance other than another list. The history and science sections that we have already illustrate some of the factors that pseudoscience lists. Really all we need is a sentence or section toward the end that neutrally states that:

Considering (all the above), some scientific philosophers consider chiropractic to have pseudoscientific characteristics.

Do you have any idea how nauseous I feel right now:P

--13:37, 8 August 2006 (UTC)

Sure, you are right. Considering the above seems a bit too conclusive though, "some" is a bit weasel, and its more than scientific philosophers considering chiropractic to be PS. A simpler way would be to say Professors a,b, and c, say chiro is PS (date:pageNo). KrishnaVindaloo 04:30, 9 August 2006 (UTC) Oh, and definitely it will be important to state exactly why they consider it to be pseudoscientific, especially as some aspects of PS have some weak support. KrishnaVindaloo 04:32, 9 August 2006 (UTC)

WP policy on controversial articles is well written and sensible. NPOV is hard for everyone, but in the end the object should be that every reasonable participant should feel that the end result is fair, honest and reasonable, and disputes are properly resolved by V RS. Every dissenting opinion need not be represented, and frankly I don't see that anyone here should feel obliged to broadcast frankly perjorative statements if the factual issues concerned are dealt with fairly. If you state the main criticisms that give rise to the allegaion of pseudoscience, I don't see what is added by even using the term pseudoscience itself.Gleng 20:32, 8 August 2006 (UTC)

All the items in the category of PS include the word pseudoscience. Are you suggesting chiropractic should be an exception to this? KrishnaVindaloo 04:30, 9 August 2006 (UTC)

But not all the subjects that contain pseudoscience are on your list, yet. Essentially, you are treating them as exceptions. --Dematt 12:41, 9 August 2006 (UTC)

Hi Dematt. Could you point out those that are missing please. I'd like to assess them for myself. If I find reliable sources and explanations for why something is considered PS, then it can be added to the cat. KrishnaVindaloo 04:53, 10 August 2006 (UTC)

Good morning KV. Surely you had a chance to read Levine and Glengs comments above. To call the entire field of chiropractic pseudoscience has not been supported by reliable and verifiable sources. Any attempt at this point would be WP:OR. To contend that there are not pseudoscientific elements in other fields that are also not considered pseudosciences either emanates from a position of dubious intention or ignorance of the history of healthcare. Since I assume good faith, I would suggest that you begin by familiarizing yourself with the histories of the those fields to start. --Dematt 12:42, 10 August 2006 (UTC)

Hello Dematt. Levine and Gleng are not NPOV policy. There are no sources I know of that even place astrology as a field that is entirely pseudoscience. It has nothing to do with healthcare. It is a scientific position. The scientific view on pseudoscience is that there are several characteristics that help to identify PS subjects. It is up to those sources to say which characteristics are more relevant for each subject in the pseudoscience category. I am becoming more familiar with pseudoscientific fields, such as chiropractic, and there are verifiable and reliable views that chiropractic is pseudoscientific. Those views need clarifying if this article is to be fair to chiropractic and to science. I am only concerned with those editors who wish to make this article something informative and fair. It is none of my concern that some editors are here to promote their vested, or otherwise, interests. There is one benefit from having promotional editors here though. In objecting to reasonable sources, other sources are found that both corroborate those sources, and clarify them. It is inevitable that they will be presented on this article, and it is also inevitable that this article be placed in the pseudoscience category. Those promotional editors are just going to have to put up with NPOV policy. KrishnaVindaloo 06:09, 11 August 2006 (UTC)

Okay, just wanted to make sure your intentions were honorable and NPOV. It sounds like you will treat this subject with the delicate respect it deserves. --Dematt 11:24, 11 August 2006 (UTC)

Although, I suppose a good start would beQuackwatch, NCAHF, and Stephen Barrett being placed in the pseudoscience category under the pseudoskepticism heading. --Dematt 18:50, 10 August 2006 (UTC)

If you manage to find reliable and informative sources that place Barrett et al as pseudoskeptics then I am sure your suggestion will be acceptable to NPOV policy. KrishnaVindaloo 06:09, 11 August 2006 (UTC)

I didn't think I had to as long as they deal with the skeptic subject and it is mentioned in the article, they should be placed on the pseudoskeptic list as an example. Am I missing something? --Dematt 11:24, 11 August 2006 (UTC)

They are already in the quackery category because they deal with it, and listing them there helps people interested in the subject to find them. As far as I can see, there is no pseudoskepticism heading in the pseudoscience category. Otherwise Marcello Truzzi made some very interesting observations, with which I agree:

"In science, the burden of proof falls upon the claimant; and the more extraordinary a claim, the heavier is the burden of proof demanded. The true skeptic takes an agnostic position, one that says the claim is not proved rather than disproved. He asserts that the claimant has not borne the burden of proof and that science must continue to build its cognitive map of reality without incorporating the extraordinary claim as a new "fact." Since the true skeptic does not assert a claim, he has no burden to prove anything. He just goes on using the established theories of "conventional science" as usual. But if a critic asserts that there is evidence for disproof, that he has a negative hypothesis -- saying, for instance, that a seeming psi result was actually due to an artifact -- he is making a claim and therefore also has to bear a burden of proof." Zetetic Scholar, #12-13, 1987 [4] [5]

As a skeptic, I have my own practical application of this, and provide this deliberately provocative introduction to my website (not my blog):

"The fact that this website focuses on one side of the coin, is an acknowledgement that there is another side which has been investigated. This website has a definite and conscious bias, which isn't the same thing as a negative "prejudice", which is defined as "an opinion or leaning adverse to anything without just grounds or before sufficient knowledge."

I see an informed and conscious bias as something positive & desirable, in contrast to prejudice. If one doesn't have a bias, one doesn't have an opinion worth defending. I see it as the result of an analysis of the issues, resulting in the taking of a standpoint more in favor of one side than of the other side. In other words, I am biased for objective evidence, and biased against a lack of such evidence. This naturally results in a bias for Evidence-Based Medicine (EBM) and modern medicine, and a bias against so-Called "Alternative" Medicine (sCAM). I'm not interested in anything that is just "so-called". I don't want to base my clinical decisions and my consumer protection efforts on something that is anecdotal, tenuous, unproven, speculative, and often deceptive.

As a former true believer in so-Called "Alternative" Medicine, even using it to treat terminally ill patients, I have experience from the "inside". I have seen too many deaths, including among my own family members who were believers in sCAM, and can no longer close my eyes to this situation.

I am not interested in making all forms of sCAM practices illegal. What I want to see is truth in advertising and no more false claims of proven effectiveness. The public should understand what it is they are dealing with. What they then do is their own choice. I simply do not believe that promoters should have the freedom to deceive their hapless victims. This "freedom" is what the so-called "Health Freedom" movement is fighting for. On the contrary, I believe in something entirely different. I believe in Freedom of Informed Choice."

-- Fyslee 19:47, 10 August 2006 (UTC)

I agree 100% with the above. My contention is that your blame is misguided when you place all of your accusations of Alt Med on all of chiropractic. Chiropractic is in direct opposition to Homeopathy. There is no assertion by chiropractors that everyone needs vitamins, mushroom baths, or gumbo juice, or whatever it is that we are being accused of that is killing people. That is like me blaming Cardiologists for the Vioxx mishap. That would not be correct and is fallacious thinking. Levine, Hughgr, and others have shown us multitudes of research to illustrate the effort that chiropractic has been making to pull out of the pseudoscientific rhealm, but it's vetoed as not reliable. What's with that? Sure, the quality may be lacking in some, but even Gleng, a research scientist in neurosciences(sorry for invoking this fact Gleng), agrees. Of course chiropractic appears pseudoscientific under those circumstances. Then when someone with an open mind such as Kv does approach the subject, what is she going to see? Of course she sees pseudoscience. My question is, KV did you see the science? Did you see the effort made by chiropractic to shed this image in the last 20 years? If not, then we have not covered this subject well enough, because it is there.

I think if you look for Pathological pseudoskepticism. It's in the Pseudoscience category list. I did notice that those articles had Scientific skepticism attached to them;) --Dematt 21:29, 10 August 2006 (UTC)

I'm not sure if you're actually referring to me when you mention "blame" above. You need to be more specific.

I think we've been over this a number of times. The accusations of various dubious behaviors and beliefs (including pseudoscience) are not directed at good research of manipulation, but at dubious behaviors and beliefs of various kinds. They are also named and criticized by Keating. (He also criticizes chiropractic research.)

As far as the "multitudes of research," that have been mentioned, it is a very mixed bag that we're just expected to accept as is, when in fact it is a mixture of good and bad research about all kinds of subjects. I have repeatedly asked for a few of the best research citations to be used specifically to document specific claims. That kind of thing has been accepted here, by myself and others. But expecting a long laundry list of good and bad (including one-case studies of weird things) to just be accepted without examination is not a good idea. Volume is no guarantee for quality, so such a bag can't get a seal of approval as counting towards anything. I know you aren't expecting that, but others have not only expected that, but have refused to even produce "one" good study from the bag when requested. I know they exist, and when presented have been added unopposed by myself. I just don't like references to "hundreds" of studies as an argument. I'll accept individual studies we can check for quality, but I won't accept the whole bag, just because the bag likely contains some good studies. Each study must stand on its own merits. I think that's a reasonable request.

As to pseudoskepticism, you're right. It's listed there as pathological skepticism (an article, not category). -- Fyslee 21:57, 10 August 2006 (UTC)

Quality RCT's apparently aren't available, as with other medical procedures, but I think the "hundreds" of peer reviewed studies in several peer reviewed magazines should illustrate that it is not because of the lack of effort, or the lack of will. What makes you think chiropractors don't read Spine or don't read every relevant article that comes out in JAMA. That's just as much their research as the local MD. Public money paid for it. I think it is quite arrogant of us to assume that they don't read. What I apparently can tell you is that 90% of patients that go to chiropractors go for back or neck pain and funny thing is that is what the current research states they can help. So maybe this should be telling us that chiropractors are following protocols. Who cares if they believe in God, or Buddha, or Universal intelligence. There are MDs who believe in God, Buddha, and some are even Masons and believe in a Universal Intelligence. That does not make them pseudoscientists. I have no trouble with presenting the skeptical side of the science related to chiropractic. That's the way we all grow. I even do that myself when I read research from any source. I don't even have a problem with discussing it in a public forum, you've seen me do it. I was the one that suggested that we add pseudoscience elements to this page, but lets be reasonable. We must not turn chiropractic into chiroquactic. That is not the purpose of WP. Medicine is a science, an art and a philosophy. Chiropractic is a science, an art and a philosophy as well. We must present it that way. The reader can decide. We cannot write in such a way to lead them to "our" conclusion.

Fyslee, please don't make me do that again, I really am just hungry;) --Dematt 23:38, 10 August 2006 (UTC)

Intro question

In the second paragraph in the introduction is this sentence.

"However, the concept of the subluxation, for which there is disputed scientific evidence, remains integral to typical chiropractic practice, and in 2003 90% of chiropractors believed the vertebral subluxation complex played a significant role in all or most diseases, and practiced accordingly."

My problem is with "for which there is disputed scientific evidence". The reference at the end of the sentence is for the 90% of chiros believe, but there is no evidence being stated for VS, so what is being disputed? BTW, here is some evidence, [6] [7]while perhaps not conclusive, is it disputed?--Hughgr 18:08, 10 August 2006 (UTC) And another interesting article. [8]

We would need to start with a definition of vertebral subluxation, to the extent to which there would be general agreement as to whether it exists in a given patient (and vertebra), to determine whether it has anything to do with symptoms. I don't think that exists enough for there to be scientific evidence of any sort. — Arthur Rubin | (talk) 01:31, 11 August 2006 (UTC)

Thanks for the reply Arthur, the definition is in the first paragraph of the VS page; a mis-aligned vertebra can compromise/alter nerve interferrence. Is the evidence of this disputed? Cheers.[9][10]--Hughgr 17:12, 11 August 2006 (UTC)

That (as written) is not a definition, it's an assertion. But my question is (more or less) whether, in the case of an individual patient, would there be any general agreement (even among chiropractors) as to (1) which vertebrae are misaligned, and (2) which such misalighnments constitute subluxations. If there would not be general agreement of some sort, any evidence related to subluxations is purely anecdoctal, even if nominally done in a scientific manner. — Arthur Rubin | (talk) 17:56, 13 August 2006 (UTC)

There would absolutely be agreement. Some doctors may read x-rays and may diagnose differently... you can't account for that in any profession (hence "getting a second opinion"). But by the strict sense of chiropractic diagnosis, in a room full of chiropractic doctors examining one patient, there would absolutely be an overwhelming consensus on which vertebra are misaligned (subluxated). Chiropractors are trained to detect vertebral misalignment on sight and by feel. Also, there are heat sensitive instruments (which are actually based on old school technology) which can detect a vertebral misalignment (as the misalignment of vertebra can also create a marginal difference in heat energy on either side of the vertebrae). These instruments have now been combined with computer techology, so if a doctor chooses, he/she can take a reading of a patient before an adjustment to find the heat imbalance, then perform the adjustment and re-scan. In my experience, the adjustment most always balances this instrument's reading. You can perform this experiment over and over, all day long with different patients (as many chiropractors do in their regular practice) and see the positive results time after time. What I like about this - in a clinical study sense - is that now you eliminate any subjectivity in the examining doctor. That being said, these devices may not be able to detect every misalignment.Read about one such device here. Levine2112 18:29, 13 August 2006 (UTC)

Thanks for the pointer Levine2112. I read up on the neurocalometer. I'll find the appropriate place to add it. KrishnaVindaloo 03:39, 14 August 2006 (UTC)

That (agreement as to which vertebrae have subluxations) is subject to scientific testing. Has it been done? (For what it's worth, I have gone to a number of chiropractors, specifically for back pain, and they've never used a heat-sensitive instrument, although some have used electrical conductivity tests.) — Arthur Rubin | (talk) 16:14, 14 August 2006 (UTC)

Hi Arthur, please see this article. I think it addresses your questions.--Hughgr 23:19, 14 August 2006 (UTC)

Actually, no. It says they're trained in them and believe in them, but there seem to be no studies confirming that two chiropractors might agree as to where the subluxations are. — Arthur Rubin | (talk) 19:03, 15 August 2006 (UTC)

Well Arthur, you may be right, I can't find that kind of study. But putting that aside for the moment, is the assertion that a mis-aligned vertebra can compromise/alter the action-potential disputed? Cheers--Hughgr 23:47, 15 August 2006 (UTC)

I suppose not. Whether a misalignment diagnosed as a subluxation necessarily changes the action-potential is disputed, but I see no dispute that a misalignment can change the action-potential. — Arthur Rubin | (talk) 01:37, 16 August 2006 (UTC)

So back to my original question about this sentence:

"However, the concept of the subluxation, for which there is disputed scientific evidence, remains integral to typical chiropractic practice, and in 2003 90% of chiropractors believed the vertebral subluxation complex played a significant role in all or most diseases, and practiced accordingly."

should be re-phrased. How about, "However, the concept of the subluxation, which has marginal evidence, remains integral to typical chiropractic practice, and in 2003 90% of chiropractors believed the vertebral subluxation complex played a significant role in all or most diseases, and practiced accordingly."

I bolded the possible change. Looking for input. Thanks.--Hughgr 22:50, 16 August 2006 (UTC)

I have no problem with it, though I think Mccready was the one that put it in. I like the arrangement better. It flows. --Dematt 00:28, 17 August 2006 (UTC)

Dual Categorisation

I can't believe it is right here in front of our faces. Chiropractic is both science and pseudoscience. That's what Keating was saying. Boy, do we have blinders on or what! I'm going to try it. See what you think. --Dematt 11:06, 11 August 2006 (UTC)

Sure Dematt, lets keep things clearer though. Some of the lines were a bit argumentitive so I made a replacement in quotes. I added some clarity from Keating, and the one key fact that should be stated - a key intervention of chiro does get some support from sci testing. Keating is not the only one though. I will add more in time - all fairly presented. KrishnaVindaloo 03:37, 14 August 2006 (UTC)

No problem with the changes to mine KV. That was just to get us started. I also added some more Keating to help qualify the conundrum. --Dematt 13:05, 14 August 2006 (UTC)

Hi again Dematt. You are correct with the pseudoscience category. I'm glad some people at least, are reading the cat description. (for the benefit of some others): If there is an issue of pseudoscience, then it goes in the category to help the reader understand all the nuances of pseudoscience. It does not mean that chiro is psuedo. The cat description is clear on this. Wikipedia takes no stance on this. If it did, it would state in the definition of chiropractic that "Chiropractic is a pseudoscientific manipulation technique......etc". It doesn't. It is up to the reader to decide for themself. KrishnaVindaloo 03:50, 14 August 2006 (UTC)

It would be nice if some kind of consensus gets reached finaly on this issue. I myself have been quiter than I usually would because of my mixed feelings on this topic. I think the secion on Keating (although more authorities on this section should be sought out) is a helpful addition, and encapsulated the view of most involved. I think most doctors would agree that there could be some benifit to the practice, and most chiropracters agree that there is a significant number of people in their field who are counter-productive to achieving scientific acceptance and put the entire field in a negative light.

