This is an archive of past discussions about Chiropractic. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page.
Chiropractic is a form of alternative medicine[1] that emphasizes diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially the spine, under the hypothesis that these disorders affect general health via the nervous system.[2] It is a marginal health care profession.[3] Although chiropractors have many attributes of primary care providers, chiropractic has more of the attributes of a medical specialty like dentistry or podiatry.[4] The main chiropractic treatment technique involves manual therapy, including manipulation of the spine, other joints, and soft tissues; treatment also includes exercises and health and lifestyle counseling.[5] Traditional chiropractic assumes that a vertebral subluxation or spinal joint dysfunction interferes with the body's function and its innate intelligence,[6] a vitalistic notion that brings ridicule from mainstream health care.[7] A large number of chiropractors want to separate themselves from the traditional vitalistic concept of innate intelligence.[8] has horrid readability -- only 5% of Wikipedia articles are less readable.
Chiropractic is an alternative medicine[1] which says that mechanical problems of the spine affect general health. While chiropractors have many attributes of primary care providers, chiropractic is considered more of a specialty such as dentistry or podiatry.[4] It uses manual therapy, including manipulation of the spine, other joints, and soft tissues as well as exercises and health and lifestyle counseling.[5] It used to assume that spine problems interfere with the body's general functions and Innate intelligence. It has been ridiculed by practitioners of mainstream health care.[7] Many chiropractors now do not follow the old belief of "innate intelligence".[8]
May I suggest that replacing "it is a marginal health care profession" with a something a little more factual and less emotive, like "It is the third largest health profession and has begun to shed its status as a marginal approach to more mainstream" [1] This reference is from the RAND Corporation which is a nonprofit research organization providing objective analysis for the public and private sectors around the world.DJFryzy (talk) 22:27, 12 February 2014 (UTC)
The purpose of the exercise was to demonstrate that content and readability are not enemies - and that we can, and ought, dramatically improve the usability of the article by people less learned that Stephen Hawking. It was not intended to be "non-improvable" at all. Collect (talk) 22:49, 12 February 2014 (UTC)
The RAND source is clearly referring to the United States and Canada - where the research it cites was carried out. It can't be cited for a general statement regarding the status of chiropractic worldwide. AndyTheGrump (talk) 22:47, 12 February 2014 (UTC)
The size does not affect the fact that it's marginal. In many cases it is a "health care profession" only in the imagination of practitioners: there's precious little evidence of any effect other than accidental benefits which would be conferred just as well or better by reality-based therapists, and plenty of evidence of noxious practice (e.g. completely unnecessary "maintenance" adjustments, unnecessary X-rays, treating children, bollocks like cranio-sacral therapy, and of course the vile antivaccination propaganda). Guy (Help!) 23:20, 12 February 2014 (UTC)
The current reference is not adequate in giving any general information regarding the profession. As per AndyTheGrump, RAND only covers US and Canada... however the current Reference 4 only covers USA.. quote from the methodology " I have chosen to analyze the debate occurring amongst chiropractors in the United States as they struggle to create their own sense of identity and project that onto a larger environment of health care providers." It therefore should be replaced by the RAND article, or be deleted as is not accurate of the general population. DJFryzy (talk) 23:33, 12 February 2014 (UTC)
See WP:Leadthe lead should be written in a clear, accessible style with a neutral point of view; it should ideally contain no more than four paragraphs and be carefully sourced as appropriate.,Editors should avoid lengthy paragraphs and over-specific descriptions, since greater detail is saved for the body of the article. In short, the lead should be clear and readable, even if you feel that abstruseness is a virtue. Cheers. Collect (talk) 13:29, 13 February 2014 (UTC)
I'd like to propose this for the lead. It is based largely on Collect's copyedits, with some additional changes (integrations from the current lead, additional removal of some redundant content, etc). I also propose migrating all the refs out of the lead and into the body, which is good practice anyway. Let me know what everyone thinks. — Jess· Δ♥15:00, 13 February 2014 (UTC)
Definitely an improvement, though I would likely remove the "internal stuff" about different groups of chiropractors, and the iteration of such terms as "vitalism" which may be historically interesting, but are unlikely to be relevant to most readers now. Also such material as crossroads as being opinion as such. I think the lead can be brought up to the 25% WP mark without too much effort overall. Collect (talk) 15:09, 13 February 2014 (UTC)
I agree that the "straights vs mixers" bit seems overly detailed, but I do think it's important to distinguish between the two groups. I wouldn't want the lead to imply that all chiropractors fall into just one of those groups. The terminology is probably insignificant in the lead. I also have a problem with the crossroads bit, but for a different reason. The 2nd half of that paragraph seems to conflict with the final sentence (and the rest of the lead). Is it increasingly accepted by mainstream physicians, or not? That whole paragraph (after vaccinations) looks like its the result of years of editing and compromises, as opposed to being the best reflection of the sources. — Jess· Δ♥15:21, 13 February 2014 (UTC)
@Collect:, how is draft 2? I removed the antitrust campaign (figuring coverage in the body was more useful), the "crossroads" sentence, the "straights and mixers" terminology, and and then combined some ideas. It's a bit shorter. — Jess· Δ♥15:52, 13 February 2014 (UTC)
Better -- but can we lose the "laundry list" of groups not directly related to the topic, and the "vitalism" bit which may fit in the body but is likely to confuse readers looking for a clear exposition of the article. And the "controversial ... battling" bit could be changed to "conflicted with mainstream medicine" and remove the superfluous "pseudoscientific" bit as that is rather implicit in the prior clause, and does not need further exposition in the lead AFAICT. Collect (talk) 16:05, 13 February 2014 (UTC) Cheers. Collect (talk) 16:05, 13 February 2014 (UTC)
I think this is where we disagree. IMO, that shortens it too much. I'm not sure which unrelated groups you're referring to, so I might support that if you could clarify. However, I think mentioning the underpinnings of pseudoscience is important and not implicit, and I think "in addition to chiropractic's traditional [vitalism]" is significant, since removing it would imply some chiropractic is composed of entirely conventional techniques. Does that make sense? I'm open to seeing what other editors think, though. If you want to add another section called "Collect's draft", go for it. — Jess· Δ♥16:30, 13 February 2014 (UTC)
Leads are supposed to be summaries -- when entire sections get incorporated into the lead, it is no longer compliant with the MOS standards. Collect (talk) 22:34, 13 February 2014 (UTC)
Sure, but I'm not clear how that applies. Mentioning the words "pseudoscience" and "vitalism" in the lead isn't "incorporating entire sections". The lead includes a summary of chiropractic's pseudoscience and vitalistic underpinnings, which are both fairly integral to the topic. — Jess· Δ♥00:26, 14 February 2014 (UTC)
I made the change, hoping for additional input. So far, it seemed to be relatively positive reception on talk. I know Collect has some other ideas for changes. I'm hoping for some additional input from others, since it's a pretty big change on a top level article. — Jess· Δ♥00:39, 14 February 2014 (UTC)
I would like the references to stay in the lede. This will benefit the reader, especially on this controversial topic.
I think this sentence can be improved: "Some modern chiropractors now incorporate conventional medical techniques, such as exercise, massage, and ice therapy, in addition to chiropractic's traditional vitalistic underpinnings."
Previous sentence: "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; "mixers", the majority, are more open to mainstream views and conventional medical techniques, such as exercise, massage, and ice therapy.[8]"
I think the text would improve if you explain the difference between "straights" and "mixers". Stating "Some modern chiropractors"... is too vague. QuackGuru (talk) 01:09, 14 February 2014 (UTC)
Peer review in Chiropractic & Manual Therapies is designed to ensure that published articles are scientifically sound.
The submitted manuscript will be sent to two external experts for evaluation of scientific significance and validity.
Peer reviewers will have three possible options for each manuscript: accept, accept with revision, and reject. Peer reviewers are asked to justify their decision.
Based on the critiques of the reviewers, the authors may choose to revise their manuscript and resubmit it for an additional review. Chiropractic & Manual Therapies allows authors a maximum of two revisions of a manuscript."[1]
This worked for the acupuncture article: "A 2012 meta-analysis conducted by the Acupuncture Trialists' Collaboration found "relatively modest" efficiency of acupuncture (in comparison to sham) for the treatment of four different types of chronic pain, and on that basis concluded it "is more than a placebo" and a reasonable referral option.[107] Commenting on this meta-analysis both Edzard Ernst and David Colquhoun said the results were of negligible clinical significance.[108][100]"
I included both the 2010 report and the response from Ernst: Commenting on this study, Edzard Ernst stated that it was a notorious example of a pseudo-systematic review that omitted evidence, for instance, of negative primary studies.[134] QuackGuru (talk) 04:25, 11 February 2014 (UTC)
It is not an objectively reliable source, obviously, since its existence is dependent on promoting the validity of chiropractic, its editorial board are all ideologically committed to chiropractice, its authors are all chiropractors, and thus is follows the pseudoscientific method (seeking confirmation) rather than the scientific method (testing truth). It is a reliable source for what chiropractors believe, but not for truth. A bit like Acupuncture and Meridian studies or Homeopathy - we can use such junk journals to describe the views of practitioners, but not to assert that these views are in any way connected with reality. Guy (Help!) 07:20, 12 February 2014 (UTC)
You provided evidence that they claim peer review. You haven't shown that their peer review is any good or that they have any sort of reputation for fact checking; i.e that they aren't fringe. IRWolfie- (talk) 22:35, 13 February 2014 (UTC)
Dated 2005 Canadian Chiropractic Association source
Gleberzon et al. identify "deliberate fraud" as a notably harmful element of the chiropractic profession, finding that dubious practice techniques can translate into "outlandish billing and utilization rates". Those at the "fringe of ethical behavior" present the profession with a challenge, they believe, and must be weeded out.[210] Alexbrn claims chiropractic peer-reviewed journals are fringe journals but look what Alexbrn added to the article. See Chiropractic#Cost-effectiveness. Should we keep this dated source or delete it? QuackGuru (talk) 04:45, 13 February 2014 (UTC)
Their opinion is neither extraordinary nor out-of-sync with the mainstream. Is there more recent material on this topic? How is the weeding-out going? Alexbrntalk|contribs|COI07:20, 13 February 2014 (UTC)
Unless the source states that such behaviour is peculiar to chiropractic, I think it may easily hit undue weight. "Outlandish billing" has been noted recently for many medical areas, including hospitals in general. Collect (talk) 13:24, 14 February 2014 (UTC)
Enough boldness already
There are an immense number of edits, restoring much content that had previously been discussed and rejected, and introducing other questionable content. It is time to stop the rapid-fire edits and start discussing them.
For example, the section "conceptual basis" is written entirely in-universe, and fails to reflect the fact that "innate" is (a) rnonsense and (b) still believed by some; it does not reflect the fact that vertebral subluxation does not exist; it presents descriptions of straights and mixers direct from the manual and not accordding to a reality-based perspective.
There are far too many edits over too short a time to properly assess, and any attempt at discussion is steamrollered bere by "I changed that" without in any way taking on board the comments made. QuackGuru, this article is covered by the WP:FRINGE arbitration. I am rolling back to the point before your mass edit spree, per WP:BRD, you must now achieve consensus for the changes you wish to make. Guy (Help!) 23:16, 1 February 2014 (UTC)
You are engaging in argument by assertion. You made many edits in a short space of time, replacing the version thrashed out over months with a version favourable to an idealised view of chiropractic and reverting changes made to try to restore long-standing consensus wording. You falsely perceive your own biases as neutrality. The article falls under the ambit of the arbitration ruling on pseudoscience, that kind of behaviour is not going to do you any favours.
This is against a background where I know that external collusion is going on, and where the trade is desperate to refactor the Wikipedia article to follow the idealised view they like to present to legislators rather than the real-world view. Chiropractors are widely viewed as charlatans due to their practice of endless courses of wholly unnecessary "maintenance" treatment, adverse events about which they are in flat-out denial, claims of safety in the absence of any systematic adverse event reporting (and some thing that dizziness and blackouts are not significant), implausible claims to cure colic and asthma, blatantly pseudoscientific side-practices like quack nutritional therapies and cranial osteopathy, and widespread anti-vaccination activism. As your own version acknowledges, chiro needs to ditch a lot of baggage to become a reputable health profession. Until it has done that, we don't represent it as a reputable health profession.
So: propose changes, in bite-size chunks that can be assessed by others, and don't execute them until you have achieved consensus. Guy (Help!) 09:37, 2 February 2014 (UTC)
The thing is, Guy, that QG isn't pro-chiropractic; he isn't part of a grand conspiracy to promote pseudoscience; and he certainly isn't a trade-insider, looking to get rich by promoting his business in a flattering light. I don't know of an editor more skeptical of chiropractic's claims than QG. You're claiming "consensus" for the wording and sources, yet you haven't read the archives. Try 31 to 33 where even a cursory glance will show you that you've got him wrong. Your problem at present is that you're on a crusade to get chiropractic re-classified as fringe/pseudoscience, but it isn't. It is a serious discipline in the CAM field and does have good quality, reliable sources that have studied it. You'll find the jury's still out on most of the claims of effectiveness - even Ernst's 2008 review admitted some results in treating lower-back pain - and I still find Ernst's conclusion that the "risks outweigh the benefits" to be convincing. But that's not the same as feeling it necessary to paint a wholly negative picture when the best sources don't agree with that. Your extremism at one end is as misguided as those chiropractic advocates who were so relentless 3 years ago. It does us no favours to try to turn "CAM" into "Fringe", because when we fail to understand the difference, we weaken our ability to reject wholly non-scientific pseudoscience like homeopathy - and that only benefits the snake-oil salesmen in the long run.
I agree most heartily with your advice to QG (and I've already suggested the same to him, at WT:WikiProject Medicine. Let's do our best to cooperate in improving this article and genuinely seek some consensus. --RexxS (talk) 17:36, 2 February 2014 (UTC)
You did not directly response to my comment in this thread. See Talk:Chiropractic#Conceptual basis problems. You have not given a reason based on Wikipedia policy why this article should not have a good summary of the body in the lede and you have not made any legitimate objection to my edits based on any policy on Wikipedia. Your statement of chiropractic such as "Chiropractors are widely viewed as charlatans" should not get in the way of improving this article even if it is the truth. QuackGuru (talk) 17:56, 2 February 2014 (UTC)
I'm judging by the tone of the edits, many of which are functionally identical to proposals in the past by Puhlaa, who is not only pro-chiropractic but a practising chiropractor. But actually the principal point is that this is a mature article and it was extensively refactored over a rapid series of dozens of edits, with absolutely no meaningful response to any reservations raised other than to assert, basically, that QG rewrote that (as if that necessarily fixed the problem). The WHO example is a case in point. That does not belong in the lede because it makes a claim that is unsupportable (how would they know if it;s safe, every independent assessment shows that there is no systematic adverse event reporting) and it certainly doesn't belong in the block devoted to the reality-based perspective, because it's a report written by industry insiders. The WHO has fallen down in this way many times, with reports on homeopathy and acupuncture also written by insiders, at least one of which they have had to publicly distance themselves from. Developing the article is fine, change is good, but please achieve consensus first, and don't use a blunderbuss. Guy (Help!) 20:36, 2 February 2014 (UTC)
The WHO guideline belongs in the lead in the absence of any MEDRS-compliant source that contradicts it. Your personal opinion on the flaws of the WHO are worthless in the absence of reliable sources that confirm your opinion. The WHO guidelines had consensus from three years ago and it's you who are editing in defiance of that consensus. I'm happy to discuss CCC, but you need to bring sources that support your view. Or better yet, you need to amend your view to match what the best sources say and not let your personal bias cause you to reject good sources where their conclusions are inconvenient to your preconceptions.
As a matter of principle, I've restored the last-known good version of the article, because you have twice evaded my reasonable request to state which version of the article you restored. If anyone wishes to restore an earlier version, then I have no objection as long as you have the courtesy to indicate which version of the article you are restoring. --RexxS (talk) 20:55, 2 February 2014 (UTC)
The WHO source may be the most reliable source for safety information in general. No other source directly contradicts it. QuackGuru (talk) 04:06, 3 February 2014 (UTC)
Apart from the ones noting serious adverse events, anti-vaccinationism and so on, of course. The problem is that the WHO report refers to an idealised "safely practiced" chiropractic, assuming that the lack of adverse events is because there are none rather than because of the well known absence of any systematic recording of them, and begs the question of what is correct practice - something on which chiros themselves show no agreement. It's a document written by the industry to try to legitimise itself, and should not be viewed as any kind of authoritative statement on the actual safety of chiropractic as practiced. It needs to be viewed in the context of commentaries like this, which note: " In patients <45 years old, those with VBA [vertebrobasilar accidents] were 5 times as likely as controls to have visited a chiropractor in the previous week, and 5 times more likely to have made more than 3 visits for cervical treatment in the preceding month." See also this: "As they have no systematic method of compiling adverse events, they simply aren’t looking for them." And remember that the neck twist is a singularly dramatic intervention, and one that many chiros regard as a signature move. It is potentially lethal and has no proven beneficial effect. We have to be extremely careful in taking any kind of assessment of risk at face value, because as the Nerology study showed, they are normally found only by reverse engineering admissions data. You cannot survey chiropractors and ask them for adverse event data, they don't have it, and many of them are in denial about the mere possibility they might exist. And as I said before, the WHO previously published a report on hmeopathy, also written by industry insiders; it was junk. They have since distanced themselves from this. In alternative medicine the WHO is acting in a political role: it is vulnerable to lobbying by interest groups and that can and does skew output. Guy (Help!) 10:41, 3 February 2014 (UTC)
I am trying to find a better source specifically for the "safety" information. Eventually Ernst or another researcher will explain the current safety of chiropractic. QuackGuru (talk) 05:16, 4 February 2014 (UTC)
I'm not sure that Ernst is the best place to look for neutrality of information in regards to chiropractic. The following article may be of benefit for this article
"Current literature shows that minor discomfort or soreness following spinal manipulation typically fades within 24 hours."
1. Senstad O, et al. Frequency and characteristics of side effects of spinal manipulative therapy. Spine 1997 Feb 15;435-440.
"Neck manipulation is a remarkably safe procedure. While some reports have associated upper high-velocity neck manipulation with a certain kind of stroke, or vertebral artery dissection, recent evidence suggests that this type of arterial injury often takes place spontaneously, or following everyday activities such as turning the head while driving, swimming, or having a shampoo in a hair salon."
