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The verifiable fact that chiropractic is a profession has been removed in this edit by John Snow 2 and again here by Alexbrn. This proposed change is against policy for a number of reasons. First, there is no consensus to remove the description of chiropractic as a profession (the current, stable, consensus version states that chiropractic is a profession) and the editors have chosen not to bring it to the talk page despite my sourced and policy based objections. Second, no source at all has been provided that suggests that chiropractic is not a profession, it has been the editors opinion that the word profession is ‘debatable’, but Wikipedia doesn’t care if John Snow can debate this term, we need reliable sources that could suggest that chiropractic is not a profession. Third, there are multiple reliable sources that verify the fact that chiropractic is indeed a profession:
Puhlaa ( talk) 15:06, 28 April 2013 (UTC)
Puhlaa — your reply is irrelevant: read my response again. This is not a controversial edit, just a common sense improvement. Alexbrn talk| contribs| COI 19:36, 28 April 2013 (UTC)
Come off it. Describing Chiropractic primarily as a profession is undue. Let's see what really neutral sources have ... Britannica says: "A system of healing ..."; and Websters: "a system of therapy ...". Instead Wikipedia is now mirroring the definition of a chiropractic advocacy group, the World Federation of Chiropractic: "A health care profession concerned with the diagnosis, treatment and prevention ...". And this text is being reverted to (over 3RR now?) by an editor with a COI. Hmmmm. Alexbrn talk| contribs| COI 20:51, 28 April 2013 (UTC)
To repeat, whether it's a profession or not is not the issue AFAIAC. The issue is whether it's the first thing that is mentioned (as though this is it principal attribute). It's undue, and out of line with serious sources. Alexbrn talk| contribs| COI 07:37, 29 April 2013 (UTC)
A thought from a random passer-by:
Why not state both? E.g. Chiropractic is a health care profession and an approach to healing concerned with...
This way those who feel that naysayers are trying to slight chiropractic by not explicitly stating the obvious - that it is a health care profession - will be satisfied. And those who feel strongly that the reader will benefit from knowing that it is also an approach to healing will also be satisfied.
68.120.91.227 (
talk)
04:33, 30 April 2013 (UTC)
Zad
68
04:43, 30 April 2013 (UTC)
This edit does a better job a giving a historical perspective to data offered in the dated reference. However, it also introduces information about safety that seems like a non sequitur to the subtopic: International reception. Whereas, a discussion of chiropractic's usage in the United States makes sense under such heading, the material about the serious complications seems out of place and frankly, argumentative there. I'd recommend removing that bit and reserving it for a more relevant section. 68.120.91.227 ( talk) 03:36, 7 May 2013 (UTC)
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I have found a reference for the "manipulative lesion" which says is in need of a citation.
The manipulative lesion, also known as a spinal biomechanical lesion is deifined as "a pathological condition involving discontinuity (loss of cohesion) of tissue, and loss of normal vertebral joint function (kinesio-pathology) that often has injury as its cause"
Reference: http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=56115
Thanks DJFryzy ( talk) 08:58, 7 May 2013 (UTC) DJFryzy ( talk) 08:58, 7 May 2013 (UTC)
Thanks for your reply Puhlaa
Biomechanics of spinal manipulative therapy John J Triano, DC, PhD The Spine Journal Volume 1, Issue 2, March–April 2001, Pages 121–130http://www.sciencedirect.com/science/article/pii/S1529943001000079 http://dx.doi.org/10.1016/S1529-9430(01)00007-9,
"A 2009 review evaluating maintenance chiropractic care found that spinal manipulation is routinely associated with considerable harm and no compelling evidence exists to indicate that it adequately prevents symptoms or diseases, thus the risk-benefit is not evidently favorable.[183]" -does sometone have a copy of this journal article they could look over. where is he citing evidence from that "spinal manipulation is routinely associated with considerable harm"...? thanks. — Preceding unsigned comment added by 66.190.94.157 ( talk) 18:43, 6 June 2013 (UTC)
I would like to discuss proposed changes in relation to a section within the introduction as well as the safety section within this article.
Currently the introduction contains "and some evidence of severe adverse effects from cervical vertebral manipulation.[10] ". I feel this would be better represented within the "Safety" section. In addition to this, a more appropriate source is warranted to verify this.
Furthermore, the safety article is lacking the most up to date studies in regards to the more serious complications that have previously been reported in relation to spinal manipulative therapy (SMT) and vertebral artery dissection (VAD).
Below I have added areas which I would like to see looked at either adding to the current safety section, or changing dated and bias statments.
The most recent in-depth review, published in the Feb 15, 2008 Spine Journal [1] was completed by members of the Spine Decade Task Force. These researchers reviewed 10 years worth of hospital records, involving 100 million person-years. These clinical records revealed no increase in vertebral artery dissection risk with chiropractic, compared with medical management, and further stated that “increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection (already in progress) seeking care before their (eventual) stroke.”
It is now apparent that chiropractors prematurely accepted the notion that cervical adjusting/manipulation could be a “causative” event for VAD. That was a reasonable and professional response to case-studies and reports in the peer-reviewed medical literature, which was often based on a pattern of medical mis-reporting, as was later documented by Terrett. [2]
The recently published “Current Concepts: Spinal Manipulation and Cervical Arterial Incidents 2005” (NCMIC) [3] concludes in it's Executive Summary: “Unfortunately, opinion rather than fact has tended to dominate discussions regarding CVAs and chiropractic, even though there has been no definitive evidence that chiropractic adjustments (actually) cause strokes. This monograph notes that a causative relationship between chiropractic manipulation and stroke is unlikely. There is an associative relationship between the two because people may go to chiropractors for relief of stroke-related symptoms”.
DJFryzy ( talk) 04:32, 14 May 2013 (UTC) Thanks for your time and looking forward to editing with you.
I have just removed a split tag, again. If you think there should be a split then please explain why here so that it may be discussed. Op47 ( talk) 22:25, 16 May 2013 (UTC)
As far as i know, a medial diagnosis is generally given only by Doctors of Medicine and at more specific occasions, Psychologists. a Chiropractic, on the other hand, is not a medical adviser, nor a medical pathologist. he treats. not more. correct me if I'm wrong. Ben-Natan ( talk) 07:17, 17 May 2013 (UTC)
This article has just copy-pasted some paragraphs from the article Chiropractic history, on Harvey Lillard. It is completely taken out of context, it makes absolutely no sense as it stands, and it seems at first to be connected to the words before. I see no reason why it has been added.
If it is important, one should include the rest from the article Chiropractic history (or an edited version). As it stands now, the opening words (“However, this version was disputed by Lillard's daughter”) seems to be related to the closing words of the paragraph before (“One student, his son Bartlett Joshua (B.J.) Palmer, became committed to promoting chiropractic, took over the Palmer School in 1906, and rapidly expanded its enrollment”). We must either include the whole (or at least an edited) paragraph on Harvey Lillard, or just delete the two paragraphs (and mention/link to the part on Harvey Lillard from the the article Chiropractic history). Carissimi ( talk) 13:48, 21 July 2013 (UTC)
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However, this version was disputed by Lillard's daughter, Valdeenia Lillard Simons. She said that her father told her that he was telling jokes to a friend in the hall outside Palmer's office and Palmer, who had been reading, joined them. When Lillard reached the punch line, Palmer, laughing heartily, slapped Lillard on the back with the hand holding the heavy book he had been reading. A few days later, Lillard told Palmer that his hearing seemed better. Palmer then decided to explore manipulation as an expansion of his magnetic healing practice. Simons said "the compact was that if they can make [something of] it, then they both would share. But, it didn't happen." [4] In spite of the fact that Lillard could hear well enough to tell jokes, B.J. Palmer claimed under sworn testimony that Lillard had been "thoroughly deaf". [5] Since 1895, the story of Palmer's curing a man of deafness has been a part of chiropractic tradition. Palmer's account differs significantly from what actually happened, in that, according to Lillard's daughter, his improved hearing was likely caused by an accidentally fortuitous jarring of Lillard's body and not, as claimed by D.D. Palmer, caused by a "specific" adjustment. It was after this event that Palmer began to experiment with manipulation. He also claimed that his second patient, a man with heart disease, was also cured by spinal manipulation. |
Wanted to suggest a quick correction for a confirmed user to tackle - the 6th paragraph under the "Evidence" section reads "There is a wide range of ways to measure treatment outcomes.", which I believe should be "There are a wide range of ways to measure treatment outcomes.". Luke831 ( talk) 04:28, 23 July 2013 (UTC)
I just don't get it. This page has the feel that it was written in 1950's. Chiropractic has never before been as widely accepted as it is now. I know that is not saying much but this is just sad. Its a step backward and I feel that the "medical" people posting on this site are more truely unaware of chiropractic and only have E.Ernst's view of what we do. Is there much evidence for chiropractic? nope. But it does help plenty of people. and this site just steers others who could be helped away. This is a page about COMPLAMENTARY AND ALTERNATIVE MEDICINE and should be moderated as such not Medicines view of Chiropractic and its voodoo old farty unchanging ways and crazy ideas about subluxation and innate intelligence. All I as is that the lines pertaining to Objections to Chiropractic be put in a Controversy secetion. Because the way it reads now I would have no idea what chiropractic is other than a scary psuedo-science made up by some old guy who thought he knew how to heal people and only did it for money. Seriously thats the impression I get. How about adding a section on what some of the names of Chiropractic techniques are. There is Diversified, Logan Basic Technique, Webster, Applied Keniesiology, Graston, Cox flexion distraction, Gonstead, Activator, Upper cervical, Thompson. Ect. Please let me know what I need to do to make some of this happen. Thank you for your time and I apologize for the spelling grammar errors (Airport edit). — Preceding unsigned comment added by 108.206.8.214 ( talk) 06:40, 26 July 2013 (UTC)
As a long-time recipient of chiropractic care, I found this article to be very informative on the subject. However, for purely semantic reasons, I think the article puts chiropractic care in an excessively bad light by overemphasizing perspectives of 'straight' chiropractors, who are overwhelmingly in the minority if I'm not mistaken, and using unintentionally negative phrasing such as "chiropractic is only beneficial in dealing with back-pain." (Generally, non-chiropractors don't view it as accomplishing anything else, though I understand this belief's proliferation in the chiropractic community.) I may attempt to fix these issues soon, but I thought it'd be good to list these concerns here. -- 69.246.185.35 ( talk) 01:39, 24 August 2013 (UTC)
This deceptive phrasing implies that the controversy is over whether the spinal dysfunction causes all disease or only some of it, and conceals the actual controversy over whether chiropractic is a working therapy or merely total snake-oil quackery with dangerous disregard for objective reality.
It should be rephrased to something like "as a possible cause of disease". 192.249.47.181 ( talk) 16:46, 15 October 2013 (UTC)
I was reading this article and it the images seemed to be appear outdated and look shabby. First and foremost I would propose adding an image of a chiropractor working with a patient receiving a manipulation as this is probably what people associate most strongly with chiropractic. Secondly the caption below the picture of the outdated x-ray machine lacks citation about controversy. I would suggest that radiology usage is an issue within all health professions (not unique to chiropractors). Recent evidence in Australia would put most chiropractors referring for an average of 18.667 x-rays per year. http://www.australiandoctor.com.au/news/latest-news/chiropractors-defend-referral-rates/ Compared to Australian medical usage rates of 10% of patients being sent for radiological studies. http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442472723
Whilst I do agree chiropractic deserves its fair share (if not more) of criticism it does not need be littered throughout the article. I propose controversial/skeptic/pseudoscience arguments be neatly explored in the Controversy/Criticism section which is already present. Whether you the use of radiology is excessive or not (Australian data seems to paint a different picture) this is not related to scope of practice and in my opinion should be altered to a more neutral statement. May I suggest- "Many chiropractors are licensed to take their own X-rays although this practice is usually confined to the spine as per regulations". http://www.arpansa.gov.au/Publications/Codes/rps19.cfm
As I see many edits are often revised quickly and changing images is quite a big edit I decided to post here before making the edit.
To summarize I would like to:
1.) Add a picture of a chiropractor treating with a chiropractic patient with spinal manipulation 2.) Change picture of X-ray machine to something more modern looking and the quote below it to reflect that chiropractors are licensed and regulated by the same body as radiographers to take x-rays. (more neutral wording) 3.) Change pictures of chairs and tables to be more aesthetically pleasing/modern
Thanks for your consideration, I eagerly await feedback. — Preceding unsigned comment added by 19TC88 ( talk • contribs) 10:12, 20 May 2013 (UTC)
1.) Add a picture of a chiropractor treating with a chiropractic patient with spinal manipulation 2.) Change picture of X-ray machine to something more modern looking and the quote below it to reflect that chiropractors are licensed and regulated by the same body as radiographers to take x-rays. (more neutral wording) 3.) Change pictures of chairs and tables to be more aesthetically pleasing/modern DJFryzy ( talk) 12:01, 17 August 2013 (UTC)
That's great! Please add them to the article as you see fit. Roxy the dog will let us know if he misses the chairs too much. We can tweak the info boxes as needed. TippyGoomba ( talk) 04:44, 20 August 2013 (UTC)
Something to consider in this article - from The Age in Australia - and a blog post with a great deal of detail.
I'm not suggesting that this goes into the article yet, as I'm uncertain of "The Age" as an RS, but this appears to be totally despicable behaviour by chiroquacks, sneakily treating hospital patients behind the hospitals back. Not good. -- Roxy the dog ( quack quack) 13:17, 30 September 2013 (UTC)
Chiropractors primarily use a manual and conservative approach towards neuromusculoskeletal disorders. Interventions are typically multi-modal and can include:
The medicinal use of spinal manipulation can be traced back over 3000 years to ancient Chinese writings. Hippocrates, the "Father of Medicine" used manipulative techniques [6] as did the ancient Egyptians and many other cultures. A modern re-emphasis on manipulative therapy occurred in the late 19th century in North America with the emergence of the osteopathic medicine and chiropractic medicine. [7] Spinal manipulation gained mainstream recognition during the 1980s. [8] Spinal manipulation/adjustment describes techniques where the hands are used to manipulate, massage, mobilize, adjust, stimulate, apply traction to, or otherwise influence the spine and related tissues. [9] It is the most common and primary intervention used in chiropractic care; [10] In North America, chiropractors perform over 90% of all manipulative treatments [11] with the balance provided by osteopathic medicine, physical therapy and naturopathic medicine. Manipulation under anesthesia or MUA is a specialized manipulative procedure that typically occurs in hospitals administered under general anesthesia. [12] Typically, it is performed on patients who have failed to respond to other forms of treatment. [13] There has been considerable debate on the safety of spinal manipulation, in particular with the cervical spine. [14] Although serious injuries and fatal consequences can occur and may be under-reported, [15] these are generally considered to be rare when spinal manipulation is employed skillfully and appropriately. [16]
High-velocity low amplitude (HVLA) spinal manipulative therapy (SMT) is also known as adjustment, thrust manipulation, and Grade V mobilisation [17] It is distinct in biomechanics from non-thrust, low-velocity low amplitude (LVLA) manipulative techniques.