Jefffire, I really appreciate hearing that from you and hope that you'll help keep us NPOV. Thanks! --Dematt 14:00, 14 August 2006 (UTC)

P.S, I've changed the title of this section to something slightly more professional and unprovocative in the hope that it will facilitate a helpful atmosphere. Jefffire 13:02, 14 August 2006 (UTC)

Sorry about that. I have been accused of being easily excitable;) --Dematt 14:00, 14 August 2006 (UTC)

Pettibon school

I just found out that an old Chiropractor follows the Pettibon school of Chiropractic. I don't know that much about chiropractic, so I don't know whether it's seperate from the 4 schools currently listed in this article or if it's a subset, so I don't want to add it. Maybe someone more versed could add it. Here's a good link: http://www.pettibonsystem.com

Thanks, Orblivion for your interest. Pettibone is not a school per se. It is one of several proprietory techniques that has been developed and marketed to individual chiropractors as method of treatment for their patients. It does not have the same requirements that an accredited institution would be required to meet. Similar to something like a new technique for implanting stents would be marketed to a cardiologist. There may be some value in discussing various techniques, but it could open floodgates to all kinds of "advertising" claims. --Dematt 15:59, 11 August 2006 (UTC)

I agree Dematt, perhaps a seperate article on chiropractic techniques could elucidate further.--Hughgr 22:39, 11 August 2006 (UTC)

Ditto, the article is long enough without introducing theoretical information about the 100 or so chiro techniques. It would take at least 10 pages to cover that.Abotnick 01:25, 18 August 2006 (UTC)

I would suggest making separate articles for each notable technique (Activator, Gonstead, Specific, et cetera) and/or have a one article for "Chiropractic techniques" which describes basics about different techniques. Levine2112 02:07, 18 August 2006 (UTC)

Widespread false advertising by chiropractic programs-Sikorski study

Hi everyone,

I added some information about false avertising by chiro programs under education. We need to warn those students that organizations aren't playing fair.Abotnick 19:03, 15 August 2006 (UTC)

I noticed that someone deleted the reference to Sikorski's study. That's understandable because it doesn't look favorably on chiropractic-which is a primary goal for many of the posters here. Anway, I think it is an important point and should be restored. Comments?Abotnick 15:08, 17 August 2006 (UTC)

Restore by all means! --Hob Gadling 15:11, 17 August 2006 (UTC)

If you look at the edit summary, you'll see why it was removed.--Hughgr 17:55, 17 August 2006 (UTC)

I don't think it was appropriate to remove it. Instead someone should have simply paraphrased the text. Levine you should not have removed it. I have revised the text and inserted it back into the education section.Abotnick 11:45, 18 August 2006 (UTC)

I see someone removed the Sikorski paragraph in the education section. Who did this and why was it removed?Abotnick 12:10, 21 August 2006 (UTC)

Me. My edit summary reads: should probably be reworded (as not to plagiarize Stephen Barrett) & moved to a different place. Maybe more appropriate here. Levine2112 17:08, 21 August 2006 (UTC)

Levine it was reworded so please restore it.Abotnick 21:20, 22 August 2006 (UTC)

Actually it wasn't reworded too much. Just one clause from the whole paragraph was moved around. It still would be considered plagiarism on your part. Additionally, the edit, as I mentioned, would be better suited on the chiropractic schools article. So once you have reworded sufficently, feel free to stick it there. That article is barely a stub as is and could probably use some more content. Levine2112 22:44, 22 August 2006 (UTC)

Straights do a differential diagnosis?

I see that a modification was made to the straight/mixer summary at the end. It states that straight chiropractors do differential diagnosis. Where are you guys getting this from? Straights hate diagnosis and can't even order the required lab tests to do it in some states like Michigan Abotnick 19:05, 15 August 2006 (UTC)

I don't remember when that happened, but it may have gotten there when some other editor came rolling through and made several changes that sounded reasonable. I think the thought was that objective straights don't want to use differential diagnosis, but most regular straights do (as required by their state laws). Just guessing though. I may be totally wrong, but I'll do some dogging and see what I find. --Dematt 21:55, 15 August 2006 (UTC)

Nope, I was wrong. It was Hughgr[11]. When he combined the two versions that was incorporated. Considering he is a Palmer grad, I wasn't about to make changes to that one:) --Dematt 02:36, 16 August 2006 (UTC)

When you label me, you negate me. :) From some of the books I've read on objective straights, their rationale is a medical diagnosis is irrelevent to locating and correcting VS. But if you follow the history of the objective straight schools(ie.Sherman), that while there was opposition to teach DDX, the CCE stepped in and said you must teach it, or you will lose (or fail to gain) accreditation.--Hughgr 17:30, 16 August 2006 (UTC)

Opps, just realized you may be talking about trad. straights, I'll look into it.--Hughgr 17:32, 16 August 2006 (UTC)

Depends on the label:) You can be proud of yours! --Dematt 17:44, 16 August 2006 (UTC)

What straight chiropractic programs often do is create a non-integrated dual curriculum where a few credit hours of differential diagnosis taught to meet CCE requirements but the clinical experience doesn't require it in order to diagnose and treat patients which are deemed subluxated by chiropractic analysis methods. Regardless, the straight position is that DDX is not needed and the paragraph on Traditional Straight practitioners should be updated to reflect that these practitioners typically will only screen for red flags and not diagnose patient complaints using DDX. The OSC paragraphs and mixer paragraphs are accurate however. I'll make some changes and let you guys work with it.Abotnick 15:13, 17 August 2006 (UTC)

Thanks Abotnick! --Dematt 15:55, 17 August 2006 (UTC)

yw Dematt. It took a lot of rewriting but I think it's accurate now.Abotnick 01:23, 18 August 2006 (UTC)

Requested change

This part, in the third paragraph of "Introduction", looks funny; suggest that someone change it:

Today, there are 17[16] accredited chiropractic colleges

--Scott McNay 12:56, 16 August 2006 (UTC)

Good catch. I'll work with it. Thanks Scott. --Dematt 13:18, 16 August 2006 (UTC)

Chiropractic construct table

I added a table that I found that seems to help better illustrate the dilemma of what is testable and what is not. What do you think? --Dematt 15:00, 16 August 2006 (UTC)

I like it! Great addition Dematt. Cheers--Hughgr 17:36, 16 August 2006 (UTC)

Category Maintenance

Hi all. There are significant issues of pseudoscience in this article, thus, the cat applies. Excuses of the whole cat being accusatory are quite ridiculous in the context of the cat application. Either accept the cat application to this article, or have a go at trying to abolish the cat altogether from Wikipedia....again. KrishnaVindaloo 03:34, 17 August 2006 (UTC)

Sorry KV, strongly disagree here. Repeating myself from Talk:Pseudoscience because it's important:

Even if/when scholars use the term, it's still considered pejorative in general usage. That should be taken into account when we edit. Agree with the trend toward more citation. Citation and annotation are good. Slapping the label on field like chiro and acu which have PS elements but also sci elements, without annotation, is bad. It's asserting a single POV rather than presenting the range of sig POV's, and should be avoided. For those who have argued that NPOV allows unqualified categorization in the area of pseudoscience, please read WP:NPOVT#Categorisation. That's just as much an aspect of NPOV as anything else that's been cited here. Same idea as guideline #8 at WP:CG#Some_general_guidelines.

It's probably going to take awhile to iron this out on WP. Thanks for considering this. cheers, Jim Butler^(talk) 06:18, 17 August 2006 (UTC)

Sure I'll repeat here also. The cat description removes pejorative, following NPOV removes pejorative, the cat includes any article (including confirmation bias etc) that explains PS and has PS issues. This article applies. There are very strong PS issues within contemporary chiropractic teaching and practice, so adding chiropractic to the cat will be helpful to the reader. KrishnaVindaloo 09:13, 17 August 2006 (UTC)

Hi KV! The problem with your argument is this: Scholarly intention doesn't change popular usage, which remains pejorative and therefore subject to the NPOV issues mentioned above. Scholars may and do use the term "cult", and not mean it pejoratively, but it's still a pejorative term in popular usage, which makes it a "sensitive" category. Same with pseudoscience, which by definition means the proponent is engaging in misrepresentation in some way. That's a "sensitive" assertion to make, and invokes WP:NPOVT#Categorisation.

That NPOV page links to this guideline page, which says:

"For some 'sensitive' categories, it is better to think of the category as a set of representative and unquestioned examples, while a list is a better venue for an attempt at completeness. Particularly for 'sensitive' categories, lists can be used as a complement to categorization.

Thus, chiro, which per sig POV's has both sci and PS aspects, isn't a representative and unquestioned example of PS. Similarly with acupuncture. Please note: I don't make this argument for all alt-med stuff labelled as PS, just the stuff that scientists take seriously enough to test and for which significant reviewers like Cochrane say there is evidence suggesting efficacy. Acu and chiro are the only ones I can think of, apart from a few herbs. I know there are various studies supporting various alt-med things, but I don't know of evidence-based medicine reviewers saying that meta-analysis of multiple studies suggests efficacy for them. I do recall seeing a Cochrane publication supporting chiro for low back pain, and Acupuncture#Scientific_research covers existing EBM stuff for acu.

NPOV's point about categories and "representative and unquestioned examples" seems pretty clear to me. KV, I respect the fact that we may agree to disagree here, but imo just because some scholars don't mean the term pejoratively doesn't change the fact that in popular usage it actually is understood to be pejorative. What do other editors think? regards, Jim Butler^(talk) 05:44, 18 August 2006 (UTC)

I've responded to your repeat objections on the pseudoscience cat talk page. I don't mind you mentioning it here, or mentioning chiropractic on the cat talkpage. It shows your motivation for your "interpretation" of core NPOV policy. KrishnaVindaloo 06:40, 18 August 2006 (UTC)

Hi KV - The NPOV page that I cited is just as much an aspect of NPOV as any other part. I don't believe your interpretation of categories is any closer to the "core" of NPOV than mine. The reason that I added my comments to Category Talk:Pseudoscience is (a) they're relevant, (b) the issue hasn't been settled (and kindly don't presume that it has, especially when a majority of editors of this page disagree with you on categorizing chiro as PS), and (c) I wanted to be clear that I do draw evidentiary distinctions among different alt-med fields. So, no need to worry about my motives. I've stated them plainly, and my editorial conduct is consistent with them. I've always felt your motives are genuine, and I hope you'll likewise assume good faith. More on the cat talk page. best, Jim Butler^(talk) 06:40, 19 August 2006 (UTC)

Hello Jim Butler. I can point out your biases according to proper Wikipedia conduct. I did so very mildly. Other editors will have their own view of your biases. I leave it up to them to decide for themselves. I know the category matter hasn't been settled, mostly because of the association you mention above (categorizing chiro as PS). The distinctions can be easily described in the articles themselves. There is a constant pressure from some editors to paint the category as a list of pseudosciences. It is already clearly far from that as it shows a great variety of subjects, and shows articles that explain pseudoscientific elements such as confirmation bias, granfalloon etc. Understanding pseudoscience is the solution here. I know from what I have read of pseudoscientists, that they are definitely going to try to remove or cloud any PS issues within their field. That is a key characteristic of pseudoscientists. I fully accept that those elements will need maintaining, by restoring, and by resorting to mediation, and arbitration. It is not inevitable that the latter will occur. But it is inevitable that the pseudoscience category will be maintained, and it is inevitable that pseudoscience will be explained as science sees it as per NPOV policy. Wikipedia policies and enforcements are quite capable of long term handling a set of pseudoscientists who are not interested in following NPOV policy. KrishnaVindaloo 08:14, 19 August 2006 (UTC)

Just because someone objects to their field being labelled pseudoscientific doesn't mean that person is a pseudoscientist! That's like saying "if the defendent loudly proclaims his innocence, he must be guilty". Nothing to add that wouldn't be repeating myself.... cheers, Jim Butler^(talk) 22:41, 19 August 2006 (UTC)

Thats right. I left it up to other editors to make up their own mind. KrishnaVindaloo 05:14, 20 August 2006 (UTC)

Inclusionism and NPOV

Steth, imo you should chill and let Fyslee's critical links stay. There's similar stuff at acupuncture and it's fine. Like acu, chiropractic is strong enough to withstand criticism and Barrett is so over the top at times that he's his own worst enemy.... best, Jim Butler^(talk) 06:04, 18 August 2006 (UTC)

Jim, Thanks for your excellent edits here. They always represent fairness and NPOV.

I have no problem with including critics/critiques. What I do have a problem with is when an ex-psychiatrist who holds himself up as an expert yet has failed his own boards, doesn’t just criticize but actively plans and executes attacks on individuals and professions using his so-called ‘expertise’.

But that issue aside, what should be examined here is the use of Wikipedia by his disciples to promote his websites for the purpose of driving traffic, raising search engine visibility and soliciting donations to a privately owned for-personal profit, ‘non-profit’ corporation. It has been brought out here that Mr. Barrett stated under oath that he uses the ‘donations’ to pay himself as an expert in, often frivolous, litigation he brings about himself.

The ethical question is glaring enough, but should Wikipedia be exploited as yet another outlet to drive traffic to these sites? Should they be used as encyclopedic references when, in fact, they are merely just websites verbalizing the wet dreams of an ex-psychiatrist who hates everything not drug-oriented and who failed his own boards?

There is, of course, another delicate issue: Fyslee, who insists there be several links to Mr. Barrett’s ‘websites’ per WP article, also happens to perform internet responsibilities for his good friend, Mr. Barrett. A little awkward (translation: self-seving), don’t you think?

Clearly, these types of links should be removed. Surely, I can’t be the only one who recognizes this. I would love to hear your view on this, Jim, as well as anyone else’s on this issue. Thanks Steth 15:56, 19 August 2006 (UTC)

Thanks Steth! I'd agree that multiple links to Barrett's sites is a bit much. They're not flagrant advertisting, though. The issues of fund-raising are generic to non-profits, whether we disagree with that they advocate or not. Certainly I agree it's ironic that a self-proclaimed "consumer advocate" was found to be bringing SLAPP-suits. That should be, and I guess is, noted in the Barrett and NCAHF articles. Again, Barrett screws his own credibility by being such a fanatic and arguing so disingenuously. But I don't think it's a disqualifier toward linking to a site of his. best, Jim Butler^(talk) 22:46, 19 August 2006 (UTC) (minor edit for clarity 06:26, 20 August 2006 (UTC))

OK, I'm a reasonable chap. Even though I think they should all be removed, and not because he is a creepy asshole, I will go along with either NCHAF or Chirohate. I think one would be a reasonable compromise. Now that would be fair, wouldn't it? Steth 01:55, 20 August 2006 (UTC)

I would agree Chirobase is sufficient. Chirobase = Quackwatch = Barrett. Jarvis's [NCAHF article that Fyslee wanted to add is already linked from the Chirobase home page, right under "General Articles". Regarding Wikiquette for linking to one's own material, I remember reading that the proper thing to do was mention it on the talk page and let another editor add it. Can't find that page at the moment. best, Jim Butler^(talk) 06:26, 20 August 2006 (UTC)

Chirobase/Quackwatch fails WP:RS as a reliable source and is more properly classified as a "personal page". I removed this link which was placed by User:Mccready with the extremely bad-faith edit summary "let's face the truth true believers". The page describes complaints John W. Kinsinger had with a few chiropractors, which is hardly a statistically useful sample, nor does it even attempt to be impartial. Kinsinger has a chip on his shoulder from the getgo, and the "article" is written like a crank editorial, not a serious scientific refutation in general. wikipediatrix 13:10, 20 August 2006 (UTC)

I disagree. Chirobase/quackwatch is a personal site, but it is (marginally) reputable as a news source. snopes.com is also a personal site, and FoxNews used to be essentially Murdock's personal site. (What I want to know is why the category:paranormal edits didn't get reverted.) — Arthur Rubin | (talk) 18:18, 20 August 2006 (UTC)

The difference is that Snopes and FoxNews at least to try to pretend they're "fair and balanced". Chirobase/quackwatch is quite openly a site with a very specific POV mission: to ridicule (often extremely unprofessionally) and debunk entire fields of study they consider pseudoscientific. Some mainstream media news articles housed on Chirobase/quackwatch could be given as "courtesy links" but it would be preferable if they cited the original source. Like most of Chirobase/quackwatch's in-house "articles", the one User:Mccready is trying to insert is neither a news story nor a WP:RS-passing scientific source: it's scarcely more than a biased, unsourced, poorly written bloggish rant by someone who claims to be an M.D. wikipediatrix 18:26, 20 August 2006 (UTC)

Quackwatch is already deemed a reliable site at Wikipedia, depending of course on the subject matter. Chirobase likewise, and of course in the External links section, where the requirements are much more lenient than the requirements for references in articles.

