Insufficient evidence was provided to support statements about subluxation (Michael Haneline, 28 June 2011)
The authors state in their conclusion that ¿The concept of the subluxation in chiropractic is a controversial subject with a paucity of evidence.¿ but do not provide enough evidence to adequately support this statement in their paper. In fact, no definition of subluxation was given in the article and little was mentioned about what evidence exists for or against the use of the term subluxation. The purpose of this study was to determine the prevalence of the usage of subluxation in the North American English-language chiropractic college catalogs and academic bulletins. The authors should have adhered to their predetermined purpose and refrained from hyperbole about the...
read full comment
Comment on: Mirtz et al. Chiropractic & Manual Therapies, 19:14
Commentary on `Routine versus needs-based MRI in patients with prolonged low back pain: a comparison of duration of treatment, number of clinical contacts and referrals to surgery¿ (Brian Clark, 31 May 2011)
Commentary on `Routine versus needs-based MRI in patients with prolonged low back pain: a comparison of duration of treatment, number of clinical contacts and referrals to...
read full comment
Comment on: Jensen et al. Chiropractic & Manual Therapies, 18:19
Non-compliance-not just chiros AND Doppler to ease anxiety? (Michael John Haynes, 07 December 2010)
Dear Editor,
Re; Langwworthy JM, Forrest L. Withdrawal rates as a consequence of disclosure of risk associated with manipulation of the cervical spine: a survey. Chiropractic and osteopathy 2010;18:27.
I congratulate the authors for their very important study[1] that was well designed, interpreted and written. I believe that there is no excuse for chiropractors failing to obtain informed consent from their patients regarding potential risks from cervical manipulation, and that this applies to all health care providers. While their findings suggest low levels of compliance (45% of respondents always complying) among UK chiropractors, they seem to be similar to compliance rates among Australian physiotherapists (37%)[2]. I have been unable to obtain figures for...
read full comment
Comment on: Langworthy et al. Chiropractic & Manual Therapies, 18:27
Is ENAR really useful? (Leonardo Costa, 05 November 2010)
I would like firstly to congratulate the authors for their trial. However it seems that neither the authors and the reviewers paid attention to a number limitations of the study that changes the conclusions of the study completely. In addition to the lack of intention to treat analysis and a loss of 20% of follow up (30/24) the biggest problem in this paper is that there is a clear imbalance of the baseline values from all outcomes observed (as can be easily seen in figures 2, 3, 4 and 5 and tables 4, 5 and 6), being the patients allocated to the ENAR intervention with higher levels of pain and disability. This issue could be explained due to the per protocol analysis, small sample size, randomization corruption or a combination of both. This imbalance is crucial to determine the between-...
read full comment
Comment on: Vitiello et al. Chiropractic & Manual Therapies, 15:9
Erratum to Leboeuf-Yde and Hestbæk's commentary: Chiropractic and children: Is more research enough? (Charlotte Leboeuf-Yde, 02 July 2010)
The authors have found a typing error in the very last sentence under the subheading "Which diagnostic tests can we trust?". The faulty sentence is: "If the test is neither biologically implausible nor validated, it corresponds to a red light situation and should not be used."
However, this sentence should read:"If the test is neither biologically plausible nor validated, it corresponds to a red light situation and should not be used."
Subluxation epidemiology: a response to Dr. Good (Timothy Mirtz, 10 May 2010)
We wish to thank Dr. Good for his response to our recent work that was published in the December issue of Chiropractic & Osteopathy. In attempting to sift through the lengthy comment provided by Dr. Good we have chosen to only address the key points he makes.
We do not believe that the conclusion of the subluxation construct (SC) having “no valid clinical applicability” is flawed. Nor is it reckless and/or harmful. Simply put, if there is little or no data providing evidence of the SC combined with and the claim chiropractors make to treat this putative entity as a causal agent then its validity should be considered unproven. Until data comes forth that can adequately demonstrate the existence of the SC and provide the necessary data that demonstrates that it is...
read full comment
Comment on: Mirtz et al. Chiropractic & Manual Therapies, 17:13
A Criticism of an Epidemiological Examination of the Subluxation Construct using Hill’s Criteria of Causation: Limitations, Suspect Conclusions and an Opportunity Missed (Christopher Good, 06 May 2010)
As a chiropractic practitioner and educator over the past three decades I have been privileged to share the science, art and philosophy of the profession with thousands of patients, students and field doctors in both the United States and Europe. So it was with great interest that I read the work of Mirtz et al concerning the subluxation construct (SC) [1]. Indeed, their epidemiological examination of the SC utilizing Hill’s criteria was an opportunity to consider an important perspective regarding some of the evidence pertaining to it. It was also an opportunity to positively affect the evolution of the profession by buttressing the calls some academics have made to improve the SC, especially as it pertains to clinical practice [2,3]. Upon reflection however, it became apparent...
