Issue 12 / 4 April 2011

CHIROPRACTIC is, to most people, synonymous with back pain, spinal manipulation, bone-cracking and hard mattresses.

And it still would be for many of us, if the British Chiropractic Association had not decided to sue United Kingdom science writer Simon Singh for an article published in 2008. Singh claimed many chiropractic treatments were “bogus”, unintentionally bringing the dark side of chiropractic out into the open for the world to see.

Fortunately, the case was dropped in April last year. But by then these actions had backfired, with the General Chiropractic Council (GCC) being forced to admit that “chiropractic vertebral subluxations” was a made-up term used to describe invisible lesions of the spine — fundamental to chiropractic philosophy — which do not exist.

With 600 complaints being processed by the GCC, chiropractic in the UK was in meltdown.

Months after the court case, I noticed that nothing had changed in Australia with most chiropractic websites continuing to make unsubstantiated and worrying claims that chiropractic can be used to treat babies, infants and children for health conditions such colic, asthma, allergies, bedwetting, attention deficit hyperactivity disorder and ear infection.

Many chiropractors also advise parents against vaccination, recommending the Australian Vaccination Network (AVN) as a source of information.

In July 2010, the Health Care Complaints Commission issued a public warning against the AVN for inaccurate and misleading information.

Chiropractic is not even considered a safe placebo, with a review in 2010 of 26 published cases of deaths after chiropractic manipulations concluding that the “risks of this treatment by far outweigh its benefit”.

My interest in chiropractic stems from my investigation of alternative and complementary medicine that emerged from my breast cancer diagnosis in 2003 and the realisation that many alternative therapists use predatory behaviour to target the most vulnerable of patients.

Over the years, I have seen the parents of children with cancer wasting large sums of money on mostly useless complementary medicines, so I became involved in research that led to my involvement in an article published in the MJA and in a National Prescribing Service project on these non-prescription drugs.

Chiropractors also actively target vulnerable parents by including claims on websites, dropping brochures into childcare centres, advertising in parenting magazines, hosting free seminars, social networking, cold calling and providing video loops in waiting rooms. Parents of sick children are a particularly vulnerable group.

Someone had to document chiropractic claims, so I decided that it may as well be me.

So far, the project has taken 7 months, and I have written a number of reports for the newly established Australian Health Practitioner Regulation Agency (AHPRA), the organisation responsible for the registration and accreditation of chiropractors as well as other registered health practitioners.

I documented websites, promotional activities and inappropriate services, and included evidence, expert opinion and considerable research. This resulted in a meeting with AHPRA in February this year, when I was assured that advertising and testimonials were a priority and that my reports were an important part of their ongoing investigations.

An intriguing finding from my research was that nearly every Australian chiropractic website makes similar claims. I concluded that the 19th century teachings of chiropractic in universities including the RMIT University in Melbourne, Macquarie University in Sydney and Murdoch University in Perth might be part of the problem.

When I noticed that the RMIT ran a paediatric chiropractic clinic, I realised that it was probably promoting inappropriate and potentially harmful treatments.

Armed with more evidence and additional research, I asked professors of medicine, psychology and science in Australia and the UK to support a report to Federal Health Minister Nicola Roxon, requesting that this clinic be shut down.

From both sides of the planet, the response was overwhelming.

As more letters continue to head for Canberra, and more support comes in from around the world, I can only hope that our transatlantic efforts will stop this blatant exploitation of our precious children.

Ms Loretta Marron is a science graduate with a business background and was named Australian Skeptic of the Year in 2007.