Manual and manipulative techniques can be categorized by different modes depending on therapeutic intent, indications, contraindications and safety. [18] Manual and mechanically-assisted articular manipulative procedures can include:
Manual non-articular manipulative procedures can include:
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Chiropractors primarily use a manual and conservative approach towards neuromusculoskeletal disorders. Interventions are typically multi-modal and can include:
Manual and manipulative therapy![]() The medicinal use of spinal manipulation can be traced back over 3000 years to ancient Chinese writings. Hippocrates, the "Father of Medicine" used manipulative techniques [6] as did the ancient Egyptians and many other cultures. A modern re-emphasis on manipulative therapy occurred in the late 19th century in North America with the emergence of the osteopathic medicine and chiropractic medicine. [7] Spinal manipulation gained mainstream recognition during the 1980s. [19] Spinal manipulation/adjustment describes techniques where the hands are used to manipulate, massage, mobilize, adjust, stimulate, apply traction to, or otherwise influence the spine and related tissues. [9] It is the most common and primary intervention used in chiropractic care; [10] In North America, chiropractors perform over 90% of all manipulative treatments [20] with the balance provided by osteopathic medicine, physical therapy and naturopathic medicine. Manipulation under anesthesia or MUA is a specialized manipulative procedure that typically occurs in hospitals administered under general anesthesia. [21] Typically, it is performed on patients who have failed to respond to other forms of treatment. [22] There has been considerable debate on the safety of spinal manipulation, in particular with the cervical spine. [14] Although serious injuries and fatal consequences can occur and may be under-reported, [15] these are generally considered to be rare when spinal manipulation is employed skillfully and appropriately. [16] DefinitionsHigh-velocity low amplitude (HVLA) spinal manipulative therapy (SMT) is also known as adjustment, thrust manipulation, and Grade V mobilisation [23] It is distinct in biomechanics from non-thrust, low-velocity low amplitude (LVLA) manipulative techniques. CategoriesManual and manipulative techniques can be categorized by different modes depending on therapeutic intent, indications, contraindications and safety. [18] Manual and mechanically-assisted articular manipulative procedures can include:
Manual non-articular manipulative procedures can include:
Neuromusculoskeletal and somatovisceral disordersManual and manipulative therapies is a common intervention used primarily by manual medicine practitioners for the treatment of neuromusculoskeletal disorders. Spinal manipulation is widely seen as a reasonable treatment option for biomechanical disorders of the spine, such as neck pain and low back pain. However the use of spinal manipulation to treat non-musculoskeletal complaints remains controversial. [24] Research status
SafetyThe safe application of spinal manipulation requires a thorough medical history, assessment, diagnosis and plan of management. Manual medicine practitioners, including chiropractors, must rule out contraindications to HVLA spinal manipulative techniques. Absolute contraindications refers to diagnoses and conditions that put the patient at risk to developing adverse events. For example, a diagnosis of rheumatoid arthritis and other conditions that structurally destabilizes joints, is an absolute contraindication of SMT to the upper cervical spine. Relative contraindications, such as osteoporosis are conditions where increased risk is acceptable in some situations and where mobilization and soft-tissue techniques would be treatments of choice. [16] Most contraindications apply only to the manipulation of the affected region. [41] Adverse events in spinal manipulation studies appear to be under-reported [73] and appear to be more common following HVLA manipulation than mobilization. [74] Mild, frequent and temporary adverse events occur in SMT which include temporary increase in pain, tenderness and stiffness. [14] These events typically dissipates within 24–48 hours [75] Serious injuries and fatal consequences can occur, and are believed to result from upper cervical rotatory manipulation. [76] but are regarded as rare when spinal manipulation is employed skillfully and appropriately. [41] There is considerable debate regarding the relationship of spinal manipulation to the upper cervical spine and stroke. Stroke is statistically associated with both general practitioner and chiropractic services in persons under 45 years of age suggesting that these associations are likely explained by preexisting conditions. [77] [78] [79] Weak to moderately strong evidence supports causation (as opposed to statistical association) between cervical manipulative therapy and vertebrobasilar artery stroke. [80] A 2012 systematic review determined that there is insufficient evidence to support any association between cervical manipulation and stroke. [81] Cost-effectivenessSpinal manipulation is generally regarded as cost-effective treatment of musculoskeletal conditions when used alone or in combination with other treatment approaches. [82] Evidence supports the cost-effectiveness of using spinal manipulation for the treatment of sub-acute or chronic low back pain whereas the results for acute low back pain were inconsistent. [83] References
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I propose this change. QuackGuru ( talk) 01:16, 22 November 2013 (UTC)
The lead need to be updated with the relevant information. It is indeed a secondary source. QuackGuru ( talk) 01:44, 22 November 2013 (UTC)
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64.122.219.100 ( talk) 17:57, 23 November 2013 (UTC) The information on here is not only biased but is outdated and needs updating. For your knowledge, yes there are HUNDREDS if not thousands of medical research on chiropractic. So to say, there is no research supporting chiropractic is not true. People use wikipedia all the time so the information on here needs to be correct. please change:
"Collectively, spinal manipulation failed to show it is effective for any condition.[14] The scientific consensus is that chiropractic may be on a par with other manual therapies for some musculoskeletal conditions such as lower back pain, but that there is no credible evidence or mechanism for effects on other conditions, and some evidence of severe adverse effects from cervical vertebral manipulation.["
to:
There is research supporting spinal manipulation and it has been shown to be effective for most conditions ( http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3563165/) also, ( http://www.ncbi.nlm.nih.gov/m/pubmed/24262386/?i=1&from=Is%20chiropractic; "Evidence-Based Guidelines for the Chiropractic Treatment of Adults With Neck Pain." AuthorsBryans R, et al. Show all Journal J Manipulative Physiol Ther. 2013 Nov 19. pii: S0161-4754(13)00237-6. doi: 10.1016/j.jmpt.2013.08.010. [Epub ahead of print] Affiliation Guidelines Development Committee (GDC) Chairman; Chiropractor, Clarenville, Newfoundland, Canada."
The scientific consensus is that chiropractic may be on a par with other manual therapies for some musculoskeletal conditions such as lower back pain, and there is credible evidence for effects on other conditions (ex. treating hypertension with chiropractic has been shown to be successful)
"Spinal manipulation for the treatment of hypertension: a systematic qualitative literature review."
AuthorsMangum K, et al. Show all Journal J Manipulative Physiol Ther. 2012 Mar-Apr;35(3):235-43. doi: 10.1016/j.jmpt.2012.01.005. Epub 2012 Feb 17.
Affiliation Private Practice, Riverside, CA, USA.
And please change this line: "...and some evidence of severe adverse effects from cervical vertebral manipulation."
to: No research has been found to be specifically correlated with severe adverse effects. The research claiming this failed to state the preexisting conditions of the patient.
or just leave that sentence out because you cannot claim something that isn't completely true. Oh and it only happened a few times in history and it's not relevant to the profession at hand.
The evidence on chiropractic's is mixed. Doc James ( talk · contribs · email) (if I write on your page reply on mine) 22:23, 23 November 2013 (UTC)
I would expect changes be made to the description of chiropractic. The main authors are people who believe the chiropractic profession are quacks. If they researched medical studies done on chiropractic instead of finding articles that they believe should be displayed. Actually more people are realizing that chiropractic does wonders. Read the medical studies and get up to date on chiropractic instead of picking and choosing what articles fit your description of chiropractic. Ya there is controversy but how many great medical studies are successful on chiropractic? How many are against it? Successful out weigh the non successful. The research your claiming about serious adverse affects like stroke from chiropractic was already a pre existing condition and I would expect you mention that. This whole description of the profession is a joke. The evidence IS out there that the benefits FAR out weigh the adverse effects. I've personally seen hundreds of people be healed from their neuromusculoskeletal disorders by utilizing chiropractic. chronic pain gone just from seeing a chiropractor. Clinical case studies are far better than any other study done because it's with the patients not overseeing and speculating from a review. Hear it from the people. — Preceding unsigned comment added by ChiroQ ( talk • contribs) 22:48, 26 November 2013 (UTC)
There may be some aspects of chiropractic which are considered pseudoscientific . . . but as a whole the majority of the profession . . . yes it is a profession . . . is evidence-based and scientific. TheDoctorIsIn ( talk) 21:18, 21 January 2014 (UTC)
Per WP:FRINGE/PS, Chiropractic is not generally considered a pseudoscience and therefore should not be categorized as such. TheDoctorIsIn ( talk) 22:20, 21 January 2014 (UTC)
Hmmm. Not sure about that; that it's a profession is unrelated to its scientific soundness (there are, after all, professional homeopathy practitioners). And insofar as it deals with science, its theories are pseudoscientific are they not? Before such a major change as this it would be wise to get a wider view, perhaps at WP:FT/N. Alexbrn talk| contribs| COI 06:06, 22 January 2014 (UTC)
The only arguments being made here to keep the incorrect categorization are mostly based on personal opinion . . . "I feel that chiropractic is pseudoscience therefore is should be categorized as such" . . . if you are saying that the majority of the reliable scientific sources are calling chiropractic a pseudoscience, then please show us those sources . . . this article shows that there is a lot of fair to high quality research out there with conflicting conclusions about the effectiveness of chiropractic for this or that ailment . . . Vertebral subluxation and innate intelligence are very much pseudoscientific and those articles should be categorized as such . . . nobody is arguing otherwise . . . however, modern chiropractic is making all attempts to leave those concepts in the past . . . condemning all of chiropractic as pseudoscience for these historical theoretical concepts would be to some degree similar to calling medical science a pseudoscience based on the practices of bloodletting and leeching. TheDoctorIsIn ( talk) 05:49, 23 January 2014 (UTC)
Verging into WP:NOTAFORUM.
What specific improvements to the article are being suggested? If none are, then this topic should be closed. -- Harizotoh9 ( talk) 07:16, 23 January 2014 (UTC)
I think there's a decent case for keeping the category, if there's reliable sourcing that indicates that some fundamental aspects of the topic are generally considered pseudoscience. I haven't reviewed the sourcing well enough to know for sure, but I do see a few sources supporting it in the article. I don't think it's a requirement for inclusion in a category that the article topic falls 100% within it. For example, there are plenty of biographies for people involved in more than one discipline that have multiple categories, like Michelangelo is in categories for both painters and sculptors.
I think the case for keeping chiropractic in the template is weaker, because it's more selective. Does the authoritative reliable sourcing consider chiropractic to be a foremost example of pseudoscience? I am genuinely unsure.
Zad
68
03:00, 24 January 2014 (UTC)
Hi all, I've got some problems with the sections I've posted below (from the SAFETY section):
"Chiropractic care in general is safe when employed skillfully and appropriately. Manipulation is regarded as relatively safe, but as with all therapeutic interventions, complications can arise, and it has known adverse effects, risks and contraindications. Absolute contraindications to spinal manipulative therapy are conditions that should not be manipulated; these contraindications include rheumatoid arthritis and conditions known to result in unstable joints.[2]
Sustained chiropractic care is promoted as a preventative tool, but unnecessary manipulation could present a risk to patients. Some chiropractors are concerned by the routine unjustified claims chiropractors have made.[9]"
First I'm not sure chiropractic care is seen as generally safe anymore ( eg.). What is the general consensus to changing this statement to be a little less sure of itself?
Secondly what is meant by "when employed skillfully and appropriately"? This seems, to me, like a way of saying "When chiropractic care is administered safely it is safe" a subtly worded case of begging the question.
Thirdly the second sentence contradicts the first - if Chiropractic treatment is safe why would anyone be concerned with ongoing treatment?
Fourthly the reference in this sentence (from Edzard Ernst) implies that it is Chiropractors that are concerned by their own claims - the article written by Ernst doesn't mention that it is Chiropractors who are concerned specifically with the claims, and is highly critical of the efficacy of the whole field.
I'd also like to get rid of the weasel words throughout; perhaps this is a start:
Due to a lack of rigorous research and systematic under-reporting of negative affects it is difficult to gauge the safety of Chiropractic therapy 1. Most chiropractic practitioners report high levels of safety with their therapies (another ref) As with all therapeutic interventions, complications can arise, and it has known adverse effects, risks and contraindications.
I feel this is more in line with research, and also with the rest of the section which goes into detail about some of the risks associated with Chiropractic therapy. 203.38.24.65 ( talk) 05:30, 28 January 2014 (UTC)
Well, the BBC source is not strong enough for biomedical information (see WP:MEDRS). Something from PMID 23069244 (say) would be better:
Much is known about common adverse events following SMT. These events have been described in prospective, multicenter studies. In general, adverse events are mild to moderate in intensity, have little to no influence on activities of daily living ... Serious (or life-threatening) adverse events following SMT are, on the other hand, extremely rare. Because they are rare, less is known about them ...
(Add) But the systematic review behind the BBC report is definitely worth mentioning. We have enough here for something of a re-write. Alexbrn talk| contribs| COI 08:18, 28 January 2014 (UTC)
In that regard, to our knowledge, only 4 case-control studies22, 23, 24, 25 have been identified that have examined this issue, 3 of which demonstrated a strong association.22, 24, 25 However, these studies did not exclude the possibility that the observed association was related to protopathic bias (ie, a form of bias that occurs when there is a lag in time from the appearance of the initial symptoms and start of treatment yet before the actual diagnosis).
My feeling is that the similarity across articles is that the research is poor and this should be noted in the article, but I'm not sure if this is original research or contravenes whatever other WP policies I'm ignorant of. 203.38.24.65 ( talk) 08:27, 28 January 2014 (UTC)
Previous lead sentence. Chiropractic is a form of alternative medicine[1] that emphasizes diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially the spine, under the hypothesis that these disorders affect general health via the nervous system.[2] It is generally categorized as complementary and alternative medicine (CAM),[1] a characterization that many chiropractors reject.[3]
https://en.wikipedia.org/?title=Chiropractic&oldid=442127826
Check the edit history. The lead is currently a mess and the body of the article was severely hacked.
All over the article text is missing. For example, this was in the history section: Serious research to test chiropractic theories did not begin until the 1970s, and is continuing to be hampered by what are characterized as antiscientific and pseudoscientific ideas that sustained the profession in its long battle with organized medicine. QuackGuru ( talk) 19:34, 23 January 2014 (UTC)
QG, I have tried my best to adress each of your points:
1) You said "The current lede does not summarise the body at all. Would you like me to summarise the body in the WP:LEAD?"
2) You said: "Chiropractic is a "form" of alternative medicine. We can't assert it as alternative medicine or CAM in the lede when it is "generally" considered CAM. These differences are noteworthy. "
3) You said: "Chiropractic is an alternative medicine[1]" is WP:OR. The source does not assert it as alternative medicine."
4) You pointed to WP:ASSERT and said: “When chiropractic is viewed as a marginal healthcare profession[40], we can't assert it in the lede sentence that chiropractic is a healthcare profession."
Current lede sentence: Chiropractic is a health care profession in the field of complementary and alternative medicine whose practitioners emphasize manual manipulation of the spine, sometimes with the unevidenced claim this can treat a wide variety of human ailments.[1]
Proposal to replace lede sentence. '''Chiropractic''' is a form of [[alternative medicine]]<ref name=Chapman-Smith/> that emphasizes diagnosis, treatment and prevention of mechanical disorders of the [[musculoskeletal system]], especially the [[vertebral column|spine]], under the hypothesis that these disorders affect general health via the [[nervous system]].<ref name=Nelson/> It is a marginal [[complementary and alternative medicine]] [[health care profession]].<ref name="V-H"/> QuackGuru ( talk) 05:34, 29 January 2014 (UTC)
There are a lot of proposals and discussion now in this one thread, perhaps some new threads with clear proposals could be started? I am replying here to QG comment at 18:43 on Jan 28. Puhlaa ( talk) 06:44, 29 January 2014 (UTC) QG, I have already explained to you that I do not think our lede sentence has any synthesis! Our lede says: “’’ Chiropractic is an alternative medicine health care profession’’” We have RS source that says”’’ Chiropractic is the best established of the alternative health care professions’’”. You claim that the WHO source does not support that chiropractic is an alternative healthcare profession, but the WHO starts it’s chiropractic guidelines with a foreword all about traditional/alternative/complementary medicine. Remember I pointed you to this consensus-building discussion that generated the current lede sentence; you will see that editors pointed-out this fact then as well.