read full comment
Comment on: Mirtz et al. Chiropractic & Manual Therapies, 17:13
plain film radiography (Mark Lopes, 08 March 2010)
In the case studies, there is mention of plain film radiography being considered normal. The description of what views were taken is incomplete. There is a photo of an A-P lumbar view in one case reportedly showing no significant findings. The MRI reportedly picked up the malignancy. The MRI shown was a lateral view. Was there a lateral plain film taken? The point of the article seems to be that not taking a plain film initially didn't alter the outcome. The patients apparently died, but if a lateral was not taken as would be standard practice if one is to expose an area (taking opposing views of the area is generally accepted as standard) how are we to know the lateral plain film would not have shown the malignancy? The second case was similar, only showing an A-P chest view. Was a lateral...
read full comment
Comment on: Pringle et al. Chiropractic & Manual Therapies, 14:8
Subluxation, evidence-based medicine and epidemiology. Response to comments made by Drs. Demetrious and Hart (Timothy Mirtz, 07 January 2010)
We wish to thank Drs. James Demetrious and John Hart for their thoughtful Letters to the Editor concerning our recent paper “An epidemiological examination of the subluxation construct using Hill’s criteria of causation”[1].
Dr. Demetrious referred us to the paper by Phillips and Goodman entitled, “The missed lessons of Sir Austin Bradford Hill" [2]. We wish to point out that we specifically used the Phillips reference in our paper under the subheading “Limitations to utilizing Hill's Criteria” (Ref #32). Notwithstanding, Phillips and Goodman’s [2] concerns about “statistical significance” and “precision” are irrelevant in the case of subluxation because we simply have no credible data upon which to perform...
read full comment
Comment on: Mirtz et al. Chiropractic & Manual Therapies, 17:13
Literature support for subluxation theory (John Hart, 05 January 2010)
Editor:
The article by Mirtz et al regarding the application of Hill’s criteria to test whether or not subluxation is causal (1) is interesting but has a few problems, as follows.
1. Hill seems to apply his criteria to association first, rather than causation. (2) Indeed Hill himself warns that criteria alone do not establish cause-and-effect relationships. (2-3)
2. The authors seem to have overlooked literature that could qualify for at least some of Hill’s criteria for association. For example:
a) Given the large percentage of chiropractors (75%) who find that adjustment of subluxation results in improved health of the patient, (4) the criterion of consistency would seem to be satisfied.
Comment on: Mirtz et al. Chiropractic & Manual Therapies, 17:13
Subluxation, Hill's Criteria of Causation and EBM (James Demetrious, 29 December 2009)
I read with interest the paper written by Mirtz et al. I have reservations regarding the authors’ conclusions pertaining to the manner in which they have editorialized the subject matter and applied Hill’s Criteria of Causation.
First, I would direct the authors to the paper written by Phillips and Goodman [1] entitled, “The missed lessons of Sir Austin Bradford Hill." Phillips and Goodman report the following:
Making a good decision does not depend on having studies with confidence intervals that exclude the null. A best decision can be based on whatever information we have now, and indeed a decision will be made – after all, the decision to maintain the status quo is still a decision. Hill offered his clearest...
read full comment
Comment on: Mirtz et al. Chiropractic & Manual Therapies, 17:13
Through the Rear Window (David Millar, 19 January 2009)
Sincere thanks to Coulter and Khorsan for this thoughtful review of the publishing history of this journal. It is interesting to note that so many articles come from the US, however. there are likely many more chiropractors per capita in the US than elsewhere. The authors wonder about a name change. A name change would likely create confusion. I would encourage more osteopaths and osteopathic colleges to use this journal as a publishing vehicle.<br><br>I receive the alerts for the journaland find them to be very helpful. I find most of the articles to be well reasoned and generally thought-provoking.<br><br>Keep up the good work!<br><br>David P. Millar, DC, BSc<br>Chiropractic Consultant<br>Medical Services Branch<br>Department of...