Posted 4 April 2011

33 thoughts on “Loretta Marron: Cracking the chiropractic case

  1. John Reggars Vice President Chiropractic says:

    The Chiropractic & Osteopathic College of Australasia sees itself as a rational voice of the chiropractic profession. COCA promotes interprofessional collaboration and evidence based practice. Our response to Ms Marron’s article “Cracking the chiropractic case” is reflected in the letter below sent to Nicola Roxon:
    Dear Minister,
    The Chiropractic & Osteopathic College of Australasia (COCA) wishes to to respond to the recent letter forwarded to your office by Ms Loretta Marron, which primarily outlines concerns about the treatment of children with chiropractic spinal manipulation, the treatment of conditions other than disorders of the musculoskeletal system and an anti-vaccination stance adopted by some chiropractors.
    COCA is a major stakeholder in chiropractic and is a non-profit organisation (with over 1000 members) that advocates quality, safe and ethical chiropractic and osteopathic practice. Our vision is to promote “An ethical practitioner who values research, continuing professional development, evidence based practice and interprofessional cooperation, in order to improve community health through quality care.”
    While we agree with certain apsects of Ms Marron’s letter we have concerns that her letter portrays the entire chiropractic profression as a group that has abandoned science for pseudo-religious rhetoric. Those sections of the profession who espouse views that have no scientific foundation and put the public at risk have no place in the deleivery of modern health care and should be referred to the Chiropractors Board of Australia (CBA).
    COCA’s position on the treatment of children and chiropractic practice in general is reflected in our submissions to the CBA, as part of the consultation process in the develpoment of the “Code of Conduct for Chiropractors.”
    COCA wishes to inform the Hon. Minister that most chiropractors, and in particular members of our organisation, are adherents of evidence based practice i.e. they use the best available scientific information, plus clinical experience, plus patient values and circumstances. COCA does not view chiropractic as a stand alone alternative system of health care but rather a complementary one, which has benefits for patients. Chiropractic therapy, including spinal manipulative therapy, has been shown to be as safe and effective as other treatments for certain conditions causing spinal pain.
    As an organisation that promotes ethical best practice and inter-professional cooperation, we would encourage you not to judge an entire profession on the beliefs and behaviours of an unwise minority.
    Finally, COCA would be more than happy enter into further dialogue on this issue should the Hon. Minister so desire.
    Peter Tuchin Bsc, GradDip Chiro, PhD
    Chiropractic & Osteopathic College of Australasia

  2. Melissa D says:

    From what I can see on their website, the Australian Spinal Research Foundation (ASRF) only funds research that supports Palmer’s philosophy of chiropractic including those mythical ‘vertebral subluxation’ (which I might add have been discredited by the General Chiropractic Council in the UK).
    The ASRF appears to be little more than the publicity arm of the Chiropractic Association of Australia (who are against compulsory vaccination of chiropractors). They have a propaganda newsletter “Illuminate” which is full of anti-vaccination propaganda and articles relating to non-musculoskeletal conditions of children.

  3. Anonymous says:

    @Sue Ieraci
    For information on Research receiving funding grants you can check out the Aust. Spinal Research Foundations Website. With regards to continuing education, chiropractors must undertake to perform a minimum 25 hours of continuing education each year. Since the change over to AHPRA this has become self regulated with random clinic audits apparently going to be performed. Prior to the registration changes this was recorded by our association.
    I think it best if I limit my comments from now on. Firstly, I don’t want to be seen as a spokesperson for my profession, and secondly, my impression is that many of the questions being asked are not out of a genuine request to learn or form any sort of genuine interprofessional dialogue. It’s a pity.

  4. Skeptic says:

    I was a representative at the consultations for the setting up of the Australian Health Professionals Regulation Agency (AHPRA).
    At the first meeting the chiropractic representative said that he was very worried that if chiropractors were regulated nationally, then the international chiropractic body would disaffiliate the Australian body.
    Although they finally did come under AHPRA, I think that this speaks for itself.

  5. Robert Loblay says:

    Thank you again Anonymous. At *last* I understand how chiropractors assess the functioning of the nervous system and response to manipulation. I rest my case!!

  6. Melissa D says:

    For Anonymous 04/04/2011 8:46 pm:
    You state that “”Here in Australia we have the Australian Spinal Research Foundation that is funded pretty much solely by donations and memberships from chiropractors. They are working hard to increase the volume and quality of research done in the field of chiropractic.”
    Could you direct me to any substantive studies that have been published in the mainstream research literature?