2. Cassidy D, et al. Risk of Vertebrobasilar Stroke and Chiropractic Care. Spine 2008; 33:S176–S183.
"The best evidence indicates that the incidence of artery injuries associated with high-velocity upper neck manipulation is extremely rare – about 1 case in 5.85 million manipulations"
3. Haldeman S, et al. Arterial dissection following cervical manipulation: a chiropractic experience. Can Med Assoc J 2001;165(7):905-06.
The problem is that those are chiropractors denying the problem, and they have exactly the same issue that all other chiropractic claims of safety have: there is no systematic reporting of adverse events. What we do know for sure is that victims of VBAs under age 45 are substantially more likely to have recently visited a chiropractor {[2], [3]). Any paper by a chiro that does not address this head on, is by definition not a rebuttal to the point. The reason Ernst is a more reliable source than chiros, evidentially, is that he is not financially dependent on chiropractic. He's also more reliable scientifically in that his research does not start from an assumption of validity, which is the core problem that leads research in fields such as chiropractic to be characterised as pseudoscience. Guy (Help!) 13:27, 12 February 2014 (UTC)
Chiro's are not alone in not having a systematic reporting system. You will need to extend that criticism to physical therapists, osteopaths, exercise physiologists etc. In Australia at least, Chiropractors are the ones heading up the push for systematic reporting.
Ernst not making money off chiropractic? All you need to do is buy a few books that he sites his own research in and he's making money. Sorry, but that is not a good argument. Ernst has invested interest in his research. The largest study, that i'm sure you would like to rebut is the Cassidy study in regards to stroke and primary health care interaction. This would also suggest that you have an increased risk of stoke seeing your MD. DJFryzy (talk) 00:22, 13 February 2014 (UTC)
Further to this last comment. A recent paper from Tuchin et al in CMT 2012 showed "The number of errors or omissions in the 2007 Ernst paper, reduce the validity of the study and the reported conclusions. The omissions of potential risk factors and the timeline between the adverse event and SMT could be significant confounding factors. Greater care is also needed to distinguish between chiropractors and other health practitioners when reviewing the application of SMT and related adverse effects." DJFryzy (talk) 03:38, 16 February 2014 (UTC)
What's CMT 2012 ?
Radical changes to article
The recent additions and subtractions from this article have shown blatant bias to the topic. This is meant to resemble an encyclopaedia, not propaganda for ones own agenda. QuackGuru has continued to use articles from the likes of Edward Ernst, in preference to peer reviewed literature such as Cochrane and guidlines from some of the most prominent medical societies.
This page has been the subject of much vandalism in the past and it is not appropriate that we continue to allow this to happen to this page.
You will find it much more productive to refrain from accusing contributors of 'vandalism', and instead provide specific details of what exactly the problem is. AndyTheGrump (talk) 04:08, 12 February 2014 (UTC)
How about we start with reference 3. The reference never mentions the profession is marginal, however that some members remain tied to a marginal professional status..i.e. a "minority" are tying themselves to a marginal group, no longer supported by the broader profession.DJFryzy (talk) 05:06, 12 February 2014 (UTC)
Looks fine to me (though we could say it "has been called a marginal profession"). You're quoting from the abstract? "The potential movement of chiropractic from a marginal to a limited status" is one of the strands of the article. Alexbrntalk|contribs|COI06:53, 12 February 2014 (UTC)
Adding a "'Simon-says' style" like "has been called" a marginal profession raises a serious dispute as to the wording of "marginal profession".
The existence of featured articles on controversial subjects like Evolution, articles that do not use the "Simon-says" style, shows that we need not use the "Simon-says" style here. The "Simon-says" style is certainly not required for NPOV. It is merely a style; other, better styles are available.
The proposed style change, which is to insert "has been called" when the current wording has a significantly NPOV tone, raises the question of how one determines whether a word or phrase has a significantly non-NPOV tone. I think WP:ASSERT is a good way to follow when there is no serious dispute. QuackGuru (talk) 20:59, 12 February 2014 (UTC)
Bravo, point taken. Doesn't make your point though, if the article was good enough for a featured article according to whoever makes those choices, perhaps your metric isn't as good as you think it is? Anyway, that isn't what I meant, as you probably realise. -Roxy the dog (resonate) 21:27, 12 February 2014 (UTC)
We are going off topic a little here... back to the profession being labelled "marginal".. A study from the RAND corporation state, Today, chiropractors are the third largest group of health care providers, after physicians and dentists, who treat patients directly. In the last decade of the 20th century, chiropractic has begun to shed its status as a marginal or deviant approach to care and is becoming more mainstream. [2]DJFryzy (talk) 22:20, 12 February 2014 (UTC)
User:DJFryzy, you may be right. This proposal is for section Chiropractic#International reception: "In the U.S., chiropractic is the largest alternative medical profession.<ref name=Kaptchuk-Eisenberg/>
How should we go about editing the article? I suggest either removing "marginal profession" and changing to either "It is a profession moving from a marginal to mainstream health profession" ... or ... "it is a profession maturing towards mainstream healthcare profession"...or any other thoughts?DJFryzy (talk) 10:04, 13 February 2014 (UTC)
The quickest fix is probably to delete that sentence (how can a profession be based on vitalism anyway?) until the definition is nailed down better, as you are proposing below. The RAND document is not a great source - something out of an American think-tank? We can do much better. Alexbrntalk|contribs|COI08:35, 14 February 2014 (UTC)
I'm not sure I understand. Why couldn't a profession be based on vitalism? It is, isn't it? [5], [6], [7], [8], [9] Shouldn't we document this clearly in the lead, since it's such a large part of the traditional (and even current) underpinnings of the topic? — Jess· Δ♥14:51, 14 February 2014 (UTC)
I'm probably just being pedantic/weird (hey, I'm British - that's my excuse anyway) and seeing "based on" as implying an "is a" rather than "has a" type of relationship. I think one could say the beliefs in chiropractic are based on vitalism, or that the chiropractic profession is based around the sales of services which contain elements of vitalism. Alexbrntalk|contribs|COI14:57, 14 February 2014 (UTC)
I see. So you'd prefer not saying "a profession based on vitalism". Would "chiropractic is based on vitalism" be ok? We're defining chiropractic as "a form of alt med", so that seems to sidestep the issue AFAICT. I tried incorporating that into the lead. Let me know if it addresses your concerns! — Jess· Δ♥15:10, 14 February 2014 (UTC)
Or we could say "Traditional chiropractic, with beliefs based on vitalism...", but that seems a little wordy for me. — Jess· Δ♥15:12, 14 February 2014 (UTC)
Seems way too wordy... the RAND doc was a non chiropractic think tank out of the US and Canada. The two largest providers of chiropractic services. Thus probably a fitting group to define a profession. How about we make a few changes here... delete: *marginal* as we have decided that this is not the case..Second change appears to be around *vitalism*. According all the sources that have been mentioned above, vitalism is a part of the philosophy of chiropractic, not necessarily the basis of the clinical aspect of practice. Would it be more appropriate to have a sentence such as "Chiropractic philosophy is based on vitalism..." or "Vitalism is the core of chiropractic philosophy..."DJFryzy (talk) 04:34, 15 February 2014 (UTC)
That's wordier. The current approach was just to add the words ", based on vitalism," to the article. — Jess· Δ♥04:38, 15 February 2014 (UTC)
Not sure what you mean. What's the "context"? Your recent edit changed it to be only a historical connection, is that what you mean? As far as the sources I've seen indicate, the connection is not only historical, but also current. "Straights" embrace the traditional vitalistic underpinnings of the profession, and "mixers" still incorporate vitalism with bits and pieces of modern medicine. Do we have sources indicating the connection to vitalism is only in the past? — Jess· Δ♥05:08, 15 February 2014 (UTC)
Thank you Puhlaa for the link. Some critical points from this article.
Even to call chiropractic "alternative" is problematic; in many ways, it is distinctly mainstream*
Today, a substantial number of chiropractors are anxious to sever all remaining ties to the vitalism of innate intelligence. For these practitioners, the notion of the innate serves only to maintain chiropractic as a fringe professionDJFryzy (talk) 06:17, 15 February 2014 (UTC)
Furthermore, Jess, in regards to the previous changes to the lede in relation to history, the recent paper cited may assist [3] The summary of this article shows that >80% do not adhere to "traditional" chiropractic. "only a minority of the profession has retained a perspective in contrast to current scientific paradigms."DJFryzy (talk) 06:20, 15 February 2014 (UTC)
With this in mind, May i make a few suggestions for the lede.
removal of Marginal
change of "Traditional chiropractic, based on vitalism," as per this recent paper...As I have proposed "A minority of chiropractors assume that spine problems interfere with the body's and innate intelligence, a vitalistic notion that brings ridicule from mainstream health care...."
a more appropriate definition of chiropractic. "Attempts to diagnose" seems like an unusual way to put it. Particularly since multiple references quote chiropractors are trained and qualified to diagnose neuromusculoskeletal disorders. The initial sentence is also messy and difficult to read. DJFryzy (talk) 09:22, 15 February 2014 (UTC)
I haven't reviewed the sources for marginal, so I don't have an opinion, but it isn't in the lead right now.
This changes the lead to reflect that chiropractic is usually a mainstream profession, and only a minority of chiropractors (currently or historically) subscribe to topics out of the mainstream. I don't see that in the sources. What I do see is that chiropractic, as a whole, is based on vitalism, which is out of the mainstream. "Straights", which are the minority, practice this form of traditional chiropractic exclusively. "Mixers", which are the majority today, take that "outside the mainstream" practice based on vitalism and mix it with mainstream med. That means they still do it too. I also see that some chiropractors are attempting to get away from the profession's vitalistic underpinnings, such as innate intelligence. But they're still chiropractors, and I see no indication they're operating as just mainstream PCPs with no traditional chiropractic at all.
"Attempts to diagnose" isn't a bad thing; all doctors 'attempt' to diagnose and treat. However, this formulation doesn't preclude the opinion of mainstream med that manipulation of the spine is not an effective way of diagnosing and treating disease. Dropping "attempts" would preclude that opinion. Chiropractors don't only deal with musculoskeletal disorders, btw, and the def isn't limited to that area. — Jess· Δ♥14:13, 15 February 2014 (UTC)
I don't think you read the article from both myself or Puhlaa. In both articles (which are up to date and recent... both from secondary sources). They both state that chiropractic is mainstream on all accounts and only a "minority" adhere to what you state is "traditional" chiropractic. I have no issue with the statement of "vitalism" as that is a philosophical construct, however the statement "Traditional chiropractic, based on vitalism, assumes that spine problems interfere with the body's general functions and innate intelligence is a blanket statement, where in fact as the sources determine, is only a minority of the profession. The lead needs to reflect this. DJFryzy (talk) 21:48, 15 February 2014 (UTC)
Attempts infers that chirorpactors "try to diagnose.. I do not see anything of the like on the medical, dentistry or vet pages. They are trained and qualified to do so. All that needs to be changed is which diagnoses and treat patients through.... This does not change the purpose of the sentence, it makes it simpler, and is more accurate. DJFryzy (talk) 22:04, 15 February 2014 (UTC)
I read the source some time ago, actually. Your quotes were cherry picked and do not reflect the point of the paper. The paper clearly indicates that chiropractic is not accepted by the scientific or medical community. Your quoted section is the paper's attempt to demonstrate that chiropractic is popular. That's irrelevant to what we're discussing now. The very next two paragraphs begin:
"academic medicine regards chiropractic theory as speculative at best and its claims of clinical success, at least outside of low back pain, as unsubstantiated."
"Contradictions and tensions exist not only between chiropractic and mainstream medicine but within chiropractic itself."
Dentistry and veterinary medicine have no conflict with mainstream med, and there is no doubt among anyone that they can properly diagnose and treat illness. There exists controversy relating to chiropractic, and the mainstream medical community rejects the notion that traditional chiropractic is able to do what it claims. The comparison is flawed. Please establish consensus here first before making changes which have seen some opposition. Thanks. — Jess· Δ♥22:43, 15 February 2014 (UTC)
I can't speak for the authors, but what it does suggest is that a) Despite the diversity, the majority of chiropractors do consider evidence to play a role in practice and their treatments b) that despite the diversity there is a commonality and more unity than once believed and c) the unorthodox practitioners (or what you have labelled traditional), some whom claim they represent 'real' chiropractic and form the majority are less than 20% of chiropractors (i.e. the minority) and d) based on their attitudes towards vaccination, frequency of x-rays, and their belief that biomechanical spinal lesions are the underlying cause of all disease, including stuff such as cystic fibrosis which is an inherited genetic mutation (once again, these beliefs are not supported by the vast majority of the profession)
This extremist element of the profession is the one that the skeptics use to suggest they are the 'mainstream' or orthodox of chiropractic when it's the exact opposite. Although not mentioned in this paper, there is a follow up that looks into where these attitudes come from (i.e. schools and organizations). The very interesting thing that comes out of this, is this the first time we've been able to quantify the relative % of chiropractors who are extremely unorthodox (i.e. heretical).
In summary, anyone can cherry pick, just as you too have done above. It is the general consensus of a body of evidence which to date would affirm that chiropractic is mainstream. Yes, there are fringes to all profession including chiropractic, however to label the entire profession as a fringe is incorrect and misleading. DJFryzy (talk) 03:05, 16 February 2014 (UTC)
I don't know how that relates to your change, and the source you're using contradicts some of it anyway. Your change was to remove "attempts" from the def, so as to say chiropractors "treat and diagnose" through SMT. Our sources (including this one) clearly indicate that chiropractors do not and cannot diagnose and treat using SMT. So there's a controversy, and we cannot place 100% of our weight with chiropractors instead of science and mainstream med. That whole discussion isn't appropriate to be having in the first sentence. The first sentence should define the topic; that is, it should represent what chiropractors aim to do. They aim to diagnose and treat. In other words, they "attempt to diagnose and treat". We're commenting on their goal, not on their effect. BTW, careful with your html. '' means italic, and ''' means bold. No need for html tags. — Jess· Δ♥03:23, 16 February 2014 (UTC)
My apologies, I am getting my wires crossed on multiple topics. The points I am trying to put across are tabulated below. And yes, you are 100% correct. SMT is not a diagnostic tool, hence can in no way be congruent with the initial sentence of the lead. I have attempted to discuss this at length in Chiropractic#Definition_of_Chiropractic which I feel if used, would clear up all of this confusion.
Attempts to diagnose is poor form for a lead which is subjective in nature and not backed up by any source. In fact is opposed by many. This should instead be replaced by "is concerned with the diagnosis of.."
"diagnose and treat patients through manipulation" is not the case. Manipulation is not a diagnostic tool, rather an intervention. This needs to be reflected in this stentence.