Especially since it is placed in the Critiques section, removing it is very POV pushing, since it is the paramount chiro skeptical site on the internet, with input from many chiropractors, and possibly thousands of printed pages.

All the talk about donations is a smoke screen for a determined attempt to block the actual viewpoints on the site from getting any exposure. (Just what are these critics afraid of? If chiropractic can't tolerate criticism, as claimed by Keating, the profession's foremost historian, then something must be wrong!) This is all about suppression of information, not about any so-called "donation" problem. Donations are ubiquitous on practically all such sites, so that argument has no weight in this matter.

Actual advertising for multiple quack products would be a serious problem, such as the advocacy link to http://www.chiroweb.com/ . A quick look at the site, and especially any copy of Dynamic Chiropractic, will show that it is primarily an advertising medium, with quality articles few and far between. Even then I read it from cover to cover. I know chiropractors who consider it only worthy for lining their bird cages.

The objections to links in the Critiques section, coming from advocates, should be given little if any weight. They should stick to the advocacy links. I have been more than lenient in allowing such sites as the above named advertising site in the Advocacy section. The double standard being used here is quite hypocritical. Knowing the past history of these deletionists, they would be willing to allow me to delete every single advocacy site, as long as it meant Chirobase was also deleted. That is the track record so far, and it actually has happened (nearly so) in the past. They allowed deletion of multiple quality advocacy sites, in exchange for the deletion of Chirobase. Their mission is very much a violation of the NPOV policy, which requires than all major viewpoints be represented. -- Fyslee 18:43, 20 August 2006 (UTC)

First of all, you need to assume good faith on the parts of other editors: making statements like "All the talk about donations is a smoke screen for a determined attempt to block the actual viewpoints on the site from getting any exposure. (Just what are these critics afraid of?)" violates WP:FAITH and is irrelevant to the editing of the article. Secondly, I have no problem with Chirobase being in the "External links" section - in fact, I have no problem with it being top of the list. What I do have a problem with is biased, unscientific, bloggish rants (like the one User:Mccready is trying to insert) being used as a valid source citation for facts, which it is not. Removing a Chirobase link is NOT, as you claim, automatically POV, because Chirobase is an inherently POV site. I have no opinion of Chiropracty pro or con myself. wikipediatrix 18:56, 20 August 2006 (UTC)

Dear Wikipediatrix, you are absolutely correct about assuming good faith. To understand my answer above, you can easily check that user's contribution history here at Wikipedia. You will quickly discover that I haven't assumed anything. I just wish you'd direct your proper admonition at the one who started this problem with deletionism and personal attacks. The hateful personal attacks by this user have a long history, with a single minded mission to delete and demean anything that has to do with Barrett or any criticism of chiropractic's dubious aspects. The attacks are very direct and derogatory. The history shows that too, and it's not limited to the chiropractic articles. But you're quite right. I wish that this particular user would start assuming good faith and cease his constant attacks and deletism. User Dematt is a model to follow as to cooperative editing and assuming good faith, even though we don't see eye to eye on all things. A confidence in each other's good intentions does wonders for getting this article moving forward. It is after Dematt came here that the article suddenly started to move forward. I am perfectly willing to allow, and do it all the time, positive information about chiropractic being included in the article, as long as it's sourced and accurate. Unfortunately this critical user deems all negative information to be unallowed, even when well sourced. As to Mccready, I'll leave him to you. Most of his work here I have difficulty defending. He's doing more damage than good, since his editing isn't collaborative.

You write:

"Removing a Chirobase link is NOT, as you claim, automatically POV, because Chirobase is an inherently POV site."

Of course it is POV. No one is denying that. I guess I expressed myself clumsily above. Here's what I wrote:

"Especially since it is placed in the Critiques section, removing it is very POV pushing,..."

The external links are expected to be POV (especially when they are labelled as such!). NPOV requires the presentation of POV in articles, but external links are allowed to go even further. For the supporter of one POV to delete sites from the opposite POV's list of links is what I find very objectionable. That's what I meant by "POV pushing." I should probably have written something like "suppression of opposing POV," which is a violation of NPOV policy. We are supposed to present all POV here, not suppress them. Inclusionism, rather than deletionism, is the idea. -- Fyslee 19:51, 20 August 2006 (UTC)

I think the Chirobase site is top-notch. The articles are written by MDs, experts on the subject of health. It's clearly NPOV-compliant to include Chirobase as long as the pro-chiro position gets fair press in the article. At most skeptical, we should include Chirobase as a primary source about the medical community's position. I think it deserves secondary source status, though. --Davidstrauss 00:50, 21 August 2006 (UTC)

There is no evidence that Chirobase represents the medical community's position; only the opinions of those that contribute to the site. Levine2112 00:53, 21 August 2006 (UTC)

I agree DavidStrauss. Its a very informative site that Wikipedia can benefit from in quite a few ways, especially within certain pseudoscience articles. The more I read about chiropractic, the more PS appears. There are so many subjects, such as naturopathy, applied kinesiology, and various power/qi therapies that chiropractists are heavilly involved with. There is even a Scientology connection, especially regarding the dismissal of conventional medicine and the use of drugs for treating various conditions. There are good secondary sources there, plus chirobase is regularly cited in various peer-reviewed scientific publications that I have read. KrishnaVindaloo 06:02, 21 August 2006 (UTC)

So if there are some dentists using homeopathy, then dentistry is pseudoscience? Sorry, that logic won't fly here. Levine2112 05:42, 22 August 2006 (UTC)

Hi KV, Could you please list some of the peer-reviewed scientific publications that regularly cite chirobase. ThanksSteth 11:22, 21 August 2006 (UTC)

Sure Steth, I could. But I think you will benefit far more if you search for them yourself. KrishnaVindaloo 05:14, 22 August 2006 (UTC)

KV, thanks for the suggestion. I looked and looked but came up empty. It was very time consuming and exhausting. You mentioned you have stacks of papers on your desk, so I hoped you might have found some refs and could share them with us. If it is "regularly cited in various peer-reviewed scientific publications" that you have read, then I would be more open to considering leaving chirobase in. Thanks, Steth 12:01, 22 August 2006 (UTC)

I wouldn't expect many as peer reviewed journals will cite primary sources or journal reviewed secondary sources instead, although I found a few. However I think it's worth noting that the Lancet clearly regards the Barratt sites as doing a good and important job in some areas - see Antiquackery sites take aim at cancer 'cures'. The Lancet Oncology, 4: 259-259and chirobase is mentioned in passing there. I would say it is certainly not regularly cited in the way KV suggests, but it would be quite extraordinary if it was. I found a few examples of direct citation, if you sift through a Google scholar search for chirobase you'll come across them, (though most of the hits are to chirobase itself, which clearly is accepted as a source for Google scholar at least)Gleng 12:50, 22 August 2006 (UTC)

In my opinion at least, the present links to critiues are inadequate for a balanced article. I've checked the links that are there, and many (ACA, WCA for instance) are gateways to heavy advertising. I'm not suggesting that they be removed, but attacking Chirobase's relatively discreet request for donations as advertising seems one sided. Chirobase is a gateway to many other sources of criticism and provides a lucid account of the "other side" of the argument. Yes it is overtly opinionated, personally I see that as an argument very much in favour of including it, as it does not represent itself as anything else, whereas some of the other sites do not attempt to represent the criticism yet give an appearance of objectivity. This issue won't go away, if you want stabiklity, and probably we all do, we either have to restore Chirobase or make a very much more comprehensive attempt to source criticism.Gleng 21:50, 20 August 2006 (UTC)

I have no problem with Chirobase links such as this one, because this one is, though hosted by Chirobase, actually sourced from the Sept 19, 1990 issue of Medical Economics, a physicians' journal. The problem is with Chirobase pages such as this one that a user keeps trying to insert, and these vague and unsubstantiated editorial comments by "John W. Kinsinger" fail WP:RS. But even more importantly, if the case against Chiropracty is as obvious and as strong as some are maintaining, then it should be no trouble at all to go and get some ironclad sources from reputable media, professional medical journals, etc. and there shouldn't be any need to bother with small potatoes like Chirobase. wikipediatrix 23:19, 20 August 2006 (UTC)

Still fails the smell test, but if we want to appease a certain editor, then we can look the other way.

Ladies and gentlemen, I am willing to compromise and let EITHER Chirobase or NCHAF be cited, although this has nothing to with fraud and only creates confusion as well as insinuates that something fraudulent is taking place. Unlike other editors, I am open to leaving ONE Stephen Barrett Enterprise link. I don't think this or any WP article should be used as a link farm to drive traffic to an individual's personal donation box claiming to a self-appointed expert in anything except, as in this case, psychiatry. Of course, even that is suspect since Stephen Barrett failed his boards.

Of course a certain editor is protesting the loudest-- he is a personal friend of Stephen Barrett and, oh my, helps him with various internet responsibilites. Any conflict of interest here? To me this fails the smell test. So should we all cave in to his protestations. We are assuming good faith, but to me, it seems he has some vested interests in this whole mess, and is NOT assuming good faith by not disclosing these pertinent facts. Steth 02:29, 21 August 2006 (UTC)

I agree with Fyslee's comments above. Chirobase isn't being presented as a reliable source on what the scientific community says (I doubt there is a single voice here), but rather as an example of a notable POV in External Links. Is the POV notable? Yes, it's a sig minority POV; Barrett is pretty clearly notable, and certainly Dawkins (who expresses essentially the same POV) is notable. Also, Fyslee's linking to Chirobase doesn't even begin violate WP:VAIN; if WP has another smell test, we should address it specifically.

Again, wearing all the hats I do of L.Ac., parent of an often-"labelled" kid, scientist and American healthcare consumer, I have strong disagreements with Barrett and similarly-minded folks over both substance and tone. But they aren't a tiny minority, so if WP is to accomplish its mission it should certainly mention their views, even if some of us do find them distasteful in many ways. My own preference is to welcome criticism, and let advocates respond to the best of it and point out the holes in the rest, while letting the shrillest of the pseudoskeptical critics continue to alienate. Steth, hope this makes some sense. best regards, Jim Butler^(talk)

Thank you Jim, I do appreciate your rational viewpoint on this. So what about leaving Stephen Barrett Enterprise's radically insane anti-chiropractic POV hate-site, Chirobase, Inc., and removing Stephen Barrett Enterprises's radically insane anti-chiropractic POV hate-site, NCHAF, Inc. instead? Since all anti-chiropractic roads eventually lead to Stephen Barrett Enterprises, Inc. anyway, this will still allow his site to be in the article and will still allow money to flow to the collection box so he can pay himself to fund new attacks on chiropractic and other things he hates. I think this is a very fair plan. Your thoughts? Steth 03:59, 23 August 2006 (UTC)

I'm not sure. I don't see what NCAHF brings to the table that Chirobase doesn't. They seem to be composed of basically the same cast of characters. What arguments exist for having both? thanks, Jim Butler^(talk) 05:10, 23 August 2006 (UTC)

The NCAHF link is not to the website as a whole, because it doesn't concentrate on chiropractic. The link is specifically to the position paper, which exists only there. As such it represents a significant POV, especially since it's critical. -- Fyslee 08:09, 23 August 2006 (UTC)

P.S. Steth, I think you were probably right to remove Kinsinger's "research"[12] entirely. Credibility is questionable, and it seems unencyclopedic to link to disaster anecdotes. It barely qualifies for External Links and in any case it's already linked from Chirobase's home page. Should we just paste all the links on Chirobase into the critical section of External Links? Don't think so.... cheers, Jim Butler^(talk) 05:41, 23 August 2006 (UTC)

So, Jim, what I think you are saying is that you agree that NCHAF that should be removed. I think it should, too, for these reasons: How do we know that the musings of a retired PhD are representative of a significant POV? I agree, it is the same song and cast of characters as the other site in the article. It brings nothing new to the table that isn't already represented.

Also, NCHAF seems to concern itself with what they believe is fraud (yet ignores medicine and psychiatry which account for 99.9% of health fraud!) So, if a reader is unwittingly sent there, the insinuation is that there is fraud involved, which there is not. This has nothing to do with fraud. What is really fraudulent, IMO, is that they call themselves "National Council" fraudulently implying to the naive web-surfer that this is an official or governmentally sanctioned website, which clearly it is not. It is privately owned and operated by, you guessed it, Stephen Barrett Enterprises,(Donations gladly accepted!) Now that's misleading and fraudulent, IMO. So let's remove it once and for all. Chirohate, Inc. is still there. Steth 02:50, 24 August 2006 (UTC)

I agree about removing the Kinsinger link - in this case. It is unencyclopedic, and I have never defended the inclusion of that link. The point could probably be made in other ways than one man's experience, although such things are usually only done in that manner, so there can be a place for such things. There is no reason to doubt his investigation, especially since similar investigations by other individuals and groups of individuals (including law enforcement) have uncovered similar results, and even a simple web search will turn up plenty of cases that are similar to what he describes. Those of us in actual practice experience this all the time without doing such investigative research. Our patients, other providers, and other chiropractors themselves dement the accuracy of the whole paragraph.

That paragraph should be totally rewritten, as it is simply a piece of chiropropaganda, and is hardly true in all jurisdictions, and certainly not always in practice. One thing is good written intentions, policies, and laws, another thing is what actually happens in the real world. (Of course there are outstanding chiros to which it does truly apply. They do recognize problems, stick to their limited scope of practice, and refer out.) There has even been a Michigan court case where a patient died, and the (successful) defense was that the chiropractor was not required to recognize the heart problem or refer to another more qualified provider, and that doing such a thing would be acting outside of his scope of practice. The patient died and the chiropractor walked. Moral of the story? Don't trust a Michigan chiropractor to refer out or recognize a serious problem of a non-chiropractic nature. -- Fyslee 08:50, 23 August 2006 (UTC)

I can't comment on how DC's are educated, but as an L.Ac. will say that if I had wanted to learn how to diagnose biomedical disease and refer to specialists, I would have become a doc or an NP or a PA. I prefer that my patients also have a doctor evaluate their chief complaint (and the state in which I practice requires by law that I recommend they do so, which is as it should be). This is where I get very "complementary" and not "alternative".... cheers, Jim Butler^(talk) 08:10, 24 August 2006 (UTC)

This is not so much about how DCs are educated as how they are legislated. I am not familiar with the above Michigan case, but what I can tell you is that in the 1980s Michigan legislature passed laws (similar to your acu law, Jim) that do not allow chiropractors to make a diagnosis and only allow to analyze and treat the subluxation (IOW objective straight definition). There was a big battle between the Michigan Chiropractic Association and the Michigan Chiropractic Society (I think that was the name). The Michigan Chiropractic Society won. The rest of the profession was pretty much in shock when the law passed. Basically there are no more mixers practicing in Michigan. This is a good example of what the chiropractic history in this article is talking about with the battles between mixers and straights. The straight MCS was created to counter the mixing MCA. As you can see, the MCS would consider this lawsuit a successful example of why all chiropractic laws should be written this way; because they do not diagnose and don't want to be responsible for it. I am not sure, but some movement in the mixer direction may be occurring over the last few years. I am sure there are archived articles in Dynamic Chiropractic about that one.

Chiropractic education is 4400 class hours and includes all the basic sciences required in medical school. Most are taught by PhDs in their fields and even some MDs and certainly DCs. Diagnosis is certainly part of the curriculum. There is also a prerequesite for 90 semester hours toward a degree of prechiropractic studies that require the core sciences such as inrganic and organic chemistry, biology, psychology, sociology, etc.. With the current state of the science, I really can't see that there are any chiropractors that would truly think that medicine doesn't serve a very important purpose. Considering that very few chiropractors want to prescribe medications, it doesn't make sense that they would be functioning without using the referral process for conditions that are out of their scope of practice. If they don't, they are more than likely going to find themselves in court.--Dematt 14:33, 24 August 2006 (UTC)

If it helps, this page does a fairly decent job describing chiropractic education and comparing it to the education of MDs. I don't know how up-to-date it is, but it still is rather illuminating on the subject. Levine2112 18:11, 24 August 2006 (UTC)

Scientific Investigation of Chiropractic

What does the opening paragraph of this section have to do with the topic?