  7. chris says:

    Dear Sue, you say research doesn’t have to be RCT (as the gold-standard) and that’s fair to a point. The number of possible biases is enormous and there are some excellent books on the subject. Clinical trials are extremely difficult to conduct well. Much of the poor quality research out there can be actually worse than useless – because of publication bias for instance (where negative findings are NOT published because they are not submitted).

  8. Anonymous says:

    @ Robert Loblay
    I am not sure any information I provide is likely to make a difference to your opinions. Firstly, I would say that we both know chiropractors can’t use X-rays to determine the things outlined above. I would however, suggest that functioning of the nervous system can be evaluated a number of ways and the response to manipulation be measured. In the private practice setting, algometry, range of motion assessment using inclinometers, Spinal EMG analysis (both static and dynamic), thermography, heart rate variability testing, patient reported self-assessments (ie: SF36 questionnaires) and of course the standard orthopaedic and neurological testing including myotomal, dermatomal evaluation. Granted orthopaedic testing is not highly reliable, but it is still probably the most commonly used testing procedure by physio’s, chiro’s, osteo’s and ortho’s. As for the rest, I guess you will judge for yourself their respective validities and reliabilities and the corresponding predictive values to health.
    Researchers utilise EEG, fMRI and blood analysis measuring levels of antibodies, hormonal levels etc. These are probably more difficult to use in private practice settings. When I talk about the direction of research, this is generally what I am alluding to. Which also brings me back to my original point in these comments…what evidence would you accept?
    If you are “genuinely” interested in chiropractic research, its testing methods and the direction in which chiropractic research is progressing, it’s best you do some of your own research as I am by no means an authority in the field (although I do like to keep abreast of new developments).
    BTW, with the increasing volume of research on the links between the nervous system and the immune system and CNS’s potential role in modulating immune and inflammatory responses (I am sure I don’t need to point out Blalocks and the more recent Mirotti paper), you may even find our ‘parallel worlds’ collide some day!! Who knows.

  9. Sue Ieraci says:

    To Anonymous and any other chiropractor out there – can you show us where the research is published? It doesn’t have to be RCT (that might be a gold standard, but other forms of research are valid – they all add to the knowledge base, so long as they are well-constructed). Are chiropractors expected to do coninuing education to keep up with new understandings of how the body works? Do you audit your own outcomes? WHere is your research published and how does it feed into ongoing development of the body of knowledge?

  10. Chris says:

    Melisa has put it very well. The issue is one of double-standards or as someone said above, “parallel universes”.
    The main difference between the scientific community and much of the alternative industry is whether there is adherence to the scientific process.
    Although medicine makes mistakes there is continual scrutiny and checking and re-checking by different research groups all over the world and gradually there is improvement in knowledge and treatments. It’s not a perfect process but it works (look at the progress made in the last 100 years).
    By contrast chiropractors (for example) conduct “research” which is “reviewed” by chiropractors and published in a chiropractor journal. This is not science. Note how the subject remains essentially unchanged as well. The unchanging theory is passed down to students together with knowledge on how to get the customers through the door.
    As Melisa says – let all treatments be put through the same level of scrutiny – that’s not an unreasonable request.

  11. Robert Loblay says:

    Thank you Anonymous for supporting my observation that we live in parallel universes. Apparently chiropractic concepts of “dis-ease” have “morphed over time into terms such as dysautonomia, dysponesis, dyskinesia, hypomobility, central sensitisation…” and “this progress in our philosophy and science … helps form the basis for research.” Exactly what does “basis for research” mean? Where is the evidence that such slippery things as ‘dysautonomia’, ‘dysponesis’, ‘dyskinesia’, ‘hypomobility’, and ‘central sensitization’ actually exist in the patients you treat? Are they diagnosed from X-rays? If so, has chiropractic interpretation of X-rays been subjected to blinded evaluation and standardization? If not, what other diagnostic criteria are there, what is the ‘gold standard’ against which they can be evaluated, and what is their diagnostic sensitivity, specificity and predictive value? Have there been pathophysiological studies of these hypothesized ‘conditions’? And where is the evidence (other than anecdotes and testimonials) that chiropractic treatment can successfully treat them?