An appropriate definition of what chiropractors diagnose and common interventions. This has been discussed at length in Chiropractic#Definition_of_Chiropractic however the summary statement which is found universally among secondary sources quotes, "diagnosis of neuromusculoskeletal disorders or disorders arising from the structures or function of the spine...and joints of the extremities"DJFryzy (talk) 03:48, 16 February 2014 (UTC)
Alexbrn"Not and improvement"...Please make one then...because at the moment the initial sentence of the lead does not make sense.. Is incorrect, and is too wordy. We have all discussed this at length and have provided many good references to this up. We have also all agreed that it is necessary to provide a new option. I feel that the aforementioned edit was sufficient and was and improvement. DJFryzy (talk) 08:53, 16 February 2014 (UTC)
It's fine as-is. I see you have again reverted to your preferred text: you are edit-warring and POV-pushing, which this page really does not need. Incidentally, can I ask if you have any personal or professional connection to chiropractic? (And if so, if you're aware of the guidelines at WP:COI?) Alexbrntalk|contribs|COI09:03, 16 February 2014 (UTC)
Sorry Alexbrn, you are incorrect. It is not fine as is and requires collaborative effort to make sure it is correct. Which as you can see, considerable effort has gone into looking into what defines the profession and particularly from an outside source. Yes i am aware of Wikipedia:COI; and if you wish to see my professional background please see my page User:DJFryzy. My professional and personal connections are to science (more specifically, neuroscience), not chiropractic. DJFryzy (talk) 09:42, 16 February 2014 (UTC)
I suspect the consensus is that it is fine. We shall see. As to COI, I did consult your user page and it had a photo of chiropractic students in class marked as your own work, which is partly what prompted my enquiry. Thank you, however, for your clarification that you have no personal or professional connection to chiropractic. Alexbrntalk|contribs|COI09:50, 16 February 2014 (UTC)
There has not been a consensus reached for change. There has been substantial IDHT, POVPUSHING and edit warring. Leave things the way they are until a consensus is actually reached. Keep in mind that consensus is built upon policy and supportive rationale, not fiat or vote. I think the lead and the majority of the text in the article are substantially appropriate and have been worked out through careful collaborative editing over time. - - MrBill3 (talk) 09:54, 16 February 2014 (UTC)
I would like to review the definition of chiropractic. This has previously been discussed [[Talk:Chiropractic/Archive_35#MerWP:MEDMOS [WP:MEDMOS]] e|here]]. Currently it is without references and is poorly defined, poorly worded and difficult to read. I would suggest a more appropriate and referenced definition for the opening definition in the article.DJFryzy (talk) 08:20, 14 February 2014 (UTC)
What definition did you have in mind? The majority or sources I have come across say something along the lines of "A health profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the function of the nervous system and general health. There is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation." Found at the world federation of chiropractic.. " health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic care is used most often to treat neuromusculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches." found at the ACA.. plenty of references .. which one do you want to utilize? Brosurf (talk) 09:18, 14 February 2014 (UTC)
From a secondary source; "the diagnosis of neuromusculoskeletal disorders or disorders arising from the structures or function of the spine...and joints of the extremities" Chapter 21 Statues of Ontario, 1991, Sections 3 and 4. Can be found hereBrosurf (talk) 09:31, 14 February 2014 (UTC)
This last reference is from a legal paper in reference to the scope of practice and legislation governing chiropractic practice around the world. Brosurf (talk) 09:33, 14 February 2014 (UTC)
That from a chiropractic journal, so not independent. The American Cancer Society has: "Chiropractic is a health care system that focuses on the relationship between the body's skeletal and muscular structure and its functions. Treatment often involves manipulating (moving) the bones of the spine to correct medical problems. Other methods may also be used".[10] MedlinePlus has: "Chiropractic is an alternative medical system. Chiropractors perform adjustments (manipulations) to the spine or other parts of the body. The goal is to correct alignment problems, ease pain, and support the body's natural ability to heal itself. They may also use other treatments [...]".[11] This is more the sort of thing we'd use, I think. Alexbrntalk|contribs|COI09:37, 14 February 2014 (UTC)
Probably our best source is Edzard Ernst's PMID18280103. He specifically addresses the topic of definition - unfortunately it does not make our life easy as he says it has many definitions and devotes an entire table to 12 of them: "Chiropractic is a popular form of health care for which many definitions can be found1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 and 12 (Table 1).". Ho hum. Alexbrntalk|contribs|COI09:51, 14 February 2014 (UTC)
I see the difficulty. Unfortunately those that Ernst uses are primary sources as well.. Thus we are back at square one. Where does WHO fit on this scale? If we were to look at this differenlty.. say defining what dentistry, medicine, veterinary science etc is.. why would someone outside that profession need to define their own profession for them? Brosurf (talk) 10:37, 14 February 2014 (UTC)
What a strange thing to say. We use Ernst as a secondary source, it does not matter if he cites primary sources so long as we don't. Secondary sources are expected to cite primary research and interpret it for us. Do you not see the distinction? IRWolfie- (talk) 10:41, 14 February 2014 (UTC)
I agree IRWolfie-, however the point I am aiming to make is why are there double standards when an independent secondary source such as the statues which is put into affect by government, not the profession itself, are not as good as a reference as a primary reference, put into a lit review, then published... I struggle to see why Brosurf (talk) 10:47, 14 February 2014 (UTC)
The material you used was from an in universe source which would provide a favourable definition, Ernst is independent of Chiropractic and is a well known expert on AM, IRWolfie- (talk) 11:01, 14 February 2014 (UTC)
Incorrect. It is not an "in universe" source. It is an external, neutral and unbiased source completely separate from the published article. Please read WP:MEDMOS and re read the aforementioned article. Brosurf (talk) 11:53, 14 February 2014 (UTC)
So... where does this leave us? "the diagnosis of neuromusculoskeletal disorders or disorders arising from the structures or function of the spine...and joints of the extremities" as Brosurf put forward seems to be similar to previous versions of this page. I have no idea why it was changed, there is no talk on the issue. I feel this would be appropriate to revert to. DJFryzy (talk) 22:31, 15 February 2014 (UTC)
Ernst is a good source for this, because unlike the many chiropractic sources, Ernst is not trying to brush anything under the rug. Specifically, he's not trying to hide the fact that chiropractic is alternative (cf. Minchin's Law) and that it has many theories which are patently bogus. Guy (Help!) 06:53, 19 February 2014 (UTC)
Effectiveness
DJFryzy has reverted an edit on effectiveness, saying "There have been multiple systematic review showing the modalities used by chiropractors are effective". Yet PMID21952385 - a systematic reviews of systematic reviews concludes: "Collectively these data fail to demonstrate convincingly that spinal manipulation is an effective intervention for any condition". Why should Wikipedia be out-of-sync with reliable sources on this point? Are there better sources we're missing? Alexbrntalk|contribs|COI10:04, 15 February 2014 (UTC)
Thank you for taking the time to discuss this topic Alexbrn. May I suggest that "any condition" may be relating to a disease process rather than say a "condition" such as low back pain, headaches or neck pain, which there are several systematic review that support the use of spinal manipulation in the treatment of those "conditions"... DJFryzy (talk) 10:12, 15 February 2014 (UTC)
Should we include that then? It seems pretty important it's not effective for the treatment of "any condition", even in those terms. It seems a bit odd to remove this from the lede and insert instead something about how chiro is on a par with exercise (not really impressive) for back pain! And isn't including a count of trials WP:OR ? Alexbrntalk|contribs|COI10:19, 15 February 2014 (UTC)
[12] Assendelft et al found it more effective than "sham therapy" and basically as effective as other standard therapies including analgesics, etc. [13] NCCAM says it is as effective as conventional treatments. [14] Rubenstein says that it has There is a high-quality evidence that SMT has a small, significant, but not clinically relevant, short-term effect on pain relief (mean difference -4.16, 95% confidence interval -6.97 to -1.36) and functional status (standardized mean difference -0.22, 95% confidence interval -0.36 to -0.07) in comparison with other interventions. "Not superior to other conventional treatments" is not the same as "ineffective. Cheers. Collect (talk) 14:22, 15 February 2014 (UTC)
The first paper is from 2003, so rather old; the second - yes - does say it's on a par with other things for lower back pain. So perhaps it's generally ineffective except perhaps for lower back pain? Alexbrntalk|contribs|COI14:28, 15 February 2014 (UTC)
Actually one of them was just added to Cochrane in 2013 it appears ... and I found no papers in a diligent search stating that it was ineffective for lower back pain. That it works about as well as analgesics and opiates, may well mean that it is "effective" for pain reductions. Does it work for cancer? No way. So we should per NPOV state what it is effective for according to published studies per WP:MEDRS. Collect (talk) 14:44, 15 February 2014 (UTC)
I agree, of course we should list the conditions it is effective for. Is it effective for anything outside of low back pain? That's what I've seen in the sources so far. If not, we could just include "except for low back pain" in the existing text. Would that work, or do our sources show a larger positive trend? — Jess· Δ♥14:52, 15 February 2014 (UTC)
The later paper is an update on a Cochrane review; it's a good source. Agreed we can say this, but not instead of what it's not been found effective for. So something like: "Chiropractic has been found to be generally ineffective, except as a treatment for lower back pain"? (More detail in the body, natch). I'll try this for size and see what people think ... Alexbrntalk|contribs|COI14:53, 15 February 2014 (UTC)
Studies have not shown spinal manipulation therapy to be effective other than for treatment of lower back pain seems reasonable as a claim. As "Chiropractic" appears to include other factors than just SMT, including massage therapy and health counseling, it would seem a reach to assert that those other parts of chiropractic have no effect. Collect (talk) 14:59, 15 February 2014 (UTC)
Unsure how "SMT is no more effective for acute low back pain than inert interventions, sham SMT or as adjunct therapy. SMT also seems to be no better than other recommended therapies." turns into "Spinal manipulation therapy is likely to be as effective as other common therapies"? Thus reverted [15] as the ref does not support the text written. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:18, 15 February 2014 (UTC)
I was going from the conclusion: "High-quality evidence suggests that there is no clinically relevant difference between SMT and other interventions for reducing pain and improving function in patients with chronic low-back pain. Therefore, the decision to refer for SMT should be based on costs, preferences of the patient and providers, and relative safety of the treatment options" - which I took to mean it was on a par with the other treatment for effect. Alexbrntalk|contribs|COI15:25, 15 February 2014 (UTC)
Okay so back pain is divided into two types "acute back pain" and "chronic back pain". The effectiveness of different treatments is different in these two situations.
Thus we have "SMT is no more effective for acute low back pain than inert interventions, sham SMT or as adjunct therapy. SMT also seems to be no better than other recommended therapies." from this 2013 Cochrane review [16]Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:08, 15 February 2014 (UTC)
For chronic LBP we have another cochrane review, it found that "SMT appears to be as effective as other common therapies prescribed for chronic low-back pain, such as, exercise therapy, standard medical care or physiotherapy. However, it is less clear how it compares to inert interventions or sham (placebo) treatment because there are only a few studies, typically with a high risk of bias, which investigated these factors."[17].Puhlaa (talk) 21:05, 15 February 2014 (UTC)
"Condition" is a term that is too broard. I feel we need to differentiate between a MSK condition and an organic condition. I.e. SMT is effective for a variety of musculoskeletal complaints (see systematic reviews and cochrane) however is NOT effective for any organic condition. i.e. cancer, GORD, UTI's.. We need to put it into context, as defining SMT as ineffective for any condition except low back pain is simply misleading. DJFryzy (talk) 21:31, 15 February 2014 (UTC)
From the Sciatica abstract: "The findings support the effectiveness of nonopioid medication, epidural injections, and disc surgery." SMT is not in that list. Alexbrntalk|contribs|COI21:33, 15 February 2014 (UTC)
Exactly - carefully put in a different category from those therapies for which findings supported effectiveness. If you read the article you'll see this is because the evidence for SMT (it considers both osteopathic & chiropractic SMT) is relatively weak. We must be careful not to lose the source's careful distinctions here. Alexbrntalk|contribs|COI08:50, 16 February 2014 (UTC)
A point made several times above: spinal manipulation therapy is not chiropractic. It may include evidence-based spinal manipulation therapies, and it does not include the baggage of pseudoscientific nonsense that is subluxation. A study validating spinal manipulation therapy for low back pain, does not validate chiropractic, because it is a subset of what chiropractic is and a subset of what chiropractic treats. You would not claim that a study validating aspirin for headache, validates all of medicine. Guy (Help!) 06:49, 19 February 2014 (UTC)
I feel that this whole section is a mess, despite the abundance of information. Just look at the opening sentences: "Taken overall, spinal manipulation is not effective for the treatment of any condition. A 2010 report said that spinal manipulation therapies are effective for low back pain, neck pain, migraine and cervicogenic headache and a number of extremity joint conditions." So the article states, in no uncertain terms, that spinal manipulation is not effective for anything. And then it immediately contradicts itself by stating that spinal manipulation is in fact effective for several different things. Later text points to evidence that chiropractic is effective for sciatica and headaches. So which is it? Is this stuff effective, or not? Why is the initial "spinal manipulation is not effective" statement presented without qualification, when all the other statements are in the pattern of "A 20XX report reached such-and-such conclusion"? Also, I see that some editors believe that spinal manipulation is only a subset of chiropractic. If that's the case, why is the first sentence of this section exclusively devoted to spinal manipulation? Shouldn't we say something about chiropractic as a whole, since that's what the article is about? I tried to add this sentence to the section, but it was reverted: "The effectiveness of chiropractic has been examined by a large number of studies and reviews, which have often contradicted each other.". I felt that was a good way to begin the section, but now we're back to leading off with a statement on spinal manipulation specifically, which is contradicted by the very next sentence. (Granted, the sentence after that states that the pro-manipulation study was poorly executed. But then there are later bits which suggest that chiropractic is indeed effective, so the reader is still left to wonder if chiropractic is truly effective or not.) If the medical consensus is that chiropractic is generally effective, we should say so. If the consensus is that it's not effective, we should say so. If there is no consensus either way, we should say so. The section needs to be more clear. Sonicsuns (talk) 20:39, 1 March 2014 (UTC)
From the latest cochrane review, spinal manipulation is "at least as effective" as comparative modalities. Referring to it as ineffective is incorrect.Tharyanp!06:50, 2 March 2014 (UTC)
Changes to lede and body and using non-MEDRS sources
I think the lede has swung a little too much the other way again. Before I think it was a little too pro-Chiro or not having enough criticism and now it is a little too anti. So it needs some tweaking.
...and innate intelligence, a notion that brings criticism from mainstream health care.
That needs a citation. Who said that, where? Was it an individual or a professional group? Also the original wording was "ridicule". I've changed it to a more neutral "criticism".
Much of the 3rd and entire 4th paragraphs need citations.
Studies of chiropractic have found it to be an ineffective treatment, except for certain cases of lower back pain.
This definitely needs to rephrased. It sounds overly negative. An alternative:
Studies of chiropractic have found it to be effective for certain kinds of lower back pain, but ineffective for other things
.
Additionally, Jarvis should not be quoted in the lede. His personal website does not pass WP:MEDRS. And certainly shouldn't be mentioned in the lede. Ernst should not be cited in the lede. It would be WP:Undue to put such an emphasis on his views in the lede. --Harizotoh9 (talk) 18:27, 8 March 2014 (UTC)
Each of these is cited in the body.
This is cited in "Concept". Per WP:YESPOV, we should not attribute facts as though they are opinions, and it is not an opinion that mainstream health care is critical of vitalism.
This is cited in "Effectiveness"
Your proposed wording places emphasis on chiropractic being effective, with exceptions, when in reality our sources indicate it is ineffective, with exceptions. — Jess· Δ♥18:39, 8 March 2014 (UTC)
In general, ledes should contain citations. It's unfair to expect readers or editors to start hunting through the article itself, and digging through the citations. The article is pretty big. I'm scanning it now and I can't find the citations you reference. It's much easier to have the article have citations in both the lede and the body of the article. It is commonplace on Wikipedia for this (eg. Syrian Civil War among many others). I can't see why this can't be used in this article as well. --Harizotoh9 (talk) 19:08, 8 March 2014 (UTC)
No. In general, leads shouldn't contain citations. There are exceptions for particularly controversial subjects (especially in the case of BLPs), I don't see how mainstream health care rejecting vitalism is in any way controversial. The lead is supposed to be a summary of a well sourced body, which it is. — Jess· Δ♥19:14, 8 March 2014 (UTC)
That sentence is a summary of the whole "Straights and mixers" section. It has a few sources, including this one. See "The "Straight-Mixer" Schism" section. If there's OR in the body, we should of course fix that, but we shouldn't modify the lead on that basis until we've tracked down and corrected the body's OR. — Jess· Δ♥19:30, 8 March 2014 (UTC)
No. In general, leads shouldn't contain citations. There are exceptions for particularly controversial subjects (especially in the case of BLPs),
Then I am going to have to say that I 100% disagree with you on this issue. It is commonplace on Wikipedia to cite in both the lede and body. It is significantly clearer. A reader/editor knows exactly what source is being used to cite which claim. That I am even having any difficulty finding a citation is all the evidence that is needed that cites should be in the lede.
Also your opinion does not appear in WP:LEDECITE. It does not say that citations should not be in the lede as a firm rule.
The lead must conform to verifiability and other policies. The verifiability policy advises that material that is challenged or likely to be challenged, and quotations, should be supported by an inline citation. Because the lead will usually repeat information that is in the body, editors should balance the desire to avoid redundant citations in the lead with the desire to aid readers in locating sources for challengeable material.
I don't see how mainstream health care rejecting vitalism is in any way controversial
It's the way it is phrased:
...and innate intelligence, a notion that brings criticism from mainstream health care.
That is a very specific claim. It claims specific people or organizations within mainstream medicine have criticized or ridiculed (using the original phrasing) innate intelligence. It would be WP:Synth to merely assume that criticism of vitalism infers criticism of Innate intelligence. The source has to discuss Chiropractic and innate intelligence.
--Harizotoh9 (talk) 19:35, 8 March 2014 (UTC)
Harizotoh, can you please use conventional indenting on your posts? Weird indenting combined with tons of blockquotes makes this whole section nearly impossible to parse. My summary above was of WP:LEDECITE, and our conventions on featured articles; I don't see any discrepancy. Your last claim just swaps "vitalism" for "innate intelligence". I'll reiterate, I don't see how mainstream health care rejecting innate intelligence is in any way controversial. — Jess· Δ♥19:41, 8 March 2014 (UTC)
I strongly disagree that's better written. The current lead was discussed quite a bit before being implemented; the goal was to reduce clutter, while leaving all the same information. IIRC, there's no information missing from the current lead that was there before, and it's considerably shorter and easier to understand. QG left some notes on my talk, which I'm hoping to address, but in the meantime, going back to an older, wordier version does not strike me as an improvement. — Jess· Δ♥22:14, 8 March 2014 (UTC)
Why was this removed?
Specific guidelines concerning the treatment of nonspecific (i.e., unknown cause) low back pain remain inconsistent between countries.Murphy AY, van Teijlingen ER, Gobbi MO (September 2006). "Inconsistent grading of evidence across countries: a review of low back pain guidelines". J Manipulative Physiol Ther. 29 (7): 576–81, 581.e1–2. doi:10.1016/j.jmpt.2006.07.005. PMID16949948.{{cite journal}}: CS1 maint: multiple names: authors list (link) in this edit? [18]Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:11, 5 March 2014 (UTC)
That was me, in this edit[19] because the source was old in comparison to what we had, and seemed irrelevant to effectiveness (covered by more recent sources). Alexbrntalk|contribs|COI06:32, 5 March 2014 (UTC)
It seems to me that inconsistency in treatment protocols is very relevant to the topic of general effectiveness of a treatment. jps (talk) 12:18, 5 March 2014 (UTC)
So, wouldn't juxtaposing it with recent recent Cochrane conclusions imply there was "more to it" than Cochrane was saying, though? And again, there is this question of when SMT "is" chiropractic. Alexbrntalk|contribs|COI13:00, 5 March 2014 (UTC)
I'm not sure I understand. The fact that there is inconsistency could just mean that there was lots of confusion which is certainly what one would expect if there was no efficacy. jps (talk) 13:14, 5 March 2014 (UTC)
I suppose it's useful since, although it's a bit old, it discusses nonspecific LBP, which is not otherwise mentioned by us. In general I think this section could be slimmed down and the evidence for nonspecific, chronic and acute back pain teased out. Alexbrntalk|contribs|COI13:27, 5 March 2014 (UTC)
hang on
Actually, looking more closely, this content seems to have been in the article all long. It's the last sentence of the "lower back pain" list item, and so what I removed was duplicate info. Alexbrntalk|contribs|COI13:35, 5 March 2014 (UTC)
Should we maybe try to consolidate these sections? I think it makes more sense int he efficacy area. jps (talk) 13:36, 5 March 2014 (UTC)
It is in the "Effectiveness" section (where it discusses LBP). This section definitely needs some work and could be much simplified I think. Alexbrntalk|contribs|COI13:41, 5 March 2014 (UTC)
Ah great thanks. Yes Cochrane discusses the best available evidence. What national guidelines do is more variable but still notable. It is similar with breast cancer. Cochrane states the evidence is not good. The US recommends mammography q 2 years. We mention both positions. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:30, 8 March 2014 (UTC)
User:Harizotoh9 why did you change "Specific guidelines concerning the treatment of nonspecific (i.e., unknown cause) low back pain are inconsistent between countries" back to "Methods for formulating treatment guidelines for low back pain differ significantly between countries, casting some doubt on their reliability". This article is not about "formulating treatment guidelines" and I am unsure what text supports that it casts doubt on their reliability? Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:49, 13 March 2014 (UTC)
Hello. It is my opinion that this article is biased in favour of chiropractic. I find that the article minimises the risks of chiropractic. Here are some examples of what I find to be non-neutral sectiosn:
Chiropractic curricula in the U.S. have been criticized for failing to meet generally accepted standards of evidence-based medicine. However as the profession evolves there is a greater push for more evidence based and evidence informed clinical application.
Chiropractic care in general is safe when employed skillfully and appropriately. Manipulation is regarded as relatively safe, but as with all therapeutic interventions, complications can arise, and it has known adverse effects, risks and contraindications.
Also, I find that the article isn't of great quality. Take for instance the following sections:
Throughout its history, chiropractic has been controversial, battling with mainstream medicine and sustained by pseudoscientific ideas. Despite the general consensus of public health professionals regarding the benefits of vaccination, there are significant disagreements among chiropractors, which has led to negative impacts on public vaccination and acceptance of chiropractic.