read full comment
Comment on: Coulter et al. Chiropractic & Manual Therapies, 16:14
Authors' response to Christopher Good (Donald Murphy, 19 January 2009)
We would like to thank Dr. Good for reading and commenting on our paper. We find it interesting that he predicts the "disastrous end" of an entire profession based on a single statistic (a recent decrease in graduates), ignoring all the evidence we presented of the success of the podiatry profession, particularly in comparison to the chiropractic profession. <br>Regarding his points about the successes chiropractic medicine has had, and the means by which we can build on those successes, these are points we cover in detail in our paper, so there is nothing more to be said except that the one point Dr. Good did not include was perhaps the most important. Chiropractic lacks a clear identity, and without deciding who or what we are, there is nothing to build upon. Virtually all of...
read full comment
Comment on: Murphy et al. Chiropractic & Manual Therapies, 16:10
Podiatry probably is not the profession we want to emulate (Christopher Good, 14 January 2009)
While many of the arguments developed by my colleagues made good sense, there is an important bit of information they didn't take into account. That is the fact the podiatry profession appears to be coming to a disastrous end, at least in the United States. According to the US National Center for Educational Statistics from 1996 to 2005 the annual number of graduates of podiatric schools declined by 44% (from 612 to 343 students). Interestingly enough, in the same time frame US chiropractic enrollment decreased 25%, from 3395 to 2564 students, while osteopathy increased 76% (1547 to 2718).(1) While I agree we need to dramatically improve our cultural authority I would respectfully suggest that a small, dwindling profession is hardly one we would wish to emulate. In fact in contrast the...
read full comment
Comment on: Murphy et al. Chiropractic & Manual Therapies, 16:10
SMT to Thoracic Spine (Charles Blum, 15 December 2008)
I have a difficult time with the concept of having students delivering a thoracic spinal adjustment and that being equated to a practitioner in practice over 5 years or more. If I was attempting to devalue SMT for the thoracic spine one way would be to have students do the adjustment, under the guidance of a registered doctor or not.The use of static or motion palpation of the thoracic spine as a rational to deliver a thrust is also might devalue the SMT since the assumption is that that joint is fixated and a thrust will reduce the fixation. In a subset of patients with this condition it may well lead to a positive outcome.Other methods of diagnosis such as determining if the vertebra or costovertebral region has a directional preference based on pain or even adjacent muscle strength...
read full comment
Comment on: Crothers et al. Chiropractic & Manual Therapies, 16:12
Erratum (Raheleh Khorsan, 01 December 2008)
In our recent article for Chiropractic & Osteopathy ("Through the rear view mirror: a content evaluation of the journal Chiropractic & Osteopathy for the years 2005-2008" Chiropr Osteopat. 2008 Nov 13;16(1):14.) it has been pointed out to us that we inadvertently have an error in some of the data in the paper. Our comparison of the number of clinical trials in Chiropractic & Osteopathy to the number published in JMPT is incorrect. The actual number of trials in Chiropractic & Osteopathy was 10/84 or 12%. This figure was arrived at by surveying each article. The comparative figure for JMPT was derived from the data from MEDLINE and is 16.6% for trials. Unlike our analysis for Chiropractic & Osteopathy we have no way of knowing if the figure in MEDLINE is accurate or not....
read full comment
Comment on: Coulter et al. Chiropractic & Manual Therapies, 16:14
Disentangling manual muscle testing and Applied Kinesiology: critique and reinterpretation of a literature review. A reply (Scott Cuthbert, 31 August 2007)
Letter to the EditorDisentangling manual muscle testing and Applied Kinesiology: critique and reinterpretation of a literature review. A reply We would like to comment on this paper by Haas, Cooperstein, and Peterson where they critique our publication. The validity of the MMT for neuromusculoskeletal (NMS) diagnosis (its construct and content validity [1-2], convergent and discriminant validity [3], concurrent and predictive validity [4-5]) was presented in our paper after peer review and accepted by Haas, Cooperstein, and Peterson. The internal validity was strong in a number of the papers reviewed. These studies were time-series experiments that help to rule out rival explanations for beneficial clinical changes following treatment [6]. We disagree with Haas et al’s interpretation...
