Misplaced Pages

..."concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system"... This is what the WHO source says.

..."concerned with the diagnosis, treatment and prevention of mechanical disorders of the neuro-musculoskeletal system. This is what the current lede says.

I think this is a WP:COPYVIO. QuackGuru (talk) 18:07, 20 March 2014 (UTC)

Copyvio

As previously discussed above the first sentence is a copyvio from WHO. QuackGuru (talk) 04:27, 2 April 2014 (UTC)

Easily remedied without manual thumping. Collect (talk) 19:03, 15 April 2014 (UTC)

Original research in the lede?

In the lede it says ...a notion that brings "criticism" from mainstream health care.

Acceptable as hypothesis, the widespread assertion of the clinical meaningfulness of this notion brings ridicule from the scientific and health care communities and confusion within the chiropractic profession.

The source says "ridicule". Without sources in the lede problems like this are continuing. QuackGuru (talk) 15:18, 5 April 2014 (UTC)

citations in the lead

Are generally deprecated as the lead is a summary of what is already in the article. If the material is already in the article, it makes no sense to require duplicating citations in the lead as well. The first sentence is, in fact, a summary of what is already in the article. Cheers. Collect (talk) 21:15, 15 April 2014 (UTC)

Actually the lead is not exempt from WP:V in two circumstances (WP:WHYCITE):

1. Claims which are particularly contentious or counter-intuitive may be challenged and should then be cited, rather than forcing a casual reader to go through the entire article to find where the claim is verified. It's just a matter of courtesy.
2. The first part of a well-developed lead is not a summary of the rest of the article, but a definition and an introduction. Non-obvious claims made in that part should be cited inline as usual.

I expect that QG was asking for a reliable source that defines chiropractic in the way that we do in the first sentence. Hope that helps, --RexxS (talk) 00:15, 16 April 2014 (UTC)

Read the body: Chiropractic combines aspects from mainstream and alternative medicine, and there is no agreement about how to define the profession: although chiropractors have many attributes of primary care providers, chiropractic has more of the attributes of a medical specialty like dentistry or podiatry. It has been proposed that chiropractors specialize in nonsurgical spine care, instead of attempting to also treat other problems, but the more expansive view of chiropractic is still widespread. Mainstream health care and governmental organizations such as the World Health Organization consider chiropractic to be complementary and alternative medicine (CAM); and a 2008 study reported that 31% of surveyed chiropractors categorized chiropractic as CAM, 27% as integrated medicine, and 12% as mainstream medicine.

The first sentence does not summarise the body: Chiropractic is an alternative medicine based on diagnosis, treatment and prevention of problems of the neuro-musculoskeletal system.

This is not cited in the body because there is disagreement that chiropractic is an alternative medicine. The edit by Collect confirmed we should used references in the lede. This will cut down on original research. The way it was written before was much better. The current WP:LEDE is poorly written and not a summary. QuackGuru (talk) 05:01, 16 April 2014 (UTC)

The Wikilink defines "alternative medicine" and the term is widely used in academic sources. The article, in fact, clearly states: any practice that is put forward as having the healing effects of medicine but is not based on evidence gathered using the scientific method. Do you have a problem with this? As for insisting on citations in the lead -- they are rarely used for good reason - if the gist is already in the body of the article, it should be already cited there. And what term would you use other than "alternative medicine" as defined by that article? I note it is repeatedly called an "alternative medicine" in the body of the article - would you elide them even where the sources clearly call it such? Cheers. Collect (talk) 13:23, 16 April 2014 (UTC)

Rel POV tag on first sentence of intro, previously tagged as copyright violation

1. A quick search engine check, avoiding chiropractic sites, indicates this is a neutral way to introduce the subject:, , , , , just for examples. 2. It would be helpful if the fellow editor has an alternative proposal, based on a neutral source as he requires, to produce it and its source. 3. I am still reading and digesting the big arbitration decisions that happened some years ago about alternative medicine, but they would appear to possibly have some applicability here. Regards, Paavo273 (talk) 22:31, 18 April 2014 (UTC)

Concerns of Bias in the Lede and within the Article

There is a heavy concern of bias in the lede and the article, one gives the minority a dominant voice and one that overstates certain points in terms of prejudicial spacing in the article (that does not follow MEDMOS) and heavy use of Edzard Ernst at key points in the article that have been usurped by existing studies or newer, secondary sources.

Many studies of treatments used by chiropractors have been conducted, with conflicting results.

Many studies of treatments used by MDs have been demonstrated as well, with conflicting results. What specifically is the argument? Joint manipulation studies? Effectiveness, cost-effectiveness? Safety?

Systematic reviews of this research have not demonstrated that spinal manipulation is effective, with the possible exception for the treatment of back pain.