Chiropractic historian Joseph Keating Jr., PhD states that Palmer's first theory of chiropractic offered mechanical metaphors; the human was construed as a machine that would operate smoothly, without friction, if all parts were in their proper place. Not until 1904 do distinctions between "innate" vs. "educated" nerves appear in his publications, and not until 1906 does "innate" become a distinct personality, Innate Intelligence. He noted "DD Palmer may not have equated Innate Intelligence with Universal Intelligence until after his conviction and incarceration in Scott County Jail in 1906 for practicing medicine without a license. Eventually, his religious platform was offered to provide legal protection to chiropractors under the religious exemption clauses in many medical practice acts."

This seems more apt for the history section than the science section. Levine2112 23:42, 18 August 2006 (UTC)

Thanks for asking Levine! Part of the prerequisites of developing a theory start with developing a hypothesis and working to disprove it. DD's first hypothesis was bold and all encompassing. As he worked the next few years, he apparently (he left no notes) disproved parts of his hypothesis and adapted it to include a tighter hypothesis (in effect, he performed a reduction of his theory). This is necessary in the scientific method. It wasn't until he was incarcerated did he begin to use the religious explanations. Even Karl Popper, scientific philosopher concerned mostly with pseudoscience, allows for a new science to "protect" itself until it is able to mature. Keating's point was that chiropractic started as a science, but was forced to go vitalistic in order to protect it from the AMA's early grab for all things health related. Remember, all schools were private back then.

That's why it's in the science section, along with the pseudoscience stuff. You are certainly welcome to do anything that you think might be more appropriate with it.

--Dematt 00:18, 19 August 2006 (UTC)

I understand what you are saying, but the paragraph doesn't really give us that. Instead it seems to gratuitously mention Palmer's incarceration. Can we reword or find something else that put the point your are making across? Levine2112 00:26, 19 August 2006 (UTC)

I'll see what I can find, though go ahead and feel free to make whatever changes you think might fit and still say what Keating was saying. --Dematt 00:33, 19 August 2006 (UTC)

See what you did, you put me in the delete mood:) I just got rid of it! I think we have enough Keating anyway. Lets start citing others. --Dematt 00:59, 19 August 2006 (UTC)

Agreed. That being said, I like what you are doing with the Science section by first showing its historical roots which leads into the modern look at chiropractic science today. Levine2112 01:07, 19 August 2006 (UTC)

Levine2112. The practices and beliefs followed within chiropractic today can be stated as being practiced today. Consigning them to history causes POV forks. The literature as it is says that the reformers are fighting an uphill battle against the majority who follow pseudoscientific ideas and activities. There are abundant sources saying that old practices are still widespread, and being taught at chiropractic schools. KrishnaVindaloo 08:15, 19 August 2006 (UTC)

KV, I don't disagree with anything you just wrote. But I'm not quite sure how it relates to this topic thread. Please clarify. The Science section, I would hope would deal with the current state of science in relation to chiropractic. However, as I say above, I like the idea of leading into that by talking about the history of chiropractic relative to scientific research. Certainly, we should remind the reader that historically (at least up until 1990), the AMA engaged in conspiracy to squelch any positive results in any chiropractic research and actually go so far as falsely disparage the practice. You talk about fighting an uphill battle, imagine taking on the bloody AMA and the Pharmaceutical lobby, two of the most powerful lobbyist groups in the United States. Whoa! It's astonishing that chiropractic has all of the positive scientific research out there that it does have in the short time since the U.S. court system found the AMA guilty of this financially-driven, fear-of-competition conspiracy and forced them to change their adversarial stance (at least on the public economic level) as they were in clear violation of the Antitrust laws. Having this in mind, I think would greatly help the reader appreciate why there is a derth of strong research out there and possibly hint at the true reason behind why such contraversy still surrounds chiropractic. Power and money; specifically the AMA and Big Pharma's fear of losing it. After all, it's hardly been 17 years since the AMA had to change their public stance on chiropractic. It's reasonable for the reader to assume that there is still bad blood out there, and the AMA to protect the wallets of their members by disparaging chiropractic. KV, how do feel about having that little POV fork as the lead into the Science section? Levine2112 08:50, 19 August 2006 (UTC)

Yes, I've heard this conspiracy theory before. I've nothing against presenting such theory in the article. My objection was to inferring that older ideas are not being followed now. There is abundant literature that states chiropractors adhering to pseudoscientific dogma. KrishnaVindaloo 05:18, 20 August 2006 (UTC)

Here's the catch. What you are talking about... older ideas being still used by a large sector of chiropractors... is just a theory (and a completely unsubstantiated one at that). However, what I am talking about... the AMA's financial-fear-based conspiracy to undermine chiropractic's scientific effectiveness is not a theory at all. A U.S. judge ruled and three appeals upheld that the AMA had in fact engaged in a massive fear-of-competition conspiracy as recently as 1990. Levine2112 18:36, 20 August 2006 (UTC)

No Levine2112, its the view of reputable authors. It can be included in the article. A single U.S. court case (that placed competition law above the welfare of the public) is not an alternative to Wikipedia's requirement for science above pseudoscience. KrishnaVindaloo 05:56, 21 August 2006 (UTC)

"placed competition law above the welfare of the public". That's a very slanted POV interpretation on your part. One could easily respond by saying that the AMA put greed above the welfare of the public. Regardless, the court proved beyond a resaonable doubt and several appeals courts upheld that the AMA engaged in anti-competition conspiracy by, for one, covering up positive chiropractic scientific research. The AMA political machine was manipulating the public's perception of chiropractic in order to protect their pocketbooks. That's indefensible and inexcusable. Levine2112 16:36, 21 August 2006 (UTC)

We may include any information that is verifiable and reliable. It does not have to be void of POV, though quality sources will be. All need to be careful not to assume that descriptions of some (or even most) of chiropractors behavior by some authors may sound like pseudoscientific behavior by current WP standards. In other words, when an author states that "chiropractic web sites advertise vitamins", that does not mean that the author is stating that chiropractic is pseudoscience. That would be an example of a WP editor pushing a POV and leading the reader.

The AMA's position on chiropractic may have created a pseudoscientific anomaly that precludes it from being a pseudoscience. In other words, it was not respected scientists that caused early chiropractors to protect their field, it was the AMA. The two are not synonymous. The AMA is a political machine with a financial motive, while science does not care what the evidence shows. I don't see how we can discuss pseudoscience in this article without discussing the AMA's role in creating the chiropractic anomaly. If we discuss one, we have to discuss the other. I see no problem with Levines line or KV's at this point.

--Dematt 12:07, 21 August 2006 (UTC)

"placed competition law above the welfare of the public" is more-or-less accurate. It would be more precise to state that the court explicitly did not consider the welfare of the public in its finding on competition law, but I can understand the confusion. — Arthur Rubin | (talk) 19:05, 21 August 2006 (UTC)

You're right, Arthur. This is a subtle difference. It's the difference between saying something accurately and saying something slanted. Levine2112 19:53, 21 August 2006 (UTC)

It's slanted, but completely accurate. Trying parsing it carefully. The court, for the purpose of the case, did place competition law over considerations of public welfare. It probably was right to do so. — Arthur Rubin | (talk) 20:41, 21 August 2006 (UTC)

But it's this kind of phrasing which when taking out of context can lead to POV issues. You are using the word "over" where the statement above used "above". I'm just making sure that you (and our other readers here) know that the court wasn't hurting the welfare of the public when making its ruling. It was not putting citizenry's health at risk by not factoring it into its decision. The court is not qualified to rule on science; just the law. That is why they ruled that the AMA was guilty of engaging in an unlawful conspiracy that was not about protecting the welfare of the public but rather protecting the welfare of their wallets. Choose your phrasing carefully; that's all. Often times they can have more than the intended meaning and I am very sensitive to that. That's why I often rework sentence structure in an article in order to get the intended point across and minimalize the risk of having it read with a different interpretation. Levine2112 20:59, 21 August 2006 (UTC)

Healthy skepticism

Hey everybody. I think what we have started here is a very healthy move in the right direction. In order to proceed with this next part, we need to ask ourselves what is [scientific skepticism] and what is [pseudoskepticism]. To assure that we are all working with the same defintions, I used the WP links. (I personally do not agree with the WP definitions, i.e. I prefer to think skepticism is used in all science not just alt med, but I am just another editor at this point). Perhaps if we can all agree on these, then we can better evaluate their counterparts, science and pseudoscience. In other words, while we should deal with the scientist's POV and the skeptic's POV, I don't think WP expects us to deal with the pseudoscientists POV any more than we should deal with the pseudoskeptics POV. Both are minority POV's. Agreed?

Well put. I fully agree.Gleng 12:18, 21 August 2006 (UTC)

I agree, provided that we can distinguish what is a scientist's POV and what is a pseudoscientist's POV. Unfortunately, I think here that the definition of a "pseudoscientist" is one whose science you don't agree with. The same goes for skeptics and pseudoskeptics. Though I'm not sure what would qualify someone to be a "pseudoskeptic"... perhaps they are a "pseudoscience skeptic", meaning that the rely on "pseudoscience" to confirm what they are skeptical about. Levine2112 16:39, 21 August 2006 (UTC)

Do you have a problem with this differentiation of skepticism vs pseudoskepticism from Marcello Truzzi:

In science, the burden of proof falls upon the claimant; and the more extraordinary a claim, the heavier is the burden of proof demanded. The true skeptic takes an agnostic position, one that says the claim is not proved rather than disproved. He asserts that the claimant has not borne the burden of proof and that science must continue to build its cognitive map of reality without incorporating the extraordinary claim as a new "fact." Since the true skeptic does not assert a claim, he has no burden to prove anything. He just goes on using the established theories of "conventional science" as usual. But if a critic asserts that there is evidence for disproof, that he has a negative hypothesis --saying, for instance, that a seeming psi result was actually due to an artifact--he is making a claim and therefore also has to bear a burden of proof.

--Dematt 21:08, 21 August 2006 (UTC)

I like this (and have read it before), but is the latter description truly that of a "pseudoskeptic"? Is it a skeptic that does more that not believe something to be proven true, but also believes that something is false unless proven true? Levine2112 21:37, 21 August 2006 (UTC)

Good question. Does anyone else have any input on this? I have read some Popper and think an argument can be made to support the above breakdown. I am not as concerned about the "titles" as I am about the concepts. As long as we are all using the same titles for the same concepts. --Dematt 22:15, 21 August 2006 (UTC)

That's incorrect. Skeptics do not actively believe something is false by default. They just refuse to believe it without lots of proof. --Davidstrauss 22:33, 21 August 2006 (UTC)

Thanks Davidstrause, Do you have a definition for lots? --Dematt 22:53, 21 August 2006 (UTC)

I think lots implies more than some, but I am curious what DavidStrauss considers to be 'lots too. Levine2112 00:33, 22 August 2006 (UTC)

Dematt, I think notability should be the threshold, not the label applied to the views (pseudoscientific or pseudoskeptical or whatever), which as editors we should be very careful of applying. I certainly agree that not all those who use the word "pseudoscience" speak for the scientific community, even if they claim to. As has been correctly noted many times, people who criticize what they say is pseudoscience frequently don't themselves achieve WP:RS for scientific sources. So we can't cite them for that, but we can (and should) cite them as a sig POV.

Sometimes, as here, we can't verify whether there is a single consensus view on every aspect of a topic. In these cases the best we can do is cite sig POV's and try our best to guess at how to weight them; imo, we should err on the side of inclusion, and cover all sig views, and not be deletionists. best, Jim Butler^(talk) 06:56, 22 August 2006 (UTC)

Jim, I am open to the suggestion of notability as the "bar". Can you expound on your comment, "So we can't cite them for that, but we can (and should) cite them as a sig POV." In particular, can you explain what you meant by the word "that"? —Preceding unsigned comment added by Dematt (talk • contribs)

Hi Dematt -- sorry I was vague. By "that" I meant "scientific consensus" or "scientific majority". That is, various skeptical sites qualify as sig POV but can't necessarily be taken as scientific majority (or scientific consensus) POV. best, Jim Butler^(talk) 05:29, 23 August 2006 (UTC)

It's the job of a scientist to be permanently skeptical, and to reject "belief"; we accept some things as facts, knowing that our evidence for them might be unreliable and that we might be wrong about these; and we accept some explanations as the best available, knowing that they will probably be replaced by better, more complete explanations in time and that they too will be replaced in turn. We don't use the word "proof", or at least we shouldn't. So we have a body of "knowledge" that is provisional, that consists of "facts" (generally undisputed apparently reliable observations) and of "theories" ( carefully argued causal explanations that are internally coherent and consistent and externally consistent with the accepted facts). We don't discard theories easily, because to discard a theory means replacing it with a better one, and it's hard to construct a theory that is coherent and consistent with everything else. So if an observation comes along that is inconsistent with an accepted theory then it will be challenged, tested hard for reproducibility, verifiability etc. and alternative explanations of it will be tested. This is skepticism, and it's an essential part of science; without it we'd have no stable theoretical foundations, and it's theories that allow us to progress. Gleng 08:47, 22 August 2006 (UTC)

Well-said, Gleng; I agree with all of that. The important point for WP sourcing is that the process of honing scientific hypotheses takes place via peer review. The publications of various popular and advocacy groups who self-identify as "skeptical" generally aren't peer-reviewed, and can't be assumed to represent scientific consensus or majority. Cf. WP:RS's criteria for sources on medicine. regards, Jim Butler^(talk) 05:29, 23 August 2006 (UTC)

Double standard: "manipulation" or "adjustment"

The long-standing double standard regarding scientific research and spinal "manipulation" or spinal "adjustment" is coming to a head in a very obvious way on the spinal adjustment article:

Read the edit history

For a long time positive research for "manipulation" has been willingly accepted by chiropractic editors here as proof for the effectiveness and safety of chiropractic "adjustments," but (especially) now, any research on "manipulation" that is in any way negative or exposes any safety issues, is rejected as not being about chiropractic "adjustments," even though most of the manipulations were performed by DCs.

The problem is that there is no quality scientific research that is limited to exclusively examining "adjustments." There is only chiropractic research, usually of very poor quality, and often in the form of case studies. Chiropractic journals aren't interested in debunking chiropractic's pet technique, especially if the pet theory upon which it is based is in the oxymoronic title of the "journal" (Journal of Vertebral Subluxation Research).

The matter is complicated by the fact that much of the research and statistics on "manipulation" includes chiropractic "adjustments" or chiropractic "manipulations." That is simply because somewhere around 90% of all manipulations are performed by chiropractors, which, to a straight chiropractor, means that such a study consists of the examination of 90% "adjustments" and 10% "manipulations." Chiropractors are perfectly willing to use both terms to describe what they are doing, including in their own research, yet unwilling to accept the results if it's negative. Suddenly negative results are interpreted as the 10%, when it would logically include the 90%.

The Terrett study is often quoted in this connection. Oddly (not!) NCMIC has long since withdrawn its availability from their website. I would love to get the actual study, since it is often misused to imply that the real incidence of injuries and deaths caused by chiropractically applied "adjustments" is next to nothing, and is actually caused by misunderstandings about who actually did it. (Of course it must be the Indian barber!)

This confusing of the difference between "misreporting" (a "misattribution" error) and "underreporting" is a key to the continued denial going on. The best study on the subject of manipulation-induced injuries and deaths ever done was done by a PT to uncover the role which PTs play in the statistics. It of course uncovered the role chiropractors and other providers played, so the author carefully applied the Terrett figures to adjust the results, so as to avoid misattributing any results to the wrong parties. It had very little effect, with chiropractors still responsible for about 60% of all deaths and injuries. There were 32 deaths.

Terrett's figures are vastly overrated. While he did point out misreporting, underreporting is still a huge problem (around 100%), so his study doesn't make that much difference, especially if one's first concern is patient safety. If, on the other hand, it is the defense of chiropractic, Terrett's study will continually be misused.

Manipulation of the cervical spine: risks and benefits

In a study to identify cases of injury involving treatment by physical therapists.... Any study would unavoidably also turn up the involvement of chiropractors, so they ended up also being part of the study's statistics.

The graphs are interesting, especially Figure 2, where the type of practitioner was adjusted according to the findings by Terrett.

DCs were involved in a little more than 60% of all cases of injuries and deaths, and PTs were involved in less than 2% of all cases, with no deaths caused by PTs. Death occurred in 32 cases.

Before adjusting the numbers according to the findings by Terrett, it looked like DCs were involved in more cases than was actually the case. The revised figures made DCs look a very little bit better, but were still far too high. A casual glance at these numbers could lead to the partially incorrect conclusion, that manipulation, when performed by a chiropractor, is much more dangerous than when performed by other practitioners. No, that would not be entirely correct. They should be seen more as a reflexion of the fact that manipulation is most often performed by DCs.