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Comment on: Haas et al. Chiropractic & Manual Therapies, 15:11
One additional correction (Dana Lawrence, 28 May 2007)
Please note that I had an additional error in my paper. Ramsey et al.’s study (the first listed) concerned older adults with osteoarthritis, not osteoporosis. The discussion of this study in the text is correct; in the table it is typed improperly.
read full comment
Comment on: Lawrence et al. Chiropractic & Manual Therapies, 15:2
Typographic error correction (Dana Lawrence, 30 January 2007)
While I am extremely thrilled to see my article be made live as a final pdf just today, I must also note two typographic errors in my entry regarding the work of Hawk et al cited in reference 46. The correct wording is that 72% of DCs used acupressure, not acupuncture (only 17% reported using acupuncture); and 8% (not 68%) of respondents thought chiropractic should be viewed as a therapeutic modality. I apologize for these errors.
read full comment
Comment on: Lawrence et al. Chiropractic & Manual Therapies, 15:2
In Response to Dr. Nick Donovan (Dana Lawrence, 11 January 2007)
Thank you for your comment. Our interest in this subject is more geared toward understanding the level of knowledge within the chiropractic academic and research communities, not in comparing that understanding to the medical profession, though that would certainly make for an interesting study. To this end, we have noted in our paper that we would like to broaden our survey to include all chiropractic institutions, no matter what philosophical stripe. Thanks for writing,Dana J. Lawrence, DCPalmer Center for Chiropractic Education
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Comment on: Lawrence et al. Chiropractic & Manual Therapies, 14:27
A Wider Examination Spectrum is Needed (Nicholas Donovan, 22 December 2006)
It may be a bit more relevant to poll various medical colleges as well as schools of Chiropractic to get a better understanding of the differences in understanding of the subject.Further contrasting those from a Chiropractic perspective would be to include the more 'mixed' schools such as Parker College and those in the liberal arts schools such as Bridgeport or D'Youville as their perspectives may be a bit different.Cheers,Nick
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Comment on: Lawrence et al. Chiropractic & Manual Therapies, 14:27
Alternative interpretation of needle electrode findings (George Kukurin, 19 October 2006)
I read with interest the case report "Improvement of lower extremity electrodiagnostic findings following a trial of spinal manipulation and motion-based therapy" Chiropractic & Osteopathy 2006, 14:20 doi:10.1186/1746-1340-14-20.Congratulations should go out to Dr. Morningstar for his contributions to the literature. However in perusing his Table 1, pre-post electrodiagnostic findings; it appears that there were very minimal, if any, changes reported in the needle portion of the EMG between pre and post interventions.Before addressing specifically the data presented in table one, a very brief review of needle electrode examination (NEE) findings may be in order. Once the connection between the motor nerve and muscle is interrupted (denervation) the newly denervated muscle becomes...
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Comment on: Morningstar Chiropractic & Manual Therapies, 14:20
Timely article (Joe Ieranò, 31 August 2006)
Dr. Wenban's article struck an immediate chord of importance as I had just had a letter to a journal refused - apparently without peer review, without reason or attempt to revision - regarding an article allegedly misrepresenting the term "chiropractic manipulation". Wenban's discourse is important for the advancement of Evidence Based health care, because without accurate classification of therapeutic interventions data is made virtually useless.
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Comment on: Wenban Chiropractic & Manual Therapies, 14:16
Is There Evidence?: Reply to Drs. Blum and Cuthbert (Steve Hartman, 26 July 2006)
Is There Evidence?: Reply to Drs. Blum and CuthbertDr. Norton and I are grateful that Drs. Blum and Cuthbert (hereafter, "Drs. B and C") have taken the time to highlight what they perceived as deficiencies in our research. Others may have had similar reactions and this gives us an opportunity to put some illuminating flesh on these bones. We first will try to summarize the authors' main points. We then will react to each point (in order) and close with a suggestion that we hope will help us be productive in any further dialogue.The authors' main points:1) In our critiques, Dr. Norton and I have put too much emphasis on aspects of Sutherland's biological mechanism. For that reason and because we lacked familiarity with relevant literature (see item 3), some of our critical conclusions...
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Comment on: Hartman Chiropractic & Manual Therapies, 14:10
Cranial Therapeutic Care: Is There any Evidence? (Charles Blum, 12 July 2006)
Cranial Therapeutic Care: Is There any Evidence?Charles L. Blum, DCScott Cuthbert, DCIt appears from a review of past letters by. Hartman [1] and Norton [2] that they are making a concerted effort to gain some recognition for their premise by questioning the efficacy of cranial osteopathy or cranial therapeutic care. One way they have chosen to elicit a response has been by making far overreaching statements, which are ironic since Hartman thinly veils himself in a gossamer cloak of science, research, and evidence-based healthcare. While it is common for researchers to have preferences and exhibit a bias we will note that our preference is for an open-minded dialogue of the risk/benefit ratio of a treatment, its biological plausibility, and its evidence base, which includes case histories...