You want to add the term 'marginal' to the first sentence of the lede along with the alternative medicine description. I have already shown you that Yvonne_VRussell explains in her source what she means by 'marginal' – alternative medicine professions are 'marginal' to mainstream medicine, just as they are also 'alternative' to mainstream medicine. There is no need to describe chiropractic as 'marginal' AND 'alternative' in the lede sentence, as you propose, when they are referring to the same characteristic – their position relative to mainstream medicine.
With regard to you newest concern; I dont think we are violating any copyright policy by using a half-sentence from the WHO guidelines source. However, if you feel strongly that this is a big problem, perhaps you could show good intent and start a thread for a clear proposal for how to address your copyright concerns without also trying to change all the other components of the lede sentence where there are no problems and where we have good consensus. For example, there is no reason, based on WP:copyright to remove the WHO source, or to remove the general description of chiropractic the WHO gives us; but perhaps we can re-word the general description so that you are confident we are not copying the WHO too closely. Puhlaa ( talk) 06:44, 29 January 2014 (UTC)
Alexbrn, I would like to discuss this series of recent edits you made. Improvements to the article, in my opinion, were the addition of the sceptical source to the ‘further reading’ section, done with these 2 edits and the addition of criticism to the ‘Conceptual basis’ section done with this edit. I did not modify these edits in any way. I did find some edits controversial and I have reverted them, per WP:BRD. I have tried to clearly explain what I reverted and why. Puhlaa ( talk) 06:55, 29 January 2014 (UTC)
These edits removed text from the body of the “Scope of Practice” section and replaced it with text using a different source. I have reverted these edits because there is no consensus to remove the WHO and Nelson sources from this section at this time, nor the text that was associated with the sources. However, I believe that there is merit to the additions. I suggest we add the ad your new text back into the article without removing the existing text.
My suggestion: “Chiropractors emphasize the conservative management of the neuromusculoskeletal system without the use of medicines or surgery, [14] with special emphasis on the spine.[ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1185558/] They generally emphasize spinal manipulation but sometimes offer other treatments, such as advice on diet and lifestyle, provide exercises, or perform acupuncture. [15]" Puhlaa ( talk) 06:55, 29 January 2014 (UTC)
These edits removed the WHO guidelines and the general description/definition of chiropractic from the lede and replaced it with text about unsupported claims of efficacy and a source from The National Health Service – chiropractic. My concerns:
Reply:
I have reverted 2 edits that are attempting to remove the verified fact that chiropractic is a profession; first here, then here. The first time I reverted I referred to previous consensus in the edit summary of my revert; now this second time I will point editors directly to the previous consensus so that we can hopefully avoid an edit war. You will note that the recent discussion Recent_controversial_edits_-_profession_vs._approach resulted in a clear consensus for the current version; there has been no discussion to change the consensus version. Puhlaa ( talk) 16:03, 20 January 2014 (UTC)
Well I guess the key here is, John, it doesn't matter what you, or I, do or do not have a problem with; wikipedia follows reliable, mainstream sources, not my opinion or yours. Reliable sources say that chiropractic is a profession; do you have any sources to present that suggest chiropractic is not a profession? The most recent consensus, which I have already pointed to repeatedly here, was to include the ideas that it is a profession and an 'approach'. The onus is on you, John, who wants to change the lede away from the consensus version to provide sources and seek consensus. Here is what supports the term profession in the lede:
Puhlaa ( talk) 20:35, 20 January 2014 (UTC)
We've maybe got off the piste here. The point was never to get into one of those endless tennis matches about sources - it was about making the lede clear enough to be readable and informative. I'm not an anti-chiro campaigner and I do not question the relevance of material about how chiros are trained, licensed and employed, so I do not have a vested-interest POV to push here. But squeezing every possible point into the intro does not look like a sensible approach and my feeling is that the consensus has in fact evolved. Thanks. John Snow II ( talk) 12:10, 21 January 2014 (UTC)
I can certainly agree "The archives are pretty clear, sources appear to win out" but it's not necessary to get into our personal feelings regarding the subject and I'm hoping we don't use the article Talk page for any more of that. Let's just look at what the sources say and reflect those accurately in the article. The article itself devotes a non-trivial amount of space to discussing it as a profession, and nine months ago in
this discussion, authoritative reliable sources were brought that discuss chiropractic as a profession. Both those sympathetic to and skeptical of chiropractic came to a compromise agreement to mention both in the lead and that part of the article has been stable since. I don't see any significant change in the circumstances since that time.
Zad
68
18:34, 21 January 2014 (UTC)
Zad
68
18:56, 21 January 2014 (UTC)There appears to be some interest in removing the word "profession" from the opening sentence of the lead. I think the word "profession" is supported by the sourcing and the article, but understand the existing sentence is a bit of a mouthful. Can new wording be proposed that addresses the issues raised above, so we can come to consensus on what to include and how to word it?
Zad
68
21:45, 21 January 2014 (UTC)
Proposal: Chiropractic is a complementary and alternative medicine[1] "health care approach" to healing concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health.[2] QuackGuru ( talk) 02:48, 22 January 2014 (UTC)
I do not object to the term "profession" in the lede. According to our own Wikipedia page on the term:
A profession is a vocation founded upon specialized educational training, the purpose of which is to supply objective counsel and service to others, for a direct and definite compensation, wholly apart from expectation of other business gain.
It does not imply scientific validity. It is often confused by the public as meaning that, but we should not let the public misunderstandings of terms dictate how we use words on WP. So, I am okay with the term, as long as the article discusses in depth some of the disproven or controversial aspects of Chiropractic. -- Harizotoh9 ( talk) 07:29, 23 January 2014 (UTC)
Zad
68
02:34, 24 January 2014 (UTC)Alexbrn, you just reverted the addition of a secondary source that I had added to the article body. Your edit summary claim 2 concerns:
I fail to understand your concerns Alexbrn, can you clarify these concerns for me? Puhlaa ( talk) 19:54, 29 January 2014 (UTC)
Puhlaa, will you please step away from this for a while. No-one doubts your good intentions but repeatedly pushing your chosen occupation into the lede is not appropriate, and correcting for this is inevitably taking up other people's time unnecessarily now. With respect, an argument about whether a source is primary or secondary isn't moving us on here. John Snow II ( talk) 23:17, 29 January 2014 (UTC)
I am not pleased with the shift from reasoned discussion at this article over the past many months to the petty edit warring of late. Consider this a heads up. My next step is to fully protect the page for a week if necessary, to encourage that happening (or get another admin to do so as I used to edit this article). After that, if individual editors can't resist the urge to make and repeat making changes without consensus, there may be blocks (or bans) as needed. The key here is to have reasoned discussion, and you know what that looks like. If you're getting frustrated or making knee-jerk reverts, you are probably not in a good position to be reasonable so step back and ask for help from others. If you are trying to shape the page so that it looks the way it looked before months of discussion helped it evolve, you are probably not being reasonable. For formality's sake, this page is already under ArbCom Discretionary Sanctions, which means sanctions can be more swift or broad than usual. I'm not threatening action or any one person... just shift the path towards reasoned discussion with reasonable editors and take the extra time to do it right. Cheers, Ocaasi t | c 02:16, 24 January 2014 (UTC)
@Ocaasi: I am very familiar with the subject. There are actually numerous sects within chiropractic (e.g. McTimoney in the UK), but they broadly separate, like Catholic and Protestant, into Straight and Mixer. Straights are out-and-out quacks, holding to an entirely discredited model of physiology. Mixers occupy a spectrum. At oen end are the quacks, who promote anti-vaccinaiton nosnense, concern themselves primarily with "practice building" and aggressively sell "maintenance adjustments", especially to children. At the other end are those who practise based on evidence, with Sam Homola being the best known example to skeptics. The problem is that most chiros incorporate at least some pseudoscientific practices, virtually all will treat children, which is completely unsupportable, most will claim to treat colic and other diseases entirely unrelated to the musculoskeletal system, and virtually all depend for their livelihood on conducting unnecessary and occasionally dangerous (e.g. manipulation of the neck, wholespine x-rays) procedures and treatments. Puhlaa in particular wants to document an idealised form of chiro that does not do these things, but the evidence shows that the majority of chiros do it all the time.
Skeptics are perfectly content to include the valid indications for chiro: treatment of pain in the musculoskeletal system, where serious underlying disease has been ruled out. Skeptics also want inclusion of the documented adverse events, the lack of any systematic recording of adverse events by chiros, the side-order of pseudoscientific practices and so on. A warts-and-all portrait, in other words. WP:FRINGE entirely supports that. In fact, it mandates it. Guy ( Help!) 15:09, 30 January 2014 (UTC)
Manual therapies commonly used by chiropractors are as effective as other manual therapies for the treatment of low back pain,[122][123] and might also be effective for the treatment of lumbar disc herniation with radiculopathy,[124][125] neck pain,[126] some forms of headache,[127][128] and some extremity joint conditions.[129][130] While guidelines issued by the WHO state that chiropractic care may be considered safe when employed skillfully and appropriately,[2] chiropractic spinal manipulation is frequently associated with mild to moderate adverse effects, and with serious or fatal complications in rare cases.[131][132][133]
There is a POVPUSH in the introduction of effectiveness. QuackGuru ( talk) 19:53, 30 January 2014 (UTC)
What happened to the Utilization, satisfaction rates, and third party coverage section? A lot text was deleted when the section was split into two separate sections. QuackGuru ( talk) 20:30, 30 January 2014 (UTC)
Most people who seek chiropractic care do so for low back pain.[6] QuackGuru ( talk) 18:41, 30 January 2014 (UTC)
Chiropractic theory on spinal joint dysfunction and its putative role in non-musculoskeletal disease has been a source of controversy since its inception in 1895. The controversy is due in part to chiropractic's vitalistic and metaphysical origins, and use of terminology that is not always amenable to scientific investigation.[7] Far-reaching claims and lack of scientific evidence supporting spinal dysfunction/subluxation as the sole cause of disease[8][9] has led to a critical evaluation of a central tenet of chiropractic and the appropriateness of the profession's role in treating a broad spectrum of disorders that are unrelated to the neuromusculoskeletal system.[10] Although there is external and internal debate within the chiropractic profession regarding the clinical significance of joint dysfunction/vertebral subluxation complex,[11] the manipulable lesion/functional spinal lesion[12] remains inextricably linked to the profession as the basis for spinal manipulation.[13]
There is definitely a POVPUSH in the lede. This is poorly written text. It can be improved. QuackGuru ( talk) 07:01, 30 January 2014 (UTC)
For most of its existence, chiropractic has been sustained by pseudoscientific ideas such as subluxation and innate intelligence[16] which are not based on solid science.[9] Some chiropractors have been criticized for having an anti-immunization stance, despite the consensus of public health professionals on the benefits of vaccination,[17] which has led to negative impacts on both public vaccination and mainstream acceptance of chiropractic.[18] The American Medical Association called chiropractic an "unscientific cult"[19] and boycotted it until losing an antitrust case in 1987.[20] Chiropractic is said to have developed a strong political base and to have sustained demand for services; researchers Cooper and McKee report that it has gained more legitimacy and greater acceptance among physicians and health plans in the U.S. for the treatment of some musculoskeletal conditions[20] and the principles of evidence-based medicine have been used to review research studies and generate practice guidelines.[21] Traditional (or straight) chiropractic still assumes that a vertebral subluxation interferes with the body's "innate intelligence",[22] a vitalistic notion ridiculed by the scientific and healthcare communities.[23] Other chiropractors want to separate themselves from the traditional vitalistic concept of innate intelligence[24] – John W Reggars wrote in 2011 that chiropractic was at a crossroads, and that in order to progress it would need to embrace science; in his view, the promotion of chiropractic as a cure-all was both "misguided and irrational".[25]
See Chiropractic#Conceptual basis.
None of this text belongs in the Conceptual basis/Philosophy section. The first section is about philosophy. The above text is misplaced and not relevant to the section. Most of this text was originally in the lede. See paragraph three in the well written lede. Why was the lede summary moved to Conceptual basis? QuackGuru ( talk) 07:01, 30 January 2014 (UTC)
Information that was not about conceptual basis was restored to the section. Also the lede should summarise the body. The text that summarize the body should never have been moved to another section.
https://en.wikipedia.org/?title=Chiropractic&diff=prev&oldid=529303776 A section was spun off from the lede into a "background" section.
https://en.wikipedia.org/?title=Chiropractic&diff=prev&oldid=529645465 A section was spun off from the lede into a "background" section.
https://en.wikipedia.org/?title=Chiropractic&diff=next&oldid=530067980 A section was spun off from the lede into a "background" section.
https://en.wikipedia.org/?title=Chiropractic&diff=next&oldid=530492360 A section was spun off from the lede into a "background" section.
These changes did not improve the article. Moving the text to a background section that is a summary of the body is not appropriate. QuackGuru ( talk) 23:26, 1 February 2014 (UTC)
Chiropractors practice in over 100 countries in all regions of the world, but they are most prevalent in North America, Australia and parts of Europe.[2][5]
There is a POVPUSH in the lead. Chiropractors practice in over 100 countries in all regions of the world?
For the lede: Chiropractic is established in the U.S., Canada, and Australia.
For the body: Chiropractic is established in the U.S., Canada, and Australia, and is present to a lesser extent in many other countries.
The text in the lede must be improved. QuackGuru ( talk) 03:50, 31 January 2014 (UTC)
There is too much information on Palmer and Palmer's son. See Chiropractic#History. Similar sentences is duplication:
Palmer, a magnetic healer, hypothesized that manual manipulation of the spine could cure disease.
According to D.D. Palmer, subluxation was the sole cause of disease and manipulation was the cure for all diseases. See Chiropractic#History. QuackGuru ( talk) 18:49, 31 January 2014 (UTC)
"Chiropractic has had a strong salesmanship element since it was started by D.D. Palmer. His son, B.J. Palmer, asserted that their chiropractic school was founded on "…a business, not a professional basis. We manufacture chiropractors. We teach them the idea and then we show them how to sell it".[120] D.D. Palmer established a magnetic healing facility in Davenport, Iowa, styling himself ‘doctor’. Not everyone was convinced, as a local paper in 1894 wrote about him: "A crank on magnetism has a crazy notion hat he can cure the sick and crippled with his magnetic hands. His victims are the weak-minded, ignorant and superstitious, those foolish people who have been sick for years and have become tired of the regular physician and want health by the short-cut method…he has certainly profited by the ignorance of his victims…His increase in business shows what can be done in Davenport, even by a quack."[120] D.D. Palmer remarked that "Give me a simple mind that thinks along single tracts, give me 30 days to instruct him, and that individual can go forth on the highways and byways and get more sick people well than the best, most complete, all around, unlimited medical education of any medical man who ever lived."[9]"
I deleted this text above because it is not a good summary. A long run on quote is not a well written summary. I improved the section that accurately explained about the history of chiropractic. See here. QuackGuru ( talk) 02:54, 2 February 2014 (UTC)
No single profession "owns" spinal manipulation and there is little consensus as to which profession should administer SM, raising concerns by chiropractors that other medical physicians could "steal" SM procedures from chiropractors.