Regardless of who performs the manipulation - the more it gets done, the greater the risk. Sooner or later someone is going to get hurt. It needs to be used much more judiciously, by whoever it is that uses it, than most DCs use it today. If a PT or MD were to use spinal manipulation in precisely the same way, extent and frequency that DCs do, they would be exposing their patients to the same risks that chiropractic patients are exposed to every day. The statistics would then reveal more injuries from PTs and MDs.

While the technique itself is potentially problematic, the attitude of most chiropractors towards it makes it doubly so when applied by them.

Here is a conclusion from the summary of the article above:

"The literature does not demonstrate that the benefits of MCS outweigh the risks."

The subject of manipulation (including "adjustments") has been studied and "adjustments" have not been shown to be totally safe. This fact should be represented in the chiropractic articles.

Interestingly, some of the best known research documenting the (sometimes positive) effects of spinal manipulation come out of Holland, and the manipulations are performed by PTs, not DCs. If we strictly apply the "double standard reasoning," this research should not be included in any chiropractic article as a support for chiropractic "adjustments." If we find it being cited, it should be removed, including all other positive research that includes 10% non-DCs. What's left would be chiropractic research that is not RS. -- Fyslee 09:45, 23 August 2006 (UTC)

Why aren't JVSR and JMPT reliable sources? They are both peer reviewed scientific journals. Of course they are reliable sources. For years, skeptics had attacked chiropractic for not having enough research. Now when chiropractic goes ahead and funds research and creates peer-reviewed jounals and supplies the requested research, the skeptics say that it is all no good? There's the real double-standard. Nothing satisfies these skeptics. And when you have a skeptic who remains skeptical despite being presented with scientific evidence, then that skeptic starts becoming a pseudoskeptic.

For a detailed analyis of all of the viable and notable cervical manipulation/adjustment safety studies I point you here. It even has your Dutch study in there as well. Now, we know that Fyslee has been shown plenty of research that demonstrates chiropractic's efficacy. We know he has been shown research showing its astounding record of safety. He knows that chiropractors have one of the lowest malpractice insurance rates going in the healthcare industry and that it also has one of highest overall patient satisfaction ratings. Fyslee has been presented with all of this documented, scientific research and evidence and yet he still remains skeptical. The only defense that he offers now is that all of the research and all of the journals that support chiropractic must all be bunk. Now he talks about a double-standard? Interesting. Levine2112 17:49, 23 August 2006 (UTC)

I have not mentioned the JMPT, nor have I said "all." (As far as the JVSR, it makes a mockery of the phrase "peer reviewed." When an oxymoron - "scientific" vertebral subluxation - is the driving motive of the journal, something's very wrong.) The stated subject of this thread - which you're deviating from - stills stands: You are willing to accept positive research about "manipulation" and apply it to "adjustments," but you are unwilling to accept research based on the same conditions, that happens to be negative. That's rather one-sided. No real treatment method is completely safe, including adjustments. In principle even you will agree with that statement, but when push comes to shove, you won't admit the evidence that has been provided as applying to "adjustments." Suddenly anything negative must be applying to the non-chiros who manipulate, or the Indian barber, or whoever.... -- Fyslee 19:50, 23 August 2006 (UTC)

You say that JVSR makes a mockery of "peer reviewed"? Why? You say that scientific vertebral subluxation is an oxymoron, but that is your opinion. Your opinion doesn't render JVSR invalid.

And since you are willing to accept JMPT, I take it that supportive research specific to Verterbal Subluxation that it lists is valid. Ah, here's one...

Abstract

Background: The traditional chiropractic vertebral subluxation hypothesis proposes that vertebral misalignment cause illness, disease, or both. This hypothesis remains controversial. Objective: To briefly review and update experimental evidence concerning reflex effects of vertebral subluxations, particularly concerning peripheral nervous system responses to vertebral subluxations. Data source: Information was obtained from chiropractic or, scientific peer-reviewed literature concerning human or animal studies of neural responses to vertebral subluxation, vertebral displacement or movement, or both. Conclusion: Animal models suggest that vertebral displacements and putative vertebral subluxations may modulate activity in group I to IV afferent nerves. However, it is not clear whether these afferent nerves are modulated during normal day-to-day activities of living end, if so, what segmental or whole-body reflex effects they may have. (J Manipulative Physiol Ther 2000;23:101–3)

So according to this research, which is in JMPT, there is scientific research supporting the existence of vertebral subluxation and its effect on neural response. By the way, this was the very first piece of research that came up when I did a search on JMPT for vertebral subluxation. Though there are 5 pages listing more supportive research, I figure that this was a good place to start. Levine2112 20:26, 23 August 2006 (UTC)

Oh, and in case we are looking for chiropractic adjustment specific research (not general spinal manipulations performed by who knows who), here is one that shows that "Chiropractic was more beneficial than placebo in reducing pain and more beneficial than either placebo or muscle relaxants in reducing GIS." Levine2112 20:41, 23 August 2006 (UTC)

I don't think there is any problem with the research that either of you are presenting. The problem is the "tone" with which you are presenting it. Try a more neutral tone and lets see if it doesn't stick better. --Dematt 21:12, 23 August 2006 (UTC)

New category?

When dealing with the differing groups of DC's, (trad. straight, mixer, o.s. and reform) Abotnick moved info from the obj. str. to the trad. straight definition. While I don't think this is wholly incorrect, it makes me think a new group should be added, Modern Straight, since his main point is the use(or lack) of differential dx. As a grad from Palmer(1999), which is considered a "straight" school, ddx was taught. I don't have the info in front of me at the moment as to when it was included, but I'm sure its out there..Dematt? :) What do you all think.--Hughgr 00:14, 24 August 2006 (UTC)

Hughgr, I'm 95% sure that all accredited schools in the US teach ddx. I am quite sure that Palmer has been since at least the 1970's. The challenge is that these categories are arbitrary. When I was in school, there were mixers and there were straights. Palmer School had made the move toward CCE accreditation much earlier and its doctors were leaning more toward science than philosophy. DCs loyal to BJs philosophy created "ultrastraight" schools, ADIO (Above Down Inside Out) in Pennsylvania and Sherman College in South Carolina to keep chiropractic pure. One name that comes to mind is Reggie Gold. The problem was that their graduates could not pass the National Board Exams. They tried to create their own accrediting agency that almost worked, but eventually lost its bid with the US Department of Education, who gave it to CCE. I think these two schools eventually changed their standards to match CCE or closed because their graduates could not practice in all the states in the US. Of course, this means that BJs philosophy gets watered down again by CCE accreditation standards and their doctors practice more like mixers, but they are still called "straight". What it looks like is that these new "objective straights" are another name for the same BJ philosophy, only straighter. Mixers have gone further to the left and distance themselves further from BJ calling themselves reformers. I am sure I am missing something, but I'm not sure it matters that much to this article. I think all we really need is to show that there are those who practice like what Abotnick is calling objectve straight and then there is the other extreme where the DC doesn't even acknowledge subluxation exists. Most everyone else falls close to the middle. As Life was trying to float more to the objective straight side, CCE pulled their accreditation and apparently Abotnick got caught in the middle.

So really Hughgr, technically, you are not really from a straight school anymore. But then again, neither is anyone else. I'm not sure this helps. What's everybody else think? --Dematt 03:33, 24 August 2006 (UTC)

Elequently put Dematt. If we could get that across in the article, I'd be happy. :) It doesn't seem correct to me now...but I've read it so many times that I need to step back. :)--Hughgr 03:59, 24 August 2006 (UTC)

Seconded; I feel much better educated on the history of chiropractic education. Thanks very much Dematt! best, Jim Butler^(talk) 08:05, 24 August 2006 (UTC)

OK, I think what is bothering me most is the "50% grad... 75% of practitioners". This has a citation needed tag and doesn't seem to fit if schools like Palmer are now considered mixer. Maybe it should be taken out, its been there a long while with the citation needed tag.--Hughgr 18:36, 24 August 2006 (UTC)

I'm the one that put it on there because I had the same confusion. It's okay with me if we take the sentence out at least until we find out what it means. --Dematt 19:51, 24 August 2006 (UTC)

Citation style

G'day, this article has a mix of reference styles, with two independent series of numbered references. Someone (who cares about this article, i.e. not me) should consolidate reference styles to just one, preferably:

<ref>[[reference address]]</ref>

or even better:

<ref>{{cite web ... }}</ref>.

Webaware 00:22, 24 August 2006 (UTC)

I agree. I should have done that a long time ago. I'll work on that. --Dematt 01:49, 24 August 2006 (UTC)

Proposal to Remove NCAHF

(Reprinted from above)

How do we know that the musings of a retired PhD are representative of a significant POV? I agree, it is the same song and cast of characters as the other site (Chirobase)in the article. It brings nothing new to the table that isn't already represented.

Also, NCHAF seems to concern itself with what they believe is fraud (yet ignores medicine and psychiatry which account for 99.9% of health fraud!) So, if a reader is unwittingly sent there, the insinuation is that there is fraud involved, which there is not. This has nothing to do with fraud. What is really fraudulent, IMO, is that they call themselves "National Council" fraudulently implying to the naive web-surfer that this is an official or governmentally sanctioned website, which clearly it is not. It is privately owned and operated by, you guessed it, Stephen Barrett Enterprises,(Donations gladly accepted!) Now that's misleading and fraudulent, IMO. So let's remove it once and for all. Chirohate, Inc. is still there. Thanks Steth 12:34, 24 August 2006 (UTC)

Keep it. It's a well-written article by an author not cited elsewhere. --Ronz 16:49, 24 August 2006 (UTC)

Keep it, keep it, keep it! Nicely written, and no, I never have thought that "national council" part means that its a government body. I just thought that it means... that its scope is national in nature. No implication of governmental approval was ever infered by me. Second, even if they're biased and ignored "99% of health fraud" that's irrelevent in this issue. Is it relevent to the article? The article does fit in with wikipedia's external links policy as well--Havermayer 03:30, 25 August 2006 (UTC)

Keep it. --CarnivorousGoat 04:02, 25 August 2006 (UTC)

I agree that "National Council" makes it sound officially like something which it is not. It fooled me until I read into it. Levine2112 04:05, 25 August 2006 (UTC)

OK, now. Just relax, Havermayer. I completely disagree that it should stay. Since it is the so-called "National Council Against Health Fraud", what does what we are doing here have to do with fraud? Answer: NOTHING! The point being that it is misleading to the unwary visitor by drawing them into an unofficial, privately-owned and operated, corporation dealing with what they feel is fraud, even though this isn't about the topic of fraud. Therefore, it is false, irrelevant and unreliable and should not be used here. Need I say more? Steth 04:08, 25 August 2006 (UTC)

This is a controversial topic both sides need to be represented. In their opinion, they think that Chiropractors make claims that are false, and this constitutes fraud. Putting it in is consistent with the external links policy at wikipedia. And, even if you're correct and its not fraud, that should be irrelevent, as external links are more about linking to both pro, con, and neutral sites in a controversial topic. --Havermayer 04:19, 25 August 2006 (UTC)

My major contention with this external link is that it presents its information as facts. It calls itself a "fact sheet". But much of the information presented is spun version of facts and a lot of it is opinion. I think that itself presenting itself as a "fact sheet" when clearly it is not constitutes fraud. Levine2112 04:39, 25 August 2006 (UTC)

Havermayer, Chirobase is still represented from the same ex-psychiatrist with a so-called 'opposing view', although it, too, is spin doctoring at it's finest and should probably be removed as well. Steth 11:22, 25 August 2006 (UTC)

What would you replace it with. The problem is that if a person is against chiropractic, they tend to be fanatically so. Do you have a site that argues the "cons" without getting emotionally involved? --Dematt 12:34, 25 August 2006 (UTC)

How about the chiropractic entry at The Skeptic's Dictionary? Not that I'm arguing to remove the NCAHF link, but skepdic's is concise. Include them both. --Ronz 14:45, 25 August 2006 (UTC)

Ronz, some guy puts together a 'dictionary' of the things that really bug him - - and suddenly it's a verifiable encyclopedic reference?! NOT!

Dematt, why replace it with anything when the anti-chiropractic view is already well represented with Barrett Enterprises' Chirohate, er, ah, I meant Chirobase. I think that would be more than generous. Don't you? We might want to think about removing Chirobase as a commercial website, which I understand is not encyclopedic and is a usual reason for removal. Steth 20:24, 25 August 2006 (UTC)

I think that they (ncahf and chirobase) are non-profit organizations and are not commercial sites. That they accept donations is irrelevent as most non-profit organizations do that, and at the end of the day they probably run a deficit. Also, your view that its "spin doctoring" is irrelevent as to its status as an external link isn't about being right or wrong, but showing a certain point of view. Young earth creationist advocacy links are perfectly fine in articles relating to that.

You may want to limit the amount of ad hominems you use as well. --Havermayer 21:40, 27 August 2006 (UTC)

Recommendation noted, Havermayer. Most real non-profits aren't owned by one person who takes the profits (donations)and pays themselves with it, as Barrett does as he testified under oath. The main issue is that this is not about fraud, but the intentional insinuation this link creates is that there must be fraud involved. So even though you feel this is irrelevant and it is OK, I don't agree and think it should be removed. Steth 22:24, 27 August 2006 (UTC)

Removal of ChiroWeb from external links

Geni, your edit summary says, "americanco centric and doesn't appear to be provideing vast amounts of relivant information". What does that mean? The "americanco centric" part? Certainly the news articles it provides are relevant to chiropractic. At the same time, I don't want to get in a revert war. Please comment. Levine2112 01:34, 26 August 2006 (UTC)

Focused on US issues only.Geni 01:41, 26 August 2006 (UTC)

Is Americanocentrism really at issue here when the vast majority of chiropractors are Americans? Is that truly grounds to ding something off the external links list? If so, there is a link to the National Association of Healthcare Fraud which should be deleted on the same grounds as it is an exclusively American organization.

Is there something else at issue here? Otherwise, I think the ChiroWeb link should be reinstated or the NAHCF should be deleted as well. Levine2112 01:48, 26 August 2006 (UTC)

National Association of Healthcare Fraud may be a US organisation but the issues they cover go beyond the US. Does not appear to be the case for ChiroWeb.Geni 01:58, 26 August 2006 (UTC)

Not to nitpick, but there is a section of the front page of ChiroWeb entiteld "international News". It contains links to several international chiropractic related news articles, including a link for "more international articles"... clicking there reveals articles broken down by country. There's got to be 30-40 countries listed there with articles. Actually, I just counted... there are over 50 countries there with relevant chiropractic news articles. Are you still sure about the "americanocentric" charge? I urge you to reconsider.

NAHCF is a "national" organization. I am not aware of any international dealings. Levine2112 02:01, 26 August 2006 (UTC)

Speaking for myself, the removal of the Chiroweb site is based on several different considerations:

1. It points out the extreme hypocrisy and double-standard being exercised by certain chiropractic editors here.

The Chiroweb site is a purely commercial site, using the provision of information and services to earn its money from advertising. That applies to the website and the paper edition of Dynamic Chiropractic, which isn't the only service provided by Donald Peterson's advertising firm. The website is covered with advertising. It isn't his hobby, but his way of earning a living. He doesn't donate his time and money from his own pocket to cover any deficits. It isn't a non-profit in any sense, but a purely profit making organization.

By contrast, Chirobase and NCAHF are not commercial sites, and certainly not even close to Chiroweb. The contrast is enormous. Their mission is to provide information, and they present massive amounts from many sources. Barrett is just one of many contributors, and chiropractors are among them.

That the sites discretely solicit donations is ubiquitous for profit and non-profit sites and organizations, and in and of itself it is therefore a non-issue. It is perfectly proper to do so. It is expected that they do so, and a non-profit that doesn't solicit donations - well, find me one that doesn't!

That issue should never be named again at Wikipedia. It is a denial of a proper, unavoidable, and necessary reality, and in this case it is clearly based on a hypocritical attempt to suppress an opposing POV, which is very unwikipedian, since NPOV requires the presentation of opposing POV, not their suppression.

That would be like excluding all Norwegians because they speak Norwegian. Duh! Norwegians speak Norwegian. It can't be any other way, nor should one expect it to be so. A Norwegian that doesn't speak Norwegian is hardly worthy of the name. (Let's not carry that example too far, since of course there are people of Norwegian descent who don't speak their forefather's language....;-)

If skeptics applied the logic currently being used by certain editors here, all Advocacy websites that are more "commercial" than the Chirobase or NCAHF websites should be deleted, which would mean a lot of them, which critics are generously allowing to remain. If the issue gets pressed, those sites are next in line, a long time before Chirobase or NCAHF.

Since Chiroweb so obviously violates Wikipedia's rules for advertising sites, it should be dropped permanently. That will be the price for the hypocrisy and double-standards being exercised here. This matter will not be forgiven or forgotten. (One shouldn't throw stones when one lives in a glass house.) If the issue hadn't been pushed so hard, Chiroweb might have been allowed to quietly stay a bit longer, although any editor could have (and will) legitimately removed it at any time.