Taken overall, spinal manipulation is not effective for the treatment of any condition.[123] A 2008 critical review found that with the possible exception of back pain, chiropractic manipulation has not been shown to be effective for any medical condition.
In general, I think that this page needs a major review and it would probably be a good idea to add some tags to notify other editors and readers of the issues surrounding the page. Thanks! NHCLS (talk) 15:37, 17 March 2014 (UTC)
The changes were reverted because the changes to the text were not supported by the source in safety and the sources were deleted because they were not WP:MEDRS compliant. I made changes to the article where I agreed with you about your concerns. However, I do agree with you about the text in the lede. I think there should be sources in the lede. QuackGuru (talk) 20:15, 17 March 2014 (UTC)
Pseudo-science
It was written in the article that: "Throughout its history, chiropractic has been controversial, battling with mainstream medicine and sustained by dated dogmatic philosophical beliefs. Some have suggested certain elements of chiropractic philosophy constitutes pseudoscientific ideas. Despite the general consensus of public health professionals regarding the benefits of vaccination, there are significant disagreements among chiropractors, which has led to negative impacts on public vaccination and acceptance of chiropractic. The American Medical Association boycotted chiropractic until 1987, but in recent decades, chiropractic has developed a strong political base and sustained demand for services. Medical guidelines have been developed for the profession, and it has seen coverage by most health plans in the United States."
Here are few references to international publications though, that quite indisputably state that chiropractic is nowadays acknowledged by the traditional medicine as a special field of treatments, as well as included in the Current Care Guidelines on an International basis:
World Health Organization WHO (Switzerland). Guidelines on basic training and safety in chiropractic. Geneva; 2005. www.who.org [20]
Leboeuf-Yde C, Pedersen EN, Bryner P, Cosman D, Hayek R, Meeker WC, Shaik J, Terrazas O, Tucker J, Walsh M. Self-reported nonmusculoskeletal responses to chiropractic intervention: a multination survey. J Manipulative Physiol Ther. 2005 Jun;28(5): 294–302. [21]
Hurwitz EL, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Côté P, Hogg-Johnson S, Cassidy JD, Haldeman S; Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Treatment of neck pain: noninvasive interventions. Spine (Phila Pa 1976). 2008 Feb 15;33(4 Suppl):S123–52. [22]
Rubinstein SM, Terwee CB, Assendelft WJ, de Boer MR, van Tulder MW.Spinal manipulative therapy for acute low back pain: an update of the cochrane review. Spine (Phila Pa 1976). 2013 Feb 1;38(3):E158–77 [23]
Rubinstein SM, van Middelkoop M, Assendelft WJJ, de Boer MR, van Tulder MW. Spinal manipulative therapy for chronic low-back pain. Cochrane Database of Systematic Reviews 2011, Issue 2. Art. No.: CD008112. DOI: 10.1002/14651858.CD008112.pub2. [24]
All the well sourced text in the lede was deleted. I think the sourced text should be restored not deleted. The current lede is poorly written.QuackGuru (talk) 08:18, 2 April 2014 (UTC)
This was not my original post to this talk page. You moved my comment from your talk page here without my permission. QuackGuru (talk) 06:53, 3 April 2014 (UTC)
There was varying quality of evidence (from very low to moderate) suggesting no difference in effect for SMT when compared with other interventions, with the exception of low quality evidence from one trial demonstrating a significant and moderately clinically relevant short-term effect of SMT on pain relief when compared to inert interventions, as well as low quality evidence demonstrating a significant short-term and moderately clinically relevant effect of SMT on functional status when added to another intervention. In general, side-lying and supine thrust SMT techniques demonstrate a short-term significant difference when compared to non-thrust SMT techniques for the outcomes of pain, functional status, and recovery. ("low quality evidence", pertaining to the GRADE guidelines, which define it as: "Randomized trials begin as high-quality evidence, observational studies as low quality"[25][)
"The results of this review demonstrate that SMT appears to be as effective as other common therapies prescribed for chronic low-back pain, such as, exercise therapy, standard medical care or physiotherapy. However, it is less clear how it compares to inert interventions or sham (placebo) treatment because there are only a few studies, typically with a high risk of bias, which investigated these factors. Approximately two-thirds of the studies had a high risk of bias, which means we cannot be completely confident with their results. Furthermore, no serious complications were observed with SMT.
In summary, SMT appears to be no better or worse than other existing therapies for patients with chronic low-back pain."
Therefore, I don't quite understand why you removed those sources. Ps. There is also a wikiarticle on the GRADE guidelines, if you are interested: [[27]] Jayaguru-Shishya (talk) 13:03, 2 April 2014 (UTC)
You removed the tags but the text still failed WP:V. The following sentence is sourced text that summarises the 2013 review in accordance with V: A Cochrane review found that spinal manipulation therapy was no more effective than inert interventions, sham SMT or as an adjunct therapy for acute low back pain.<ref name=Cochrane-2013/>QuackGuru (talk) 16:44, 2 April 2014 (UTC)
Yes, and I quoted the more detailed research results above that demonstrate statistical significance. I'd suggest that you read the abstracts a bit further and in more detail ;) Besides, it is clearly stated there that there is "low quality evidence", i.e. still further research is needed, so what's the problem with you here? It's not an opinion of POV, I am afraid. Jayaguru-Shishya (talk) 06:09, 3 April 2014 (UTC)
I noticed that you have used the same sources as I did in other parts of the article. I will revise later that there isn't any misinterpretation of statistical results. Jayaguru-Shishya (talk) 06:09, 3 April 2014 (UTC)
It seems that you are leading yourself into a trap here. I already apologized since in my edit I got mistaken that you were again editing your old posts (https://en.wikipedia.org/w/index.php?title=User_talk%3AJayaguru-Shishya&diff=602543745&oldid=602543340), and I was about to revert my own edit also but you already had done so in less than one minute. So, first you were ranting that I moved your discussion from my personal talk page to here, even it is completely according the Wikipedia Good Practices for talk pages (https://en.wikipedia.org/wiki/Wikipedia:MULTI#multi) (WP:MULTI) that suggest: If you find a fragmented discussion, it may be desirable to move all posts to one location, and linking to it. Make sure you state clearly in edit summaries and on talk pages what you have done and why.. I'd like to remind you, that you are conducting aggressive editing policies, and try to edits behind other contributors' backs. Do you think it's fair that other contributors are not able to read your "arguments" for the reverts you do?
Anyway, that's exactly the reason why all the talks concerning an article should be kept to one place only, just like WP:MULTI tells you. It seems that you are losing the track even yourself already while posting some of your comments on my personal talk page (where they do not belong), and some of your comments here. Jayaguru-Shishya (talk) 09:20, 3 April 2014 (UTC)
There was no link in the section topic, and you shall not add one afterwards either. I guess I have violated the 3RR myself as well, but I have no other choice than make a report from your actions now. Jayaguru-Shishya (talk) 09:20, 3 April 2014 (UTC)
Lead changes
Kshilts has made edits to the lead (such as this one) that are removing fairly important and well-supported information from the lead. Overall, the edits seem to support a particular POV. Despite some pointers to use the talk page in the edit summaries, a warning on their talk page and a message on their talk explicitly directing them here, they have not started a discussion. I am hoping they will use this to discuss their changes before they get blocked. Ravensfire (talk) 20:23, 31 March 2014 (UTC)
Stop reverting to add original research
The edit that made it clear that "some" mixers use other forms of alternative medicine as opposed to all mixers was reverted. This reversion was original research. Please include a source that states that all mixers use homeopathy, acupuncture, etc. The current reference does not say this at all! The source says that some mixers use techniques from conventional medicine and some use acupuncture and other alternative medicine. It does not imply that all mixers use all of these techniques. Since that edit was right before a bunch POV edits I assume the revert was by accident 132.236.122.51 (talk) 22:35, 2 April 2014 (UTC)
note the first half of the reversion is a good revert, but the second half does not. I assume this was by mistake?
I suppose you are pertaining to me? Yes, I think your assumption is quite right. Sorry, as you can see I had terrible juggling with the earlier versions as I was trying to restore some contributions by Kshilts. On my behalf, you are the most welcome to restore the later part (mixers and stuff) that I hassled up :) Sorry for the inconvenience! Jayaguru-Shishya (talk) 06:28, 3 April 2014 (UTC)
Original research in the lede?
In the lede it says ...a notion that brings "criticism" from mainstream health care.
I have brought this up on many occasions. I have previously discussed this at length at [[28]].. seems like general consensus agreed upon "The American Cancer Society has: "Chiropractic is a health care system that focuses on the relationship between the body's skeletal and muscular structure and its functions. Treatment often involves manipulating (moving) the bones of the spine to correct medical problems. Other methods may also be used". MedlinePlus has: "Chiropractic is an alternative medical system. Chiropractors perform adjustments (manipulations) to the spine or other parts of the body. The goal is to correct alignment problems, ease pain, and support the body's natural ability to heal itself. They may also use other treatments"DJFryzy (talk) 03:23, 12 March 2014 (UTC)
Since DJFryzy has failed to reply, how about we use the definition from previous discussions. "A health profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the function of the nervous system and general health. There is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation" or ""the diagnosis of neuromusculoskeletal disorders or disorders arising from the structures or function of the spine...and joints of the extremities" ??Tharyanp!11:19, 20 March 2014 (UTC)
Or a combination of the two to include both the notion of high utilisaion of SMT and the correct definition of diagnosis. A health profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the neuromusculoskeletal systems with an emphasis on manual treatments including spinal manipulation and other joint and soft tissue therapies" Tharyanp!11:22, 20 March 2014 (UTC)
..."concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system"...[29] 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.
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):
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.
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.[29] It has been proposed that chiropractors specialize in nonsurgical spine care, instead of attempting to also treat other problems,[9][29] but the more expansive view of chiropractic is still widespread.[30] Mainstream health care and governmental organizations such as the World Health Organization consider chiropractic to be complementary and alternative medicine (CAM);[4] and a 2008 study reported that 31% of surveyed chiropractors categorized chiropractic as CAM, 27% as integrated medicine, and 12% as mainstream medicine.[31]
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.
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:[30], [31], [32], [33], [34], 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)
Semi-protected edit request on 29 April 2014
This edit request to Chiropractic has been answered. Set the |answered= or |ans= parameter to no to reactivate your request.
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)
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.[9]
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.[10]
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.[11]
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.[13]
Untrue, manipulative therapy has proven effectiveness in chronic LBP in maintenance care conditions
The evidence suggests that spinal manipulation therapy is safe[14] but the rate of adverse events is unknown[15] as there is under-reporting.[16]
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.[17] It has been suggested that the relationship is causative,[18] 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.[19]
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.[21]
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.[23] 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[25] that are not based on solid science.[10]
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,[26] which has led to negative impacts on both public vaccination and mainstream acceptance of chiropractic.[27]
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"[28] and boycotted it until losing an antitrust case in 1987.[29]
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.[31]
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.
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 Wikipedia 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[35] 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"[36]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.htmDVMt (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.
The book is currently used in the article.[37][38] I updated the body with this source. The lede does explain that "mixers", are the majority, and are more open to mainstream views. There is an article for Sports chiropractic. QuackGuru (talk) 18:27, 1 May 2014 (UTC)
D VMt (talk), I'm impressed, you made pretty well the point in your last post. I think the time is ready to start fixing the strong bias in this article. Whatever recent changes user QuackGuru (talk may have made recently, I can't really see how they'd have fixed the problem. Also dear QuackGuru, as much as you might love editing these articles non-stop (please see the new thread below), could you please keep your editing undisruptive? Thanks. Jayaguru-Shishya (talk) 11:02, 2 May 2014 (UTC)
Thanks for your comment Jayaguru. I agree and will make some proposals soon, the most important is getting the article to follow proper MEDMOS. Quack, you have not addressed my key points again, despite my repeated attempts to get a meaningful dialogue established to improve the article. As you mentioned, there is a sports chiropractic article (which is not given it's proper diligence and weight in the main article) but I was using it as an example of how MSK-related chiropractic is given the short shrift at the expense of the non-msk 'controversies'. DVMt (talk) 11:22, 2 May 2014 (UTC)
Chiropractic overlaps with several other forms of manual therapy, including massage therapy, osteopathy, physical therapy, and sports medicine.[21][52]
On Wikipedia, we summarise the mainstream research. The sources cited are being done appropriately and neutrally. For example, the author Ersnt is serious mainstream researcher. The results should not be rejected; editors were giving the weight it is due. There is nothing extremist or flawed about the research per WP:MEDRS. Ernst's work is critical of CAM, and he gets criticized back; there is nothing surprising about this. Obviously, the article represent serious research that should not be ignored by any neutral summary of chiropractic. It is irrelevant whether you personally disagree with Ernst or other researchers. Removing the summaries will not bring justice to a serious encyclopedia. What is being portrayed is according to WP:V. and WP:NPOV. QuackGuru (talk) 17:00, 2 May 2014 (UTC)
With all due respect Quack, I am familiar with the rules and spirit of WP. There is another editor who shares the same concerns as I, and we're going to make proposals to improve the article. The most glaring aspect is WEIGHT given to mainstream or orthodox chiropractic (spine and MSK) which as you saw, represents 81% of the practicing DCs. Since we all agree that the mainstream view within chiropractic orthodoxy is spinal and MSK focused, that should play a large voice as this is why chiropractic is today. The article is dramatically geared towards the past. Ernst's view is actually the outlier, given his results haven't been independently replicated in studies that didn't directly involve him. Also, Ernst view, as you mentioned has been repudiated and his research questioned and is highly controversial himself. You also imply that Ernst's POV is synonymous with the "medical" POV or speaks for the medical profession. I challenge that inference and claim. I can present numerous instances of present-day MD-DC collaboration for spinal problems (https://d2oovpv43hgkeu.cloudfront.net/newsroom/Dr-Mike-Kates-story.pdf) international collaboration with the WHO Bone and Joint Decade, which affiliated with World Spine Care as I mentioned previously. The chiropractic profession is also behind the World Spine Day (http://www.worldspineday.org/world-spine-day/about-wsd/) a means to create awareness for spinal health. The readers of the article need to understand not only how it was back in the day (pre 1980s) but how it is today. This encyclopedia already has its fair share of problems with fleeing editors and questions of reliability and very apparent in articles like this that are a generation behind and where the 4/5 of MSK is obliterated by the 1/4 quackery. How about chiropractic scientists (DC PhDs) working in mainstream universities such as this initiative in Canada? http://www.canadianchiropracticresearchfoundation.com/research-chairs--professorships.html. DVMt (talk) 23:48, 2 May 2014 (UTC)
We are not going to add junk sources or replace high-quality sources. It's not about Ernst's POV. It's about the sources are reliable despite who the author is. QuackGuru (talk) 04:18, 3 May 2014 (UTC)
Why would you assume that 'we' are going to add junk sources? You didn't address my key point was that Ernst POV = medical profession mainstream POV. Also, the Posadzki source is exactly the type of source that is misused. There is no study that confirms his findings and they way it's being used at the article to present 'the other' POV is giving one study far more weight than the majority of others which contradicts the findings (i.e. manipulation for pain, as these new review suggests (http://www.ncbi.nlm.nih.gov/pubmed/24436697), (http://www.ncbi.nlm.nih.gov/pubmed/23339721). I've raised a key point 3 times, and you seem to be ignoring it, so I'll as you directly: If we agree that the mainstream and majority of chiropractors practice in a manner that is spine/MSK based (81%) then why doesn't the weight or tone of the article reflect that? DVMt (talk) 17:48, 3 May 2014 (UTC)
"Collectively, these data fail to demonstrate that spinal manipulation is an effective intervention for pain management."[39] The source written by Posadzki is reliable and not misused.
We have a great list of concerns here by DVMt. One being "The efficacy and cost-effectiveness of maintenance chiropractic care are unknown.[13] Untrue, manipulative therapy has proven effectiveness in chronic LBP in maintenance care conditions". We have a 2008 review that supports this statement [40] "Efficacy and cost-effectiveness of maintenance care for various types of conditions are unknown."Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:13, 3 May 2014 (UTC)
The efficacy and cost-effectiveness of maintenance chiropractic care are unknown.[13]
This sentence in the lede is specifically about maintenance of chiropractic care. Most of the other sources are about spinal manipulation in general. QuackGuru (talk) 20:52, 3 May 2014 (UTC)
Yes I am aware of that. I am just wondering if we should summary the overall cost effectiveness in the lead. Not sure why maintenance chiropractic care was single out. Maybe we could have "spinal manipulation may be effect for certain condition but not others" Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:57, 3 May 2014 (UTC)
I have been observing the editing style of a certain user, QuackGuru (talk), for quite a while now. Out of the 500 last edits on this article's page, 244 has been carried out by the same user (which is 48,8% of all edits). The editing is really disruptive, as there might be even up to 10 different edits in a row from the same user with immature edit summaries, such as "nonsense", "total nonsense", etc. There is no question why the articles have so strong opinionated bias.
Also the user is clearly more interested in pushing his own opinions rather than building a well-balanced, neutral point of view article. For example, in the narrow field of alternative medicine articles, QuackGuru is clearly switching between different wikitags according to whatever best might suit his personal views:
1. The user adds a {{copyright violation}} tag[42].
2. The user changes it to a {{citation needed}} tag[43].
3. As this didn't work out with the other editors either, now he changes the tag into {{POV-statement}}[44].
4. Finally, user Paavo273 reverts the latest attempt of QuackGuru by stating: "...Remove POV tag that replaced one or more other tags. See talk...."[45]
This applies to all the alternative medicine articles (Traditional Chinese Medicine, Chiropractic, etc.) Overall, the editing is aggressive in both terms of reverts and misuse of wikitags, as well as it is fragmented and hard to follow.