  12. Mellisa D says:

    Dr Woodford said it all in AusDoc: “Why get on the defensive about a submission to the health minister requesting that educational content and clinical training practices at a university (ie, RMIT) be reviewed?”
    Ms Marron is an increasingly well recognised advocate for the consumer’s right to evidence-based medical care – regardless of the clinical discipline involved. She is asking that children’s rights be protected by lobbying for a review of the educational curriculum and treatment methods at the RMIT paeds clinic.
    Her research has highlighted what should be a worrying question for all clinicians – are the treatments which students are taught safe, effective and evidence based or are they questionable and ineffective? Even more importantly – are they dangerous?
    Please note that Vioxx was removed from the market when epidemiological evidence showed that this drug has a serious side effect of a significantly increased risk of an AMI.
    If no one had made the observations or asked the questions, this medication would still be on the market as it was, without doubt, an effective anti-inflammatory. Why should paediatric chiropractic theory and treatments be exempt from external scrutiny? Why should any clinical theory or practice be exempt? Independent audit/review is one way to try to secure more effective medical care and, hopefully, clinicians who are well up to their jobs.
    Reviews; clinical audits; investigation of RMIT paediatric clinic; assessment of clinical training…. Bring it on!!! (But let us all read the results; otherwise, what’s the point?)”

  13. Anonymous says:

    also, although I don’t agree that “research that uses a sham manipulation is not worth a pinch of salt’ it does highlight some of the difficulties in researching spinal manipulation/treatment procedures. As Ben Goldacre says in his book ‘Bad Science’, a pill is the easiest thing in the world to study. Providing a “sham” adjustment is difficult and I would imagine quite easy for the patient to pick up if they are in the treatment group or control group. It is difficult to blind the practitioner providing the manipulation, manipulation require skill of the practitioner and that skill can vary. ‘Manipulations” can come in different forms ie: manipulations that result in audible clicks and those that use instrumentation. This of course doesn’t just affect chiropractic research but also research done by other professions performing spinal manipulation.

  14. Robert Loblay says:

    BTW Chris, since chiropractors are not ‘homoeopaths’, you do not have to describe yourself as an ‘allopath’ in this debate. Those of us who are open to falsificationism can simply describe ourselves as ‘science-based’ practitioners.

  15. Robert Loblay says:

    Anonymous claims chiropractors are “working hard to increase the … quality of research”, but in the next breath he says: “…in my opinion any research that uses a sham manipulation is not worth a pinch of salt.” As pointed out by Chris Del Mar, this smacks of ‘unfalsifiability’ which, according to Popper, is the definition of a pseudoscience. Seems we are living in parallel universes.

  16. Anonymous says:

    @ Chris Del Mar
    If you follow Chiropractic politics and science I think you will find that chiropractic has challenged and continues to challenge its philosophical and mechanistic views on the subluxation and nervous system. The chiropractic philosophy and knowledge of the chiropractic vertebral subluxation has undergone significant changes over time as science and our understanding of the human body has changed. The old belief of “bone out of place, pinches nerves, causes all disease’ has progressed through a myriad of stages and imo will likely continue to change as we progress in our understanding of the human body. Unfortunately, whilst this type of development over time in other fields of science is highlighted as progress, similar such changes and developments in chiropractic can either go unrecognised or are dismissed as disunity and ‘changing the goal posts’.
    I don’t wish to hijack these comments pages, but with regards to linking alignment of the spine with pathologies, I don’t think this is the case. My understanding of chiro philosophy and history is that the ‘founder’ of chiropractic linked vertebral subluxations to all disease, but the ‘developer’ distanced himself from the word disease and preferred the term ‘dis-ease’ or lack of ease. This ‘dis-ease’ has morphed over time into terms such as dysautonomia, dysponesis, dyskinesia, hypomobility, central sensitisation etc. It is this progress in our philosophy and science that helps forms the basis for research. From the beginning of chiropractic, the philosophy has incorporated mental, chemical and physical stressors as causes of dis-ease or dysfunction within the body. And we continue to expand on our understanding of how these factors affect nervous system health and overall health.
    I also don’t think that chiropractic care is an either/or with regards to caring for patients with asthma, colic, hypertension, back pain or migraine. Ie: you either go to a chiropractor or a doctor for your colic but not both. Most chiropractors, and certainly the associations within Australia recognise the importance of integrating care with other health professionals and actively seeking the participation of patients to adjust their lifestyles to minimise any negative impacts on their health.