Since Dynamic Chiropractic itself is a valuable source (even I archive my copies as documentation of quackery) of information (even though often false and misleading) for the Advocacy section, if it could be linked to directly without seeing all the advertising, I'd reconsider allowing a specific link to that part of the site. (I'm still not sure if that would or wouldn't violate Wikipedia's rules.) I'm all for the inclusion of chiro-positive information sites, but the sites must be allowable according to Wikipedia's rules.

I really don't see any abundance of advertising on the ChiroWeb page as you claim. No more than say your average online newspaper. I see a banner ad on top and some Google links way at the bottom. What you describe as a "purely commercial site", I believe any reasonable person would describe as an online newspaper providing articles relevant to chiropractic. This point of yours is moot. Levine2112 18:27, 26 August 2006 (UTC)

2. The alleged truth or falsity of the POV is somewhat irrelevant in the External links section. If it represents a verifiable POV, it can be placed there. Commercial sites, libelous hate sites, blogs, discussion forums, etc. are not allowed according to Wikipedia's rules.

Even though a site provides misleading and false information by scientific and skeptical standards, that is irrelevant to the determination of appropriateness for its inclusion in the Advocacy external links.

This works both ways. Both sides present their information as "facts." Chiropractic advocates should apply the same reasoning to the Critiques section. It is not their business to judge the appropriateness of the links included there, based on their own determination of the truthfulness or falseness or POV of the sites. If they represent a critical POV, they can stay.

If skeptics applied the logic currently being used by certain editors here, all Advocacy websites that present a POV or ideas determined by skeptics to be in error or of the wrong POV, should be deleted. That would be ludicrous, but if these editors push the point, that may be the result.

So this point gives no support to deleting ChiroWeb, but rather justification to keep skeptic sites. Levine2112 18:28, 26 August 2006 (UTC)

3. There is a hierarchy of standards for inclusion used here at Wikipedia. The strictest standards are for sources used in articles themselves. The most lax are those applied to External links. One must remember to apply the standards appropriately, and not expect or require sites in the External links to meet the same standards as for references in articles. Even then, sites that are often considered substandard for scientific references are still often appropriate for documentation of existing viewpoints, including some pretty off-the-wall ones.

The mentioned chiropractic editors fail to understand the difference, and often use links to Tim Bolen's and Negrete's sites to smear Barrett and NCAHF, even when Bolen himself has been forced to admit under deposition that his false charges are just a "euphemism" he made up for what he himself believed. He is being sued by Barrett for libel. [13] This use of such a source of obviously hateful and dishonest propaganda reveals that these editors aren't interested in using reliable sources, but in pushing hate through the use of ad hominem attacks. Bolen doesn't document his viewpoints, and doesn't even address Barrett's criticisms, choosing instead to attack the man himself.

In contrast, Barrett and NCAHF provide well-reasoned arguments with documentation and references. Those who disagree with them can check them out and attempt to debunk them. That is the proper response. Personal attacks, suppression of their views, and deletism, are the acts of desperation made by those who have no proper response. Wise men would be silent and let others who are more qualified do the debunking.

I don't see the relevance of your comments in terms of the deletion ofChiroWeb from the external links. I see that you are attacking my usage of Bolen's comments on another article apart from the chiropractic article. Note that I have never included Bolen/Negrete on the chiropractic article. They are extrememly relevant to Barrett and NCAHF and Quackwatch article. Of course it makes sense to source them there. Anyhow, save this for those pages' discusion pages and try to stay on point please. That you are dragging this into this discussion shows that perhaps it is you making "acts of desperation" because you "have no proper response". Stop attacking editors and stay on point. Levine2112 18:31, 26 August 2006 (UTC)

4. Americanocentricism is irrelevant to the discussion. It's a red herring. While it would be natural to have mostly English-speaking and -relevant stuff here, there is room for relevant international information.

The NCAHF got its name because it started in the USA, but its members and contributors are international, and its principles of consumer protection and ethics are used by - and referred to by - activists, websites, journalists, politicians, lawmakers, and scientists in many nations. They just have to adapt their application to local conditions, whereas the legal aspects discussed on the NCAHF site are usually already-tailor made for the USA market and laws. The internet makes the dissemination of once-national viewpoints an easy matter, so they gain international significance with time. (The internet must be an American conspiracy....;-) What started as a fusion of activists in Southern California and Pennsylvania has become an international movement. "NCAHF may be a US organisation but the issues they cover go beyond the US." (Geni [14])

Americanocentricism is something that Geni brought up. He mistook ChiroWeb as an exclusively American site. It is not. It contains articles about chiropractic from around the world. There is no relevance in deleting ChiroWeb based on this. Levine2112 18:33, 26 August 2006 (UTC)

5. A call for reason and fairness. As one of the skeptics here at Wikipedia, I request that certain chiropractic advocates refrain from pushing their POV on the Critiques section and on other controversial articles, and that they stop suppressing opposing POV, in violation of Wikipedia's NPOV policy. Deletism is not appropriate. I do not practice it, and I allow plenty of information that is positive about chiropractic, as long as it is included in harmony with Wikipedia's rules. If it violates the rules, that's another matter. I expect the same treatment. -- Fyslee 09:47, 26 August 2006 (UTC)

Again, this has nothing to do with the topic on hand... the deletion of the ChiroWeb link.

So it looks like you haven't been able to provide any real justification for ChiroWeb's deletion other than a retalitory strike because a link that you like got deleted. Instead of retaliating in this juvenile manner, please discuss your grievances. You say at the top of this that you are presenting "several different considerations" for your deletion of Chiroweb. I can only see one real point... about the advertising, however, it is a weak argument because Chiroweb really doesn't have that much advertising on it; certainly not as you have fraudulantly described. I am going to reinstate the ChiroWeb link now. Please refrain from deleting it again. Levine2112 18:36, 26 August 2006 (UTC)

Let’s be reasonable and fair

“Since Chiroweb so obviously violates Wikipedia's rules for advertising sites, it should be dropped permanently. That will be the price for the hypocrisy and double-standards being exercised here. This matter will not be forgiven or forgotten.” - - Fyslee

Doling out punishment, are we? What's up with the emotional short-circuits. Can't an editor express opposing views?

I have no problem with removing Chiroweb or other commercial sites. I have a problem with Chirobase (private, solicits donations, etc.) but as I said, I am OK with leaving one Barrettly-owned and operated enterprise. But multiple duplicities of the same slanted stuff are unnecessary.

As for NCAHF, this WP article has nothing to do with fraud, it is about chiropractic. Despite the fact that certain editors may believe they are one and the same, that is irrelevant. Corralling unwary visitors to a ‘Fraud’ site intentionally insinuates that chiropractic is fraudulent, which is pushing heavy POV. That is not acceptable. Free advertising for a privately-owned so-called ‘consumer protection’ website should not be allowed. Loud protesting doesn’t make it more acceptable.

So as punishment for uppity behaviour, we get the wrath of an emotionally hyper-charged certain editor who is now pushing something called ‘The Skeptics Dictionary” on us. This really fails the smell test. The link takes us to an unprofessionally written rant, filled with negative emotions attempting to pass it’s opinions off as facts. This page looks like a white supremacist consulted on it. If that’s not enough, it is filled with; you guessed it, loads of links to Stephen Barrett Enterprises! Do all roads lead to Stephen Barrett Enterprises? Where does it end?

Worse, if it can get any worse, is the fact that this page is a FREE ADVERTISEMENT for the author’s book. Now why would Fyslee insist this link be added, if it is so obviously commercial? Bolster sagging sales perhaps? And at the risk of being indelicate, but just in case you hadn’t noticed, his very own personal site also has a link on this page! Can you find it? It is the second link from the top. Now why has he neglected to mention this? Isn’t this a bit self-serving? I mentioned it in an edit summary recently, but it seemed to have been ignored. I note this, not to harbor any ill-will towards an enterprising endeavour, but merely to point out that there may be some unintentional self-interest involved. I am assuming good faith because perhaps this editor didn’t realize this when he added the link.

So Fyslee, I don’t think it is good Wikipedian behaviour to lecture about hypocrisy. OK?

So, there is still a link to Chirobase with plenty of opportunity to rummage around the oodles of musty corridors to gain insight into the inner workings of the mind of an ex-psychiatrist. There is the PBS link, again brought to us by SB Enterprises with ample opportunity to click on one of his links. There are also several critical links written, much more professionally by Keating. The rest is just unnecessary overkill that should be jettisoned.

Now that’s fair. Thanks Steth 03:16, 27 August 2006 (UTC)

There are two subjects to be addressed here: (1) a misunderstanding about a changed link (2) the reinstatement of the Skeptic's Dictionary article.

Here's the original link I deleted, which was not to Dynamic Chiropractic Online (in spite of the text), but was to the index page of Chiroweb, with lots of advertising, so my objection was correct and justified:

Dynamic Chiropractic Online -- ChiroWeb

My edit summary was "rmv extremely commercial link," which was quite true.

The next time I deleted it I hadn't noticed the change in the link that Levine2112 had made:

Dynamic Chiropractic Online -- ChiroWeb

which actually solved the problem.

Notice that the description of the link is unchanged, although the original link was not to Dynamic Chiropractic, as originally described. The new link is correct.

My deletion was a very unintentional mistake, for which I apologize. The change actually resolved the problem in the way I slightly later suggested:

"Since Dynamic Chiropractic itself is a valuable source (even I archive my copies as documentation of quackery) of information (even though often false and misleading) for the Advocacy section, if it could be linked to directly without seeing all the advertising, I'd reconsider allowing a specific link to that part of the site. (I'm still not sure if that would or wouldn't violate Wikipedia's rules.) I'm all for the inclusion of chiro-positive information sites, but the sites must be allowable according to Wikipedia's rules." [15]

His edit summary when he reinstated the changed version was "... but ChiroWeb is a news resource. Should stay." If his edit summary had alerted me to the fact that he had changed the link to Dynamic Chiropractic itself, I wouldn't have deleted it.

This later comment was regarding the new page, to which my old objections certainly did not apply:

"I really don't see any abundance of advertising on the ChiroWeb page as you claim. No more than say your average online newspaper. I see a banner ad on top and some Google links way at the bottom. This point of yours is moot. Levine2112 18:27, 26 August 2006 (UTC) [16]

My objection had been to a different link with an abundance of advertising, so my point was not "moot" as originally intended, but this new link is a different matter, so I fully agree with the comment above (except that the link is to DC, not to "Chiro Web"....), and as far as I'm concerned it should stay. It's a valuable pro-chiropractic source, and a valuable source for students of quackery in chiropractic, since the advertising and many articles are so chock-full of it. Even though that page has more advertising than Chirobase and the article at NCAHF (they only have a possibility for a donation, and no commercial advertising), I'll look the other way. (Fortunately I don't use Steth's logic here.)

Basically all of Levine2112's comments from this point on are based on the misunderstanding about the changed link mentioned above. I have apologized and I'm leaving the link alone. It's fine with me.

The reinstatement of the long-since deleted Skeptic's Dictionary article on chiropractic was done after reading Ronz' suggestion. I had no idea that Dr. Carroll had a link to my blog, among many other good links. The link to Dr. Carroll's site is directly to the article, not to the site itself. There is no Wikipedia rule that forbids its inclusion in the external links, or as a source of an opinion. Especially since the objections are coming from advocates, its inclusion in the Critiques section is even more important, since they consider it significant enough to object to it. Their attempts to suppress opposing POV is a pretty compelling ground for inclusion! -- Fyslee 14:26, 27 August 2006 (UTC)

Thanks for the apology and the change of heart. I'm sorry I didn't alert you that the link had changed to a more apporpriate page. Levine2112 17:35, 27 August 2006 (UTC)

It was my error. That's what can happen when the editing gets too fast. Your link fix was the perfect solution. I really do think that Dynamic Chiropractic should be represented in the Advocacy section. It's the most widely read chiropractic publication, and regardless of what I or other skeptics and reform chiropractors might think of it (and precisely therefore!), it represents a significant POV and should be there. I follow a couple columnists who do write some good stuff, and of course the news is always interesting. I archive every copy. -- Fyslee 19:07, 27 August 2006 (UTC)

Perfectly understandable. I didn't notice the change either. Thanks for the heads up. --Dematt 19:27, 27 August 2006 (UTC)

Yes, I commend you Fyslee for owning up to your link being on the Skeptic Dictionary page. However, returning Skeptic Dictionary as as a sort of retribution for what you view as naughty behaviour, I think, is not very civil nor proper Wikipedian behaviour. I suggest you please control your temper and edit with a cool head and try to stay on point.

I disagree that this should remain in the article. I believe that the Skeptic Dict. is nothing more than a collection of things the author doesn't like and is passing it off as something real. This is opinion and unverifiable. The fact that it is an advertisement for the author's book just adds more reasons why it doesn't belong. Steth 22:46, 27 August 2006 (UTC)

Steth, your attacks are sometimes just wearisome, and they detract from your arguments when the points that you make are worth taking seriously. I've looked at the critiques links and think that you have a good case for excluding the NCAHF link - for the following reasons

1) as you say the direct link to a site with that name seems just provocatively offensive

2) It looks to me as though the orgainisation itself has had second thoughts about its name, and tried to rename itself as the National Council for Responsible Health Informmation - this causes confusion in many links via google, and it looks to me as though this might not have proceeded because the ncrhi.com domain was taken?

3) the article itself seems unobjectionable as a reasoned critique, but it's headed "Fact sheet"

4) the article is readily accessed via the main page of chirobase

So adding this link seems to duplicate access to a particular critical article in a way that appears to give particular and undue prominence to it, for no very good reason that I can see except to associate the criticism with the words "Facts" aand "Fraud". I'd favour deleting the NCAHF link, BUT I would suggest adding evidence that very critical views of chiropractic are widely held within Universities in the USA. The following is a link to what seems to me to be a notable expression of opinion [17]

On a different, specific issue, I think that the content of the critiques section should adequately cover the range of issues that attract criticism, and one specific criticism is the advertising of unsupported claims of treatment efficacy. Keating has a very sharp letter on this to Dynamic Chiropractor [18].Gleng 08:48, 28 August 2006 (UTC)

Gleng, I'll go along with that. I think [19] explains the FSU situation very well and objectively. It could and should be include somewhere. I'm not sure that critiques is the best place, because I don't see it as much as a critique as good newspaper reporting. the Keating article on the other hand, is certainly a critique in the truest sense of the word. It came from inside the profession and addressed a very contentious issue. This could certainly be used as a starting point for discussion in the article concerning advertising as you suggest. Certainly another bag of worms, but I think we have all been able to wrestle with worms and come out okay:) I say we go for it! --Dematt 12:58, 28 August 2006 (UTC)

I am moving Glengs previous edits earlier on this talk page (concerning the House of Lords comments about CAM) to this location as it may pertain to the way we may present both Keatings Editorial and the House of Lords Report to address the advertising issue and using validating research for whatever we see fit. Gleng wrote:

The House of Lords committee report covers all CAM not just chiropractic - chiropractic is Group 1 and comes off well generally in the report, but the report seemed to make some apt points: "The Department of Health summed up their opinion of the evidence base "Evidence for CAM in the form of research has been criticised as being inadequate, and there is some justification in this claim" the Department of Health [acknowledged] that the same could be said for some conventional medicine. It is our view that most modern conventional therapies are backed by scientific evidence. ...There are two notable weaknesses of the evidence base for CAM. One is that in most of these areas little research is being done, and the second is that the few studies which have been completed are given disproportionate weight. ..All the therapies .. in Group 1 either have done, or are working on, rigorous trials to test their claims. However, one or two studies with positive results in support of their claims for efficacy are not enough. ..... Evidence for the efficacy of the treatment itself is not the only important factor .. evidence of the validity of diagnostic procedures is as important as evidence supporting efficacy of a treatment.....Diagnostic procedures must be reliable and reproducible and more attention must be paid to whether CAM diagnostic procedures as well as CAM therapies, have been scientifically validated."

I think we can make these two go together. We could also use anything else someone might feel is appropriate and of course is verifiable and reliable. Any input?--Dematt 14:23, 28 August 2006 (UTC)

External links

I am concerned that the external links has become overwhelmed by the numerous links to Keating's articles. Where does it end? We can't link to all of his articles. Perhaps one that is representative of his thoughts and views might be sufficient.

Also, I have a problem with an article entitled "How to find a Good Chiropractor". Why it is in the 'Critiques' section is curious enough, but then to find out it is the AMA giving out the advice, making it totally untrustworthy! Recall that this is an organization with a history of criminal behaviour in it's past, not just regarding the landmark chiropractic Wilk decision, but in other legal troubles, that has a history of lying to the public and tried to destroy chiropractic.