Deleting this text does not improve the article. This is very relevant text. QuackGuru ( talk) 05:03, 30 January 2014 (UTC)
The part, as these are the only areas where evidence supports its use. is not about the scope of practice section and no rationale for deleting No single profession "owns" spinal manipulation and there is little consensus as to which profession should administer SM, raising concerns by chiropractors that other medical physicians could "steal" SM procedures from chiropractors. has been given. QuackGuru ( talk) 03:01, 2 February 2014 (UTC)
See Chiropractic#Straights and mixers. "Despite this finding, a 2008 survey of 6000 American chiropractors demonstrated that most chiropractors seem to believe that a subluxation-based clinical approach may be of limited utility for addressing visceral disorders, and greatly favored non-subluxation-based clinical approaches for such conditions.[11][not in citation given][33]"
"The data reported in Figure 1 suggest a more complex picture regarding how chiropractors specifically apply the concept of subluxation in actual clinical practice. Most chiropractors typically reported that over 75% of their clinical approach to addressing musculoskeletal or biomechanical disorders such as back pain was “subluxation-based”.' Conversely, most chiropractors also reported that less than 20% of their clinical approach was “subluxation-based” for patient complaints deemed to be principally problems with circulation, digestion, or similarly “visceral” in nature." page 3
The text follows the source accurately but did not include the part "Most chiropractors typically reported that over 75% of their clinical approach to addressing musculoskeletal or biomechanical disorders such as back pain was “subluxation-based”". Reference 11 is misplaced. QuackGuru ( talk) 06:05, 30 January 2014 (UTC)
I fixed the lopsided view but it was reverted. QuackGuru ( talk) 23:34, 1 February 2014 (UTC)
There have been a very substantial number of edits by QuackGuru, plus additional advocacy by others, I have seen OTRS requests relating to the "imbalance" of the chiropractic article; months of stability have been replaced by a rapid push towards a more flattering portrayal of chiro, and (purely by coincidence) my sinister agents tell me that chiros are once again angling for money under Obamacare and for primary care provider status. Very singular... Guy ( Help!) 21:11, 1 February 2014 (UTC)
"When employed skilfully and appropriately, chiropractic care is safe and effective for the prevention and management of a number of health problems. There are, however, known risks and contraindications to manual and other treatment protocols used in chiropractic practice."Now unless you can find an equally strong MEDRS-compliant source that contradicts that (hint: Ernst will have done so), it needs to be in the article - and it's so much a central point that it needs to be in the lead. If you can't come up with a source and a wording that describes a disagreement between MEDRS sources, I'm going to have to insist that QG's wording goes back in.
WP:FRINGE also applies, and guides us to use independent sources. The WHO guidelines go on to say the guidelines were finalized by their panel (of chiropractors and CAM advocates), which suggests this is not such an independent text. However, even in purely MEDRS terms this is rather an old document; we should do better.
In 2008 Ernst wrote about chiropractic safety in the review, PMID 18280103. First (of relevance to the above) he notes statements such as "chiropractic is safe" "can be found abundantly" in "chiropractic literature". Based on poor available evidence he then goes on to say that "it seems highly doubtful whether reliable incidence figures can presently be calculated". Alexbrn talk| contribs| COI 07:26, 2 February 2014 (UTC)
As the Ernst abstract has it, "Manipulation is associated with frequent mild adverse effects and with serious complications of unknown incidence". That is different from the bromide offered by the "WHO" document. As to synchronizing the lede and body, I see that as a housekeeping exercise that can be done once we know what the neutral point of view is which WP should be taking. Alexbrn talk| contribs| COI 08:20, 2 February 2014 (UTC)
"When employed skilfully and appropriately, chiropractic care is safe and effective for the prevention and management of a number of health problems."Effective for the prevention of a number of health problems? really? Are we really saying this is fine? Alexbrn talk| contribs| COI 17:43, 2 February 2014 (UTC)
"Spinal manipulation is regarded as relatively safe, but as with all therapeutic interventions, complications can arise, and it has known adverse effects, risks and contraindications.<ref name=WHO-guidelines/> Spinal manipulation is frequently associated with mild to moderate adverse effects, with serious or fatal complications in rare cases.<ref name=Ernst-adverse/><ref name=CCA-CFCREAB-CPG/>"which looked like a good summary to me of both the WHO general view and Ernst's investigations of particular, but thankfully rare, serious adverse effects. Whereas Guy prefers
"there is ... some evidence of severe adverse effects from cervical vertebral manipulation.<ref name=Trick-or-Treatment>{{cite book |pages=145–90 |chapter=The truth about chiropractic therapy |title=[[Trick or Treatment: The Undeniable Facts about Alternative Medicine]] |author=Singh S, Ernst E |year=2008 |publisher=W.W. Norton |isbn=978-0-393-06661-6 }}</ref>"to be the sole comment about chiropractic safety in the lead. I think that we could (and should) have more to say about safety than that. Please understand, I'm only talking about what the lead says about safety - not effectiveness, nor risk/benefit that always get confused here. So, the question should be "does including a summary in the lead of what the WHO has to say about safety improve the article or not?" I would remind everyone that simply dismissing a source as "written by pro-chiropractic authors" makes it very hard for us to counter the chiropractor advocates when they want to dismiss Ernst "because he's an anti-chiropractic author". And believe me, I know how hard that is. -- RexxS ( talk) 22:11, 2 February 2014 (UTC)
There are a couple of sources from Michael Shermer:
In both, Shermer places chiropractic in what he calls "borderlands science", i.e. a gray area between science and pseudoscience. He also says (in the second source) that demarcation depends on multiple factors -- including efficacy, btw -- which ties into Brangifer's point about chiro being a mixed bag. Unlike the question of whether to eat the Curate's egg, demarcation is frequently considered fuzzy (particularly among scholarly sources), and this view appears to be a significant one with respect to chiro specifically. Shermer and similar sources turn up with a Google books search for chiro and terms like "demarcation" and "gray area". (If you just google for chiro and pseudoscience you're more likely to find the sources that take a bright line approach & call it pseudo outright.) -- Middle 8 ( leave me alone • talk to me) 08:56, 3 February 2014 (UTC)
Current text: "A 2010 report found that manual therapies commonly used by chiropractors are effective for the treatment of low back pain, neck pain, some kinds of headaches and a number of extremity joint conditions.[133]" See Chiropractic#Effectiveness.
Proposal: "A report found that spinal manipulation therapies are effective for the treatment of low back pain, neck pain, migraine and cervicogenic headache and a number of extremity joint conditions." Read the conclusion for ref 133 The part "commonly used by chiropractors" is not part of the conclusion. The part "some kinds of headaches" might be WP:OR. QuackGuru ( talk) 02:15, 5 February 2014 (UTC)
I'd like to have some discussion about the appropriateness of this source.
{{
cite journal}}
: CS1 maint: unflagged free DOI (
link)Cheers, Ocaasi t | c 14:28, 30 January 2014 (UTC)
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link) CS1 maint: unflagged free DOI (
link) The article may need updating because we have a lot more independent sources available at this time.
QuackGuru (
talk)
19:42, 30 January 2014 (UTC)On the NHS Choices website, they make patients aware that there is "no scientific evidence to support the idea that most illness is caused by misalignment of the spine."[111] This is not about international reception. See Chiropractic#International reception. QuackGuru ( talk) 03:24, 6 February 2014 (UTC)
A study of California disciplinary statistics during 1997–2000 reported 4.5 disciplinary actions per 1000 chiropractors per year, compared to 2.27 for MDs; the incident rate for fraud was 9 times greater among chiropractors (1.99 per 1000 chiropractors per year) than among MDs (0.20).[94] The same sentence is found in another section. See Chiropractic#Ethics. QuackGuru ( talk) 05:30, 6 February 2014 (UTC)
A 2010 analysis of chiropractic websites found the majority of chiropractors and their associations made claims of effectiveness not supported by scientific evidence, including claims about the treatment of asthma, ear infection, earache, otitis media, and neck pain.[103] Read the conclusion. See Chiropractic#Ethics. QuackGuru ( talk) 05:30, 6 February 2014 (UTC)
I found a more recent source for the safety information. I made this change to summarise the body. QuackGuru ( talk) 07:04, 7 February 2014 (UTC)
UK chiropractic organizations and their members make numerous claims which are not supported by scientific evidence. Many chiropractors adhere to ideas which are against science and most seemingly violate important principles of ethical behaviour on a regular basis. The advice chiropractors gave to their patients is often misleading and dangerous.[106] This situation, coupled with a backlash to the libel suit filed against Simon Singh, has inspired the filing of formal complaints of false advertising against more than 500 individual chiropractors within one 24 hour period,[107][108] prompting the McTimoney Chiropractic Association to write to its members advising them to remove leaflets that make claims about whiplash and colic from their practice, to be wary of new patients and telephone inquiries, and telling their members: "If you have a website, take it down NOW." and "Finally, we strongly suggest you do NOT discuss this with others, especially patients."[107] See Chiropractic#Ethics.
In 2008 and 2009, chiropractors, including the British Chiropractic Association, used libel lawsuits and threats of lawsuits against their critics.[124] Science writer Simon Singh was sued for libel by the British Chiropractic Association (BCA) for criticizing their activities in a column in The Guardian.[125] A preliminary hearing took place at the Royal Courts of Justice in front of Justice David Eady. The judge held that merely using the phrase "happily promotes bogus treatments" meant that he was stating, as a matter of fact, that the British Chiropractic Association was being consciously dishonest in promoting chiropractic for treating the children's ailments in question.[126] An editorial in Nature has suggested that the BCA may be trying to suppress debate and that this use of British libel law is a burden on the right to freedom of expression, which is protected by the European Convention on Human Rights.[127] The libel case ended with the BCA withdrawing its suit in 2010.[128][129] See Chiropractic#History.
In two different sections we have similar, almost duplicate text. I think for the history section it should be shortened or deleted. QuackGuru ( talk) 19:32, 4 February 2014 (UTC)
If another article is kept this section stills requires a summary. See WP:SUMMARY. I suggest an AFD or redirect for Chiropractic professional ethics. Or maybe the new article could be kept. QuackGuru ( talk) 20:48, 9 February 2014 (UTC)
The part " According to one controversial source is OR and the text is sourced. [19] QuackGuru ( talk) 21:14, 9 February 2014 (UTC)
The American Chiropractic Association (ACA) has a Code of Ethics "based upon the acknowledgement that the social contract dictates the profession’s responsibilities to the patient, the public, and the profession; and upholds the fundamental principle that the paramount purpose of the chiropractic doctor's professional services shall be to benefit the patient." [1] The International Chiropractor's Association (ICA) also has a detailed set of professional canons. [2]
This can be discussed in this article. QuackGuru ( talk) 02:22, 10 February 2014 (UTC)
I recommend an AFD for Chiropractic professional ethics. I don't see a reason to have a separate article for duplicate information. QuackGuru ( talk) 04:58, 11 February 2014 (UTC)
Students attending the chiropractic program at Canadian Memorial Chiropractic College during 2011-12 had a positive outlook toward vaccination.[213][undue weight? – discuss]
The source ( PMID 23997247) is reliable but it is a weight issue. QuackGuru ( talk) 16:14, 11 February 2014 (UTC)
A 2013 systematic review and meta-analysis found a statistically significant improvement in overall recovery from sciatica following spinal manipulation, when compared to usual care, and suggested that spine manipulation may be considered.
Lewis RA, Williams NH, Sutton AJ; et al. (2013). "Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses". Spine Journal.
doi:
10.1016/j.spinee.2013.08.049.
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link) We are using numerous sources about spinal manipulation in this article. I don't understand why this particular source was deleted.
QuackGuru (
talk)
08:17, 7 February 2014 (UTC)
An inconclusive RfC from 6 years ago doesn't overturn community consensus as embodied now in one of our chief guidelines, WP:OR. It states: "To demonstrate that you are not adding OR, you must be able to cite reliable, published sources that are directly related to the topic of the article, and directly support the material being presented." (bolding in original). That is perfectly clear. Alexbrn talk| contribs| COI 09:11, 7 February 2014 (UTC)
So if SMT in general is not chiropractic per se, and the source doesn't mention chiropractic, then why include it? What possible reason could there be? Alexbrn talk| contribs| COI 19:47, 9 February 2014 (UTC)
https://en.wikipedia.org/?title=Chiropractic&diff=next&oldid=592768717
https://en.wikipedia.org/?title=Chiropractic&diff=next&oldid=593089869
https://en.wikipedia.org/?title=Chiropractic&diff=593850971&oldid=593850690
"A 2012 study suggests that chiropractors may be used in a more complementary role to primary medical intervention." See ( PMID 23171540).
Per NPOV, we must include opposing POV. All the journals are reliable. Move on. QuackGuru ( talk) 18:41, 5 February 2014 (UTC)
Alexbrn, do you agree it was a mistake to try to delete chiropractic reliable sources solely based on authorship. QuackGuru ( talk) 18:02, 7 February 2014 (UTC)
QuackGuru: You are showing distinct signs of trying to WP:OWN the article. Statements such as "Reliable sources must not be deleted again" are classic ownership. We are not bound to install every source, however reliable; that is a matter of editorial judgment. Guy ( Help!) 13:43, 12 February 2014 (UTC)
Many studies of treatments used by chiropractors have been conducted, with conflicting results.[14] A critical evaluation found that collectively, spinal manipulation failed to show it is effective for any condition.[23] A Cochrane review found good evidence that spinal manipulation therapy was no more effective than inert interventions, sham SMT or as an adjunct therapy for acute low back pain.[24] The efficacy and cost-effectiveness of maintenance chiropractic care are unknown.[25] Although evidence published by practitioners suggests that spinal manipulation therapy is safe,[26] the actual prevalence of adverse events is unknown[27] as there is no systematic reporting;[28] it is frequently associated with mild to moderate adverse effects, with serious or fatal complications in rare cases.[27][29] ranks at the 12% level for readability.