Therefore, I'd like the user to stop the disruptive editing and respect the other contributors as well. Wikipedia isn't one man's project. Should there be any difficulties with the technical side of editing, please get familiar with WP:SANDBOX[46] where he can practice editing without causing a nuisance to the other users. Jayaguru-Shishya (talk) 10:52, 2 May 2014 (UTC)
Quack has been banned before from alt-med articles and chiropractic as well for the same editorial behaviour that you describe. These style of editors have driven away several health professionals who want to improve the article due to the drama and gerrymandering behind the scenes. There does seem to be an ownership issue and a lack of balance in the edits that would reflect true neutrality. DVMt (talk) 11:10, 2 May 2014 (UTC)
The content was word for word the same as that on page three of this WHO document [47]. Thus yes there was a copyright concern and QG tagged it. He then fixed the concern by paraphrasing. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:22, 3 May 2014 (UTC)
There seems to be different interpretations of when copyvio is applied and to which research it is applied to at this article, another form of inherent bias that dominates the article. I disagreed with his edit and so does Jayguru. The main point was the fact that nearly 50% of the recent edits are by QG and they increase the fringe viewpoint which dominates at the expense of the spine and MSK. More of the same. Myself and other editors currently and in the past have had grave concerns with respect to what gets 'highlighted' at the article and it seem like the unorthodox fringe practices which constitute less than 20% gets the most weight. For instance, spinal joint dysfunction /subluxation section presents the fringe viewpoint but does not address any of the scientific research with respect to the biomechanical, histological, anatomical, physiological and neural (neuromuscular) that looks at the subluxation/joint dysfunction in a MSK context. Also, Ernst' viewpoint and critique of joint dysfunction/subluxation is arguably fringe since the ICD-10 recognizes the subluxation complex as a diagnosis. (http://www.icd10data.com/ICD10CM/Codes/M00-M99/M99-M99/M99-/M99.13). Note that it's under the MSK section of the 2014 ICD-10, which is a reliable and internationally accepted medical diagnostic compendium. The MSK viewpoint is under-represented again. DVMt (talk) 18:17, 4 May 2014 (UTC)
The source you provided that recognizes the subluxation complex as a diagnosis is unreliable.
You originally added the WP:COPYVIO to the lede on November 21, 2011.
Another account also added the copyvio to the lede on March 20, 2014. What a coincidence!?
The source is perfectly reliable. Just the fact that you give your opinions here as facts does not change it. More facts, less opinions. Jayaguru-Shishya (talk) 11:31, 5 May 2014 (UTC)
...and after the {{copyright violation}}? Then you went through two more wikitags, seeing if any of them might suit your own, opinionately driven purposes. Jayaguru-Shishya (talk) 11:31, 5 May 2014 (UTC)
Using someones elses words regardless of attribution is a "copy and paste" concern. We must paraphrase. There is no if or buts about this.
We have already had the APA send us a cease and desist notice for using the DSM criteria to closely. I have meet with WHO and they do not seem interested in releasing their content under a CC license at this point in time. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:20, 4 May 2014 (UTC)
No. 244 edits out of the last 500 has been carried out by the one and same user, QuackGuru. This means that nobody will post 244 different posts discussing every single edit at the Talk Page; the problem is the user himself. Jayaguru-Shishya (talk) 11:40, 5 May 2014 (UTC)
The ICD-10 is just a classification system and is neither here nor there with respect to if Ernst is a reliable source or not.Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:42, 4 May 2014 (UTC)
The primary issue is the weight given to the fringe/unorthodox aspects of chiropractic vs. the mainstream/orthodox aspects. IOW, the non-MSK vs. the MSK emphasis. It's pretty clear there is a specialized focus in this particular domain of medicine, which is clearly cited. Regarding, Ernst, the dispute is not if it a reliable source, it's a) the weigh given to it, in that it is implied that Ernst's POV is the equivalent and synonymous of the medical profession. The relevance of the ICD-10, and by extension the WHO, is that is not only a reliable source, an organization and a credibility that trumps any individual researcher, especially one as controversial as Ernst. Despite the fact that evidence-based chiropractic (spine/MSK health) has been on the radar now for 10 years, with guidelines (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1839918/) and textbooks (http://www.amazon.com/Evidence-Based-Chiropractic-Practice-Michael-Haneline/dp/076373571X) and evidence-based resources (http://clinicalcompass.org) yet the attempts over the years to discuss and highlight the mainstream materials has been effectively censored. Ironically enough, Ernst is in complete denial about EB chiropractic, it seems like there is some serious cognitive dissonance. "http://edzardernst.com/2013/08/evidence-based-chiropractic-is-an-oxymoron. The collaboration between the medical and chiropractic professions have increased dramatically as well, with specialized focus on spine and musculoskeletal care. Hospital based chiropractic services are beginning to be offered (http://www.stmichaelshospital.com/programs/chiropractic/), (http://sunnybrook.ca/content/?page=sjr-patvis-prog-chiro), for spine, MSK conditions, which reflects also change in attitude and culture in recent times amongst the profession. Ernst' current POV is actually fringe, in that he is intolerant of the the chiropractic profession under any circumstances (including spine/MSK), which is essentially bigotry. He is also aiming his critiques traits that are specific to a faction (unorthodox) but the article fails address this and provide proper context. If we agree that the mainstream and majority of chiropractors practice in a manner that is spine/MSK based (81%) then why doesn't the tone and weight of the article reflect that? DVMt (talk) 00:16, 5 May 2014 (UTC)
Did not address my concern. Are you suggesting that 81% of the article is focused on the MSK aspects of chiropractic and the weight is representative to the majority group? Unfortunately it seems like there is more stonewalling going on, as I cannot get a straight answer. The pseudoscientific aspects dominate, so does their viewpoint despite representing less than 1/5 of practicing DCs. There was also no rebuttal of any other of my concerns and points I addressed in my previous comment addressed to you. Please address my concerns and the points that I have raised above, thank you. DVMt (talk) 02:20, 6 May 2014 (UTC)
Ernst is the only critical source being used, if he does represent the 'medical mainstream opinion' there must be other papers that replicate his findings and agree with his POV? The dominant voice of the article belongs to a skeptic MD whose obsessive critique of chiropractic (note the 64 article found, http://www.ncbi.nlm.nih.gov/pubmed/?term=Ernst+E+%5BAU%5D+and+Chiropractic) undermines his credibility so much that his conclusions simply aren't be reproduced by other researchers that aren't affiliated with him. DVMt (talk) 02:20, 6 May 2014 (UTC)
I believe we can overcome the strong bias in this article. It's not really good if we give one critique dominate over the wider concensus in the field. Jayaguru-Shishya (talk) 11:31, 5 May 2014 (UTC)
Yes, agreed. The article is a sham, and it's troublesome that politicking here trumps common sense. The is a gross misrepresentation of the facts, the factions, the identity, the research, the evidence, the contributions to health care (in the MSK arena and the research into joint and spinal manipulation). I'm going to create a new section for a neutral lede that doesn't trivialize and minimize the effectiveness of manipulation for MSK conditions and has far greater weight on the adverse events despite being considerably safer than the alternatives (opioids, acetaminophen, NSAIDs) whose side-effects are strangely missing from the article. DVMt (talk) 02:20, 6 May 2014 (UTC)
Besides from being banned earlier for editwarring alternative medicine articles, user QuackGuru has also been warned by administrator EdJohnston from editwarring the very alternative medicine articles here: [48].
He has been warned by another administrator, Tiptoety, as well here: [49]. "...Hi QuackGuru. Please consider this your only warning for edit warring... //// ...I'll also note that if you continue to edit war on Pseudoscience related articles, I will impose a 1RR restriction your account per the discretionary sanctions..."
It is clear that the user is still continuing the same disruptive way of behaviour. Jayaguru-Shishya (talk) 11:40, 5 May 2014 (UTC)
See WP:TALK#USE and WP:TPG#YES. If you have a problem with content, then go after the content. Article talk pages are not for you to whinge on about perceived ownership or any user behavior, or to quote " Keep the discussions focused upon the topic of the talk page, rather than on the personalities of the editors contributing to the talk page.". You do not have to comment on every single edit QuackGuru has made, you just have to discuss what in the article you disagree with and how it should be changed. Cannolis (talk) 12:33, 5 May 2014 (UTC)
QG is has a long hx of disruptive editing. Some feel that he deserves a barnstar. Others disagree. QG has made this article incredibly difficult to edit for 6 years now, driving away a plethora of talented editors in the process. There are 2 concerned editors here and it doesn't seem like our concerns are being taken seriously, at least by the admin. I'd prefer a neutral party admin to 'oversee' the the article and the behaviours of the editors. There's a COI there.
Chiropractic is health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual and manipulative therapy and its role in joint dysfunction. Currently, chiropractic medicine is regulated and practiced in over 100 countries, however chiropractors are most prevalent in North America, Australia and parts of Europe.[1] The majority of mainstream health care and governmental organizations classify chiropractic as traditional/complementary alternative medicine[2] Most people who seek chiropractic care do so for primarily for low back pain and other neuromusculoskeletal complaints.[3] Though chiropractors have many similarities to primary care providers, they are more similar to a medical specialty like dentistry or podiatry.[5]
Chiropractic was founded in 1895 by magnetic healer, D.D. Palmer, in Davenport, Iowa, United States. Chiropractic theory on spinal joint dysfunction/subluxation and its putative role in non-musculoskeletal disease has been a source of controversy since its inception in 1895. The controversy is due in part to chiropractic's historical vitalistic and metaphysical origins, and use of terminology that is not always amenable to scientific investigation. Far reaching claims and lack of scientific evidence supporting spinal joint dysfunction/subluxation as the sole cause of disease has led to a critical evaluation of a central tenet of chiropractic and the appropriateness of the profession's role in treating a broad spectrum of disorders that are unrelated to the neuromusculoskeletal system.[4] Today the monocausal view of disease has been abandoned by the profession [59]preferring a holistic view of subluxation that is viewed as theoretical construct in a "web of causation" along with other determinants of health.[6]
Although there is external and internal debate within the chiropractic profession regarding the clinical significance of joint dysfunction,[5] the manipulable lesion remains inextricably linked to the profession as basis for spinal manipulation.[6] In 1963 the American Medical Association formed a "Committee on Quackery" designed to "contain and eliminate" the chiropractic profession. In 1966, the AMA referred to chiropractic an "unscientific cult" and until 1980 and held that it was unethical for medical doctors to associate themselves with "unscientific practitioners".[38] The 1987, the AMA was found guilty of being engaged in an unlawful conspiracy in restraint of trade "to contain and eliminate the chiropractic profession." [37] In the 1980s, spinal manipulation gained mainstream recognition[39] and has spurred ongoing collaboration into research of manipulative therapies and models of delivery of chiropractic care for musculoskeletal conditions in the mainstream healthcare sector.[40][41][42]
Manual and manipulative therapies commonly used by chiropractors other manual medicine practitioners are used primarily to help treat low back pain,[7] and other neuromusculoskeletal disorders[3] Manual therapies appear to be as effective as standard medical care, exercise therapy and physiotherapy in the treatment of low back pain [8][9], and may be effective for non-specific neck pain, [10][11][12] headaches,[13][14][15]and extremity conditions.[16][17] Although serious injuries and fatal consequences can occur[18]and may be under-reported,[19] spinal manipulation is relatively safe[20] when employed skillfully and appropriately.[1] There is ongoing research investigating upper cervical manipulation and incidence of stroke.[166]
This proposal eliminates a lot of the bias and neutralizes the tone. It focuses on the primary MSK role and presents evidence of NMSK management of DCs. Unlike the current version which omits that the AMA tried to destroy chiropractic and was found guilty of restraint of trade, this new version presents the history (1963 to the present which shows the changing relationships of the medical and chiropractic professions. At some point in time one of the most critical sources, that states that the monocausal (one cause, one cure) approach has been abandoned has conveniently disappeared. DVMt (talk) 23:32, 7 May 2014 (UTC)
The first sentence is the same WP:COPYVIO you originally added to the lede on November 21, 2011 using the WHO source. There is no reason to repeat past mistakes.
The second sentence is not a summary of the body: Currently, chiropractic medicine is regulated and practiced in over 100 countries, however chiropractors are most prevalent in North America, Australia and parts of Europe.[1]
The lede says: Chiropractic is well established in the U.S., Canada and Australia.[21] This is a summary of the body that says: Chiropractic is established in the U.S., Canada, and Australia, and is present to a lesser extent in many other countries.[21][50]
The WP:LEDE should summarise the body. Your proposal is not a summary of this article. For example, a good summary of Chiropractic#Cost-effectiveness is:Spinal manipulation may be cost-effectiveness for sub-acute or chronic low back pain but the results for acute low back pain were insufficient.[13] The efficacy and cost-effectiveness of maintenance chiropractic care are unknown.[14] Cheers. QuackGuru (talk) 23:53, 7 May 2014 (UTC)
No disagreement with the research added? Good. You're pointing out technical details, which can be ironed though at a later point. We're just establishing a narrative and principles. We're going to cover the past and present in an equal manner, we're going to present the mainstream of chiropractic as the majority group with the dominant voice, while acknowledging and delineating the fringe. The criticism of Ernst are directed specifically to a faction within the profession that has x,y,z practice traits and x,y,z beliefs. Besides, he is an outlier in his views, especially in his "conclusions" on the safety, effectiveness and cost effectiveness of joint and spinal manipulation". Tuchin (2013) provides a much better source to discuss chiropractic and stroke (http://www.medscape.com/viewarticle/809688_4). The AMA is on board with DCs for LBP management and that's a huge event in the profession's history. LBP is the #1 reason why patients present to chiropractors and the #1 leading cause of disability in the world (http://www.webmd.com/back-pain/news/20140325/low-back-pain-leading-cause-of-disability-worldwide-study). Residencies are coming to the US in Veterans Affairs under primarily a MSK role (http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=56655). We agree that ICD-10 is a reliable source, and that subluxation complex is listed in the MSK section and biomechanical lesions. We also see it is in Medicare and there is a specific PARTS criteria. There is the mainstream view of the subluxation within chiropractic and there is a fringe view. We present the 'mythical' version here but actually the one that is currently being studied with respect to spinal biomechanics, neuromuscular responses. How can Wikipedia's entry of Chiropractic be legitimate and reliable if exclusively relies on a fringe narrative that excludes the dominant themes within the profession today by the mainstream group? Is the mainstream, majority group primarily NMSK focused? Yes or No. As one wiki editor to another, I ask of you to please answer my question. I'd ask that you bring citations to support your claim. Cheers. DVMt (talk) 04:42, 8 May 2014 (UTC)
Great work! I think this helps us to overcome many of the problems discussed earlier. Also a great summary of body WP:LEDE. There are, however, a lot to fix in the body itself, but I'm confident we can manage that. Jayaguru-Shishya (talk) 14:47, 8 May 2014 (UTC)
Thanks! I am awaiting for a direct answer to my question to Quack re: the mainstream of the profession being primarily MSK based. I understand for some it may cause cognitive dissonance but we need to be objective about what the literature is stating in terms of practice characteristics and educational training. Speaking of which, here is an interesting video about the education chiropractors along side medical physicians (https://www.youtube.com/watch?v=O7wUJXo25JE). DVMt (talk) 15:21, 8 May 2014 (UTC)
Your proposal is similar to old text that was in the lede that was not a summary of the body. You claim your proposal is a new proposal but it looks like you trying to go back to a version similar to an older version. We should not go backwards and restore text that does not summarise the body.
For example, A Cochrane review found very low to moderate evidence that spinal manipulation therapy was no more effective than inert interventions, sham SMT or as an adjunct therapy for acute low back pain.[12][51]
Another example, A critical evaluation found that collectively, spinal manipulation was ineffective for any condition.[11][52]
We should keep the most current Cochrane review (PMID23169072) along with other reviews (PMID21952385) about the effectiveness in the lede.
The current text in the lede passes WP:V and summarises the body.
Your proposal includes: Manual therapies appear to be as effective as standard medical care, exercise therapy and physiotherapy in the treatment of low back pain...
Quack has refused to answer my question Is the mainstream, majority group primarily NMSK focused? Yes or No. despite repeated attempts to communicate with him/her, and considering the problems that are also occurring at the acupuncture page with similar editing practices, I'm going to take this question to a different venue. This is eerily similar to what was done when there was continual censorship and deletion over the inclusion of the fact that chiropractic was a 'health care profession' despite have several reliable sources that stated the obvious. The issue of weight, tone, npov with respect to this topic has been steadily increasing over the years and now it has hit a tipping point. NPOV tagging will seek remediation to discuss this critical issue. DVMt (talk) 21:03, 9 May 2014 (UTC)
This is in the lede: 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; "mixers", the majority, are more open to mainstream views and conventional medical techniques, such as exercise, massage, and ice therapy.[8]
The lede makes it clear that the "straights" are the minority and the "mixers" are the majority that are more open to mainstream views. QuackGuru (talk) 21:06, 9 May 2014 (UTC)
You have still not answered my question directly. Is the primary, dominant, mainstream group NMSK focused, yes or no? DVMt (talk) 21:11, 9 May 2014 (UTC)
Perhaps you can take a look at this: "Back and neck pain are the specialities of chiropractic but many chiropractors treat ailments other than musculoskeletal issues." This is currently in the lede. There's a COI there? I'm not sure what you are talking about but of course I have received numerous peer-reviewed studies by e-mail from you know who. QuackGuru (talk) 02:06, 10 May 2014 (UTC)
I'm afraid Wikipedia isn't interested about your personal emails, QuackGuru. Anyway, you have been asked a question and it seems that you are avoiding it at all costs. So what is your answer? Enough with your pointless blabber about the lede and your endless fire of links, just answer the question okay? Jayaguru-Shishya (talk) 12:55, 10 May 2014 (UTC)
"Back and neck pain are the specialities of chiropractic but many chiropractors treat ailments other than musculoskeletal issues.[10]"
The text in the lede answered the question. The specialties of chiropractic are back and neck pain but many chiropractors treat ailments other than musculoskeletal issues. QuackGuru (talk) 16:01, 10 May 2014 (UTC)
You still have not answered the question yourself QG. Your refusal to answer my question (https://en.wikipedia.org/wiki/Wikipedia:IDHT#Failure_or_refusal_to_.22get_the_point.22) is a perfect example of being tendentious and a breaking the spirit of collaborative editing. Most shockingly, you just admitted to being canvassed and de-facto meat puppet for Edzard Ernst. Congratulations. Nonmusculoskeletal complaints accounted for 10.3% of the chief complaints (http://www.ncbi.nlm.nih.gov/pubmed/11313611). Why are you, and the article, so focused on the 10% as opposed to the 90% of MSK based treatments, majority of whom are for LBP? Is that what Ernst wants you to do? DVMt (talk) 17:22, 10 May 2014 (UTC)
That makes really clear the point what you just said DVMt. Given the fact that QuackGuru is constantly refusing to answer the question, it is reasonable to make the conclusion that he doesn't have a say in the matter and we can continue editing the article in order to remove the current strong bias in the article. Thanks. Jayaguru-Shishya (talk) 13:50, 11 May 2014 (UTC)
I'm not asking you about your opinion I'm asking you about the facts. Secondary sources are of course preferred when they exist. When they don't we can use a primary source, especially given this context which is not making a judgment on the efficacy of a medicine/therapy/intervention, but rather to highlight practice characteristics. So, the 10.3% source is perfectly valid, and reliable in the context that it is being used. So, now we have several facts: 1. Roughly 90% of chiropractic patients are for musculoskeletal disorders, primarily low back pain. 2. The mainstream, or orthodox group in the profession, representing 81% of the profession, practices primarily in musculoskeletal medicine, most of which are spinal disorders. 3. The majority (73) of chiropractors see themselves as conservative spine care specialists.. Here is another question: How long have you been a meat puppet for Edzard Ernst? You are pushing and unduly weighing his research. This is a serious concern. DVMt (talk) 22:23, 10 May 2014 (UTC)
Quack, doesn't come even close to failing MEDRS. Still dodging my questions I see. More proof of the chiropractic profession and MSK focus "These data support the theory that patients seek chiropractic care almost exclusively for musculoskeletal symptoms and that chiropractors and their patients share a similar belief system." http://www.ncbi.nlm.nih.gov/pubmed/11805694.