Even though the article is written by a former chiropractor (with a bit of a chip on his shoulder) his advice seems to be that while spinal manipulation may be useful, he doesn't think chiropractic is. How's that for advice for finding a good chiropractor! Perhaps the American Chiropractic Association should have advice on finding a good MD or surgeon or physical therapist. I think it is better to have a bad chiropractor than a bad surgeon.

I am in favour of removing this link since it is as far from neutral as one can get and serves no useful purpose other than to continue the failed AMA led boycott of chiropractic. Steth 11:23, 29 August 2006 (UTC)

The AMA is clearly a reputable source, just as the ACA is, and its opinion is notable whether or not you disagree with it. Our opinions do not matter, what does matter is that all notable opinions are represented; placing that link in the critiques section is a flag that the information there might be opinionated. As for the links to Keating, it would be better certainly to find other critical sources that cover the issues. However, you can't have it all ways, if you don't like links to Skeptic sites and the Skeptics dictionary, then you have to go with those critics that write on open access non-skeptic sites. There are plenty of books of course, but these are less useful as they are less accessible. If you can find a more effective way of conveying the critical views then go ahead - how about proposing alternative critical links?Gleng 12:39, 29 August 2006 (UTC)

I would like to see other sources besides Keating (not just in the critiques section, but throughout the article). If he is our only source, then we are just getting one man's POV about of chiropractic. Chiropractic is rich with ideas and theories and POV's that contradict each other and make for great discussions around the convention dinner tables. Though Keating is well respected, he is not the end all for chiropractic. So, if we're going to represent chiropractic properly, we need sources from chiropractors. I know John Triano has made some critical arguments that could be used. I am sure they would create quite a stir. There are others as well. I would also like to see some "scholarly" advocates as well. They, too, are out there. Canadian Chiropractic, LACC, National CC, Logan and other schools have departments that do research and chair techniques that write regularly. We can cite them as well.

I am a little concerned about any source for "how to find a chiropractor". That could open a door that would not be encyclopedic at all. There are sites that promote reformers, straights, this technique and that. Although, I suppose we could have a section just for that purpose and call it "Finding a Chiropractor."

--Dematt 12:59, 29 August 2006 (UTC)

The article is obviously not an AMA production, and is placed in the Critiques section because it recommends chiropractic, while warning about the pitfalls of going to the wrong chiro. It is the production of Samuel Homola, DC, a now-retired (never "former") chiropractor, quite literally the "Luther" of chiropractic, since he was the first to write a major expose of the profession, and got banned for doing so. He continued to practice for the rest of his career. Such POV are precisely what the Critiques section is for.

The argument against the link fails on logical, Wikipedia, and ethical grounds: ad hominem attack, straw man attack, and especially because it is POV suppression and a continuation of the hatred of all skepticism that examines chiropractic. That hatred is continually revealed here by the demonization of skeptics and their POV.

The article is also notable because it is not from Chirobase. I chose the AMA article as a very Wikipedia RS, and to avoid Steth's constant and illegitimate objections against anything from Chirobase, Barrett, NCAHF, or any other notable skeptic.

Here's another excellent article of this type, written by a chiropractor, and published in a chiropractic publication: It definitely belongs in the Critiques section:

How to Choose a Chiropractor (or the Eight Warning Signs that You May Need a Different Chiropractor) - G. Douglas Andersen,DC,DACBSP,CCN

I'm sure Donald Petersen, the editor, wasn't very happy to print it, but it was from one of his best columnists. The articles I have listed in the link are very stimulating and enlightening reading. -- Fyslee 21:57, 29 August 2006 (UTC)

Keating history collation

Came across this fascinating and rich source of history and opinion - collated by Keating, but a very broad collation nonetheless [20] Gleng 13:11, 29 August 2006 (UTC)

Wow, isn't that interesting. Thanks, Gleng. --Dematt 21:15, 29 August 2006 (UTC)

revert based on edit summary

A user reverted my last edit based on an objection to my edit summary, not based on the contents. The user's revert also wiped out uncontrovesial edits. I have reverted and expect a discussion (of the edits). Mccready 13:27, 29 August 2006 (UTC)

I did not revert based on your summary, I reverted because some of the changes you made were controversial, and not neutraly put. I warned you about your edit summary, which was incivil. You've just come out of a lengthly block on the understanding that you would not behave in this fashion. In your forthcoming absence I will do my best to represent some of the proposals you have introduced. Jefffire 13:33, 29 August 2006 (UTC)

We all know this article has a problem with POV pushers who have, as their stated aim, the goal of removing material critical of chiro. For me to borrow the words of an Administrator who said so may be confrontational to some, but the truth needs to be faced before we can move forward. Pls address the substance of my edits rather than revert for the reason of "controversial". Mccready 14:04, 29 August 2006 (UTC)

Mccready, I think your edits are getting deleted because they seem to be "deletionist POV pushing" as well. We all know about sPOV, so there's no need for me to lecture you. You do seem to identify areas that need work, and if we get a chance, we may actually be able to reach a verifiable and reliable consensus that works for everyone, but your heavy handedness triggers defensive postures in everyone that don't allow that to happen. I'll be glad to support a well placed, thoughtfully constructed and accurate edit. --Dematt 16:09, 29 August 2006 (UTC)

Kinsinger article

My two cents on the Kinsinger article are: Though it is quite possible that this MD did exactly as described in the paper, there is not enough information to determine if what the chiropractors did was inappropriate. Anyone can go into any type of doctor's office and mislead them with the right information. The fact that this guy was an anesthesiologist suggests he had some knowledge of how to answer the questions as well. Had he also done the exact same thing in 9 medical doctor's offices, it is quite possible that he would have had similar experiences, though perhaps with more invasive procedures and at significantly more cost. Certainly the "side stitch" that "could have been an appendicitis" and "killed him" would not have been considered life threatening. Without a fever or a positive McBurney point test, the protocols would not necessarily call for an immediate appendix workup. McBurney point pertains to this procedure:

Slight pressure is applied to the right lower abdomen and released. If this is painful, inflammation of the peritoneum(outer lining) and is a good indicator of infection.

Other observations will be evaluated:

During the physical exam, a doctor may press down on the lower left quadrant of your body to see if the pressure causes pain in your lower right quadrant. You also may lie on your left side and extend your right leg to see if that position is painful. Your doctor may rotate your right hip toward the center of your body to see if you have pain in the appendix area.

If Dr. Kinsinger did not exhibit this behavior, then the likelihood of appendicitis was diminished and looking for other causes would be quite appropriate. In fact, had he presented to his local emergency room, he would have spent a long as 24 - 48 hours lying in bed while they ran blood work and waited to see if the pain got worse before removing the appendix, thank goodness. If the blood work was negative, it would be likely that a CT scan would be run as well to rule out other possibilities and it is likely that he would be placed on antibiotics just in case and hopefully, nothing unusual would show up that would require exploratory surgery, like a gall stone, or he would have ended up with a cholecystectomy.

Similar arguments exist for each of the scenerios that Dr. Kinsinger presents. Considering the source, the credibility factor is lacking as well. In other words, his intentions were predetermined to discredit, so we don't know how honestly he may have presented himself to these DC's or to the reader. So, the problem with the Kinsiger paper is that there is not enough information to decide anything, much less whether Dr. Kinsiger thinks chiropractors are trained to recognize signs of cancer, etc..

Therefore, while it might be able to fit into the critiques section, I think it substantially lowers the bar and would allow low quality info into both critiques and advocacy. It certainly does not belong as a source in the introduction, or really anywhere as a source. It appears as one antagonists low level attack. Material such as this is certainly valid for forums and blogs, but not for encyclopedias. --Dematt 14:13, 29 August 2006 (UTC)

More like ten dollars worth than two cents. There's plenty of info to decide on chiro's behaviour and the reader can judge it. There was no "misleading". Yes by all means do the same to medical doctors (they aren't immune to being ripoff bullshit artists) but that's not the focus of this article. As to the intention to discredit. Right on. That's what science does. It sets up tests and if they are failed .... By the way, that's what examinations at university do too. And some of the ones presented here are the simplistic stuff I learned in first year clinical medicine. That's first year. So the chiros failed. So the source should stay. It certainly balances the ridiculous POV that chiros are trained to detect blah blah blah and then refer. And it belongs extactly where it is to balance the claim in the previous sentence, not tucked away in "the crititques section". Mccready 14:30, 29 August 2006 (UTC)

Strictly, the wording of Mccready's insertion is false; nothing that Kinsinger said disputes the assertion that "some" chiropractors are trained etc; this evidence is anecdotal, the sort generally that we would try to exclude, and it is not a V RS. Kinsinger could fairly be said to be questioning how well many chiropractors are trained; it's an minor piece of mischief that echoes Rosenham's test of how well psychiatrists were able to distinguish between sane and insane; I don't think anyone drew the conclusion from that that psychiatrists were not trained to do just this, despite the high profile embarrassment caused. In response to the general criticism of Mccready, this is an article being edited collaboratively and for the most part amicably by people of very diverse povs; there are always attempts to introduce slants in one direction or another; in the end it's up to all of us to defend the fair expression of all povs in the context of V RS.Gleng 14:34, 29 August 2006 (UTC)

Looking more closely at the Kinsinger article it is even more inappropriate as cited; although he says he sets out to test the assertion that chiropractors refer patients on where appropriate, in most of his examples he declared at the outset that he had already consulted conventional physicians, which would indicate to me that referral was redundant. I'm accordingly removing it; it's not a good source, and it's isn't internally consistent, and it doesn't support the point its intended for.Gleng 14:44, 29 August 2006 (UTC)

I'd prefer you to replace the source until there is agreement (and try to spell my name correctly). The reference to anecdotoal evidence is unacceptable because it is an oxymoron. The evidence is fine regardless of his hypothesis (ie chiros are quacks). You of all people should know you can't reject evidence post hoc based on the hypothesis from which it was gathered. The accusation that it is therefore internally inconsistent is nonsense, with respect. It's like saying the discovery of penicillin was illegitimate because the null hypothesis model, controversial in itself, wasn't followed. "Minor mischief" is an attempt to denigrate the research. Not a scientific attitude. In any case the Rosenham stuff is well referenced and supported in wikipedia. Therefore why try to delete Dr Kinsinger who according to you is doing a similar thing? Your arguments don't stack up. There is evidence that contradicts the claim and you want to exclude it on spurious grounds. Mccready 15:10, 29 August 2006 (UTC)

I apologise for misspelling your name. I don't think that the phrase anecdotal evidence is an oxymoron; most of the evidence underlying clinical practice comes from case reports which are exactly that; in this context an anecdote is an isolated observation, an uncontrolled experiment, or an incidental observation, all are evidence and often the only available evidence, but all qualify as anecdotal. The Rosenham study is indeed well planned on a large scale and properly documented; it too was mischievous and I don't regard that as denigratory (actually quite the contrary); the difference is that it was properly conceived and executed major mischief. Nevertheless I drew attention to the fact that the analagous conclusion (that psychiatrists are not trained to distinguish between sane and insane) was not drawn and wouldn't be. Now look at exactly what Kinsinger says: "Chiropractors like to tell people that they have sufficient training to make appropriate diagnoses and to refer people for medical treatment when needed. I have tested this assertion in several ways." Fine, good idea, but then "During my first call to a chiropractic office, I told the receptionist that I had recently been diagnosed with ulcers and was supposed to be on medication" Now how exactly is this protocol supposed to test the assertion? I'm sorry, this is not published in a peer reviewed reputable journal and wouldn't be, not out of political correctness but because this is not science as we know it or even logic as we know it. If you want to include evidence of this standard then I'm afraid you really are opening the floodgates to including a host of nonsense. I don't like double standards, I really don't: it's not the nature of the content that I object to but its quality. This article is a personal account of nine different episodes, anecdotal in any understanding of the word, evidence of the very weakest kind even in this weakest of categories.Gleng 15:45, 29 August 2006 (UTC)

I must second the viewpoints and objections above. Even though I believe Kinsinger's conclusions were correct (he has only done what others, including law enforcement, have done before to chiropractors), it's being used in the wrong setting here, and just isn't good enough as a RS in the article, although it qualifies as a RS of an opinion, and as a possible External link, though I wouldn't recommend it here. I also can't support its inclusion because of Mccready's constant misuse of pop-ups to revert, and his making of large edits without discussion. His heavy-handedness in other situations thus affects the way his possibly reasonable edits are treated. Too bad. -- Fyslee 22:03, 29 August 2006 (UTC)

Critiques

Steth has rightly alerted us to the appearance that criticism of chiropractic is limited to a single voice. It is important that the critiques section is balanced and representative of issues and voices. I would not suggest extending the present size of the list, as I think that would be counterproductive (for the skeptical case), and chirobase anyway is itself a gateway into many sources. But I would favour some close consideration of the contents, to consider whether there are more powerful or notable alternatives to some of the items. Of the two links below, the Open letter to the profession from McAndrews [21] appears to be notable in itself; and I'd offer for consideration the link below, which is to a scholarly discussion of ethics from within chiropractic. [22]. Of the Keating items, one is a review of Homola's book; maybe the book itself should be cited with the review as a secondary link to it? Similarly another is related to the McAndrews open letter and could be associated with it. I also support Fyslee's suggestion Gleng 09:43, 30 August 2006 (UTC)

I understand what you're saying about the number of items in the list. There is no absolute limit, but some good and representative links are appropriate.

Both of the links you provide are excellent examples from within the profession, and I always favor such sources when available, and they certainly are available!

Homola's book has been in the Critiques section before, but has been suppressed with the old and illegitimate argument that the book is housed at Chirobase. Since that happens to be the only source for the book, then that's where the link has to point, and POV suppression should not be allowed to remove the link.

Here are the links. You are most welcome to add them yourself in the appropriate (alphabetically) spots:

Open Letter to the Profession - George P. McAndrews (attorney for ACA)
Chiropractic Ethics: An Oxymoron? - J.C. Smith, DC
Chiropractic, Bonesetting, and Cultism - Samuel Homola, DC (entire book on-line)

The extent to which POV suppression from certain editors dominates here is evident in the fact that Homola is not named a single time in the article or external links. That amounts to the Catholicism article not mentioning Luther, and would be evidence that pro-Catholic editors are succeeding in suppressing any Protestant input. (Fortunately that is not the case.) This matter should be fixed in some manner. I'm not suggesting great coverage, but short mention of Homola's role in internal criticism (a needed subheading...) would be appropriate. -- Fyslee 11:14, 30 August 2006 (UTC)

I hope we're heading together on this. To summarise my view, an article is as strong as its weakest part: if the criticism is not expressed adequately, then everyone loses because the article loses authority and the respect that it would otherwise deserve. Equally if the case for chiropractic is not put as effectively as possible, then any criticism is strawman criticism. In all cases, an effective argument is one that is honest, cogent, and well sourced. To me at least, the signs of controversy and debate within chiropractic are signs of integrity, vigor and health within the profession, and to suppress them would give a false impression of complacency and dogma. This article needs stability, and so we do need some consensus on the principles that guide us in areas of particular contention, because it should be up to all of us to protect all aspects of the article (including aspects that we might personally dislike), against attrition that will upset the overall balance and authority. This is emerging as an outstanding article in itself as well as an outstanding example of WP editing.Gleng 12:18, 30 August 2006 (UTC)

These are good links, but how do we present them. These are battles from within the profession in the early 1990's. Indeed, as a student, I had the opportunity to meet McAndrews in 1983 (after he won the appeal) and when he shook my hand, he looked me in the eye and said, "Chiropractors have 10 years to get it together, because the AMA will come at them again." The suit was won in 1990 and the article is dated early 1992 about certain chiropractors ruining the chiropractic image with advertising. The second article by Smith addresses the same concern about advertising, but goes further in blaming a certain group of chiropractors, and particularly those connected to Sid Williams, Life Chiropractic Colleges Founder and President, obviously a straight (objective straight)POV. There were others in this same vane as well, of course. Then there was the ACA which tried to develop the more scientific side with Louis Sportelli, et al. and even offered Homola an olive branch and asked him to reconsider rejoining the ACA (apparently he agreed). Foundation for chiropractic education and research(FCER) grows. JMPT develops into a respected peer reviewed journal. All along the NCAHF was gathering information from all the chiropractic colleges and asked Homola to give them his infomation that he used to write his book, he apparently later joins their efforts. The National Association of Chiropractic Medicine forms with "orthopractic" evolving and aks Homola to join as well. Meanwhile, common efforts to join the ACA and ICA by some within each association is shot down "again" by mostly ICA(straight) representatives. The profession grows in leaps as a result of the newborn respect earned from the lawsuit. State laws begin to crack down on advertising, but Arizona supreme court rules it illegal for lawyers to restrict advertising (freedom of speech and free market expression of some sort), so states have to back off. Some restrictions are effective (restricting "free" advertising, etc.). Life College looses its accreditation from CCE and students are stuck without a state to practice in(Abotnick). Sid Williams sues and gets injunction. Then comes the internet. And the lid is blown off it all. Web pages make outlandish claims again(straights?), Barrett, NCAHF go online.

