In praise of chiropractic?

The Journal of Health Services Research and Policy has just published a ‘perspective’ piece by Professor Alan Breen of the Anglo-European College of Chiropractic in which he, unsurprisingly, praises Chiropractic (Breen, 2009). 

The concluding paragraph is quite amazing: 

“To portray only part of the relevant information in a critique is itself pseudoscience, yet strong ontological commitment to only part of the knowledge base seems often to be the stance taken to contest the scientific basis of Chiropractic. Rather like psychiatry, debates about musculoskeletal practice need to go beyond positivist science and recognize that we have entered a more democratic and inclusive, post-normal age.” (Breen, 2009) 

In this he seems to be committing himself to evaluate Chiropractic in the light of all the relevant information.   Let’s see if he does.

In search of the black swans

The April edition of Physics World carried an interesting article on risk-taking in science.  The central question posed by the author was, “are [we] pushing revolutionary ideas to the margins. ”

Unfortunately in this thought-provoking and otherwise excellent article the author asserted that “utterly profound discoveries”:

“[...] do not flow out of what the philosopher of science Thomas Kuhn called “normal science” — the paradigm-supporting and largely mechanical working out of established ideas — but from “revolutionary”, disruptive and risky science.”

Lewith lashes out

From his letter published in this week’s New Scientist it is clear that Professor George Lewith doesn’t like Edzard Ernst’s recent opinion piece on Chiropractic.  However, it is just as clear that Lewith is prepared to use fallacious reasoning and debunked statistics, among other things, to support his argument.^*

It’s not as though he even manages to properly engage with Ernst’s criticisms.  Through cherry picking and a meticulous avoidance of published evidence he first constructs then attacks a straw man. 

His opening accusation is that, “[…] Ernst fails to give a balanced view of Chiropractic”.^**  Is this a true reflection of what Ernst wrote?  Well, Ernst’s article maps out the origins of Chiropractic, and then describes three major schools: 

No room for the evidence

Last week I tried to get a modestly sized letter published in the New Scientist, to highlight just one of the very poor pieces of argumentation displayed by BCA vice-president Richard Brown in an opinion piece.  Unfortunately, I failed.  Space is very limited and I guess that they just had to make room for another error-strewn contribution from the indefatigable George Lewith^*.

So, I’ve published it here to make at least some use of it.

Plethora or paucity? The BCA and bedwetting

The BCA have, at last, released their much heralded “plethora” of evidence.  They preface this with an incredible statement, which includes the following gems: 

“In the spirit of a wider scientific debate, and having taken appropriate professional advice, the BCA has decided that free speech would be best facilitated by releasing details of research that exists to support the claims which Dr. Singh stated were bogus. This proves that far from there being “not a jot of evidence” to support the BCA’s position, there is actually a significant amount. 

It has never been the BCA’s case that the evidence is overwhelmingly conclusive. It is the BCA’s case that there is good evidence. […] 

[…] The BCA welcomes full, frank and open scientific debate. […]”

That’s good then, the BCA will welcome my frank take^* on their summary of the evidence for chiropractic helping children with nocturnal enuresis. 

False positives?

George Lewith, Michael Dixon and Peter Fisher had a puzzling letter in The Guardian yesterday, defending homeopathy.  One of the odd things in the letter was the contention that, “out of six reviews of the scientific evidence carried out by the independent and respected Cochrane Collaboration, two are cautiously positive and four inconclusive.” 

This description bears little resemblance to what they actually say.  As you read these excerpts from their plain language summaries just remember that these gents are not appealing for more research, but for ongoing funding to treat patients at the UK taxpayer’s expense. 

Here is what the six reviews actually say.  Try and see if you can spot the two that are, “cautiously positive” (emphasis mine). 

Defending chiropractic?

The Great Chiropractic Debate rumbles on in the pages of the New Scientist.  This week Richard Brown, a Chiropractor and vice-president of the BCA, has a comment piece entitled, “Defending chiropractic”. 

It is worth looking at it as an exemplar of fallacious argument and claims about Chiropractic practise that do not stand scrutiny.  For instance, he uses a typical quack defence: critics claim that chiropractic lacks evidence, but they overlook, “the fact that many accepted medical interventions have little or no research evidence to support them.”

Martineau chiropractic to check with the BCA

As part of my brief survey of the claims Chiropractors make for the treatment of bedwetting (nocturnal enuresis) in children I contacted Martineau Chiropractic (Cached URL).  They claim that “research has shown chiropractic to be an effective treatment” for “bed wetting”.  Of course, it has shown no such thing. 

I have had a brief and interesting reply^*: 

“Thankyou for looking at our website, I hope you enjoyed it. I shall be taking advice from my professional association regarding the content of the website […]” 

Alternative Memory?

George Lewith has an interesting letter in the New Scientist this week, in which he criticises David Allen Green’s^* excellent article “Don’t criticise, or we’ll sue“.  One of his objections is that he is, “unaware of anybody prior to the chiropractors” threatening critics with libel in the UK. 

He seems to have missed Drs Alan Lakin and Ann Walker threatening defamation proceedings against University College London and Professor David Colquhoun over the latter’s criticism^** of, herbal medicine practitioner, Dr Walker’s views on the ‘blood cleansing’ properties of red clover and the benefits of vitamin supplements.

More Bedwetting Bogosity*

I was pretty surprised to find that many Chiropractors claim to treat bedwetting (nocturnal enuresis) in children.  They often cite studies published in their own ‘academic’ journal to back up this claim.  After finding that even these studies do not really support the chiropractic treatment of this condition, I wondered how Chiropractors justify offering this treatment: so I decided to contact an un-scientifically chosen^** sample of chiropractic clinics, pointing out the weakness of the evidence and asking them to consider correcting any errors in the way that they were representing it.   I also wanted to see how open they would be to the idea of including good conventional advice on their websites, as a service to their customers.