read full comment
Comment on: Hartman Chiropractic & Manual Therapies, 14:10
RSS
Latest comments
Insufficient evidence was provided to support statements about subluxation (Michael Haneline, 28 June 2011)
The authors state in their conclusion that ¿The concept of the subluxation in chiropractic is a controversial subject with a paucity of evidence.¿ but do not provide enough evidence to adequately support this statement in their paper. In fact, no definition of subluxation was given in the article and little was mentioned about what evidence exists for or against the use of the term subluxation. The purpose of this study was to determine the prevalence of the usage of subluxation in the North American English-language chiropractic college catalogs and academic bulletins. The authors should have adhered to their predetermined purpose and refrained from hyperbole about the... read full comment
Comment on: Mirtz et al. Chiropractic & Manual Therapies, 19:14
Commentary on `Routine versus needs-based MRI in patients with prolonged low back pain: a comparison of duration of treatment, number of clinical contacts and referrals to surgery¿ (Brian Clark, 31 May 2011)
Commentary on `Routine versus needs-based MRI in patients with prolonged low back pain: a comparison of duration of treatment, number of clinical contacts and referrals to... read full comment
Comment on: Jensen et al. Chiropractic & Manual Therapies, 18:19
Non-compliance-not just chiros AND Doppler to ease anxiety? (Michael John Haynes, 07 December 2010)
Dear Editor,
Re; Langwworthy JM, Forrest L. Withdrawal rates as a consequence of disclosure of risk associated with manipulation of the cervical spine: a survey. Chiropractic and osteopathy 2010;18:27.
I congratulate the authors for their very important study[1] that was well designed, interpreted and written. I believe that there is no excuse for chiropractors failing to obtain informed consent from their patients regarding potential risks from cervical manipulation, and that this applies to all health care providers. While their findings suggest low levels of compliance (45% of respondents always complying) among UK chiropractors, they seem to be similar to compliance rates among Australian physiotherapists (37%)[2]. I have been unable to obtain figures for... read full comment
Comment on: Langworthy et al. Chiropractic & Manual Therapies, 18:27
Is ENAR really useful? (Leonardo Costa, 05 November 2010)
I would like firstly to congratulate the authors for their trial. However it seems that neither the authors and the reviewers paid attention to a number limitations of the study that changes the conclusions of the study completely. In addition to the lack of intention to treat analysis and a loss of 20% of follow up (30/24) the biggest problem in this paper is that there is a clear imbalance of the baseline values from all outcomes observed (as can be easily seen in figures 2, 3, 4 and 5 and tables 4, 5 and 6), being the patients allocated to the ENAR intervention with higher levels of pain and disability. This issue could be explained due to the per protocol analysis, small sample size, randomization corruption or a combination of both. This imbalance is crucial to determine the between-... read full comment
Comment on: Vitiello et al. Chiropractic & Manual Therapies, 15:9
Erratum to Leboeuf-Yde and Hestbæk's commentary: Chiropractic and children: Is more research enough? (Charlotte Leboeuf-Yde, 02 July 2010)
The authors have found a typing error in the very last sentence under the subheading "Which diagnostic tests can we trust?". The faulty sentence is: "If the test is neither biologically implausible nor validated, it corresponds to a red light situation and should not be used."
However, this sentence should read:"If the test is neither biologically plausible nor validated, it corresponds to a red light situation and should not be used."
Our apologies to the readers!
read full comment
Comment on: Leboeuf-Yde et al. Chiropractic & Manual Therapies, 18:11
Subluxation epidemiology: a response to Dr. Good (Timothy Mirtz, 10 May 2010)
We wish to thank Dr. Good for his response to our recent work that was published in the December issue of Chiropractic & Osteopathy. In attempting to sift through the lengthy comment provided by Dr. Good we have chosen to only address the key points he makes.