This information is all very interesting and appropriate for a chiropractic history buff, but is it encyclopedic? It will make the article much longer, is it the direction we want to go? Or are we just talking about adding links to the appropriate sections?

--Dematt 14:10, 30 August 2006 (UTC)

You do such a good job of selling; when you write your book I'll buy it for sure. Maybe some of this can go into the Wilk article as an "Aftermath" section led by the McAndrews challenge to the profession. Just a suggestion, I'm not qualified to contribute. Here, I think we should start by agreeing on the most appropriate critiques to add as links, but maybe Homola deserves a bio as a clearly interesting and controversial character (Fyslee?) and a link. Need to think of this article now as the gateway to others.Gleng 15:15, 30 August 2006 (UTC)

I'm not sure that it's a good idea to create too large a section on criticisms, but the major points of contention should get short mention, and those points can get more attention in the respective articles that get linked to from the criticisms section here. Some articles exist, and others may need to be created. This one should just briefly mention the major points, and since the lead needs to reflect the content of the article, as additional headings are created they need short mention in the lead.

Homola and Keating both deserve articles. -- Fyslee 16:32, 30 August 2006 (UTC)

After reviewing the current list, I don't have a problem with most of its content, but Keating is representing 5 out of 9 which strikes me as odd. Maybe he should have his own subsection (Criticisms by ....) or something like that. Not sure about the skeptics dictionary addition...the article seems to repeat all of chirobase's criticisms. Do we need to say the same thing twice?--Hughgr 22:23, 30 August 2006 (UTC)

No, of course we don't need to. It repeats the same criticisms, because if you notice it is a link farm for Barrett Enterprises. All anti-chiropractic roads lead to SB Enterprises. Do you think there was collaboration? I'm not sure. ;-)

How about reducing Keating's links to just one or at most two the way many articles do it here? Steth 02:00, 31 August 2006 (UTC)

We have to include some critiques Steth :) I've read them but I don't remember if they say the same things so I'll have to recheck.--Hughgr 04:59, 31 August 2006 (UTC)

NACM notability

The federal government recognizes the existence of the NACM and included a representative in its Veterans Administration's Chiropractic Advisory Committee. [23]

Dynamic Chiropractic, the most widely circulated chiropractic publication, admits to the existence of the NACM, even going so far as to launch a very public campaign to get the president of the NACM evicted from the Veterans Administration's Chiropractic Advisory Committee. The campaign was unsuccessful.

Let's Send a Message! - Dynamic Chiropractic, September 24, 2002, Volume 20, Issue 20

DuVall's VA Report Shows NACM's True Colors - Dynamic Chiropractic, November 18, 2002, Volume 20, Issue 24

The chiropractic profession admits to its existence and makes it very notable by the way it has criticized it and reacted to its criticisms of aberrant practices in the chiropractic profession. The behavior of certain editors here also reveals just how notable it is to them. They do all they can to ensure that it doesn't get mentioned here. They are thus attempting to press their POV on the article by suppressing the existence and opinions of a group of chiropractors. This kind of censorship should not be tolerated.

As for size and membership data, the WCA is mentioned, and it is about the same size and does not publish a members list. Such information is confidential, even in other groups. Membership estimates for both groups is 1-2%. BTW, NACM members can be members of other groups at the same time as being members of the NACM.

The WCA has this to say:

The ACA criticized the WCA for having a “secret” non-published membership list. Why it is so important to the ACA to know the names of our members? We have never claimed to have a majority of D.C.s as members in the WCA. No organization can make that claim. We have chosen not to release the names of our members since, in the past, members have been harassed by the ACA and targeted with correspondence “suggesting” they resign from the WCA. The WCA should be judged on its effectiveness rather than its size. Considering the amount of time and energy the ACA spends discussing our activities, we must be very effective!

The ACA found fault with our organizational structure, noting that we have a “self-proclaimed and un-elected president for life.” Admittedly, the WCA is not structured like the ACA, which is one of the reasons we have been able to act quickly and effectively for the good of the profession. The members of our Board of Directors are chosen according to the WCA by-laws. Our members don’t have a problem with this – why does it bother the ACA so much?[24]

Membership figures for various chiropractic associations vary depending on the source, but here is one list from the ACA, comparing to other professions:

FACTS Licensed DCs: 60,000

ACA 18,000
ICA 8,000
WCA 250?? undocumented

Licensed PTs: 203,261

APTA 66,000

Licensed MDs: 583,000

AMA 275,000
AOA 1,200

[25]

Just to show how confusing the numbers game is, here's another estimate:

"Oddly enough, the national organizations only represent a fraction of all Chiropractors. Believe it or not, the ACA, ICA and WCA together have fewer than ten thousand members, collectively. That means that there are 50,000 DC.s in America alone who belong to nothing!" [26]

The WCA is a recognized chiropractic organization, and considers its membership and organizational structure to be none of the ACA's business.

So......why should the NACM have to answer to Steth? He may not want to recognize it, but the rest of the chiropractic world does, whether they like it or not (which they don't....;-). -- Fyslee 00:11, 29 July 2006 (UTC)

Agreed. NACM doesn't appear to represent the sort of "tiny minority" viewpoint that would be excluded under WP:NPOV#Undue weight. They represent a certain skeptical POV a la other groups like NCAHF. (Not without bias, imo, but that goes with the territory for most controversial topics.) It is possible to name "prominent adherents" of this POV, e.g . Barrett, Sampson, etc., so it meets the WP threshold of significance. In general, best to err on the side of inclusion, imo... thx, Jim Butler^(talk) 02:29, 29 July 2006 (UTC)

Now, Fyslee, don't go Mccready on us. Remember -- civility. You don't have to answer to me, you have to answer to verifiablity here at WP.

OK, so you have showed that it has one member. There are numbers for the other groups, why not NACM. Most reformers are not members. It would seem that most chiropractors are not members of NACM. Where is the notability of that? And, what about the other stuff like, meetings, officers, seminars, elections? The other groups sponsor seminars, published notices of the speakers, locations, etc. Nada, zip, zilch.

As for Barrett, well, at the bottom of the one-page NACM website, he gets three of the four links that send viewers to his pages where he gets a chance to solicit donations and pay himself from the 'non-profit' profits, as discussed on his talk page. It seems that he is having his own credibility issues, flunking the board and passing himself off as a so-called 'expert'. Barrett/ Talk So it's no surprise he wholeheartedly endorses a club that he likely had a hand in forming!

Fyslee, why is it that most, if not all, of your contributions are either striving to marginalize chiropractors and chiropractic, OR send people to your pal Mr. Barrett's websites where he solicits donations? Can you really be objective here when he appears when you snap your fingers, oh yes, and you perform internet administrative responsibilities for him?

My personal view is that this whole thing doesn't pass the smell test. Steth 11:15, 29 July 2006 (UTC)

You dare to speak of civility with this message? You keep hounding us and demanding things which you have no right to demand of anyone. I write a very civil message and only mention you once, in a civil way, and you not only fail to respond to the content of my entry, you respond with a personal attack. Typical. As for your other insinuations, they have been answered many times before. Comment on content, not other editors. -- Fyslee 16:26, 29 July 2006 (UTC)

Compromise on the NACM problem

Talk about people in glass houses! You seem to have had more than your share of run-ins with those who don't quite seem to see chiropractic from the "reality" POV of a physical therpist.

As much as you whine about it, your insistence about NACM being paraded in the body of the article, just doesn't pass the smell test. For one thing, most chiropractors aren't members - FACT. Next, most 'reformers' (a term made up by radical anti-chiropractic fundamentalist extremists like your self) aren't even members of NACM - FACT!! Well how about that?

Oh, yes and this so-called 'association' is a secret society that won't reveal it's members or numbers - FACT, has no officers, doesn't sponsor any continuing education seminars - FACT, and holds no elections - FACT. You have proven it has a member, so that makes it an association? Who are the officers and how long have they served?

I am putting aside the equally disturbing facts that you have self-serving interests as it's spokesperson/historian, and the additional fact that at the bottom of the one-page website are four links, three of which conveniently direct us to -- Barrett Enterprises!? Your pal? Leader? Do you perform internet responsibilities for him? Increase web traffic for him? Certainly donations must have increased as a direct result of adding Barrett's links to WP. How many dozens of links to Barrett Enterprises have you sprinkled around Wikipedia, Tinker Bell? Why won't you answer these questions, before you accuse me of not answering questions?

So please don't get huffy with me, Fyslee. In the interest of assuming good faith -- difficult, given your preponderance of self-serving interests listed above -- I am willing to compromise on the NACM problem by keeping the link at the bottom, but in no way does it belong in the body.

If you can't verify something, it, of course, just doesn't belong in WP and isn't notable either. Steth 17:12, 31 July 2006 (UTC)

steth wrote>Hi Abotnick. Could you point us to the source for this claim. Maybe a membership list. Otherwise unverifiable. Determined that most reformers not members.)

What do you mean most reformers are not members? The platform stated on their website is the only reform message of any chiropractic organization. Their membership list is not available, try contacting them and ask for statistics. You are really picking nits here to try to keep NACM from being mentioned in the body and it's very immature. Just because you don't like their position doesn't give you the right to censor them from the body.

NACM is a legitimate chiropractic organization and does represent the reform chiropractors. They have a discussion group and a website. I previously added a line to them in the reform section but someone snipped it out. I ask that this be restored in fairness to the group.Abotnick 20:36, 5 September 2006 (UTC)

This is ridiculous. WCA is allowed as a group but NACM is censored off for the reform chiropractors? This is unfair to the readers.

Abotnick 19:54, 13 September 2006 (UTC)

Hey Abotnick! No, I haven't forgotten about them. I'm actually slowly working on the transformation from the 60s and 70s to the 80s and 90s. NACM was created in 1984 and there are apparently some influential types in the association so it is notable. I just haven't been able to get there yet. Hang in there, I have to get back to work. --Dematt 20:43, 13 September 2006 (UTC)

Sophistry versus evidence

Gleng removes the Kinsinger link without addressing my criticism of his straw man null hypothesis model of Kinsinger's methodology. Indeed Gleng repeats the strawman arguemnt. But whichever way you cut and dice or duck and weave the fact remains that Kinsinger is notable, is qualified and has provided material which shows the alleged training of chiros is not being put into practice. This should be placed before the reader who can then make up their own minds about the methodology. I await discussion before replacing the link. It would have been good manners of gleng to replace it while this was sorted. I also wish to replace the deleted material showing how chiros had misused the Duke report. I also wish to replace the deleted material to say Chiropractic's vertebral subluxation, for which there is no accepted scientific evidence, should not be confused with other forms of [subluxation]. Mccready 16:04, 31 August 2006 (UTC)

I don't think so, Mccready. I think you are fighting an uphill battle. Just because some hate-filled anesthesiologist annoints himself chiro-slayer of the year with the full blessings of Stephen Barrett Enterprises, doesn't make him notable. In his own mind maybe. As for qualifications, owning a chiro-hate franchise doesn't qualify him for anything either. His only training is anesthesia (I'd have second thoughts before he put me under!), telemarketing (would you really trust them?) and bus advertising.

And unless you speak for the entire scientific community, this notion won't float either. Levine and others have graciously provided numerous reasons why statements like that are heavy on the POV and unacceptable.

It is, however, nice to see you back...again. ; - ) Steth 16:43, 31 August 2006 (UTC)

The Kinsinger link is not notable due to the reasons Gleng gave above. A charge of that nature needs to have strong V:RS, and the link doesn't pass muster. Your assertion that there is no scientific evidence for VS is a false statement. See my above discussion with Arthur Ruben. Lastly, the diff for subluxation is on the VS page, I really doubt someone on the chiro page would make that mistake and even if they did, the link goes to the VS page which points that out.--Hughgr 18:32, 31 August 2006 (UTC)

My opinion remains the same as above on Kinsinger. I don't see how we can allow it without allowing other material that is just as RS.

I'm not familiar with the Duke report misused by chiros.

As for VS, we've been all through that and you didn't seem to want to accept that there may be even "some" scientific evidence to support it, so out of WP:Etiquette the entire sentence was removed. I am willing to try again to find an alternative that is VR. --Dematt 19:51, 31 August 2006 (UTC)

Dear Mccready: yes I reverted an edit of yours that in my judgement hopelessly failed V RS, in line with WP policy; I did it myself rather than leave it to the chiropractors to do so precisely because I had hoped that it would be clearly recognisable as an edit that could not be interpreted as pov pushing. Nevertheless I explained my reversion on the Talk page extensively. If you read through the very extensive Talk here, you will recognise that the issues raised by your edit have been explored in the past at great depth; you will also see that it has become general practise to propose controversial edits on the Talk page before including them, to establish consensus first. If you do likewise, I am sure that your proposals will receive the same considerate attention that all do. This page has contributors from a very wide range of backgrounds and povs; I believe that we have learned that the assumption of good faith is generally justified; if you take a confrontational attitude in your edits, assuming that this is a battle between povs not a collaboration, then I think you will find little support here, even from those of us who share your pov.Gleng 08:32, 1 September 2006 (UTC) Finally as to the straw man hypothesis argument, I'm afraid I didn't respond to it as I didn't see any coherent argument here. I pointed out that if you are going to test whether chiropractors will refer a patient to medical treatment, then it doesn't seem sensible to begin by telling them that you are already receiving conventional medical advice, as it would seem to be reasonable to me for the chiropractor to believe that offering such advice would be redundant. I wouldn't have rejected the article for publication because of the hypothesis but because of poor design. I rejected it as V RS because it hasn't been published in a peer reviewed RS, and I'd reject links to patient testimonials for chiropractors in the same way and for the same reasons.Gleng 10:59, 1 September 2006 (UTC)

Looking at the following "Most patients who visit a chiropractor do so initially because of symptoms arising from musculoskeletal problems, especially low back and neck pain, .... " and in relation to the above comments of Mccready, I believe it is true, and if true important to note here, that most patients initially consult a chiropractor because of symptoms that have been refractory to conventional medical treatment. Some of the opposition to chiropractic derives from the sincere fear that some patients will not reach conventional medical treatment in cases where conventional treatment might be very effective. In practice, for a wide range of conditions, many patients have conditions that are not amenable to objective diagnosis; such patients can be referred on and on from one speciality to another until they get exhausted or the condition resolves spontaneously. Personally I find it unsurprising that when such a patient reaches a practioner who takes the time to listen to them carefully and with respect, and offers advice and treatment based on extensive personal experience, explained in terms that they feel they understand, then they are likely to respond well, even if the treatment itself is objectively ineffective. This is or should be a principle of treatment in conventional medicine, but is often neglected for pressure of time. It is also true that patients are likely to ascribe spontaneous recovery to the coincidental interventions of a respected and caring practitioner. Please note that I am not attempting to judge whether treatment is effective or not, only that the equation of possible harm vs potential benefit is very different when we're considering patients whose symptoms have not been diagnosed or resolved by conventional routes.This note is also to expand on the distinction I make between case reports as evidence and trials.Gleng 12:31, 1 September 2006 (UTC)

Grouping in Advocacy

Hey, anybody think that grouping the lists is not a good idea?

Chiropractic organizations

Mixer Chiropractic

Straight Chiropractic

Reform Chiropractic

National Association for Chiropractic Medicine

Dematt, while it is a creative thought, I think it adds unnecessary layers of detail that are meaningless to readers who land here. Just my thoughts. Steth 16:47, 31 August 2006 (UTC)

It did look good didn't it:) I agree we will then have to try to decide what belongs where. It will probably be more trouble than it is worth. No problem. That's why I asked. --Dematt 17:37, 31 August 2006 (UTC)

Dematt, I don't see why they are listed under "Advocacy" on the Chiropractic page. Shouldn't they be listed beneath the "Organizations" heading and move the "Advocacy" heading below this section? They are just organizations. What do you think? Steth 19:47, 31 August 2006 (UTC)

What would you put in the Advocacy section? --Dematt 20:22, 31 August 2006 (UTC)

With only one exception (NACM) they are all advocacy sites, and should be listed as such. The NACM should be placed back in the Critiques section, where it originally was listed, or listed as you have done above, since it represents a form of internal critical advocacy.

Dematt, your suggestion above adds a layer of detail that creates meaning, and thus enriches the article. -- Fyslee 20:58, 31 August 2006 (UTC)