  17. Anonymous says:

    @ Robert Loblay
    I think Prof Eddy’s qualifications speak for themselves, and as such is well placed to comment on research in health care. His assertion has subsequently been supported by information I posted in my first comments as well as the more recent work of Dr. John Ioannidis with regards to quality of medical research (and other fields too). But that is not really my point.
    I am not a scholar of the English word, so to be fair, probably didn’t put my point across very articulately. I am not meaning to criticise medicine or medical research. I am criticising the double standard in place. I don’t expect medicine to be perfect nor do I expect that RCT should govern all the doctors do. I think that David Sackett summarises EBM best (for me at least) in an editorial in the BMJ in 1994.
    I have to disagree that there is not a commitment to seek evidence in Chiropractic. Here in Australia we have the Australian Spinal Research Foundation that is funded pretty much solely by donations and memberships from chiropractors. They are working hard to increase the volume and quality of research done in the field of chiropractic. With some significant government funding, I am sure this would happen more rapidly.

  18. Chris Del Mar says:

    Dear Anonymous and other responding chiropractors,

    You make the very good point that allopathic (conventional) medicine needs to put its own house in order before casting aspersions.


    But this is an easy counter-attack. It belies a major difference between the way science (representing allopathic meedicine), as opposed to chiropractic, views itself. Science is by its nature sceptical. Indeed Popper argued that science never proves anything — it only DISproves stuff. No mechanism, model, or process is sacred. Anything can be, and is, challenged. Chiropractic on the other hand, starts off with a prerequisite belief about the alignment of the spine to many (too many?) pathologies. This appears to outsiders like me to be un-challengeable. It is this that makes ‘allopaths’ like me so uneasy. Especially as that belief has little to support it from the sciences of physiology, anatomy or pathology.

    So, yes, we are all guilty as charged about needing to maintain the rigor of the evidence underlying our clinical practices. But allopathic medicine is by its scientific nature sceptical, and the pathway for change is well established and regularly exercised. Can chiropractic also make that claim? Until it is ready to reject its central tenets, then it is going to look more like a fundamentalist religion than a science.

  19. Chris Richardson says:

    To all those chiropractors out there, and others, getting shirty, Loretta’s crusade is against the shonks of chiropractic – those claiming to cure or treat conditions such as asthma and colic. Not only is there not a scrap of credible evidence for these claims, there is no apriori plausibility, no anatomical or physiological basis upon which they can be made. As long as chiropractors stick to minor back pain (for which there is a little bit of reasonable evidence), I don’t think Loretta’s got any problem with them.

    And by the way, bringing up the flaws in the practice in traditional medicine is not a logical counter argument – more like an “oh yeah…”. Which is kind of silly. In my opinion.

  20. braillon says:

    Congratulations to Loretta. Her claims are not only useful but also successful. She is a beacon for all of us in a world of inertia.
    Now, everyone is aware of the scandal, eg. see :
    RMIT and its unsubstantiated claims is not a reason why we can’t see the wood for the trees.
    The problems are:
    1 lack of concern of the gov, of the agencies or of the medical council/college (I guess laws exist but are not implemented);
    2 the widspread use of unsubstantiated claims and unrealistic hopes, from screening to treatment, in medicine, it is not only about chiropracty or homeopathy;
    3 poor level of science education at school

  21. Robert Loblay says:

    Peter says: “there is significant evidence to support chiropractic treatment”. But the real question is: WHAT TREATMENT? As Loretta points out, most websites make unsubstantiated claims that “chiropractic can be used to treat … colic, asthma, allergies, bedwetting, attention deficit hyperactivity disorder and ear infection.”
    As for Anonymous, s/he trots out the tired old argument that most of medical practice is not ‘evidence based’. As evidence for this statement s/he quotes a figure of 15% from Prof David Eddy, a long-standing participant in the ongoing debate about EBM which the profession has been engaging in from the very beginning (many of his criticisms – which most of us would share – are about lack of head-to-head comparative RCTs of interventions that are known to work.)
    This figure of David Eddy’s (15%) is often bandied around, but is in itself not supported by any solid evidence as far as I can see. If Anonymous took the trouble to do a Google Scholar search on any orthodox medical treatment in current use, s/he would find that studies have been conducted on virtually all of them. That’s not to say the evidence is settled on all issues (which is why guidelines are needed), but at least there is a commitment to SEEK evidence. I don’t see this happening with chiropractic.