Studies about chiropractic have conflicting results. One found spinal manipulation was not shown effective for any condition. A Cochrane review found it ineffective for low back pain. The cost-effectiveness of chiropractic is unknown. Evidence published by practitioners show the therapy is safe, although the number of adverse results is not known, and there are reports of mild to serious adverse effects.
gets us up to a rating of 36% (an improvement of 24%), while only sacrificing the added bit about deaths in rare cases. Collect ( talk) 20:40, 12 February 2014 (UTC)
Only 11% of Wikipedia articles are less readable, ensuring that no one can understand this article as it sits. [25]. I would award it the "barbstar of unreadability" but that page seems quite difficult to find ... Collect ( talk) 15:30, 12 February 2014 (UTC)
The safety information using the WHO source was previously deleted from the lede. [26]
This is another WP:MEDRS compliant source: "So, do the risks outweigh the benefits? The best evidence suggests that SMT, whether it be for neck or low back pain, is a safe and effective therapy. At a population level, the benefits still outweigh the risks." [27]
I don't see a serious dispute to the text. What is the point to adding " published by practitioners". Is there evidence that specifically says it is not safe. "Although" is unnecessary grammar and suggests there is a dispute when none is being presented. These are different sources that make different distinct points in the lede. The part "published by practitioners" is not what the source says anyhow. QuackGuru ( talk) 07:09, 13 February 2014 (UTC)
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Archive 30 | ← | Archive 34 | Archive 35 | Archive 36 | Archive 37 | Archive 38 | → | Archive 40 |
The verifiable fact that chiropractic is a profession has been removed in this edit by John Snow 2 and again here by Alexbrn. This proposed change is against policy for a number of reasons. First, there is no consensus to remove the description of chiropractic as a profession (the current, stable, consensus version states that chiropractic is a profession) and the editors have chosen not to bring it to the talk page despite my sourced and policy based objections. Second, no source at all has been provided that suggests that chiropractic is not a profession, it has been the editors opinion that the word profession is ‘debatable’, but Wikipedia doesn’t care if John Snow can debate this term, we need reliable sources that could suggest that chiropractic is not a profession. Third, there are multiple reliable sources that verify the fact that chiropractic is indeed a profession:
Puhlaa ( talk) 15:06, 28 April 2013 (UTC)
Puhlaa — your reply is irrelevant: read my response again. This is not a controversial edit, just a common sense improvement. Alexbrn talk| contribs| COI 19:36, 28 April 2013 (UTC)
Come off it. Describing Chiropractic primarily as a profession is undue. Let's see what really neutral sources have ... Britannica says: "A system of healing ..."; and Websters: "a system of therapy ...". Instead Wikipedia is now mirroring the definition of a chiropractic advocacy group, the World Federation of Chiropractic: "A health care profession concerned with the diagnosis, treatment and prevention ...". And this text is being reverted to (over 3RR now?) by an editor with a COI. Hmmmm. Alexbrn talk| contribs| COI 20:51, 28 April 2013 (UTC)
To repeat, whether it's a profession or not is not the issue AFAIAC. The issue is whether it's the first thing that is mentioned (as though this is it principal attribute). It's undue, and out of line with serious sources. Alexbrn talk| contribs| COI 07:37, 29 April 2013 (UTC)
A thought from a random passer-by:
Why not state both? E.g. Chiropractic is a health care profession and an approach to healing concerned with...
This way those who feel that naysayers are trying to slight chiropractic by not explicitly stating the obvious - that it is a health care profession - will be satisfied. And those who feel strongly that the reader will benefit from knowing that it is also an approach to healing will also be satisfied.
68.120.91.227 (
talk)
04:33, 30 April 2013 (UTC)
Zad
68
04:43, 30 April 2013 (UTC)
This edit does a better job a giving a historical perspective to data offered in the dated reference. However, it also introduces information about safety that seems like a non sequitur to the subtopic: International reception. Whereas, a discussion of chiropractic's usage in the United States makes sense under such heading, the material about the serious complications seems out of place and frankly, argumentative there. I'd recommend removing that bit and reserving it for a more relevant section. 68.120.91.227 ( talk) 03:36, 7 May 2013 (UTC)
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I have found a reference for the "manipulative lesion" which says is in need of a citation.
The manipulative lesion, also known as a spinal biomechanical lesion is deifined as "a pathological condition involving discontinuity (loss of cohesion) of tissue, and loss of normal vertebral joint function (kinesio-pathology) that often has injury as its cause"
Reference: http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=56115
Thanks DJFryzy ( talk) 08:58, 7 May 2013 (UTC) DJFryzy ( talk) 08:58, 7 May 2013 (UTC)
Thanks for your reply Puhlaa
Biomechanics of spinal manipulative therapy John J Triano, DC, PhD The Spine Journal Volume 1, Issue 2, March–April 2001, Pages 121–130http://www.sciencedirect.com/science/article/pii/S1529943001000079 http://dx.doi.org/10.1016/S1529-9430(01)00007-9,
"A 2009 review evaluating maintenance chiropractic care found that spinal manipulation is routinely associated with considerable harm and no compelling evidence exists to indicate that it adequately prevents symptoms or diseases, thus the risk-benefit is not evidently favorable.[183]" -does sometone have a copy of this journal article they could look over. where is he citing evidence from that "spinal manipulation is routinely associated with considerable harm"...? thanks. — Preceding unsigned comment added by 66.190.94.157 ( talk) 18:43, 6 June 2013 (UTC)
I would like to discuss proposed changes in relation to a section within the introduction as well as the safety section within this article.
Currently the introduction contains "and some evidence of severe adverse effects from cervical vertebral manipulation.[10] ". I feel this would be better represented within the "Safety" section. In addition to this, a more appropriate source is warranted to verify this.
Furthermore, the safety article is lacking the most up to date studies in regards to the more serious complications that have previously been reported in relation to spinal manipulative therapy (SMT) and vertebral artery dissection (VAD).
Below I have added areas which I would like to see looked at either adding to the current safety section, or changing dated and bias statments.
The most recent in-depth review, published in the Feb 15, 2008 Spine Journal [1] was completed by members of the Spine Decade Task Force. These researchers reviewed 10 years worth of hospital records, involving 100 million person-years. These clinical records revealed no increase in vertebral artery dissection risk with chiropractic, compared with medical management, and further stated that “increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection (already in progress) seeking care before their (eventual) stroke.”
It is now apparent that chiropractors prematurely accepted the notion that cervical adjusting/manipulation could be a “causative” event for VAD. That was a reasonable and professional response to case-studies and reports in the peer-reviewed medical literature, which was often based on a pattern of medical mis-reporting, as was later documented by Terrett. [2]
The recently published “Current Concepts: Spinal Manipulation and Cervical Arterial Incidents 2005” (NCMIC) [3] concludes in it's Executive Summary: “Unfortunately, opinion rather than fact has tended to dominate discussions regarding CVAs and chiropractic, even though there has been no definitive evidence that chiropractic adjustments (actually) cause strokes. This monograph notes that a causative relationship between chiropractic manipulation and stroke is unlikely. There is an associative relationship between the two because people may go to chiropractors for relief of stroke-related symptoms”.
DJFryzy ( talk) 04:32, 14 May 2013 (UTC) Thanks for your time and looking forward to editing with you.
I have just removed a split tag, again. If you think there should be a split then please explain why here so that it may be discussed. Op47 ( talk) 22:25, 16 May 2013 (UTC)
As far as i know, a medial diagnosis is generally given only by Doctors of Medicine and at more specific occasions, Psychologists. a Chiropractic, on the other hand, is not a medical adviser, nor a medical pathologist. he treats. not more. correct me if I'm wrong. Ben-Natan ( talk) 07:17, 17 May 2013 (UTC)
This article has just copy-pasted some paragraphs from the article Chiropractic history, on Harvey Lillard. It is completely taken out of context, it makes absolutely no sense as it stands, and it seems at first to be connected to the words before. I see no reason why it has been added.
If it is important, one should include the rest from the article Chiropractic history (or an edited version). As it stands now, the opening words (“However, this version was disputed by Lillard's daughter”) seems to be related to the closing words of the paragraph before (“One student, his son Bartlett Joshua (B.J.) Palmer, became committed to promoting chiropractic, took over the Palmer School in 1906, and rapidly expanded its enrollment”). We must either include the whole (or at least an edited) paragraph on Harvey Lillard, or just delete the two paragraphs (and mention/link to the part on Harvey Lillard from the the article Chiropractic history). Carissimi ( talk) 13:48, 21 July 2013 (UTC)
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However, this version was disputed by Lillard's daughter, Valdeenia Lillard Simons. She said that her father told her that he was telling jokes to a friend in the hall outside Palmer's office and Palmer, who had been reading, joined them. When Lillard reached the punch line, Palmer, laughing heartily, slapped Lillard on the back with the hand holding the heavy book he had been reading. A few days later, Lillard told Palmer that his hearing seemed better. Palmer then decided to explore manipulation as an expansion of his magnetic healing practice. Simons said "the compact was that if they can make [something of] it, then they both would share. But, it didn't happen." [4] In spite of the fact that Lillard could hear well enough to tell jokes, B.J. Palmer claimed under sworn testimony that Lillard had been "thoroughly deaf". [5] Since 1895, the story of Palmer's curing a man of deafness has been a part of chiropractic tradition. Palmer's account differs significantly from what actually happened, in that, according to Lillard's daughter, his improved hearing was likely caused by an accidentally fortuitous jarring of Lillard's body and not, as claimed by D.D. Palmer, caused by a "specific" adjustment. It was after this event that Palmer began to experiment with manipulation. He also claimed that his second patient, a man with heart disease, was also cured by spinal manipulation. |
Wanted to suggest a quick correction for a confirmed user to tackle - the 6th paragraph under the "Evidence" section reads "There is a wide range of ways to measure treatment outcomes.", which I believe should be "There are a wide range of ways to measure treatment outcomes.". Luke831 ( talk) 04:28, 23 July 2013 (UTC)
I just don't get it. This page has the feel that it was written in 1950's. Chiropractic has never before been as widely accepted as it is now. I know that is not saying much but this is just sad. Its a step backward and I feel that the "medical" people posting on this site are more truely unaware of chiropractic and only have E.Ernst's view of what we do. Is there much evidence for chiropractic? nope. But it does help plenty of people. and this site just steers others who could be helped away. This is a page about COMPLAMENTARY AND ALTERNATIVE MEDICINE and should be moderated as such not Medicines view of Chiropractic and its voodoo old farty unchanging ways and crazy ideas about subluxation and innate intelligence. All I as is that the lines pertaining to Objections to Chiropractic be put in a Controversy secetion. Because the way it reads now I would have no idea what chiropractic is other than a scary psuedo-science made up by some old guy who thought he knew how to heal people and only did it for money. Seriously thats the impression I get. How about adding a section on what some of the names of Chiropractic techniques are. There is Diversified, Logan Basic Technique, Webster, Applied Keniesiology, Graston, Cox flexion distraction, Gonstead, Activator, Upper cervical, Thompson. Ect. Please let me know what I need to do to make some of this happen. Thank you for your time and I apologize for the spelling grammar errors (Airport edit). — Preceding unsigned comment added by 108.206.8.214 ( talk) 06:40, 26 July 2013 (UTC)
As a long-time recipient of chiropractic care, I found this article to be very informative on the subject. However, for purely semantic reasons, I think the article puts chiropractic care in an excessively bad light by overemphasizing perspectives of 'straight' chiropractors, who are overwhelmingly in the minority if I'm not mistaken, and using unintentionally negative phrasing such as "chiropractic is only beneficial in dealing with back-pain." (Generally, non-chiropractors don't view it as accomplishing anything else, though I understand this belief's proliferation in the chiropractic community.) I may attempt to fix these issues soon, but I thought it'd be good to list these concerns here. -- 69.246.185.35 ( talk) 01:39, 24 August 2013 (UTC)
This deceptive phrasing implies that the controversy is over whether the spinal dysfunction causes all disease or only some of it, and conceals the actual controversy over whether chiropractic is a working therapy or merely total snake-oil quackery with dangerous disregard for objective reality.
It should be rephrased to something like "as a possible cause of disease". 192.249.47.181 ( talk) 16:46, 15 October 2013 (UTC)
I was reading this article and it the images seemed to be appear outdated and look shabby. First and foremost I would propose adding an image of a chiropractor working with a patient receiving a manipulation as this is probably what people associate most strongly with chiropractic. Secondly the caption below the picture of the outdated x-ray machine lacks citation about controversy. I would suggest that radiology usage is an issue within all health professions (not unique to chiropractors). Recent evidence in Australia would put most chiropractors referring for an average of 18.667 x-rays per year. http://www.australiandoctor.com.au/news/latest-news/chiropractors-defend-referral-rates/ Compared to Australian medical usage rates of 10% of patients being sent for radiological studies. http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442472723
Whilst I do agree chiropractic deserves its fair share (if not more) of criticism it does not need be littered throughout the article. I propose controversial/skeptic/pseudoscience arguments be neatly explored in the Controversy/Criticism section which is already present. Whether you the use of radiology is excessive or not (Australian data seems to paint a different picture) this is not related to scope of practice and in my opinion should be altered to a more neutral statement. May I suggest- "Many chiropractors are licensed to take their own X-rays although this practice is usually confined to the spine as per regulations". http://www.arpansa.gov.au/Publications/Codes/rps19.cfm
As I see many edits are often revised quickly and changing images is quite a big edit I decided to post here before making the edit.
To summarize I would like to:
1.) Add a picture of a chiropractor treating with a chiropractic patient with spinal manipulation 2.) Change picture of X-ray machine to something more modern looking and the quote below it to reflect that chiropractors are licensed and regulated by the same body as radiographers to take x-rays. (more neutral wording) 3.) Change pictures of chairs and tables to be more aesthetically pleasing/modern
Thanks for your consideration, I eagerly await feedback. — Preceding unsigned comment added by 19TC88 ( talk • contribs) 10:12, 20 May 2013 (UTC)
1.) Add a picture of a chiropractor treating with a chiropractic patient with spinal manipulation 2.) Change picture of X-ray machine to something more modern looking and the quote below it to reflect that chiropractors are licensed and regulated by the same body as radiographers to take x-rays. (more neutral wording) 3.) Change pictures of chairs and tables to be more aesthetically pleasing/modern DJFryzy ( talk) 12:01, 17 August 2013 (UTC)
That's great! Please add them to the article as you see fit. Roxy the dog will let us know if he misses the chairs too much. We can tweak the info boxes as needed. TippyGoomba ( talk) 04:44, 20 August 2013 (UTC)
Something to consider in this article - from The Age in Australia - and a blog post with a great deal of detail.
I'm not suggesting that this goes into the article yet, as I'm uncertain of "The Age" as an RS, but this appears to be totally despicable behaviour by chiroquacks, sneakily treating hospital patients behind the hospitals back. Not good. -- Roxy the dog ( quack quack) 13:17, 30 September 2013 (UTC)
Chiropractors primarily use a manual and conservative approach towards neuromusculoskeletal disorders. Interventions are typically multi-modal and can include:
The medicinal use of spinal manipulation can be traced back over 3000 years to ancient Chinese writings. Hippocrates, the "Father of Medicine" used manipulative techniques [6] as did the ancient Egyptians and many other cultures. A modern re-emphasis on manipulative therapy occurred in the late 19th century in North America with the emergence of the osteopathic medicine and chiropractic medicine. [7] Spinal manipulation gained mainstream recognition during the 1980s. [8] Spinal manipulation/adjustment describes techniques where the hands are used to manipulate, massage, mobilize, adjust, stimulate, apply traction to, or otherwise influence the spine and related tissues. [9] It is the most common and primary intervention used in chiropractic care; [10] In North America, chiropractors perform over 90% of all manipulative treatments [11] with the balance provided by osteopathic medicine, physical therapy and naturopathic medicine. Manipulation under anesthesia or MUA is a specialized manipulative procedure that typically occurs in hospitals administered under general anesthesia. [12] Typically, it is performed on patients who have failed to respond to other forms of treatment. [13] There has been considerable debate on the safety of spinal manipulation, in particular with the cervical spine. [14] Although serious injuries and fatal consequences can occur and may be under-reported, [15] these are generally considered to be rare when spinal manipulation is employed skillfully and appropriately. [16]
High-velocity low amplitude (HVLA) spinal manipulative therapy (SMT) is also known as adjustment, thrust manipulation, and Grade V mobilisation [17] It is distinct in biomechanics from non-thrust, low-velocity low amplitude (LVLA) manipulative techniques.