We do not believe that the conclusion of the subluxation construct (SC) having “no valid clinical applicability” is flawed. Nor is it reckless and/or harmful. Simply put, if there is little or no data providing evidence of the SC combined with and the claim chiropractors make to treat this putative entity as a causal agent then its validity should be considered unproven. Until data comes forth that can adequately demonstrate the existence of the SC and provide the necessary data that demonstrates that it is... read full comment
Comment on: Mirtz et al. Chiropractic & Manual Therapies, 17:13
A Criticism of an Epidemiological Examination of the Subluxation Construct using Hill’s Criteria of Causation: Limitations, Suspect Conclusions and an Opportunity Missed (Christopher Good, 06 May 2010)
As a chiropractic practitioner and educator over the past three decades I have been privileged to share the science, art and philosophy of the profession with thousands of patients, students and field doctors in both the United States and Europe. So it was with great interest that I read the work of Mirtz et al concerning the subluxation construct (SC) [1]. Indeed, their epidemiological examination of the SC utilizing Hill’s criteria was an opportunity to consider an important perspective regarding some of the evidence pertaining to it. It was also an opportunity to positively affect the evolution of the profession by buttressing the calls some academics have made to improve the SC, especially as it pertains to clinical practice [2,3]. Upon reflection however, it became apparent... read full comment
Comment on: Mirtz et al. Chiropractic & Manual Therapies, 17:13
plain film radiography (Mark Lopes, 08 March 2010)
In the case studies, there is mention of plain film radiography being considered normal. The description of what views were taken is incomplete. There is a photo of an A-P lumbar view in one case reportedly showing no significant findings. The MRI reportedly picked up the malignancy. The MRI shown was a lateral view. Was there a lateral plain film taken? The point of the article seems to be that not taking a plain film initially didn't alter the outcome. The patients apparently died, but if a lateral was not taken as would be standard practice if one is to expose an area (taking opposing views of the area is generally accepted as standard) how are we to know the lateral plain film would not have shown the malignancy? The second case was similar, only showing an A-P chest view. Was a lateral... read full comment
Comment on: Pringle et al. Chiropractic & Manual Therapies, 14:8
Subluxation, evidence-based medicine and epidemiology. Response to comments made by Drs. Demetrious and Hart (Timothy Mirtz, 07 January 2010)
We wish to thank Drs. James Demetrious and John Hart for their thoughtful Letters to the Editor concerning our recent paper “An epidemiological examination of the subluxation construct using Hill’s criteria of causation”[1].
Dr. Demetrious referred us to the paper by Phillips and Goodman entitled, “The missed lessons of Sir Austin Bradford Hill" [2]. We wish to point out that we specifically used the Phillips reference in our paper under the subheading “Limitations to utilizing Hill's Criteria” (Ref #32). Notwithstanding, Phillips and Goodman’s [2] concerns about “statistical significance” and “precision” are irrelevant in the case of subluxation because we simply have no credible data upon which to perform... read full comment
Comment on: Mirtz et al. Chiropractic & Manual Therapies, 17:13
Literature support for subluxation theory (John Hart, 05 January 2010)
Editor:
The article by Mirtz et al regarding the application of Hill’s criteria to test whether or not subluxation is causal (1) is interesting but has a few problems, as follows.
1. Hill seems to apply his criteria to association first, rather than causation. (2) Indeed Hill himself warns that criteria alone do not establish cause-and-effect relationships. (2-3)
2. The authors seem to have overlooked literature that could qualify for at least some of Hill’s criteria for association. For example:
a) Given the large percentage of chiropractors (75%) who find that adjustment of subluxation results in improved health of the patient, (4) the criterion of consistency would seem to be satisfied.
b) Given the literature... read full comment
Comment on: Mirtz et al. Chiropractic & Manual Therapies, 17:13
Subluxation, Hill's Criteria of Causation and EBM (James Demetrious, 29 December 2009)
I read with interest the paper written by Mirtz et al. I have reservations regarding the authors’ conclusions pertaining to the manner in which they have editorialized the subject matter and applied Hill’s Criteria of Causation.
First, I would direct the authors to the paper written by Phillips and Goodman [1] entitled, “The missed lessons of Sir Austin Bradford Hill." Phillips and Goodman report the following:
Making a good decision does not depend on having studies with confidence intervals that exclude the null. A best decision can be based on whatever information we have now, and indeed a decision will be made – after all, the decision to maintain the status quo is still a decision. Hill offered his clearest... read full comment
Comment on: Mirtz et al. Chiropractic & Manual Therapies, 17:13
Through the Rear Window (David Millar, 19 January 2009)