Several studies has shown that manipulative therapy is has effectiveness in upper and lower extremity MSK conditions, including systematic reviews. There is an evidence-based resource that precisely looks at the evidence for what conditions DCs treat and what is the evidence for their interventions most commonly used in clinical practice? http://clinicalcompass.org/category_ccgpp/scientific-studies. How has this source been omitted the whole time?

A critical evaluation found that collectively, spinal manipulation failed to show it was effective for any condition.

Why does an outdated study that has been usurped by new evidence on the same topic make it to the lede?

The efficacy and cost-effectiveness of maintenance chiropractic care are unknown.

Untrue, manipulative therapy has proven effectiveness in chronic LBP in maintenance care conditions

The evidence suggests that spinal manipulation therapy is safe but the rate of adverse events is unknown as there is under-reporting.

The sentence begins with the conclusion, the adverse rates are known in some instances and the citation does not state there is under-reporting it suggest that it may be under-reported.

There is controversy surrounding the level of risk of stroke from cervical manipulation. It has been suggested that the relationship is causative, but this is disputed by many chiropractic proponents of this treatment modality, who believe the association between chiropractic therapy and vertebrobasilar artery stroke is unproven.

The arrangement of the paragraphs suggests that it safe, then the body is essentially about the risks of cervical manipulations which are very low according to the data, and the opposition to the conclusion that there is a causative link is already discussed in the literature which is to say, there is no conclusive evidence of that claim and this is maintained by the research that was done by chiropractic and other health scientists.

It overlaps with other manual-therapy professions, including massage therapy, osteopathy, and physical therapy.

This point, which fails to appear in the MT, Osteopathy and PT articles, is not central to any significant degree, and chiropractic is considered the leader in manual methods in health care as demonstrated by this lay article demonstrating how the WHO and the WFC collaborated on this regard (http://www.canadianchiropractor.ca/content/view/1307/38/).

D.D. Palmer founded chiropractic in the 1890s, and his son B.J. Palmer helped to expand it in the early 20th century. It has two main groups: "straights", now the minority, emphasize vitalism, innate intelligence and spinal adjustments, **and consider vertebral subluxations to be the cause of all disease;**

Please show citation to be cause of all disease

For most of its existence it has been at odds with mainstream medicine, sustained by pseudoscientific ideas such as subluxation and innate intelligence that are not based on solid science.

Ernst again prevails as the dominant 'voice' despite the fact there is no proof that he speaks for the medical profession or any scientific 'consensus' and is also critiquing the minority viewpoint of the profession and not the mainstream or dominant viewpoint of the majority of the profession.

Despite the general consensus of public health professionals regarding the benefits of vaccination, among chiropractors there are significant disagreements over the subject, which has led to negative impacts on both public vaccination and mainstream acceptance of chiropractic.

Yet again, the minority viewpoint is being used as a means to discredit the majority position which, in fact is more complex and involves the argument of the freedom of choice when considering mandatory, blanket vaccinations. Also, there are other elements not described in the critique such as the effectiveness of certain vaccinations such as the Tamiflu Debacle (http://www.digitaljournal.com/life/health/tamiflu-research-questioned/article/382174).

The American Medical Association called chiropractic an "unscientific cult" and boycotted it until losing an antitrust case in 1987.

What is the relevance of the statement that the AMA once called Chiropractic an unscientific cult and only giving the AMA viewpoint which was found guilty of conspiring to contain, eliminate and destroy the chiropractic profession as per Will et al 1976? Does this sentence belong in the lede as well, highlighting how the Journal of the AMA now recommends chiropractic care for LBP (http://jama.jamanetwork.com/article.aspx?articleid=1681414)

Chiropractic remains at a crossroads, and that in order to progress it would need to embrace science and not ideological dogma.

This concluding sentence infers that the majority of chiropractors and/or their institutions do not embrace science, the dogma is perpetuated by a minority of practitioners. This is also a rather poor use of an source, merely an opinion piece rather than a preferred secondary or tertiary source.

DVMt (talk) 23:42, 26 April 2014 (UTC)

Good points, DVMt (talk)! There sure is a strong need for a revision of sources and reassessment of bias in the article. I think you made the point really clear. Currently there's a lot of opinionated views present. Jayaguru-Shishya (talk) 09:01, 27 April 2014 (UTC)

All the text in the lede is well sourced and on Misplaced Pages we WP:ASSERT the text according to what the source says. The text in the lede is a summary of the body. The text in the lede is sourced. For exmaple: ""Straights" tend to rely exclusively on spinal adjustments, to emphasize innate intelligence, and to subscribe to the notion that subluxation "is the leading cause of disease in the world today."42 The text in the body is also sourced. For example: "“Innate intelligence” evolved as a theological concept, the representative of Universal Intelligence (=God) within each person.36 D.D. Palmer was convinced he had discovered a natural law that pertained to human health in the most general terms. Originally, manipulation was not a technique for treating spinal or musculoskeletal problems, it was a cure for all human illness: “95% of all diseases are caused by displaced vertebrae, the remainder by luxations of other joints.”37" QuackGuru (talk) 16:27, 27 April 2014 (UTC)