Manual and manipulative techniques can be categorized by different modes depending on therapeutic intent, indications, contraindications and safety. [18] Manual and mechanically-assisted articular manipulative procedures can include:
Manual non-articular manipulative procedures can include:
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Chiropractors primarily use a manual and conservative approach towards neuromusculoskeletal disorders. Interventions are typically multi-modal and can include:
Manual and manipulative therapy![]() The medicinal use of spinal manipulation can be traced back over 3000 years to ancient Chinese writings. Hippocrates, the "Father of Medicine" used manipulative techniques [6] as did the ancient Egyptians and many other cultures. A modern re-emphasis on manipulative therapy occurred in the late 19th century in North America with the emergence of the osteopathic medicine and chiropractic medicine. [7] Spinal manipulation gained mainstream recognition during the 1980s. [19] Spinal manipulation/adjustment describes techniques where the hands are used to manipulate, massage, mobilize, adjust, stimulate, apply traction to, or otherwise influence the spine and related tissues. [9] It is the most common and primary intervention used in chiropractic care; [10] In North America, chiropractors perform over 90% of all manipulative treatments [20] with the balance provided by osteopathic medicine, physical therapy and naturopathic medicine. Manipulation under anesthesia or MUA is a specialized manipulative procedure that typically occurs in hospitals administered under general anesthesia. [21] Typically, it is performed on patients who have failed to respond to other forms of treatment. [22] There has been considerable debate on the safety of spinal manipulation, in particular with the cervical spine. [14] Although serious injuries and fatal consequences can occur and may be under-reported, [15] these are generally considered to be rare when spinal manipulation is employed skillfully and appropriately. [16] DefinitionsHigh-velocity low amplitude (HVLA) spinal manipulative therapy (SMT) is also known as adjustment, thrust manipulation, and Grade V mobilisation [23] It is distinct in biomechanics from non-thrust, low-velocity low amplitude (LVLA) manipulative techniques. CategoriesManual and manipulative techniques can be categorized by different modes depending on therapeutic intent, indications, contraindications and safety. [18] Manual and mechanically-assisted articular manipulative procedures can include:
Manual non-articular manipulative procedures can include:
Neuromusculoskeletal and somatovisceral disordersManual and manipulative therapies is a common intervention used primarily by manual medicine practitioners for the treatment of neuromusculoskeletal disorders. Spinal manipulation is widely seen as a reasonable treatment option for biomechanical disorders of the spine, such as neck pain and low back pain. However the use of spinal manipulation to treat non-musculoskeletal complaints remains controversial. [24] Research status
SafetyThe safe application of spinal manipulation requires a thorough medical history, assessment, diagnosis and plan of management. Manual medicine practitioners, including chiropractors, must rule out contraindications to HVLA spinal manipulative techniques. Absolute contraindications refers to diagnoses and conditions that put the patient at risk to developing adverse events. For example, a diagnosis of rheumatoid arthritis and other conditions that structurally destabilizes joints, is an absolute contraindication of SMT to the upper cervical spine. Relative contraindications, such as osteoporosis are conditions where increased risk is acceptable in some situations and where mobilization and soft-tissue techniques would be treatments of choice. [16] Most contraindications apply only to the manipulation of the affected region. [41] Adverse events in spinal manipulation studies appear to be under-reported [73] and appear to be more common following HVLA manipulation than mobilization. [74] Mild, frequent and temporary adverse events occur in SMT which include temporary increase in pain, tenderness and stiffness. [14] These events typically dissipates within 24–48 hours [75] Serious injuries and fatal consequences can occur, and are believed to result from upper cervical rotatory manipulation. [76] but are regarded as rare when spinal manipulation is employed skillfully and appropriately. [41] There is considerable debate regarding the relationship of spinal manipulation to the upper cervical spine and stroke. Stroke is statistically associated with both general practitioner and chiropractic services in persons under 45 years of age suggesting that these associations are likely explained by preexisting conditions. [77] [78] [79] Weak to moderately strong evidence supports causation (as opposed to statistical association) between cervical manipulative therapy and vertebrobasilar artery stroke. [80] A 2012 systematic review determined that there is insufficient evidence to support any association between cervical manipulation and stroke. [81] Cost-effectivenessSpinal manipulation is generally regarded as cost-effective treatment of musculoskeletal conditions when used alone or in combination with other treatment approaches. [82] Evidence supports the cost-effectiveness of using spinal manipulation for the treatment of sub-acute or chronic low back pain whereas the results for acute low back pain were inconsistent. [83] References
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I propose this change. QuackGuru ( talk) 01:16, 22 November 2013 (UTC)
The lead need to be updated with the relevant information. It is indeed a secondary source. QuackGuru ( talk) 01:44, 22 November 2013 (UTC)
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64.122.219.100 ( talk) 17:57, 23 November 2013 (UTC) The information on here is not only biased but is outdated and needs updating. For your knowledge, yes there are HUNDREDS if not thousands of medical research on chiropractic. So to say, there is no research supporting chiropractic is not true. People use wikipedia all the time so the information on here needs to be correct. please change:
"Collectively, spinal manipulation failed to show it is effective for any condition.[14] The scientific consensus is that chiropractic may be on a par with other manual therapies for some musculoskeletal conditions such as lower back pain, but that there is no credible evidence or mechanism for effects on other conditions, and some evidence of severe adverse effects from cervical vertebral manipulation.["
to:
There is research supporting spinal manipulation and it has been shown to be effective for most conditions ( http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3563165/) also, ( http://www.ncbi.nlm.nih.gov/m/pubmed/24262386/?i=1&from=Is%20chiropractic; "Evidence-Based Guidelines for the Chiropractic Treatment of Adults With Neck Pain." AuthorsBryans R, et al. Show all Journal J Manipulative Physiol Ther. 2013 Nov 19. pii: S0161-4754(13)00237-6. doi: 10.1016/j.jmpt.2013.08.010. [Epub ahead of print] Affiliation Guidelines Development Committee (GDC) Chairman; Chiropractor, Clarenville, Newfoundland, Canada."
The scientific consensus is that chiropractic may be on a par with other manual therapies for some musculoskeletal conditions such as lower back pain, and there is credible evidence for effects on other conditions (ex. treating hypertension with chiropractic has been shown to be successful)
"Spinal manipulation for the treatment of hypertension: a systematic qualitative literature review."
AuthorsMangum K, et al. Show all Journal J Manipulative Physiol Ther. 2012 Mar-Apr;35(3):235-43. doi: 10.1016/j.jmpt.2012.01.005. Epub 2012 Feb 17.
Affiliation Private Practice, Riverside, CA, USA.
And please change this line: "...and some evidence of severe adverse effects from cervical vertebral manipulation."
to: No research has been found to be specifically correlated with severe adverse effects. The research claiming this failed to state the preexisting conditions of the patient.
or just leave that sentence out because you cannot claim something that isn't completely true. Oh and it only happened a few times in history and it's not relevant to the profession at hand.
The evidence on chiropractic's is mixed. Doc James ( talk · contribs · email) (if I write on your page reply on mine) 22:23, 23 November 2013 (UTC)
I would expect changes be made to the description of chiropractic. The main authors are people who believe the chiropractic profession are quacks. If they researched medical studies done on chiropractic instead of finding articles that they believe should be displayed. Actually more people are realizing that chiropractic does wonders. Read the medical studies and get up to date on chiropractic instead of picking and choosing what articles fit your description of chiropractic. Ya there is controversy but how many great medical studies are successful on chiropractic? How many are against it? Successful out weigh the non successful. The research your claiming about serious adverse affects like stroke from chiropractic was already a pre existing condition and I would expect you mention that. This whole description of the profession is a joke. The evidence IS out there that the benefits FAR out weigh the adverse effects. I've personally seen hundreds of people be healed from their neuromusculoskeletal disorders by utilizing chiropractic. chronic pain gone just from seeing a chiropractor. Clinical case studies are far better than any other study done because it's with the patients not overseeing and speculating from a review. Hear it from the people. — Preceding unsigned comment added by ChiroQ ( talk • contribs) 22:48, 26 November 2013 (UTC)
There may be some aspects of chiropractic which are considered pseudoscientific . . . but as a whole the majority of the profession . . . yes it is a profession . . . is evidence-based and scientific. TheDoctorIsIn ( talk) 21:18, 21 January 2014 (UTC)
Per WP:FRINGE/PS, Chiropractic is not generally considered a pseudoscience and therefore should not be categorized as such. TheDoctorIsIn ( talk) 22:20, 21 January 2014 (UTC)
Hmmm. Not sure about that; that it's a profession is unrelated to its scientific soundness (there are, after all, professional homeopathy practitioners). And insofar as it deals with science, its theories are pseudoscientific are they not? Before such a major change as this it would be wise to get a wider view, perhaps at WP:FT/N. Alexbrn talk| contribs| COI 06:06, 22 January 2014 (UTC)
The only arguments being made here to keep the incorrect categorization are mostly based on personal opinion . . . "I feel that chiropractic is pseudoscience therefore is should be categorized as such" . . . if you are saying that the majority of the reliable scientific sources are calling chiropractic a pseudoscience, then please show us those sources . . . this article shows that there is a lot of fair to high quality research out there with conflicting conclusions about the effectiveness of chiropractic for this or that ailment . . . Vertebral subluxation and innate intelligence are very much pseudoscientific and those articles should be categorized as such . . . nobody is arguing otherwise . . . however, modern chiropractic is making all attempts to leave those concepts in the past . . . condemning all of chiropractic as pseudoscience for these historical theoretical concepts would be to some degree similar to calling medical science a pseudoscience based on the practices of bloodletting and leeching. TheDoctorIsIn ( talk) 05:49, 23 January 2014 (UTC)
Verging into WP:NOTAFORUM.
What specific improvements to the article are being suggested? If none are, then this topic should be closed. -- Harizotoh9 ( talk) 07:16, 23 January 2014 (UTC)
I think there's a decent case for keeping the category, if there's reliable sourcing that indicates that some fundamental aspects of the topic are generally considered pseudoscience. I haven't reviewed the sourcing well enough to know for sure, but I do see a few sources supporting it in the article. I don't think it's a requirement for inclusion in a category that the article topic falls 100% within it. For example, there are plenty of biographies for people involved in more than one discipline that have multiple categories, like Michelangelo is in categories for both painters and sculptors.
I think the case for keeping chiropractic in the template is weaker, because it's more selective. Does the authoritative reliable sourcing consider chiropractic to be a foremost example of pseudoscience? I am genuinely unsure.
Zad
68
03:00, 24 January 2014 (UTC)
Hi all, I've got some problems with the sections I've posted below (from the SAFETY section):
"Chiropractic care in general is safe when employed skillfully and appropriately. Manipulation is regarded as relatively safe, but as with all therapeutic interventions, complications can arise, and it has known adverse effects, risks and contraindications. Absolute contraindications to spinal manipulative therapy are conditions that should not be manipulated; these contraindications include rheumatoid arthritis and conditions known to result in unstable joints.[2]
Sustained chiropractic care is promoted as a preventative tool, but unnecessary manipulation could present a risk to patients. Some chiropractors are concerned by the routine unjustified claims chiropractors have made.[9]"
First I'm not sure chiropractic care is seen as generally safe anymore ( eg.). What is the general consensus to changing this statement to be a little less sure of itself?
Secondly what is meant by "when employed skillfully and appropriately"? This seems, to me, like a way of saying "When chiropractic care is administered safely it is safe" a subtly worded case of begging the question.
Thirdly the second sentence contradicts the first - if Chiropractic treatment is safe why would anyone be concerned with ongoing treatment?
Fourthly the reference in this sentence (from Edzard Ernst) implies that it is Chiropractors that are concerned by their own claims - the article written by Ernst doesn't mention that it is Chiropractors who are concerned specifically with the claims, and is highly critical of the efficacy of the whole field.
I'd also like to get rid of the weasel words throughout; perhaps this is a start:
Due to a lack of rigorous research and systematic under-reporting of negative affects it is difficult to gauge the safety of Chiropractic therapy 1. Most chiropractic practitioners report high levels of safety with their therapies (another ref) As with all therapeutic interventions, complications can arise, and it has known adverse effects, risks and contraindications.
I feel this is more in line with research, and also with the rest of the section which goes into detail about some of the risks associated with Chiropractic therapy. 203.38.24.65 ( talk) 05:30, 28 January 2014 (UTC)
Well, the BBC source is not strong enough for biomedical information (see WP:MEDRS). Something from PMID 23069244 (say) would be better:
Much is known about common adverse events following SMT. These events have been described in prospective, multicenter studies. In general, adverse events are mild to moderate in intensity, have little to no influence on activities of daily living ... Serious (or life-threatening) adverse events following SMT are, on the other hand, extremely rare. Because they are rare, less is known about them ...
(Add) But the systematic review behind the BBC report is definitely worth mentioning. We have enough here for something of a re-write. Alexbrn talk| contribs| COI 08:18, 28 January 2014 (UTC)
In that regard, to our knowledge, only 4 case-control studies22, 23, 24, 25 have been identified that have examined this issue, 3 of which demonstrated a strong association.22, 24, 25 However, these studies did not exclude the possibility that the observed association was related to protopathic bias (ie, a form of bias that occurs when there is a lag in time from the appearance of the initial symptoms and start of treatment yet before the actual diagnosis).
My feeling is that the similarity across articles is that the research is poor and this should be noted in the article, but I'm not sure if this is original research or contravenes whatever other WP policies I'm ignorant of. 203.38.24.65 ( talk) 08:27, 28 January 2014 (UTC)
Previous lead sentence. Chiropractic is a form of alternative medicine[1] that emphasizes diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially the spine, under the hypothesis that these disorders affect general health via the nervous system.[2] It is generally categorized as complementary and alternative medicine (CAM),[1] a characterization that many chiropractors reject.[3]
https://en.wikipedia.org/?title=Chiropractic&oldid=442127826
Check the edit history. The lead is currently a mess and the body of the article was severely hacked.
All over the article text is missing. For example, this was in the history section: Serious research to test chiropractic theories did not begin until the 1970s, and is continuing to be hampered by what are characterized as antiscientific and pseudoscientific ideas that sustained the profession in its long battle with organized medicine. QuackGuru ( talk) 19:34, 23 January 2014 (UTC)
QG, I have tried my best to adress each of your points:
1) You said "The current lede does not summarise the body at all. Would you like me to summarise the body in the WP:LEAD?"
2) You said: "Chiropractic is a "form" of alternative medicine. We can't assert it as alternative medicine or CAM in the lede when it is "generally" considered CAM. These differences are noteworthy. "
3) You said: "Chiropractic is an alternative medicine[1]" is WP:OR. The source does not assert it as alternative medicine."
4) You pointed to WP:ASSERT and said: “When chiropractic is viewed as a marginal healthcare profession[40], we can't assert it in the lede sentence that chiropractic is a healthcare profession."
Current lede sentence: Chiropractic is a health care profession in the field of complementary and alternative medicine whose practitioners emphasize manual manipulation of the spine, sometimes with the unevidenced claim this can treat a wide variety of human ailments.[1]
Proposal to replace lede sentence. '''Chiropractic''' is a form of [[alternative medicine]]<ref name=Chapman-Smith/> that emphasizes diagnosis, treatment and prevention of mechanical disorders of the [[musculoskeletal system]], especially the [[vertebral column|spine]], under the hypothesis that these disorders affect general health via the [[nervous system]].<ref name=Nelson/> It is a marginal [[complementary and alternative medicine]] [[health care profession]].<ref name="V-H"/> QuackGuru ( talk) 05:34, 29 January 2014 (UTC)
There are a lot of proposals and discussion now in this one thread, perhaps some new threads with clear proposals could be started? I am replying here to QG comment at 18:43 on Jan 28. Puhlaa ( talk) 06:44, 29 January 2014 (UTC) QG, I have already explained to you that I do not think our lede sentence has any synthesis! Our lede says: “’’ Chiropractic is an alternative medicine health care profession’’” We have RS source that says”’’ Chiropractic is the best established of the alternative health care professions’’”. You claim that the WHO source does not support that chiropractic is an alternative healthcare profession, but the WHO starts it’s chiropractic guidelines with a foreword all about traditional/alternative/complementary medicine. Remember I pointed you to this consensus-building discussion that generated the current lede sentence; you will see that editors pointed-out this fact then as well.