Sincere thanks to Coulter and Khorsan for this thoughtful review of the publishing history of this journal. It is interesting to note that so many articles come from the US, however. there are likely many more chiropractors per capita in the US than elsewhere. The authors wonder about a name change. A name change would likely create confusion. I would encourage more osteopaths and osteopathic colleges to use this journal as a publishing vehicle.<br><br>I receive the alerts for the journaland find them to be very helpful. I find most of the articles to be well reasoned and generally thought-provoking.<br><br>Keep up the good work!<br><br>David P. Millar, DC, BSc<br>Chiropractic Consultant<br>Medical Services Branch<br>Department of... read full comment
Comment on: Coulter et al. Chiropractic & Manual Therapies, 16:14
Authors' response to Christopher Good (Donald Murphy, 19 January 2009)
We would like to thank Dr. Good for reading and commenting on our paper. We find it interesting that he predicts the "disastrous end" of an entire profession based on a single statistic (a recent decrease in graduates), ignoring all the evidence we presented of the success of the podiatry profession, particularly in comparison to the chiropractic profession. <br>Regarding his points about the successes chiropractic medicine has had, and the means by which we can build on those successes, these are points we cover in detail in our paper, so there is nothing more to be said except that the one point Dr. Good did not include was perhaps the most important. Chiropractic lacks a clear identity, and without deciding who or what we are, there is nothing to build upon. Virtually all of... read full comment
Comment on: Murphy et al. Chiropractic & Manual Therapies, 16:10
Podiatry probably is not the profession we want to emulate (Christopher Good, 14 January 2009)
While many of the arguments developed by my colleagues made good sense, there is an important bit of information they didn't take into account. That is the fact the podiatry profession appears to be coming to a disastrous end, at least in the United States. According to the US National Center for Educational Statistics from 1996 to 2005 the annual number of graduates of podiatric schools declined by 44% (from 612 to 343 students). Interestingly enough, in the same time frame US chiropractic enrollment decreased 25%, from 3395 to 2564 students, while osteopathy increased 76% (1547 to 2718).(1) While I agree we need to dramatically improve our cultural authority I would respectfully suggest that a small, dwindling profession is hardly one we would wish to emulate. In fact in contrast the... read full comment
Comment on: Murphy et al. Chiropractic & Manual Therapies, 16:10
SMT to Thoracic Spine (Charles Blum, 15 December 2008)
I have a difficult time with the concept of having students delivering a thoracic spinal adjustment and that being equated to a practitioner in practice over 5 years or more. If I was attempting to devalue SMT for the thoracic spine one way would be to have students do the adjustment, under the guidance of a registered doctor or not.The use of static or motion palpation of the thoracic spine as a rational to deliver a thrust is also might devalue the SMT since the assumption is that that joint is fixated and a thrust will reduce the fixation. In a subset of patients with this condition it may well lead to a positive outcome.Other methods of diagnosis such as determining if the vertebra or costovertebral region has a directional preference based on pain or even adjacent muscle strength... read full comment
Comment on: Crothers et al. Chiropractic & Manual Therapies, 16:12
Erratum (Raheleh Khorsan, 01 December 2008)
In our recent article for Chiropractic & Osteopathy ("Through the rear view mirror: a content evaluation of the journal Chiropractic & Osteopathy for the years 2005-2008" Chiropr Osteopat. 2008 Nov 13;16(1):14.) it has been pointed out to us that we inadvertently have an error in some of the data in the paper. Our comparison of the number of clinical trials in Chiropractic & Osteopathy to the number published in JMPT is incorrect. The actual number of trials in Chiropractic & Osteopathy was 10/84 or 12%. This figure was arrived at by surveying each article. The comparative figure for JMPT was derived from the data from MEDLINE and is 16.6% for trials. Unlike our analysis for Chiropractic & Osteopathy we have no way of knowing if the figure in MEDLINE is accurate or not.... read full comment
Comment on: Coulter et al. Chiropractic & Manual Therapies, 16:14
Disentangling manual muscle testing and Applied Kinesiology: critique and reinterpretation of a literature review. A reply (Scott Cuthbert, 31 August 2007)
Letter to the EditorDisentangling manual muscle testing and Applied Kinesiology: critique and reinterpretation of a literature review. A reply We would like to comment on this paper by Haas, Cooperstein, and Peterson where they critique our publication. The validity of the MMT for neuromusculoskeletal (NMS) diagnosis (its construct and content validity [1-2], convergent and discriminant validity [3], concurrent and predictive validity [4-5]) was presented in our paper after peer review and accepted by Haas, Cooperstein, and Peterson. The internal validity was strong in a number of the papers reviewed. These studies were time-series experiments that help to rule out rival explanations for beneficial clinical changes following treatment [6]. We disagree with Haas et al’s interpretation... read full comment
Comment on: Haas et al. Chiropractic & Manual Therapies, 15:11
One additional correction (Dana Lawrence, 28 May 2007)