  22. Sue Ieraci says:

    One of the features of a mature profession is the way in which it regulates practice within its field. It is feasible that some skilled manipulation can assist with musculoskeletal problems. It is much less feasible that musculoskeletal manipulation would do anything for allergic-inflammatory conditions like asthma. IF there is a mature scientific community within chiropractic, isn’t it the responsibility of that community to outline what is best practice, and regulate the poor practice out of the market?
    The relevant factor about Patel is that he is no longer practising.

  23. berylshaw says:

    How biased can you be? Like any other discipline there are better, worse, best.
    I was totally cured of life disrupting migraine of around 8 years duration (twice a month for 3-5 days each, when I had young children to care for) by a very gifted chiropractor. No doctor had helped me. One even gave me an injection of a very heavy narcotic even though he knew I had to drive myself home. After one block I had to pull over and phone for help because I was almost running off the road into a lamp post.
    This all happened 40 years ago and still the cure holds – and in that time I have been close to death at least 3 times as a result of inadequate medical doctors.
    So get your facts straight.

  24. Anonymous says:

    I am a chiropractor and can see both sides of this campaign. There are a number of chiropractors out there who do use unethical means to either scare or trick people into seeking treatment. This group of chiropractors do not represent all chiropractors just as Dr Jayant Patel (Dr Death) does not represent all medical doctors! I have treated many children and will continue to do so. I however treat musculoskeletal problems not conditions such as colic, asthma and so on. Chiropractors (or physiotherapists) who actually take a good history and give a thorough physical examination are better at diagnosing musculoskeletal conditions than the average GP. In Australia, a chiropractor undergoes 5 years of university training concentrating on the neuromusculoskeletal system yet we are consistently labelled as “quacks”. Yes some are quacks, just as some in every health profession are quacks! Chiropractic is one of many health professions that need to “clean out” the crap and move on. As far as evidence-based medicine goes it is very difficult to compare a ‘sham’ manipulation as we do not know how much force is needed to make a manipulation effective or not. Until we are able to determine this, in my opinion any research that uses a sham manipulation is not worth a pinch of salt.

  25. Bruni Brewin says:

    Anonymous – I would like to add to this to support your post. There are skeptics like Ms Loretta Marron that spend a considerable time in their endevour to oust CAM alternatives, mostly to preserve their own allopathic practices that really has a pretty drastic past history itself. One such article; ‘Allopathic Medicine and Adverse Outcomes: The iatrogenic Problems Continue, by John Raymond Baker’. On the website: is a good response to this article. Instead of slandering others who in their own right are also forwarding their diciplines for the benefit of those in need of help, (just as doctors needed to do in their early days before they became accepted as a main stream healing modality), wouldn’t that time be better spent at looking for solutions in our own discipline.

  26. chris rook says:

    Loretta Marron is a tireless campaigner and makes important points.
    Those scientists and researchers who have looked at the evidence for chiropractic treatment have shown on numerous occasions that if you look at the quality clinical trials (and clinical trials are very difficult to conduct well) then apart from a small amount of evidence for low back pain and neck pain, the results from chiropractic treatment are no better than placebo.
    Certainly many of the claims made by chiropractors are outrageous and they have no place treating children. The curious anti-vaccination stance taken by chiropractors is also puzzling; they are extraordinarily unqualified to be pushing this advice!