You want to add the term 'marginal' to the first sentence of the lede along with the alternative medicine description. I have already shown you that Yvonne_VRussell explains in her source what she means by 'marginal' – alternative medicine professions are 'marginal' to mainstream medicine, just as they are also 'alternative' to mainstream medicine. There is no need to describe chiropractic as 'marginal' AND 'alternative' in the lede sentence, as you propose, when they are referring to the same characteristic – their position relative to mainstream medicine.
With regard to you newest concern; I dont think we are violating any copyright policy by using a half-sentence from the WHO guidelines source. However, if you feel strongly that this is a big problem, perhaps you could show good intent and start a thread for a clear proposal for how to address your copyright concerns without also trying to change all the other components of the lede sentence where there are no problems and where we have good consensus. For example, there is no reason, based on WP:copyright to remove the WHO source, or to remove the general description of chiropractic the WHO gives us; but perhaps we can re-word the general description so that you are confident we are not copying the WHO too closely. Puhlaa ( talk) 06:44, 29 January 2014 (UTC)
Alexbrn, I would like to discuss this series of recent edits you made. Improvements to the article, in my opinion, were the addition of the sceptical source to the ‘further reading’ section, done with these 2 edits and the addition of criticism to the ‘Conceptual basis’ section done with this edit. I did not modify these edits in any way. I did find some edits controversial and I have reverted them, per WP:BRD. I have tried to clearly explain what I reverted and why. Puhlaa ( talk) 06:55, 29 January 2014 (UTC)
These edits removed text from the body of the “Scope of Practice” section and replaced it with text using a different source. I have reverted these edits because there is no consensus to remove the WHO and Nelson sources from this section at this time, nor the text that was associated with the sources. However, I believe that there is merit to the additions. I suggest we add the ad your new text back into the article without removing the existing text.
My suggestion: “Chiropractors emphasize the conservative management of the neuromusculoskeletal system without the use of medicines or surgery, [14] with special emphasis on the spine.[ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1185558/] They generally emphasize spinal manipulation but sometimes offer other treatments, such as advice on diet and lifestyle, provide exercises, or perform acupuncture. [15]" Puhlaa ( talk) 06:55, 29 January 2014 (UTC)
These edits removed the WHO guidelines and the general description/definition of chiropractic from the lede and replaced it with text about unsupported claims of efficacy and a source from The National Health Service – chiropractic. My concerns:
Reply:
I have reverted 2 edits that are attempting to remove the verified fact that chiropractic is a profession; first here, then here. The first time I reverted I referred to previous consensus in the edit summary of my revert; now this second time I will point editors directly to the previous consensus so that we can hopefully avoid an edit war. You will note that the recent discussion Recent_controversial_edits_-_profession_vs._approach resulted in a clear consensus for the current version; there has been no discussion to change the consensus version. Puhlaa ( talk) 16:03, 20 January 2014 (UTC)
Well I guess the key here is, John, it doesn't matter what you, or I, do or do not have a problem with; wikipedia follows reliable, mainstream sources, not my opinion or yours. Reliable sources say that chiropractic is a profession; do you have any sources to present that suggest chiropractic is not a profession? The most recent consensus, which I have already pointed to repeatedly here, was to include the ideas that it is a profession and an 'approach'. The onus is on you, John, who wants to change the lede away from the consensus version to provide sources and seek consensus. Here is what supports the term profession in the lede:
Puhlaa ( talk) 20:35, 20 January 2014 (UTC)
We've maybe got off the piste here. The point was never to get into one of those endless tennis matches about sources - it was about making the lede clear enough to be readable and informative. I'm not an anti-chiro campaigner and I do not question the relevance of material about how chiros are trained, licensed and employed, so I do not have a vested-interest POV to push here. But squeezing every possible point into the intro does not look like a sensible approach and my feeling is that the consensus has in fact evolved. Thanks. John Snow II ( talk) 12:10, 21 January 2014 (UTC)
I can certainly agree "The archives are pretty clear, sources appear to win out" but it's not necessary to get into our personal feelings regarding the subject and I'm hoping we don't use the article Talk page for any more of that. Let's just look at what the sources say and reflect those accurately in the article. The article itself devotes a non-trivial amount of space to discussing it as a profession, and nine months ago in
this discussion, authoritative reliable sources were brought that discuss chiropractic as a profession. Both those sympathetic to and skeptical of chiropractic came to a compromise agreement to mention both in the lead and that part of the article has been stable since. I don't see any significant change in the circumstances since that time.
Zad
68
18:34, 21 January 2014 (UTC)
Zad
68
18:56, 21 January 2014 (UTC)There appears to be some interest in removing the word "profession" from the opening sentence of the lead. I think the word "profession" is supported by the sourcing and the article, but understand the existing sentence is a bit of a mouthful. Can new wording be proposed that addresses the issues raised above, so we can come to consensus on what to include and how to word it?
Zad
68
21:45, 21 January 2014 (UTC)
Proposal: Chiropractic is a complementary and alternative medicine[1] "health care approach" to healing concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health.[2] QuackGuru ( talk) 02:48, 22 January 2014 (UTC)
I do not object to the term "profession" in the lede. According to our own Wikipedia page on the term:
A profession is a vocation founded upon specialized educational training, the purpose of which is to supply objective counsel and service to others, for a direct and definite compensation, wholly apart from expectation of other business gain.
It does not imply scientific validity. It is often confused by the public as meaning that, but we should not let the public misunderstandings of terms dictate how we use words on WP. So, I am okay with the term, as long as the article discusses in depth some of the disproven or controversial aspects of Chiropractic. -- Harizotoh9 ( talk) 07:29, 23 January 2014 (UTC)
Zad
68
02:34, 24 January 2014 (UTC)Alexbrn, you just reverted the addition of a secondary source that I had added to the article body. Your edit summary claim 2 concerns:
I fail to understand your concerns Alexbrn, can you clarify these concerns for me? Puhlaa ( talk) 19:54, 29 January 2014 (UTC)
Puhlaa, will you please step away from this for a while. No-one doubts your good intentions but repeatedly pushing your chosen occupation into the lede is not appropriate, and correcting for this is inevitably taking up other people's time unnecessarily now. With respect, an argument about whether a source is primary or secondary isn't moving us on here. John Snow II ( talk) 23:17, 29 January 2014 (UTC)
I am not pleased with the shift from reasoned discussion at this article over the past many months to the petty edit warring of late. Consider this a heads up. My next step is to fully protect the page for a week if necessary, to encourage that happening (or get another admin to do so as I used to edit this article). After that, if individual editors can't resist the urge to make and repeat making changes without consensus, there may be blocks (or bans) as needed. The key here is to have reasoned discussion, and you know what that looks like. If you're getting frustrated or making knee-jerk reverts, you are probably not in a good position to be reasonable so step back and ask for help from others. If you are trying to shape the page so that it looks the way it looked before months of discussion helped it evolve, you are probably not being reasonable. For formality's sake, this page is already under ArbCom Discretionary Sanctions, which means sanctions can be more swift or broad than usual. I'm not threatening action or any one person... just shift the path towards reasoned discussion with reasonable editors and take the extra time to do it right. Cheers, Ocaasi t | c 02:16, 24 January 2014 (UTC)
@Ocaasi: I am very familiar with the subject. There are actually numerous sects within chiropractic (e.g. McTimoney in the UK), but they broadly separate, like Catholic and Protestant, into Straight and Mixer. Straights are out-and-out quacks, holding to an entirely discredited model of physiology. Mixers occupy a spectrum. At oen end are the quacks, who promote anti-vaccinaiton nosnense, concern themselves primarily with "practice building" and aggressively sell "maintenance adjustments", especially to children. At the other end are those who practise based on evidence, with Sam Homola being the best known example to skeptics. The problem is that most chiros incorporate at least some pseudoscientific practices, virtually all will treat children, which is completely unsupportable, most will claim to treat colic and other diseases entirely unrelated to the musculoskeletal system, and virtually all depend for their livelihood on conducting unnecessary and occasionally dangerous (e.g. manipulation of the neck, wholespine x-rays) procedures and treatments. Puhlaa in particular wants to document an idealised form of chiro that does not do these things, but the evidence shows that the majority of chiros do it all the time.
Skeptics are perfectly content to include the valid indications for chiro: treatment of pain in the musculoskeletal system, where serious underlying disease has been ruled out. Skeptics also want inclusion of the documented adverse events, the lack of any systematic recording of adverse events by chiros, the side-order of pseudoscientific practices and so on. A warts-and-all portrait, in other words. WP:FRINGE entirely supports that. In fact, it mandates it. Guy ( Help!) 15:09, 30 January 2014 (UTC)
Manual therapies commonly used by chiropractors are as effective as other manual therapies for the treatment of low back pain,[122][123] and might also be effective for the treatment of lumbar disc herniation with radiculopathy,[124][125] neck pain,[126] some forms of headache,[127][128] and some extremity joint conditions.[129][130] While guidelines issued by the WHO state that chiropractic care may be considered safe when employed skillfully and appropriately,[2] chiropractic spinal manipulation is frequently associated with mild to moderate adverse effects, and with serious or fatal complications in rare cases.[131][132][133]
There is a POVPUSH in the introduction of effectiveness. QuackGuru ( talk) 19:53, 30 January 2014 (UTC)
What happened to the Utilization, satisfaction rates, and third party coverage section? A lot text was deleted when the section was split into two separate sections. QuackGuru ( talk) 20:30, 30 January 2014 (UTC)
Most people who seek chiropractic care do so for low back pain.[6] QuackGuru ( talk) 18:41, 30 January 2014 (UTC)
Chiropractic theory on spinal joint dysfunction and its putative role in non-musculoskeletal disease has been a source of controversy since its inception in 1895. The controversy is due in part to chiropractic's vitalistic and metaphysical origins, and use of terminology that is not always amenable to scientific investigation.[7] Far-reaching claims and lack of scientific evidence supporting spinal dysfunction/subluxation as the sole cause of disease[8][9] has led to a critical evaluation of a central tenet of chiropractic and the appropriateness of the profession's role in treating a broad spectrum of disorders that are unrelated to the neuromusculoskeletal system.[10] Although there is external and internal debate within the chiropractic profession regarding the clinical significance of joint dysfunction/vertebral subluxation complex,[11] the manipulable lesion/functional spinal lesion[12] remains inextricably linked to the profession as the basis for spinal manipulation.[13]
There is definitely a POVPUSH in the lede. This is poorly written text. It can be improved. QuackGuru ( talk) 07:01, 30 January 2014 (UTC)
For most of its existence, chiropractic has been sustained by pseudoscientific ideas such as subluxation and innate intelligence[16] which are not based on solid science.[9] Some chiropractors have been criticized for having an anti-immunization stance, despite the consensus of public health professionals on the benefits of vaccination,[17] which has led to negative impacts on both public vaccination and mainstream acceptance of chiropractic.[18] The American Medical Association called chiropractic an "unscientific cult"[19] and boycotted it until losing an antitrust case in 1987.[20] Chiropractic is said to have developed a strong political base and to have sustained demand for services; researchers Cooper and McKee report that it has gained more legitimacy and greater acceptance among physicians and health plans in the U.S. for the treatment of some musculoskeletal conditions[20] and the principles of evidence-based medicine have been used to review research studies and generate practice guidelines.[21] Traditional (or straight) chiropractic still assumes that a vertebral subluxation interferes with the body's "innate intelligence",[22] a vitalistic notion ridiculed by the scientific and healthcare communities.[23] Other chiropractors want to separate themselves from the traditional vitalistic concept of innate intelligence[24] – John W Reggars wrote in 2011 that chiropractic was at a crossroads, and that in order to progress it would need to embrace science; in his view, the promotion of chiropractic as a cure-all was both "misguided and irrational".[25]
See Chiropractic#Conceptual basis.
None of this text belongs in the Conceptual basis/Philosophy section. The first section is about philosophy. The above text is misplaced and not relevant to the section. Most of this text was originally in the lede. See paragraph three in the well written lede. Why was the lede summary moved to Conceptual basis? QuackGuru ( talk) 07:01, 30 January 2014 (UTC)
Information that was not about conceptual basis was restored to the section. Also the lede should summarise the body. The text that summarize the body should never have been moved to another section.
https://en.wikipedia.org/?title=Chiropractic&diff=prev&oldid=529303776 A section was spun off from the lede into a "background" section.
https://en.wikipedia.org/?title=Chiropractic&diff=prev&oldid=529645465 A section was spun off from the lede into a "background" section.
https://en.wikipedia.org/?title=Chiropractic&diff=next&oldid=530067980 A section was spun off from the lede into a "background" section.
https://en.wikipedia.org/?title=Chiropractic&diff=next&oldid=530492360 A section was spun off from the lede into a "background" section.
These changes did not improve the article. Moving the text to a background section that is a summary of the body is not appropriate. QuackGuru ( talk) 23:26, 1 February 2014 (UTC)
Chiropractors practice in over 100 countries in all regions of the world, but they are most prevalent in North America, Australia and parts of Europe.[2][5]
There is a POVPUSH in the lead. Chiropractors practice in over 100 countries in all regions of the world?
For the lede: Chiropractic is established in the U.S., Canada, and Australia.
For the body: Chiropractic is established in the U.S., Canada, and Australia, and is present to a lesser extent in many other countries.
The text in the lede must be improved. QuackGuru ( talk) 03:50, 31 January 2014 (UTC)
There is too much information on Palmer and Palmer's son. See Chiropractic#History. Similar sentences is duplication:
Palmer, a magnetic healer, hypothesized that manual manipulation of the spine could cure disease.
According to D.D. Palmer, subluxation was the sole cause of disease and manipulation was the cure for all diseases. See Chiropractic#History. QuackGuru ( talk) 18:49, 31 January 2014 (UTC)
"Chiropractic has had a strong salesmanship element since it was started by D.D. Palmer. His son, B.J. Palmer, asserted that their chiropractic school was founded on "…a business, not a professional basis. We manufacture chiropractors. We teach them the idea and then we show them how to sell it".[120] D.D. Palmer established a magnetic healing facility in Davenport, Iowa, styling himself ‘doctor’. Not everyone was convinced, as a local paper in 1894 wrote about him: "A crank on magnetism has a crazy notion hat he can cure the sick and crippled with his magnetic hands. His victims are the weak-minded, ignorant and superstitious, those foolish people who have been sick for years and have become tired of the regular physician and want health by the short-cut method…he has certainly profited by the ignorance of his victims…His increase in business shows what can be done in Davenport, even by a quack."[120] D.D. Palmer remarked that "Give me a simple mind that thinks along single tracts, give me 30 days to instruct him, and that individual can go forth on the highways and byways and get more sick people well than the best, most complete, all around, unlimited medical education of any medical man who ever lived."[9]"
I deleted this text above because it is not a good summary. A long run on quote is not a well written summary. I improved the section that accurately explained about the history of chiropractic. See here. QuackGuru ( talk) 02:54, 2 February 2014 (UTC)
No single profession "owns" spinal manipulation and there is little consensus as to which profession should administer SM, raising concerns by chiropractors that other medical physicians could "steal" SM procedures from chiropractors.