"Drawing on practices with the patient and practice characteristics identified in this study to conduct outcomes studies on nonmusculoskeletal conditions is a possible direction for future research."[53] That is definitely a study and thus fails MEDRS.
It's not theory, it's practice. You're again trying to omit reliable sources that specifies to what extent fringe practices are (IOW, non MSK). 9/10 DCs primarily treat MSK issues since 9/10 patients present to the for MSK issues, most prevalent, spinal pain. You again point to Ernst, which is outlandish behaviour as you admitted to being in contact with him (COI and meat puppetry, possibly) but he is representing the fringe opinion. The "straight out" assertive component is rather bogus, as I've demonstrated above. You, and other enablers, including an admin, have deliberately stymied any discussion that centres on the current practice characteristics of the profession, such as the primary focus on spinal disorders and seeking to become the primary care spinal clinicians. I've tried in good faith with you here, but your editing behaviour seems to be congruent with this [55]. I'll repeat this again. Roughly 90% of chiropractic patients are for musculoskeletal disorders, primarily low back pain. 2. The mainstream, or orthodox group in the profession, representing 81% of the profession, practices primarily in musculoskeletal medicine, most of which are spinal disorders. 3. The majority (73) of chiropractors see themselves as conservative spine care specialists.. We assert facts, QG. You just can't censor the ones that you don't like. DVMt (talk) 00:13, 13 May 2014 (UTC)
"These data support the theory that patients seek chiropractic care almost exclusively for musculoskeletal symptoms and that chiropractors and their patients share a similar belief system."[56]
We assert the facts not a theory when we have better sources that do assert the same type of information.
There is no OR, and there are no other sources that yields the same information. Also MEDRS only applies when making medical claims such as efficacy or safety. WP:RS is sufficient for text that discusses social concepts or defining the profession. Secondary sources are not required for non-medical claims. So those sources are in play for the article. Also, regarding spinal joint dysfunction, the monocausal view of disease has been abandoned by the profession ( Bergmann, T.F., Perterson D.H (2011). Chiropractic Technique: Principles and Procedures. Elsevier. ISBN9780323049696.) preferring a holistic view of subluxation that is viewed as theoretical construct in a "web of causation" along with other determinants of health. Henderson, C.N.R (October 2012). Journal of Electromyography and Kinesiology 22 (5): 632–642. DVMt (talk) 23:42, 13 May 2014 (UTC)
I previously explained there is similar text in the article about the focus on musculoskeletal issues. I know it is not exactly the same information they way you want it.
There is no reason to cherry pick primary sources when we already have WP:SECONDARY sources. The WP:RS guideline that I helped write and update is correct for this situation. QuackGuru (talk) 01:34, 14 May 2014 (UTC)
Quack you're being tendentious again. The NPOV tag stays until it's resolved. Also, I was looking over the article carefully and a lot blibs that you're using or either taken out of context or were incorrectly paraphrased. It seems a big chunk of this article is unreliable. If we don't follow the sources or paraphrase them correctly or cherry pick a sentence within the source and use it out of context then this destroys the credibility of not only the article, but WP as well. DVMt (talk) 15:58, 15 May 2014 (UTC)
It seems to me that the {{NPOV}} tag is reflecting a previously resolved NPOV dispute. I haven't been active on this article for a few months, nor on Wikipedia as a whole for a few weeks, so I won't remove it, myself. If my analysis is correct, the NPOV tag should not be there. — Arthur Rubin(talk)20:51, 15 May 2014 (UTC)
It seems to that you're not reading this talk page starting with the bias in the article thread. There are several issues that I, along with others previously, that have raised concerns and never got dealt with, in addition to a litany of others. On a personal note, I hope your wife is doing better, and wish you and her the best. DVMt (talk) 22:44, 15 May 2014 (UTC)
Removal of the MEDRS tags and failure to collaborate
I agree. QG poisons the well here and he is a constant at disruptive and unprofessional behaviours. He's also admitted he's a meat puppet for Ernst which is as clear as a policy as we can get. He's tried to censor my sandbox as well. Just goes to show he will do anything to censor material that he does not agree with. My sandbox consists of over 50 new sources most of them reviews but it displays the focus on MSK and science behind joint dysfunction and spinal manipulation. DVMt (talk) 22:38, 15 May 2014 (UTC)
@DVMt: that is a lie. (See WP:SPADE; I'm not saying you are generally a liear, just that the statement is false, and that you have no evidence that it was true.) QG never said he "was a meatpuppet for Ernst". I also question whether the reference would meet {{MEDRS}}, as it is a self-proclaimed alt-med publication. However, it doesn't seem to me it needs to meet {{MEDRS}}; in context, whether or not this is a medical article overall, that paragraph is not about medicine or alternative medicine. More important, though, the stated reasons both for tagging and for untagging the reference are completely wrong. — Arthur Rubin(talk)00:55, 16 May 2014 (UTC)
Sorry @Arthur Rubin:, I disagree completely with your assertion. BMC is a completely reliable source. I know your expertise is in math, but do you have clinical competency in MSK medicine? The reference is legit, and I referred to an independent medical editor. Re: meat puppetry, if it walks like a meat puppet, and talks like a meat puppet... DVMt (talk) 01:32, 16 May 2014 (UTC)
User QuackGuru's recent violation of WP:Three revert rule
Greetings! It seems that the user QuackGuru just violated the WP:3RR in the alternative medicine articles. He has been warned already before about this by administrator EdJohnston[58], as well as administrator Tiptoety[59]:
Hi QuackGuru. Please consider this your only warning for edit warring on Traditional Chinese medicine. While it is obvious that you have intentionally not gone over three reverts in one day, please be reminded that the edit warring policy does not specify a specific number of reverts, and simply engaging in a long term pattern of edit warring can result in a block. I'll also note that if you continue to edit war on Pseudoscience related articles, I will impose a 1RR restriction your account per the discretionary sanctions authorized at Wikipedia:Requests for arbitration/Pseudoscience. Tiptoety talk 16:55, 29 April 2014 (UTC)
As Tiptoety's warning makes it really clear, there is not any "specific amount of edits that you can do each day". It does not even matter whether you continue that disruptive behaviour on just one or even more articles. QuackGuru has been specifically warned about edit warring Pseudoscience related articles. As far as I have been involved in developing some other alternative medicine articles, such as traditional Chinese medicine or acupuncture, I have noticed the same editing behaviour by QuackGuru even there.
Yesterday, QuackGuru was already warned two times:
However, it seems that the same editing pattern keeps repeating with QuackGuru:
at 21:02, 9 May 2014 on this very article, Chiropractic, QuackGuru made a revert on {{POV}} tag[62].
At 19:18, 14 May 2014, he made his second revert on this very same article, on that very same thing[63].
As stated by WP:3RR: ".... The three-revert rule ... is not a definition of what "edit warring" means, and it is perfectly possible to edit war without breaking the three-revert rule, or even coming close to doing so..."
However, today QuackGuru also made his 3rd revert, so even the bright line of three reverts applies.
Here you can see him inserting the {{MEDRS}} tags: [64][65]
Here you can see the tags being removed by another user, DVMt: [66]
Finally here, QuackGuru crosses the line and reverts the last edit by DVMt: [67]
The 3RR says an editor must not perform more than three reverts, in whole or in part, whether involving the same or different material, on a single page within a 24-hour period.
I agree. I've tried for 2 weeks to try to discuss the salient issues with QuackGuru and he simply ignores my points while removing sources he doesn't like and preventing inclusion of sources that supports the claims being made (such as 10.3% of patients who present to DCs for non-MSK issues). Support a report to the admins for edit warring and conduct detrimental to wikipedia's mission. DVMt (talk) 22:41, 15 May 2014 (UTC)
I originally added the source myself and tagged the source and self-reverted my own original edit and both of you and not collaborating here. It would help to focus on article content using reliable sources rather than your personal favorites. QuackGuru (talk) 05:11, 16 May 2014 (UTC)
There is no consensus. Consensus has changed and you have addressed none of my concerns as above. NPOV tag stays and that is seconded by a current editor, Jayguru as well. Regards, DVMt (talk) 01:27, 16 May 2014 (UTC)
Looking at the current discussion, I don't see any consensus whatsoever. The opposite actually. You don't need to explain secondary sources because I understand them full well. Why are you trying to censor a paper that clearly identifies the 81% of DCs who practice NMSK? How about we go to an independent noticeboard and get a broad consensus? DVMt (talk) 01:39, 16 May 2014 (UTC)
I wish it were that simple, James. The reliable source isn't being used to make a medical claim, it's been used to identify factions within the profession. Are you stating this source cannot be used under any circumstance? Yes/No. DVMt (talk) 01:57, 16 May 2014 (UTC)
There is no con. The current sources includes numerous primary sources. We can't cherry pick to remove sources that we don't agree with. DVMt (talk) 02:07, 16 May 2014 (UTC)
Thank you, captain obvious. You've done nothing to try to build any consensus. Time for ArbCom take a look here. You refuse to to acknowledge the massive problems here, refuse to accept there is evidence-based chiropractic, refuse to accept that 4/5 DCs practice primarily MSK, refuse to accept that only 10% of DCs treat non MSK cases, refuse to compromise, or build consensus through collaboration but rather impose your rigid interpretations and lobby accusations against editors who disagree with you. This behaviour isn't specific to chiropractic either. All alt-med articles. Didn't your bans teach you anything? DVMt (talk) 02:17, 16 May 2014 (UTC)
Actually, it seems to me that there is a strong consensus here that the tag should stay. You violated WP:3RR QuackGuru. It's all in the diffs above.
The source discussed here, as long as it's no making any claims on medical efficacy, IMO a primary source can be used. Therefore, there should be no problem with that. Jayaguru-Shishya (talk) 13:46, 16 May 2014 (UTC)
If you think that QuackGuru violated WP:3RR, go file a report at WP:AN3, if not, drop it. Your continual attempts to poison the well and use bullying tactics to change the article is starting to be annoying. When you have a minute, you should also review the policies on primary and secondary sources because you don't seem to understand them.--McSly (talk) 14:58, 16 May 2014 (UTC)
Perhaps if McSly was editing here and not doing a random drive by, he/she would understand that QG has been disruptive and tendentious in this whole process. DVMt (talk) 15:56, 16 May 2014 (UTC)
Well, you are wrong. I would explain it to you but 1) this section is already way outside the WP:TALK parameters and 2) I feel it would be a complete waste of my time so I won't bother.--McSly (talk) 22:16, 16 May 2014 (UTC)
I'd like to suggest a RfC next time. Also, it'd be nice if QuackGuru would accept us to collaborate rather than be at odds all the time. Do you? Jayaguru-Shishya (talk) 19:14, 23 May 2014 (UTC)
Misuse of sources by QuackGuru
"The American Medical Association called chiropractic an "unscientific cult"[74].
The article is being misrepresented by QuackGuru. The topic is about public health with the abstract stating " an overview of primary chiropractic issues as they relate to public health. This collaborative summary documents the chiropractic profession's current involvement in public health, reflects on past barriers that may have prevented full participation within the public health movement, and summarizes the relationship of current chiropractic and public health topics. Topics discussed include how the chiropractic profession participates in preventive health services, health promotion, immunization, geriatrics, health care in a military environment, and interdisciplinary care." The focus of the article is not on the AMA or its relationship with chiropractic. Considering that there was already proof that QuackGuru has misused sources as of last week at another article [75] and was blocked for the disruption it caused, I have concerns of other inappropriate use of sources that are not used in proper context. DVMt (talk) 16:39, 3 June 2014 (UTC)
Paper says "A policy passed by the AMA House of Delegates in 1966 stated: "It is the position of the medical profession that chiropractic is an unscientific cult whose practitioners lack the necessary training and background to diagnose and treat human disease" Looks like his text reflects well the content in question. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:04, 3 June 2014 (UTC)
So what you're saying is that it's OK to cherry pick a specific reference from a paper that has nothing to do with the conclusions of the paper and present it out of context? Do you not think that the 1966 portion is relevant? DVMt (talk) 17:19, 3 June 2014 (UTC)
You ignored my point, so I'll repeat it again: Are you saying is that it's OK to cherry pick a specific reference from a paper that has nothing to do with the conclusions of the paper and present it out of context? Because that's what occuring. DVMt (talk) 18:49, 3 June 2014 (UTC)
What I am saying is that your question is malformed. I do not see an issue with the text except that a date is needed which I added. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:00, 3 June 2014 (UTC)
The question isn't malformed, it's about the nature of properly using sources and not using them out of context. Unfortunately you don't seem to see any problems with QuackGuru edits here despite the evidence [76][77], [78]. DVMt (talk) 19:56, 3 June 2014 (UTC)
Is this the disputed content? “The American Medical Association called chiropractic an "unscientific cult" in 1966[29] and boycotted it until losing anantitrust case in 1987[30]”. The claim that the AMA “boycotted” chiropractic care until 1987 seemed kind of hard to believe, so I spent a few minutes researching it, and it appears this claim is not correct. AMA policy on chiropractic: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1349822/
Hi BMC. I wasn't disputing that the claim was true, I was suggesting that cherry picking one quote from a paper that does not deal with the topic directly leads us to a very potential slippery slope in how the sources are used. The primary topic of the paper was about musculoskeletal public health initiative that the chiropractic profession should be/are involved in. It's being used out of context, and doesn't provide the other half of the idea which was the AMA was found guilty of a conspiracy to contain and eliminate the chiropractic profession. I don't think cherry picking a specific reference from a paper that has nothing to do with the conclusions of the paper and presenting it out of context is a good thing. DVMt (talk) 23:26, 3 June 2014 (UTC)
Hi DVMt, I originally posted this with a typo that reversed the meaning. I have since edited "not incorrect" to "not correct" above. Sorry for the confusion. Apparently, the AMA did not boycott chiropractic until 1987, but as early as 1978 were allowing chiropractic referrals and in 1980 were allowing professional collaboration with chiropractors. --BoboMeowCat (talk) 23:39, 3 June 2014 (UTC)
I figured as much BMC. My understanding was that the AMA ended the boycott in 1987, and was finalized in 1990 when the AMA lost the appeal. I'm going to include those dates though, they are significant and provide more context. Thanks for helping out! DVMt (talk) 14:53, 4 June 2014 (UTC)
In my humble opinion, the whole paragraph is horribly biased and imbalanced. All mentions of chiropractic's medical recognition amid the mainstream medicine have been left out systematically. For example, chiropractic is accepted among the current care guidelines both in Finland (Käypä hoito) and Europe (European guidelines) for conditions such as chronic low back pain. Chiropractors are also required to complete an adequate university degree in order to qualify as medical practitioners. Still, these both have been dropped out from the lede completely. It seems there is only room for criticism, even for something as trivial as some comments from 1966 (!?!).
As far as I am concerned, such trivial pieces of information would better fit into a history section etc. But if people insist to include it in the lede (!), then including some of the aforementioned would be appropriate as well. Jayaguru-Shishya (talk) 15:04, 4 June 2014 (UTC)
One of the biggest imbalances is the weight on history vs. contemporary. For instance, to further your point this [ status report prepared for the WHO states "Whereas most chiropractic schools in the USA are in private colleges, most of the newer schools internationally are within the national university system (e.g. Australia, Brazil, Canada, Chile, Denmark, Japan, South Korea, Malaysia, Mexico, South Africa, Spain, Switzerland, and the UK). In some of these programs, for example, at the University of Southern Denmark in Odense and the University of Zurich in Switzerland, chiropractic and medical students take the same basic science courses together for three
years before entering separate programs for clinical training" [79]. So, the facts verify that things have indeed changed dramatically since 1966. Unless the Swiss and the Danes universities and their respective medical faculties are cool being trained along side an "unscientific cult". ;) DVMt (talk) 16:13, 4 June 2014 (UTC)
This source discussed above is a primary source. We should not use a letter to the editors to argue against a review. QuackGuru (talk) 21:11, 5 June 2014 (UTC)
A 2006 study suggested continuing education enhances the scientific knowledge of the practitioner.[76][Unreliable fringe source?]
Seems disembodied and irrelevant. The study itself is a nondescript workshop evaluation that somehow seems to be published in a journal. Shall we get rid of it? 203.38.24.65 (talk) 08:19, 23 May 2014 (UTC)
You're on a very slippery slope if you're going to cherry pick which primary sources you're going to attempt to delete. Also, there is nothing in WP that states that primary sources can never be used under any circumstance. So, if we are trimming the tree, let's make other suggestions. "The practice remains at a crossroads between science and ideological dogma.[32]" It overlaps with other manual-therapy professions, including massage therapy, osteopathy, and physical therapy.[22]." "While 84% of respondents considered nurses' ethics "very high" or "high," only 36% felt that way about chiropractors. Other healthcare professions ranged from 38% for psychiatrists, to 62% for dentists, 69% for medical doctors, 71% for veterinarians, and 73% for druggists or pharmacists.[35][185][186][187] Similar results were found in the 2003 Gallup Poll.[188]"
Jayaguru, your accusations of sock-puppetry are unbecoming. I am not a sock-puppet, I edit other wikis considerably and wikipedia only occasionally; I have no desire to sign up for an account (no offense meant to anyone). Even if I was a sock puppet you could still attempt to address the argument rather than attack the man which, although my knowledge of WP policies is perfunctory at best, used to be a core tenet here.