Precisely Quack, "originally" manipulation was done to cure 'disease' but this is no longer the case, as you alluded, its primarily for spinal or musculoskeletal problems. The source you are using from is from 1998 and has been usurped several times since then, most notably in Haldeman's 2005 text "Principles and Practice of Chiropractic"(http://www.amazon.com/Principles-Practices-Chiropractic-Scott-Haldeman/dp/0071375341) which is the current "modern" or contemporary practice of chiropractic by the mainstream of the profession. This is notable in 2 ways, first, First, Haldeman and the chiropractic profession pioneered World Spine Care (http://worldspinecare.com/) which is brings together a multidisciplinary group of doctors and therapists to help treat spinal disorders in 3rd world countries and has such notable sponsors as Elon Musk of Tesla and endorsements from the WHO, North American Spine Society, and other leading spine care organizations. This article severely minimizes the spinal MSK focus of chiropractors and puffs up the controversy which is management of non-msk which represents 10% of those who seek chiropractic care. Also, the "minority" group which represents the fringe of the profession totals at 19% according to the latest research on the topic as per this article " Less than 20% of chiropractors (18.8%) were aligned with a predefined unorthodox perspective of the conditions they treat. Prediction models suggest that unorthodox perceptions of health practice related to treatment choices, x-ray use and vaccinations were strongly associated with unorthodox group membership (X(2) =13.4, p = 0.0002).CONCLUSION: Chiropractors holding unorthodox views may be identified based on response to specific beliefs that appear to align with unorthodox health practices. Despite continued concerns by mainstream medicine, only a minority of the profession has retained a perspective in contrast to current scientific paradigms. Understanding the profession's factions is important to the anticipation of care delivery when considering interprofessional referral. Less than 20% of chiropractors (18.8%) were aligned with a predefined unorthodox perspective of the conditions they treat. Prediction models suggest that unorthodox perceptions of health practice related to treatment choices, x-ray use and vaccinations were strongly associated with unorthodox group membership (X(2) =13.4, p = 0.0002).http://www.ncbi.nlm.nih.gov/pubmed/24512507.

To summarize: Outdated sources with heavy bias on Ernst, controversy, heavy emphasis on the "unorthodox" or fringe of the profession re: subluxation/joint dysfunction, professional identity, practice characteristics, etc.. and virtually no emphasis on modern practice such as emphasis on spinal and musculoskeletal conditions, advancements in research and professionalization over the last 25 years, no mention of Haldeman, Janse and other historical and notable chiropractors in contrast to the exclusive focus on DD and BJ at this article. In plain words, the weight of the article is drastically shifted to the past and focuses a lot of the founders, the fringe of the profession, gives Ernst and his collaborators undue weight based on the criticism of the unorthodoxy of the profession. There is no mention of chiropractors being permanent members of the medical staff at the Olympics as of London Games in 2012, and the fact that medical director at Team USA was a chiropractor. The article's tone, weight, emphasis is directed to the past and to the fringe, which destroys the credibility of the article in the first place. Even comparing the Wiki version to NCCAM (branch of NIH), WHO and other mainstream, reliable and credible sites demonstrates the dramatic differences in tone, language, emphasis, etc. http://nccam.nih.gov/health/chiropractic/introduction.htm DVMt (talk) 01:07, 1 May 2014 (UTC)

 I could go on, but there is agreement from Jaygaru from my earlier post, the majority of which was not addressed.

Semi-protected edit request on 29 April 2014

108.225.17.38 (talk) 05:43, 29 April 2014 (UTC) I just read your article on chiropractic and I must say, as a chiropractor that specializes in neurological disorders, I find it most disturbing. May I ask where you found your undocumented essay on chiropractic? I personally find it slanted and invite you to interview me as well as others, about the true work of chiropractors. Our main focus is on the care of the nervous system and we have many credits to date, most recently, working with autistic children and those diagnosed with ADD and AHDD. Which, by the way, are a direct result of drugs. No, we are not Mainstream, nor do we choose to be, when Mainstream is about drugging our society, and most of all, our children. We choose to keep our patients healthy and allow them to live their best life possible, instead of drugging them to the point that they forget what their life was all about.

Not done: as you have not requested a change.
If you want to suggest a change, please request this in the form "Please replace XXX with YYY" or "Please add ZZZ between PPP and QQQ".
Please also cite reliable sources to back up your request, without which no information should be added to any article.
We never "interview" anyone - only report what has already been published in reliable sources that are independent of the subject. - Arjayay (talk) 07:41, 29 April 2014 (UTC)