  27. Kyla says:

    I briefly worked as a receptionist for a chiropractor while at uni. He told all his patients not to get their children vaccinated because he could “naturally stimulate their immune systems through chiropractic”. He made all kinds of other health claims about spinal manipulation as well. He was also raking in the cash, booking 3 patients per 15 minute slot and had multiple tables lined up in a row. He expected his staff to have the patient face down on the bed before he got there, he’d crack their backs, then send them off with minimal verbal interaction. Of course private health cover pays for almost all of this. After I started working I looked around for a fund that didn’t cover chiropractic because I didn’t want my premiums being wasted on such quackery. I can’t believe that Macquarie Uni offers the course as a supposedly academic masters degree, and that they then tend to call themselves “doctor”. As I said, quackery.

  28. Anonymous says:

    Can someone please explain to me what ‘evidence based medicine’ is? Every time I ask a GP or skeptic or anyone else who purports to support “only” evidence based care to the exclusion of all else, apparently it is evidence supported by RCTs. The double standard I see (esp from skeptics such as Ms Marron) is astounding and for one reason or another goes unquestioned.
    Prof. David Eddy some time ago suggested that only around 15% of medicine is supported by solid scientific evidence (RCT). More recently (2011), guidelines on Infectious disease control in the US suggested only around 14% of the guidelines are supported by at least 1 RCT and over 55% of the guidelines are based on ‘expert opinion’. Same can be said for the cardiovascular guidelines in the US in 2009. And what about the report in 2010 in the Archives of Internal Medicine that suggested that Australian GPs weren’t following international evidence-based guidelines on treating low back pain. In a 2006 report in the Medical Journal of Australia it was reported that off-label prescription of medications occurred in up to 40% of cases in adults and 90% of cases in paediatrics. And what about the Cochrane report for the benefits of NSAIDs for subacute and chronic neck pain…. “Limited evidence and unclear benefits”, yet NSAIDs are prescribed readily and available over the counter and yet it is widely accepted that these drugs are responsible for thousands of deaths. I could go on.
    Chiropractic care is possibly responsible for 26 deaths worldwide in over 70 years of data collection and there is an outcry from the likes of Ms Marron. And this repeated outcry of the dangers chiropractic care poses to children. Skeptics thrive on evidence… I would like to see the evidence suggesting chiropractic care is harming babies and children in the numbers that Ms Marron alludes too. She doesn’t like anecdotal evidence, unless she is using it to prove the case for harm done by chiropractors. One of the largest studies ever carried out on the link between neck manipulation and stroke was done by Dr. Cassidy last year, concluding that there was no increased association between chiro’s and VBA strokes and skeptics seem to totally ignore it.
    Am I saying chiropractic care doesn’t require more research? Absolutely not. More and better quality research is essential for chiropractic to continue to benefit people. But skeptics such as Ms Marron and I suggest a few in mainstream medicine should stop applying a double standard with regards to the level of evidence required and the harm caused by chiropractic care. Chiropractic care is safe and effective.
    Scepticism is healthy, it is when it becomes pathological cynicism that it is unhelpful.

  29. Grace Gawler says:

    Loretta – Good work as usual. I have been a part of CAM for 35 years and yet I am appalled at the epidemic of CAM and alt med casualties I see everyday. The term “evidence-based” has been misused & abused in many circles including and especially some lifestyle and integrative medicine groups. Patients don’t know how to interpret whether a study is valid. Governments must get involved in some way to help the consumer make wise and health promoting choices.

  30. peter tuchin says:

    dear loretta
    the vast majority of chiropractors follow evidence based practice and there is significant evidence to support chiropractic treatment. The 2010 study identified 26 reportedly fatal cases from a world wide search, covering over 70 years. Even if we accept all these cases are accurate (and they are not) it would make the risk of treatment minuscle! Chiropractic is a safe and effective treatment.

  31. Simon Brown says:

    Fantastic work Loretta. Has the ACCC been interested? They did a great job on the Advanced Medical Institute!

  32. Ken McLeod says:

    I quite agree, Chris. I do hope she keeps this up. The sooner we have non-evidence based medicine out of the country the better, and Loretta seems to be one of the few people working on that. Certainly governments seem to be unwilling to do anything.

  33. Chris Richardson says:

    Love your work Loretta…keep it up!

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