Regarding the sentence in question, it doesn't bother me that it's a primary source, it's just that it is basically saying 'studying science makes people better at understanding science' - a blindingly obvious statement that is not relevant to the preceding paragraph. The referenced study is a simple training evaluation, one that might be conducted after any number of minor training courses delivered around the world. Nothing about that sentence is interesting or relevant which is why I thought it would be an easy one to remove. 203.38.24.65 (talk) 02:27, 26 May 2014 (UTC)
No. Primary sources should not be used to refute secondary sources. There's nothing in WP:MEDRS or anywhere else to say they cannot be used. Stop gold-plating the rules.--FergusM1970Let's play Freckles23:40, 2 June 2014 (UTC)
This will be the last time I talk about this, but it seems that some non-sequiter argument about primary sources has hijacked a good faith attempt to improve the article. Look at the source - what does it have to do with the paragraph, what does it add to the article, why is it there? Can anyone answer these fundamental questions? Some of the players on this page need to drop the battleground mentality. 203.38.24.65 (talk) 02:19, 6 June 2014 (UTC)
Oh and if anyone can work out what the last sentence of the article proper (in the criticism section) means:
Chiropractic has been controversial, though to a lesser extent than in past years.[9]
This would be considered fringe. You seem to be conflating what constitutes 'mainstream chiropractic practice' (MSK) and fringe chiropractic practice (non-MSK). Regards, DVMt (talk) 22:21, 16 May 2014 (UTC)
If someone were to write a separate article on MSK chiropractic, that might not be pseudoscience. Any article including the history should note that it was pseudoscience when it started, putting it convincingly into the category. — Arthur Rubin(talk)22:32, 16 May 2014 (UTC)
Interesting proposal, Arthur. MSK chiropractic is essentially evidence-based chiropractic since that's where the majority of the research lies. Unorthodox, or fringe constitutes 19%. Dissidents is another word. What I do know is we can't label the whole profession 'pseudoscientific'. What about my proposal about alternative theoretical formulations? Roxy, spoken like a true extremist. DVMt (talk) 22:48, 16 May 2014 (UTC)
Vertebral subluxations (or nonallopathic lesions; you can't eliminate non-science just by renaming the terms) are still pseudoscience, although some orthopedic subluxations do exist. I wouldn't go as far as Roxy, but there are enough "mainstream" (as generally observed) chiropractors who use the "subluxation" lingo that the field still fits into pseudoscience. If the governing boards and most schools completely rejected "subluxations", I might agree it might no longer be pseudoscience, although it's still not entirely evidence-based. Mainstream medicine isn't entirely evidence-based, so I wouldn't reject chiropractic solely on that basis. — Arthur Rubin(talk)23:04, 16 May 2014 (UTC)
This is the elephant in the room. Mainstream chiropractic views subluxation as a synonym for joint dysfunction or a mechanical problem with the spine segments. Fringe chiropractic views it as interference with the life force and is a cause for disease. The current subluxation article doesn't reflect both views. Regardless of who provides the manipulation, be it a DC, DO, PT they are all attempting to restore mobility and reduce pain at a specific part of the spine, hence the term 'manipulable lesion' or IOW that site that you're applying the manipulation. The difference between a chiropractic subluxation (aka joint dysfunction) is that there is no structural damage to the corresponding joints and soft and connective tissues. It's a functional problem. Orthopedic subluxations are literally unstable joints that are hyper mobile with structural damage and an absolute contraindication to manipulative techniques. I should point out that the ICD-10 recognizes the subluxation complex as a diagnosis under the musculoskeletal section under biomechanical lesions [80]. This, again, reinforces the MSK aspect that is considered 'mainstream' unless we don't consider the ICD-10 and the WHO credible sources. DVMt (talk) 15:56, 18 May 2014 (UTC)
If it could be established by mainstream (and I mean generally recognized as mainstream, without assuming that Chiropractic is mainstream) medical reliable sources that spinal joint disfunction, not amounting to orthopedic subluxations, can cause damage to the body, and (even from Chiropractic sources), that "straight" chiropractic are no longer accepted by the profession, then there would be some justification for removing the pseudoscience characterization. You have provided plausible evidence for the first, but there's still none for the second. At best you have provided evidence that "straight" chiropractic forms a small minority, but that doesn't show they aren't accepted within the profession. A profession which accepts pseudoscientists is still pseudoscientific, even if their numbers are few. — Arthur Rubin(talk)19:18, 18 May 2014 (UTC)
Arthur Rubin (talk·contribs), take a peek in my sandbox to see spinal joint dysfunction research --biomechanics, theory, etc. As a scientist you know well that there is continuum in science --pseudoscience -> junk science ->fringe science, etc. It's not really fair to 4/5 practitioners that practice "mainstream" (defined as primarily spinal/MSK based) to be labelled pseudoscientific bc of a rogue faction that has no support within or outside the profession. Hence, the proposal for alternative theoretical formulations. Or, even having two categories, but so long as we clearly delineate what specific aspects of clinical practice are considered fringe. I'm open to suggestions. DVMt (talk) 15:06, 19 May 2014 (UTC)
Based on Arthur Rubin's comments, there seems to be the initiative to further the discussion. Where would be the best place to have such a discussion? Here, WP:FRINGE talk, etc. DVMt (talk) 20:23, 3 June 2014 (UTC)
. The article as is does not follow MEDMOS for specialties [81]. I'm going to reorganize the headings so they are consistent with this. DVMt (talk) 14:55, 4 June 2014 (UTC)
This [82] discussion is relevant here. Here [is a 2013 status report of the profession from the WFC to the WHO. It provides evidence regarding what conditions patients are presenting to chiropractors. The primary reasons patients consult chiropractors are back pain (approximately 60%), other musculoskeletal pain such as pain in the neck, shoulder, extremities, and arthritic pain (20%) and headaches including migraine (10%). About 1 in 10 (10%) present with a wide variety of conditions caused or aggravated by neuromusculoskeletal disorders (e.g. pseudo angina, dysmennorhea, respiratory and digestive dysfunctions, infant colic/irritable baby syndrome.) [83].
I began thinking this whole pseudoscience issue from a completely new perspective. So far, we know that there are critics out there who have called chiropractic as pseudoscience, and I don't doubt that this wasn't the case in the early history of chiropractic. However, what it might have been over 100 years ago, it does not define what chiropractic is today. Just like any science, chiropractic has developed over the course of years, and many believes have been dropped out later that has turned out to be total nonsense. Here, chiropractic is not alone.
However, this is my point. There sure is easy to find sources that classify chiropractic as pseudoscience. However, as we very well know, there is education given on chiropractic at public universities. Public universities do not qualify other than sciences, not even pseudosciences, no matter what some critic might say. Now, it is much easier to find a source where some critic is disputing the status of chiropractic rather than find a source where some advocate is making a plea for chiropractic. After all, the burden of proof is on the one who is making the criticism.
Mere accusations cannot undo the fact that chiropractic is accepted and educated among public universities across the countries. Therefore, accepting one critic's authority over the authority of Universities is highly ... let say, questionable. Jayaguru-Shishya (talk) 11:35, 6 June 2014 (UTC)
""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[84] 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"[85]
According to Daniel D. Palmer, the founder of chiropractic, subluxation is the sole cause of disease and manipulation is the cure for all diseases of the human race.[10][214][original research?]
The source does not state this. This is a misrepresentation of the research. What else did you take liberties with paraphrasing? This is very concerning indeed. DVMt (talk) 23:09, 22 May 2014 (UTC)
"The “straights” religiously adhere to D.D. Palmer's notions of the “innate intelligence” and view subluxation as the sole cause and manipulation as the sole cure of all human disease" Straight out of the first source under the 'Internal Conflict' section. 203.38.24.65 (talk) 08:27, 23 May 2014 (UTC)
If we don't provide the date (1910) then there is no context. Considering that leaving at is suggests there's been no change in 104 years, that seems misleading. DVMt (talk) 16:31, 2 June 2014 (UTC)
The article is also misleading in the sense that it suggest the profession has not changed/evolved from its origins, namely that subluxation is the cause of diseases which is given tremendous weight here. This tertiary source Bergmann, T.F., Perterson D.H (2011). Chiropractic Technique: Principles and Procedures. Elsevier. ISBN9780323049696. clearly states that " This monocausal view of disease has been abandoned by the profession" and this 2012 systematic review states that "preferring a holistic view of subluxation that is viewed as theoretical construct in a "web of causation" along with other determinants of health. Henderson, C.N.R (October 2012). Journal of Electromyography and Kinesiology 22 (5): 632–642.[86]. These sources changes everything because it refutes the myth that QuackGuru is trying to perpetuate in 2014: that the profession still thinks that subluxation is the sole cause of disease for the human race. The more I dig into the sources of the articles, the more I am seeing critical errors in QG's interpretation, which was also noted by other editors [87] at the Electronic Cigarette. DVMt (talk) 16:57, June 2, 2014 (UTC)
No one is disputing what was published in 1910. It's the fact that you're not providing context by not including when it was published. WP generally prefers sources within 3-5 year range and we are still using a text from 1910, out of context. I don't have a problem with using this in a historical context, and User:BullRangifer is technically wrong that a textbook is primary source, as it is a tertiary source. So, let's try to find a compromise here and work together on this minor detail. DVMt (talk) 22:26, 5 June 2014 (UTC)
We are using a 2008 review. The 1910 source was not needed to backup the content. Where in the 2008 source or the 1910 source did it say when Daniel D. Palmer made the claim. I don't know the actual date when he made the claim. Please provide a direct quote from the source. What is your specific proposal or compromise? QuackGuru (talk) 22:39, 5 June 2014 (UTC)
The use of a 1910 originating source sounds highly trivial to me but it might be justified though in the history section. If it's still included to the lede, the positive stances on chiropractic should be summarized in the lede as well. These things comprehend things such as: current recognition among mainstream medicine, acceptance in the current care guidelines on different regional levels (e.g. Finland and the European Union), and the education given in public universities (public universities do not qualify other than sciences (not even pseudo-sciences, no matter what some critic might say). Jayaguru-Shishya (talk) 11:06, 6 June 2014 (UTC)
The article covers all aspects, including the past and origins. That's the relevance here. I don't see why including the date for the publication of the quote should be problematic. Just do it. It's always good to give context, and the date is important for that purpose. This was the historical position advocated by DD Palmer and taught to his students, with some straights still believing it. It was the basis for pretty much the whole profession up until the 1970s, when some DCs started pushing for a more sensible stance. Otherwise nearly all chiro education taught this, and some of the largest schools still push it in modified forms. -- Brangifer (talk) 15:19, 6 June 2014 (UTC)
Current text: "According to Daniel D. Palmer, the founder of chiropractic, subluxation is the sole cause of disease and manipulation is the cure for all diseases of the human race."
I could not verify the claim using the source from 1910. I removed the 1910 source because I could not verify the claim but we already have a 2008 source that does clearly verify the claim. Verification for the whole sentence still has not been provided using the 1910 and it has not been verified when DD Palmer made the claim. I think context is good but verification should be provided. If editors want to keep the source for historical context that is fine with me. QuackGuru (talk) 16:02, 6 June 2014 (UTC)
I agree that the date should be provided for context, Brangifer. You made a false claim. It was the basis for pretty much the whole profession up until the 1970s That isn't accurate at all. The profession since the beginning was divided into straights/focused scope, and mixers/broad scope per this [88] tertiary source, and it's been a long time since the straights were a minority as per Kapchuk and Eisenberg, as used in this article. As I already mentioned at QG talk page, you are skewing the facts [89]. In fact, the research shows that currently less than 20% of practice according to Palmer doctrine. Despite continued concerns by mainstream medicine, only a minority of the profession has retained a perspective in contrast to current scientific paradigms. " [90]. Don't make the same mistakes as QG and misrepresent the literature. You are more moderate than he, but seem to be prone to making the same fundamental errors of citing your opinion as fact. DVMt (talk) 16:13, June 6, 2014 (UTC)
DVMt, you mention a "false claim". I think we have a rather simple misunderstanding here. The straight/mixer thing has to do with treatment modalities, not belief structure. Straights use ONLY joint adjusting (the really pure ones only use "manual" adjusting, never tools). Mixers use various modalities, in addition to manipulation. Members of both groups can believe in the "one cause, one cure" idea, but it is more prevalent among straights. Those members have the same goal (to find and remove subluxations), but use different methods. That's all. Until relatively recently Medicare only covered "manual manipulation" for the purpose of correcting subluxations visible on x-ray. That has changed. -- Brangifer (talk) 00:33, 7 June 2014 (UTC)
Brangifer, I respectfully disagree. You have made additional claims (Straights use ONLY joint adjusting (the really pure ones only use "manual" adjusting, never tools) which is refuted by this paper [91]. It states Regardless of how they label themselves philosophically, chiropractors tend to practice in similar ways: 98% recommend exercise to their patients; 94% offer periodic maintenance or wellness care; 93% make a differential diagnosis; 93% offer ergonomic recommendations; 88% provide general nutrition advice; 86% give stress-reduction recommendations. Next you claim "Members of both groups can believe in the "one cause, one cure" idea, but it is more prevalent among straights.". This not the case. Evidence shows clearly shows this belief in one cause one cure is retained exclusively by the unorthodox/fringe faction 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.[92]. Lastly, the monocausal view has been rejected by the profession this monocausal view of disease has been abandoned by the profession [4] preferring a holistic view of subluxation that is viewed as theoretical construct in web of causation along with other determinants of health.[5].
I previously requested verification for the specific date DD Palmer made the claim. So far no verification was provided. I don't have a problem with adding context but I think the context should be verified. QuackGuru (talk) 19:35, 6 June 2014 (UTC)
Try to find a chiropractor whose practice is limited to conservative treatment of back pain and other musculoskeletal problems.
In addition to manual manipulation or stretching of tight muscles or joints, science-based chiropractors commonly use heat or ice packs, ultrasound treatment
They may also recommend a home exercise program.
Negative Signs
Avoid chiropractors make claims about curing diseases, try to get patients to sign contracts for lengthy treatment,
Use scare tactics (scare care) , or disparage scientific medical treatment or
Disparage preventive measures such as immunization or fluoridation.
Who have waiting room literature promoting "nerve interference" as the underlying cause of disease,
Conclusions
Barett acknowledges there is a scientific-based chiropractor.
Scientific chiropractic is confined to practicing manipulative therapy for treating back pain
Manipulative therapy may relieve other other musculoskeletal conditions
Scientific chiropractors are multi-modal and use adjunctive therapies such as heat, ice, ultrasound, and exercise
Non-scientific chiropractors will make bogus claims that joint dysfunction/subluxation is the underlying cause of disease
Non scientific chiropractors will disparage proven health measures such as immunization and fluoridation.
Non scientific chiropractors will tend to use scare tactics and require patients to sign long term contracts, for 'subluxation correction'
Non scientific chiropractors disparage all medical treatments there are skeptical or the medical community
“
Remember that although manipulative therapy has value in treating back pain and may relieve other musculoskeletal conditions, chiropractors are not the only source of manipulative therapy. Physical therapists, many osteopathic physicians, and a small number of medical doctors do it also.
Since QW considered reliable, this should be part of the main article. As well, because Barrett acknowledges a scientific chiropractic, this [93] discussion is germane to this topic. This is also relevant to the discussions regarding ordering the sections here [94]. Neuraxis (talk) 15:44, June 7, 2014 (UTC)
Those are two different subjects. I'm not sure which part of the QW source (last updated in 2000) you'd like to include, but he made it plain that "the number of chiropractors who belong to this group [CAMT, which has changed its name to CAMPT, a group of physiotherapists] is small. CAMT's "orthopractic guidelines" describe a science-based approach to manipulative therapy."
He was unequivocally discouraging readers from visiting chiropractors, but allowed for the remote possibility that a few science-based ones existed in 2000, and only recommended them for those who insisted on going to a DC. Personally, I agree that there are many more of them now, but there is still far too much woo practiced, which is a shame for the sensible ones.