Deleting this text does not improve the article. This is very relevant text. QuackGuru ( talk) 05:03, 30 January 2014 (UTC)
The part, as these are the only areas where evidence supports its use. is not about the scope of practice section and no rationale for deleting No single profession "owns" spinal manipulation and there is little consensus as to which profession should administer SM, raising concerns by chiropractors that other medical physicians could "steal" SM procedures from chiropractors. has been given. QuackGuru ( talk) 03:01, 2 February 2014 (UTC)
See Chiropractic#Straights and mixers. "Despite this finding, a 2008 survey of 6000 American chiropractors demonstrated that most chiropractors seem to believe that a subluxation-based clinical approach may be of limited utility for addressing visceral disorders, and greatly favored non-subluxation-based clinical approaches for such conditions.[11][not in citation given][33]"
"The data reported in Figure 1 suggest a more complex picture regarding how chiropractors specifically apply the concept of subluxation in actual clinical practice. Most chiropractors typically reported that over 75% of their clinical approach to addressing musculoskeletal or biomechanical disorders such as back pain was “subluxation-based”.' Conversely, most chiropractors also reported that less than 20% of their clinical approach was “subluxation-based” for patient complaints deemed to be principally problems with circulation, digestion, or similarly “visceral” in nature." page 3
The text follows the source accurately but did not include the part "Most chiropractors typically reported that over 75% of their clinical approach to addressing musculoskeletal or biomechanical disorders such as back pain was “subluxation-based”". Reference 11 is misplaced. QuackGuru ( talk) 06:05, 30 January 2014 (UTC)
I fixed the lopsided view but it was reverted. QuackGuru ( talk) 23:34, 1 February 2014 (UTC)
There have been a very substantial number of edits by QuackGuru, plus additional advocacy by others, I have seen OTRS requests relating to the "imbalance" of the chiropractic article; months of stability have been replaced by a rapid push towards a more flattering portrayal of chiro, and (purely by coincidence) my sinister agents tell me that chiros are once again angling for money under Obamacare and for primary care provider status. Very singular... Guy ( Help!) 21:11, 1 February 2014 (UTC)
"When employed skilfully and appropriately, chiropractic care is safe and effective for the prevention and management of a number of health problems. There are, however, known risks and contraindications to manual and other treatment protocols used in chiropractic practice."Now unless you can find an equally strong MEDRS-compliant source that contradicts that (hint: Ernst will have done so), it needs to be in the article - and it's so much a central point that it needs to be in the lead. If you can't come up with a source and a wording that describes a disagreement between MEDRS sources, I'm going to have to insist that QG's wording goes back in.
WP:FRINGE also applies, and guides us to use independent sources. The WHO guidelines go on to say the guidelines were finalized by their panel (of chiropractors and CAM advocates), which suggests this is not such an independent text. However, even in purely MEDRS terms this is rather an old document; we should do better.
In 2008 Ernst wrote about chiropractic safety in the review, PMID 18280103. First (of relevance to the above) he notes statements such as "chiropractic is safe" "can be found abundantly" in "chiropractic literature". Based on poor available evidence he then goes on to say that "it seems highly doubtful whether reliable incidence figures can presently be calculated". Alexbrn talk| contribs| COI 07:26, 2 February 2014 (UTC)
As the Ernst abstract has it, "Manipulation is associated with frequent mild adverse effects and with serious complications of unknown incidence". That is different from the bromide offered by the "WHO" document. As to synchronizing the lede and body, I see that as a housekeeping exercise that can be done once we know what the neutral point of view is which WP should be taking. Alexbrn talk| contribs| COI 08:20, 2 February 2014 (UTC)
"When employed skilfully and appropriately, chiropractic care is safe and effective for the prevention and management of a number of health problems."Effective for the prevention of a number of health problems? really? Are we really saying this is fine? Alexbrn talk| contribs| COI 17:43, 2 February 2014 (UTC)
"Spinal manipulation is regarded as relatively safe, but as with all therapeutic interventions, complications can arise, and it has known adverse effects, risks and contraindications.<ref name=WHO-guidelines/> Spinal manipulation is frequently associated with mild to moderate adverse effects, with serious or fatal complications in rare cases.<ref name=Ernst-adverse/><ref name=CCA-CFCREAB-CPG/>"which looked like a good summary to me of both the WHO general view and Ernst's investigations of particular, but thankfully rare, serious adverse effects. Whereas Guy prefers
"there is ... some evidence of severe adverse effects from cervical vertebral manipulation.<ref name=Trick-or-Treatment>{{cite book |pages=145–90 |chapter=The truth about chiropractic therapy |title=[[Trick or Treatment: The Undeniable Facts about Alternative Medicine]] |author=Singh S, Ernst E |year=2008 |publisher=W.W. Norton |isbn=978-0-393-06661-6 }}</ref>"to be the sole comment about chiropractic safety in the lead. I think that we could (and should) have more to say about safety than that. Please understand, I'm only talking about what the lead says about safety - not effectiveness, nor risk/benefit that always get confused here. So, the question should be "does including a summary in the lead of what the WHO has to say about safety improve the article or not?" I would remind everyone that simply dismissing a source as "written by pro-chiropractic authors" makes it very hard for us to counter the chiropractor advocates when they want to dismiss Ernst "because he's an anti-chiropractic author". And believe me, I know how hard that is. -- RexxS ( talk) 22:11, 2 February 2014 (UTC)
There are a couple of sources from Michael Shermer:
In both, Shermer places chiropractic in what he calls "borderlands science", i.e. a gray area between science and pseudoscience. He also says (in the second source) that demarcation depends on multiple factors -- including efficacy, btw -- which ties into Brangifer's point about chiro being a mixed bag. Unlike the question of whether to eat the Curate's egg, demarcation is frequently considered fuzzy (particularly among scholarly sources), and this view appears to be a significant one with respect to chiro specifically. Shermer and similar sources turn up with a Google books search for chiro and terms like "demarcation" and "gray area". (If you just google for chiro and pseudoscience you're more likely to find the sources that take a bright line approach & call it pseudo outright.) -- Middle 8 ( leave me alone • talk to me) 08:56, 3 February 2014 (UTC)
Current text: "A 2010 report found that manual therapies commonly used by chiropractors are effective for the treatment of low back pain, neck pain, some kinds of headaches and a number of extremity joint conditions.[133]" See Chiropractic#Effectiveness.
Proposal: "A report found that spinal manipulation therapies are effective for the treatment of low back pain, neck pain, migraine and cervicogenic headache and a number of extremity joint conditions." Read the conclusion for ref 133 The part "commonly used by chiropractors" is not part of the conclusion. The part "some kinds of headaches" might be WP:OR. QuackGuru ( talk) 02:15, 5 February 2014 (UTC)
I'd like to have some discussion about the appropriateness of this source.
{{
cite journal}}
: CS1 maint: unflagged free DOI (
link)Cheers, Ocaasi t | c 14:28, 30 January 2014 (UTC)
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link) CS1 maint: unflagged free DOI (
link) The article may need updating because we have a lot more independent sources available at this time.
QuackGuru (
talk)
19:42, 30 January 2014 (UTC)On the NHS Choices website, they make patients aware that there is "no scientific evidence to support the idea that most illness is caused by misalignment of the spine."[111] This is not about international reception. See Chiropractic#International reception. QuackGuru ( talk) 03:24, 6 February 2014 (UTC)
A study of California disciplinary statistics during 1997–2000 reported 4.5 disciplinary actions per 1000 chiropractors per year, compared to 2.27 for MDs; the incident rate for fraud was 9 times greater among chiropractors (1.99 per 1000 chiropractors per year) than among MDs (0.20).[94] The same sentence is found in another section. See Chiropractic#Ethics. QuackGuru ( talk) 05:30, 6 February 2014 (UTC)
A 2010 analysis of chiropractic websites found the majority of chiropractors and their associations made claims of effectiveness not supported by scientific evidence, including claims about the treatment of asthma, ear infection, earache, otitis media, and neck pain.[103] Read the conclusion. See Chiropractic#Ethics. QuackGuru ( talk) 05:30, 6 February 2014 (UTC)
I found a more recent source for the safety information. I made this change to summarise the body. QuackGuru ( talk) 07:04, 7 February 2014 (UTC)
UK chiropractic organizations and their members make numerous claims which are not supported by scientific evidence. Many chiropractors adhere to ideas which are against science and most seemingly violate important principles of ethical behaviour on a regular basis. The advice chiropractors gave to their patients is often misleading and dangerous.[106] This situation, coupled with a backlash to the libel suit filed against Simon Singh, has inspired the filing of formal complaints of false advertising against more than 500 individual chiropractors within one 24 hour period,[107][108] prompting the McTimoney Chiropractic Association to write to its members advising them to remove leaflets that make claims about whiplash and colic from their practice, to be wary of new patients and telephone inquiries, and telling their members: "If you have a website, take it down NOW." and "Finally, we strongly suggest you do NOT discuss this with others, especially patients."[107] See Chiropractic#Ethics.
In 2008 and 2009, chiropractors, including the British Chiropractic Association, used libel lawsuits and threats of lawsuits against their critics.[124] Science writer Simon Singh was sued for libel by the British Chiropractic Association (BCA) for criticizing their activities in a column in The Guardian.[125] A preliminary hearing took place at the Royal Courts of Justice in front of Justice David Eady. The judge held that merely using the phrase "happily promotes bogus treatments" meant that he was stating, as a matter of fact, that the British Chiropractic Association was being consciously dishonest in promoting chiropractic for treating the children's ailments in question.[126] An editorial in Nature has suggested that the BCA may be trying to suppress debate and that this use of British libel law is a burden on the right to freedom of expression, which is protected by the European Convention on Human Rights.[127] The libel case ended with the BCA withdrawing its suit in 2010.[128][129] See Chiropractic#History.
In two different sections we have similar, almost duplicate text. I think for the history section it should be shortened or deleted. QuackGuru ( talk) 19:32, 4 February 2014 (UTC)
If another article is kept this section stills requires a summary. See WP:SUMMARY. I suggest an AFD or redirect for Chiropractic professional ethics. Or maybe the new article could be kept. QuackGuru ( talk) 20:48, 9 February 2014 (UTC)
The part " According to one controversial source is OR and the text is sourced. [19] QuackGuru ( talk) 21:14, 9 February 2014 (UTC)
The American Chiropractic Association (ACA) has a Code of Ethics "based upon the acknowledgement that the social contract dictates the profession’s responsibilities to the patient, the public, and the profession; and upholds the fundamental principle that the paramount purpose of the chiropractic doctor's professional services shall be to benefit the patient." [1] The International Chiropractor's Association (ICA) also has a detailed set of professional canons. [2]
This can be discussed in this article. QuackGuru ( talk) 02:22, 10 February 2014 (UTC)
I recommend an AFD for Chiropractic professional ethics. I don't see a reason to have a separate article for duplicate information. QuackGuru ( talk) 04:58, 11 February 2014 (UTC)
Students attending the chiropractic program at Canadian Memorial Chiropractic College during 2011-12 had a positive outlook toward vaccination.[213][undue weight? – discuss]
The source ( PMID 23997247) is reliable but it is a weight issue. QuackGuru ( talk) 16:14, 11 February 2014 (UTC)
A 2013 systematic review and meta-analysis found a statistically significant improvement in overall recovery from sciatica following spinal manipulation, when compared to usual care, and suggested that spine manipulation may be considered.
Lewis RA, Williams NH, Sutton AJ; et al. (2013). "Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses". Spine Journal.
doi:
10.1016/j.spinee.2013.08.049.
PMID
24412033. {{
cite journal}}
: Cite has empty unknown parameter: |month=
(
help); Explicit use of et al. in: |author=
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help)CS1 maint: multiple names: authors list (
link) We are using numerous sources about spinal manipulation in this article. I don't understand why this particular source was deleted.
QuackGuru (
talk)
08:17, 7 February 2014 (UTC)
An inconclusive RfC from 6 years ago doesn't overturn community consensus as embodied now in one of our chief guidelines, WP:OR. It states: "To demonstrate that you are not adding OR, you must be able to cite reliable, published sources that are directly related to the topic of the article, and directly support the material being presented." (bolding in original). That is perfectly clear. Alexbrn talk| contribs| COI 09:11, 7 February 2014 (UTC)
So if SMT in general is not chiropractic per se, and the source doesn't mention chiropractic, then why include it? What possible reason could there be? Alexbrn talk| contribs| COI 19:47, 9 February 2014 (UTC)
https://en.wikipedia.org/?title=Chiropractic&diff=next&oldid=592768717
https://en.wikipedia.org/?title=Chiropractic&diff=next&oldid=593089869
https://en.wikipedia.org/?title=Chiropractic&diff=593850971&oldid=593850690
"A 2012 study suggests that chiropractors may be used in a more complementary role to primary medical intervention." See ( PMID 23171540).
Per NPOV, we must include opposing POV. All the journals are reliable. Move on. QuackGuru ( talk) 18:41, 5 February 2014 (UTC)
Alexbrn, do you agree it was a mistake to try to delete chiropractic reliable sources solely based on authorship. QuackGuru ( talk) 18:02, 7 February 2014 (UTC)
QuackGuru: You are showing distinct signs of trying to WP:OWN the article. Statements such as "Reliable sources must not be deleted again" are classic ownership. We are not bound to install every source, however reliable; that is a matter of editorial judgment. Guy ( Help!) 13:43, 12 February 2014 (UTC)
Many studies of treatments used by chiropractors have been conducted, with conflicting results.[14] A critical evaluation found that collectively, spinal manipulation failed to show it is effective for any condition.[23] A Cochrane review found good evidence that spinal manipulation therapy was no more effective than inert interventions, sham SMT or as an adjunct therapy for acute low back pain.[24] The efficacy and cost-effectiveness of maintenance chiropractic care are unknown.[25] Although evidence published by practitioners suggests that spinal manipulation therapy is safe,[26] the actual prevalence of adverse events is unknown[27] as there is no systematic reporting;[28] it is frequently associated with mild to moderate adverse effects, with serious or fatal complications in rare cases.[27][29] ranks at the 12% level for readability.
Studies about chiropractic have conflicting results. One found spinal manipulation was not shown effective for any condition. A Cochrane review found it ineffective for low back pain. The cost-effectiveness of chiropractic is unknown. Evidence published by practitioners show the therapy is safe, although the number of adverse results is not known, and there are reports of mild to serious adverse effects.
gets us up to a rating of 36% (an improvement of 24%), while only sacrificing the added bit about deaths in rare cases. Collect ( talk) 20:40, 12 February 2014 (UTC)
Only 11% of Wikipedia articles are less readable, ensuring that no one can understand this article as it sits. [25]. I would award it the "barbstar of unreadability" but that page seems quite difficult to find ... Collect ( talk) 15:30, 12 February 2014 (UTC)
The safety information using the WHO source was previously deleted from the lede. [26]
This is another WP:MEDRS compliant source: "So, do the risks outweigh the benefits? The best evidence suggests that SMT, whether it be for neck or low back pain, is a safe and effective therapy. At a population level, the benefits still outweigh the risks." [27]
I don't see a serious dispute to the text. What is the point to adding " published by practitioners". Is there evidence that specifically says it is not safe. "Although" is unnecessary grammar and suggests there is a dispute when none is being presented. These are different sources that make different distinct points in the lede. The part "published by practitioners" is not what the source says anyhow. QuackGuru ( talk) 07:09, 13 February 2014 (UTC)