Please note that I had an additional error in my paper. Ramsey et al.’s study (the first listed) concerned older adults with osteoarthritis, not osteoporosis. The discussion of this study in the text is correct; in the table it is typed improperly. read full comment
Comment on: Lawrence et al. Chiropractic & Manual Therapies, 15:2
Typographic error correction (Dana Lawrence, 30 January 2007)
While I am extremely thrilled to see my article be made live as a final pdf just today, I must also note two typographic errors in my entry regarding the work of Hawk et al cited in reference 46. The correct wording is that 72% of DCs used acupressure, not acupuncture (only 17% reported using acupuncture); and 8% (not 68%) of respondents thought chiropractic should be viewed as a therapeutic modality. I apologize for these errors. read full comment
Comment on: Lawrence et al. Chiropractic & Manual Therapies, 15:2
In Response to Dr. Nick Donovan (Dana Lawrence, 11 January 2007)
Thank you for your comment. Our interest in this subject is more geared toward understanding the level of knowledge within the chiropractic academic and research communities, not in comparing that understanding to the medical profession, though that would certainly make for an interesting study. To this end, we have noted in our paper that we would like to broaden our survey to include all chiropractic institutions, no matter what philosophical stripe. Thanks for writing,Dana J. Lawrence, DCPalmer Center for Chiropractic Education read full comment
Comment on: Lawrence et al. Chiropractic & Manual Therapies, 14:27
A Wider Examination Spectrum is Needed (Nicholas Donovan, 22 December 2006)
It may be a bit more relevant to poll various medical colleges as well as schools of Chiropractic to get a better understanding of the differences in understanding of the subject.Further contrasting those from a Chiropractic perspective would be to include the more 'mixed' schools such as Parker College and those in the liberal arts schools such as Bridgeport or D'Youville as their perspectives may be a bit different.Cheers,Nick read full comment
Comment on: Lawrence et al. Chiropractic & Manual Therapies, 14:27
Alternative interpretation of needle electrode findings (George Kukurin, 19 October 2006)
I read with interest the case report "Improvement of lower extremity electrodiagnostic findings following a trial of spinal manipulation and motion-based therapy" Chiropractic & Osteopathy 2006, 14:20 doi:10.1186/1746-1340-14-20.Congratulations should go out to Dr. Morningstar for his contributions to the literature. However in perusing his Table 1, pre-post electrodiagnostic findings; it appears that there were very minimal, if any, changes reported in the needle portion of the EMG between pre and post interventions.Before addressing specifically the data presented in table one, a very brief review of needle electrode examination (NEE) findings may be in order. Once the connection between the motor nerve and muscle is interrupted (denervation) the newly denervated muscle becomes... read full comment
Comment on: Morningstar Chiropractic & Manual Therapies, 14:20
Timely article (Joe Ieranò, 31 August 2006)
Dr. Wenban's article struck an immediate chord of importance as I had just had a letter to a journal refused - apparently without peer review, without reason or attempt to revision - regarding an article allegedly misrepresenting the term "chiropractic manipulation". Wenban's discourse is important for the advancement of Evidence Based health care, because without accurate classification of therapeutic interventions data is made virtually useless. read full comment
Comment on: Wenban Chiropractic & Manual Therapies, 14:16
Is There Evidence?: Reply to Drs. Blum and Cuthbert (Steve Hartman, 26 July 2006)
Is There Evidence?: Reply to Drs. Blum and CuthbertDr. Norton and I are grateful that Drs. Blum and Cuthbert (hereafter, "Drs. B and C") have taken the time to highlight what they perceived as deficiencies in our research. Others may have had similar reactions and this gives us an opportunity to put some illuminating flesh on these bones. We first will try to summarize the authors' main points. We then will react to each point (in order) and close with a suggestion that we hope will help us be productive in any further dialogue.The authors' main points:1) In our critiques, Dr. Norton and I have put too much emphasis on aspects of Sutherland's biological mechanism. For that reason and because we lacked familiarity with relevant literature (see item 3), some of our critical conclusions... read full comment
Comment on: Hartman Chiropractic & Manual Therapies, 14:10
Cranial Therapeutic Care: Is There any Evidence? (Charles Blum, 12 July 2006)
Cranial Therapeutic Care: Is There any Evidence?Charles L. Blum, DCScott Cuthbert, DCIt appears from a review of past letters by. Hartman [1] and Norton [2] that they are making a concerted effort to gain some recognition for their premise by questioning the efficacy of cranial osteopathy or cranial therapeutic care. One way they have chosen to elicit a response has been by making far overreaching statements, which are ironic since Hartman thinly veils himself in a gossamer cloak of science, research, and evidence-based healthcare. While it is common for researchers to have preferences and exhibit a bias we will note that our preference is for an open-minded dialogue of the risk/benefit ratio of a treatment, its biological plausibility, and its evidence base, which includes case histories... read full comment
Comment on: Hartman Chiropractic & Manual Therapies, 14:10