If you want to include something from the source, write your proposed wording here and let's see if it flies. It might. -- Brangifer (talk) 20:06, 7 June 2014 (UTC)
I do find your constant insistence on the theme of a "scientific chiropractic" to be disquietingly close to the theme of the indef blocked User talk:CorticoSpinal. I suggest you study his history and see if you can avoid the same mistakes. You'll need to find different and better arguments if you're going to fare any better at improving these articles. -- Brangifer (talk) 20:17, 7 June 2014 (UTC)
Ordering of sections
User:Jmh649 reverted a change made regarding the ordering of the sections here [95] stating 'Not sure why the change in ordering of sections'. This is tendentious. I clearly stated 'Re-organize per MEDMOS [96] in the diff [97]. I had discussed this earlier today at the talk page [98] but I guess Doc James isn't listening. Why, specifically did you revert the changes when the summary was clearly listed as indicated in the diff? Please extend good faith and let other editors than QuackGuru and other skeptics edit this article. Thank you. DVMt (talk) 23:18, 4 June 2014 (UTC)
Your change did not reorganize per WP:MEDMOS. Thus I reverted. I see no consensus for the edit here. You placed your comment under the heading "Removal of chiropractic from pseudoscience category" Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:23, 5 June 2014 (UTC)
Okay have created a proper section for this discussion as it of course has nothing to do with the previous heading. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:32, 5 June 2014 (UTC)
The problem here is that Jmh649 is not a skeptic. He is a cynic operating under the grand delusion that he is a skeptic. Skeptics are open to evidence which completely belie what they already hold to be true. A cynic makes up their mind and just says "no" to everything else. Editors like this are truly as bad for WP as all the woo pushers. What's worse is that they cast all of the true skeptics down with all of the woo pushers, because they don't like anything positive ... Nay ... Neutral written about a subject which they have prejudged to be entirely woo. This article doesn't have any woo pushers AFAICT, just moderate editors who want to write a neutral article, and cynical editors who want only to present the subject in the most negative light as possible. I challenge these cynics to disengage from this article for three months to see if their worst fears come true – that the article would be completely overhauled into a complete marketing, puff piece or (and I'm betting this is more likely) a fact-based, truly NPOV article finally emerges. I encourage Doc James and the likes to accept this challenge. If I lose my bet, well good on you. Your cynical POV pushing is needed here after all. But if I win my bet, just think of all the time you will save knowing that you don't have to patrol this article anymore. Challenge accepted? — Preceding unsigned comment added by 12.9.178.2 (talk) 05:11, 5 June 2014 (UTC)
WP isn't about asserting opinions, it's about asserting facts. Chiropractic is a health care profession. It is not a treatment. This is a fundamental mistake. we've been over this. Also, according to this [99] source, it states "Chiropractic, the medical profession that specializes in manual therapy and especially spinal manipulation. The same article also states that "Even to call chiropractic "alternative" is problematic; in many ways, it is distinctly mainstream. Furthermore, it is stated in the lede "and although chiropractors have many similarities to primary care providers, they are more similar to a medical specialty like dentistry or podiatry." [100]. The evidence is compelling. The onus is on you to prove that it is not a profession, or medical specialty, since you're making the claim. DVMt (talk) 01:11, 5 June 2014 (UTC)
Your interpretation is rather bizarre and you're conflating things. Please address the literature above, with literature to rebut. You seem not to like it, but that doesn't change the fact chiropractic is a profession and not a treatment. Please use peer-reviewed literature to support your claim, your personal opinon [101] isn't relevant in this matter. DVMt (talk) 01:36, 5 June 2014 (UTC)
Thanks for chipping in User:Puhlaa. The evidence is rather overwhelming, but not surprising. What I am surprised about is such a fundamental error (technique vs. profession) can be perpetuated. DVMt (talk) 16:17, 5 June 2014 (UTC)
Now that we've established, yet again, that chiropractic is a profession and not a technique, does anyone have any specific objections to re-ordering the sections per MEDMOS The lede clearly states that the profession shares more of attributes of a medical specialty, like dentistry or podiatry and we have multiple sources that confirm this. Regards, DVMt (talk) 22:45, 5 June 2014 (UTC)
I think the current ordering of the sections per MEDMOS is okay. The previous drastic re-ordering of the sections was confusing. QuackGuru (talk) 22:49, 5 June 2014 (UTC)
The article is not ordered per MEDMOS[103]. That's the purpose of the discussion to make it compliant with MEDMOS. Also, please don't fall into the the same old habits of of not listening. It's tendentious. Lastly, please provide evidence to support your position. These discussions need to be based on facts, evidence and not asserting opinions. Thanks, DVMt (talk) 23:02, 5 June 2014 (UTC)
You're being tendentious again, QuackGuru. You're also not not listening again. You need to bring evidence to support your claim. Your opinion alone is irrelevant. Are you asserting that chiropractic is a treatment and not a profession? If not, please stop trying to own every aspect of this article. You're only 1 day back from your block and it seems as though you've learned nothing. Relying on Doc James unconditional support isn't doing him any favours. DVMt (talk) 20:45, 6 June 2014 (UTC)
Chiropractic is both a treatment and a profession. I agree that chiropractor should be arranged as per the profession but IMO this should be arrange as per a treatment. This is an editorial decision. We could have a RfC to bring in greater input if you wish. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:18, 6 June 2014 (UTC)
Doc, I presented evidence that said chiropractic was a medical specialty. You have yet to rebut this with any evidence, and your opinion isn't a substitute for facts. It is clearly a profession and thus the article should be MEDMOS compliant. We've come to a stalemate here, so we can go to dispute resolution. DVMt (talk) 06:55, 7 June 2014 (UTC)
"Chiropractic care is a way to diagnose and treat health problems" "Chiropractic is most effective for treating" and "Who Should Not Be Treated with Chiropractic" [104]. These are all uses of the term to mean a method of care or a method of treatment. It is also used to mean a profession use. And members of that profession are chiropractors and that article should be organized as per a profession. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:52, 7 June 2014 (UTC)
That logic is rather faulty. You do realize that SMT isn't the only service provided by chiropractors, no? We can take this to DR; you're still equating the profession with a treatment, and despite the plethora of evidence and a previous dispute resolution, you want to impose your interpretation. So, we will have to agree to disagree and get outside analysis. Neuraxis (talk) 15:00, 12 June 2014 (UTC)
No mention of reform chiropractic
While reviewing some of the diffs and comments from the various board postings (Arb clarification, ani) I did some google searches to evaluate some of the various statements being made by the parties involved.
I came across http://www.chiropractors.org/resources/chiropractic-specializations/what-reform-chiropractic-care.htm which says the three types of Chiropractic are straight, mix, and reform. We do not seem to mention reform anywhere. I am not claiming this site as a RS so we would need some sources, but is there a reason we do not mention reform Chiropractic in the article? It seems to be the least fringy of the types but also unfortunately the smallest group of practice too. Since it is the smallest, per WP:WEIGHT we shouldn't spend too much time on them, but it seems like they should at least be discussed? Gaijin42 (talk) 20:39, 12 June 2014 (UTC)
In this section (Chiropractic#Straights and mixers), we previously had three groups. IIRC, chiropractic editors managed to prevent and remove mention of reform chiropractors, which certainly made a lie of all their claims that the profession was reforming and becoming science-based.
We still have an article about them: National Association for Chiropractic Medicine. Reform efforts never gained any traction. They met constant opposition, other chiropractors would not associate with them, they and their families got threatened, and their ability to participate in chiropractic was seriously hampered. Membership was so risky that many of them kept their membership a secret. Their organization simply lost steam as reform seemed impossible, and many of them left the profession. Some are now MDs. You can read about their demise here: Talk:National_Association_for_Chiropractic_Medicine#Does_this_organization_still_exist.3F.
The following discussion has been closed. Please do not modify it.
This article is very unbalanced (see archive 37 where I describe the biases) and the only editor who can freely edit the page is QG. Anyone who is not a cynic/skeptic will be reverted for presenting any information that challenges the status quo. Heck, I made 14 edits (minor ones at that too) over a 6 week period and they're looking to topic ban me. So, anyone with any expertise on manipulative therapies, which obviously will involve chiropractic to a larger extent that osteopathic medicine or physical therapy, will be shunned, called a fringe-pov pusher, an edit warrior and an ongoing smear campaign that slowly but surely is done to discredit you. Take it from me, I've been here for about a month and have been treated like an absolute heretic, an extremist, for merely suggesting that things have evolved or changed over the last 20 years or so regarding the research and acceptance or manual therapies for MSK. Feel free to take a look at my page and talk page for my experience thus far. The xenophonic fear-mongering of attempting to silence or white-wash all criticism is beyong bogus, but despite me repeatedly telling them this is not the case, they will gang up on you and continue to the character assassination. Some are more inconspicuous than others, and there is a bad cop/good cop dynamic at play. Read the archives and learn the issues and learn the editors. You will notice there is a constant, and a constant theme of ownership. You will be exposed to tendentious editing, not listening to points you raised and wiki-lawyering. It has driven away any middle ground editor, for good reason. The emotional toll and the time sink that this becomes is too much for most, and it seems like the criticism WP gets for being unbalanced and not reliable (especially when it comes to CAM, as the skeptic cabal has managed to insert their own definitions of CAM (which is 100% not based on science, according to their biased sources) has led to a dysfunctional part of the encyclopedia. They will call you a lunatic charlatan for questioning the status quo and CAM articles. In essence, you will be relegated as a second class WP and treated like shit. Depending on my fate, I may not even be able to comment here anymore, but time will show that I am very knowledgeable, can write very well and will be able to increase the depth and breadth of articles relating to the manual sciences. Take care. Neuraxis (talk) 23:36, 12 June 2014 (UTC)
National Association for Chiropractic Medicine no longer exists. The previous discussion resulted in the Objective Straight and the Reform chiropractors being deleted from this article. I don't see any recent RS that Reforms (or Objective Straights) exist. If we did include it I think we would need a review that describes it.
The text was moved to Chiropractic history#Straights versus mixers: Objective Straight chiropractors, who are an off-shoot of straights, only focus on the correction of chiropractic vertebral subluxations while traditional straights claim that chiropractic adjustments are a plausible treatment for a wide range of diseases.[38] Reform chiropractors are an evidence-based off-shoot of mixers who rejected traditional Palmer philosophy and tend not to use alternative medicine methods.[39]
A 2008 review stated that "Currently, there are two types of chiropractors: those religiously adhering to the gospel of its founding fathers and those open to change."[105]QuackGuru (talk) 17:00, 13 June 2014 (UTC)
Removal of sources
@Smk65536:, you reasoned your recent removal of sources[106] by stating that:
the Meeker-Haldeman source links to the book "Chiropractic. History and Evolution of a New Profession", which is authored by a chiropractic, the neutrality of information here is questionable
Please correct me if I am wrong, but are you saying that a chiropractic author isn't a reliable source on chiropractic? How about an economist then, is an economist a reliable source on economics? Or a physician on medicine? Jayaguru-Shishya (talk) 17:06, 15 June 2014 (UTC)
A long time chiropractor is definitely a reliable source on chiropractic, but the wikipedia summary is about chiropractic in a broader professional context by comparing alternative medicine to other science-based medicines. Therefore I'm doubting the neutrality of this. Smk65536 (talk) 17:49, 15 June 2014 (UTC)
The edit summary appears to be misleading. This text was from this [107] source, Ann Intern Med. 2002 Feb 5;136(3):216-27.. It was also removed from the lede, no discussion. Neuraxis (talk) 17:52, 15 June 2014 (UTC)
Considering that there was no discussion for the removal in the lede, neither any clear WP policy why it was removed but only personal speculation, I think the source is better to be restored. If there is a clear WP policy though, please let me know. Perhaps you could find a secondary source that is doubting the very same source you removed? Then it would be alright. Jayaguru-Shishya (talk) 20:19, 15 June 2014 (UTC)
The policy is clearly WP:NPOV, the source is also a secondary source, the book is instead a primary source, the edit summary summarizes the edit well and attempts to be clear as possible. The secondary source also considers the book's view to be a point of view, but the wikipedia summary appears to state it as fact. Smk65536 (talk) 09:52, 16 June 2014 (UTC)
Jayaguru-Shishya (talk), you have to cite references for every sentence you plan to add to any article of wikipedia and avoid removing sentences with references. This article is written as per the policies of wikipedia which is that all complementary and alternative medicine articles should be written, not from the perspective of its advocates/practitioners, but from the perspective of 'researchers and scientists'. If you want to complain about wikipedia's policies, please do what LeadSongDog mentioned on the Talk:Homeopathy page which I'm linking to here (and tell me also about it, on my discussion/talk page). I'm probably the only sympathiser you'll find here, so please follow my advice or else you will get blocked, banned or topic banned (from this article).—Khabboos (talk) 16:53, 29 June 2014 (UTC)
Chiropractic: Is it Nature, Medicine or Religion?
Here's a very interesting article from a Professor of Religious Studies:
This article contains quotes and POV about chiropractic which are usable for the chiropractic articles. -- Brangifer (talk) 03:28, 9 July 2014 (UTC)
Isn't it interesting that chiropractic has such widespread popularity in treating patients suffering from a variety of ailments, most principally neuromusculoskeletal disorders. I consider the writings of 19th century individuals who attempted to explain the workings of the human body based on the limited knowledge of the day, although interesting, not very relevant to the reality of today. Chiropractic is not stagnant, limited to the dogmatic beliefs of the past, but a modern and dynamic health profession. Dr. Gunther-Brown's focus on the metaphysical beliefs of these chiropractic pioneers and fringe revivalists fits with her focus of interest and educational which is religion. It is my opinion that readers of WP would be more interested in what chiropractic actually is, as currently practiced as a licensed health care profession. I find this constant focus on how chiropractic pioneers tried to differentiate their focus from the equally unexplainable medical practices of the 19th and early 20th centuries tedious, dated and irrelevant to what I believe readers of WP would like to know about chiropractic. Kshilts (talk) 22:04, 9 July 2014 (UTC)
While it would be nice if this was of purely historical interest, there is still enough relevance that it is still worth noting. We document what RS say. Until the profession does something about cleaning up the pseudoscientific practices, and publicly distances itself from the beliefs which allow them, the profession will have to live with the disdain of mainstream medicine and science. I know that's not fair to sensible and science based chiropractors, but that's life. Change must come from inside the profession, and so far it has resisted change (the NACM gave up atttempts at reform) and tried to do some of it without anyone noticing, but that won't work. It really needs to create a clean slate. Until then, writers like Dr. Brown are going to keep writing about the problems in the profession, and Wikipedia will use those RS in articles here. -- Brangifer (talk) 02:56, 10 July 2014 (UTC)
I consider the writings of 19th century individuals who attempted to explain the workings of the human body based on the limited knowledge of the day, although interesting, not very relevant to the reality of today. Chiropractic is not stagnant, limited to the dogmatic beliefs of the past, but a modern and dynamic health profession. [...] It is my opinion that readers of WP would be more interested in what chiropractic actually is, as currently practiced as a licensed health care profession. I find this constant focus on how chiropractic pioneers tried to differentiate their focus from the equally unexplainable medical practices of the 19th and early 20th centuries tedious, dated and irrelevant to what I believe readers of WP would like to know about chiropractic. -Kshilts (talk) 22:04, 9 July 2014 (UTC)
I think it's a matter of WP:WEIGHT. Just like we don't put much emphasis in the science -article on how scientists used to believe in things like aether or such, we shouldn't put too much weight on the very early believes of chiropractic that obviously have changed to this day. Sure there might be some who still hold on to these believes, just like there are people ho still believe that the world is flat (The Flat Earth Society) or believe that the world was created in 6 days. We should be really careful with respect to giving too much weight on such views.
Mr. Rangifer,,,
I appreciate your perspective and interest on this unusual topic. I believe the chiropractic profession does not need a wholesale cleansing of the past. The past is what it was. It's impossible to go back and create a clean slate. From my perspective, the enabling philosophy of chiropractic describes how its pioneers wanted to establish something distinctly different from the prevailing medical practices of late 1800's, and explained their innovate constructs around the burgeoning science (and miracle) of the time, which was electricity. The enabling metaphysical concepts to chiropractic are well documented in WP. Unfortunately, it appears to me that the chiropractic profession's detractors refuse to appreciate chiropractic, as CURRENTLY practiced, as a regulated healthcare profession integrated into our modern health care system. Dr. Gunther-Brown's observation about a chiropractor who wraps his/her patient's needs within a holistic realm is somehow akin to a religious sermon sounds a bit silly. Chiropractic has no deity. The body's ability to heal is recognized across all medical disciplines. I'm sorry, I don't see the relevance. I also do not think the "pseudoscience" moniker that a few ardent individuals seem bent on attaching to the "chiropractic" WP page is either appropriate or accurate. Call chiropractic's beginnings what they were but let's not paint over the present using the same dismissive attitudes that apparently forged these beginnings but also perpetrates an inaccurate view of reality relative to this legitimate profession. Kshilts (talk) 21:43, 11 July 2014 (UTC)
Problem with WP:WEIGHT?
In a recent edit[108] by QuackGuru, a blog post - marketed as a survey - was used as a source for the following addition: "A 2003 profession-wide survey found "most chiropractors (whether "straights" or "mixers") still hold views of Innate and of the cause and cure of disease (not just back pain) consistent with those of the Palmers." Does a blog really qualify as an adequate source?
Besides, hasn't this topic already been discussed earlier, like in these discussions for example: [109]? Feel free to correct me if I'm wrong. Cheers and Happy Summer! ;] Jayaguru-Shishya (talk) 21:22, 12 July 2014 (UTC)
I'm not sure where you get the idea of a "blog". It's an article by an expert, referring to a published survey performed by experts who are chiropractors (!), which is now in a book. The article is a reliable secondary source, and we should just add a ref to the survey itself. That should tighten that content up quite nicely. -- Brangifer (talk) 01:32, 13 July 2014 (UTC)
This one: Gunther Brown, Candy (July 7, 2014). "Chiropractic: Is it Nature, Medicine or Religion?". The Huffington Post. Seems like a Huffington Post's blog to me. Just like we don't qualify Paul Krugman's blog on the New York Times where he calls the European Union commissars as cockroaches as a source on economics articles, we shouldn't use anybody's blog as a source on this one. Jayaguru-Shishya (talk) 18:07, 17 July 2014 (UTC)
First of all, The Huffington Post is not a blog, but it hosts certain blogs by notable journalists and editors, whose blogs are the equivalent of a newspaper column, and they have always been considered RS for certain purposes here.
There was a time, very long ago, when blogs were a new form of keeping an online personal diary, that they were pretty much totally banned as sources here. Wikipedia's position has changed quite a bit, but many editors aren't aware of that. Blogs are now used as websites by journalists, politicians, and even some businesses, and in some cases as their sole website. Only the diary type of blog by unknown people are now deprecated here. Therefore we now judge them by their publisher and their author. If the publisher is well-known (like a newspaper or magazine) and the author is an expert, we accept the article as a RS. That's the case here. In fact, this expert is merely summing up a chapter in her book, which is certainly a RS. She is an expert on her subject, just as Paul Krugman is a world renowned expert and Nobel Prize winner. If he wrote something on a piece of toilet paper, used it and flushed it, we'd rescue it and still consider it a RS for his opinion!-- Brangifer (talk) 05:45, 18 July 2014 (UTC)
The Huffington Post is not a blog, well noticed! ;D However, there is a blog section in The Huffington Post. Anyway, blogs are by no means a reliable source as they do not undergo any sort of peer-review process. A blog post by a world-class scientist like Paul Krugman can be very pleasant to read but it is not - and is not meant to - make any scientific claims. Jayaguru-Shishya (talk) 14:03, 18 July 2014 (UTC)
I can't speak for every blog hosted at The Huffington Post (THP), but I suspect most are what we would call a "column" used by a noted contributor. Their use would have to be considered on an individual basis, but a blanket refusal to use any of them because of the word "blog" is wrong. I don't think that THF is a blog hosting service in the same sense as Blogger (service), where anyone can have a blog.
Krugman is not a scientist, and we would likely not use him for scientific claims of the type governed by MEDRS. As a notable person, we might use his statements as documentation for his opinion on many types of articles, including ones not directly related to economics. Again, judging on an individual basis. -- Brangifer (talk) 15:37, 18 July 2014 (UTC)
No, not really. Blogs are non-scientific sources and are not meant to make any scientific claims. Opinions are opinions, scientific claims are scientific claims. That's why we have both blogs and peer-reviewed articles. ^^
This is a bit off-topic, but, Krugman is a a politician, although he may have been a scientist at one point. Nonetheless, his comments may be used if usable under WP:SPS. This applies whether the publication is in a blog, a letter, or a column, or in any form other than that of an edited publication. — Arthur Rubin(talk)16:03, 21 July 2014 (UTC)
"The NBCE Part-IV examination is a comprehensive practical exam that assesses case history, orthopedic & neurological testing, clinical diagnosis, radiography & imaging interpretation, manual techniques and case management. The Part-VI exam has generally replaced individual state examinations. Jurisdictions still administer a jurisprudence examination to test a candidate's knowledge of the statutes and regulations that govern chiropractic practice within its particular jurisdiction." This unsourced text was restored again. It is also a violation of summary. This is way too detailed.
In my humble opinion, information about things such as education, licensing, and regulation are important for the article and therefore not too detailed. Jayaguru-Shishya (talk) 21:03, 23 July 2014 (UTC)
Please, let's discuss Kshilts edits (including two other interleaved edits by BullRangifer & Monkbot). Per 2over0, QuackGuru, and Bullrangifer, these edits seem to have a fair amount of unsourced material. I will {{tb}} all who appear to be involved here. Jim1138 (talk) 23:02, 24 July 2014 (UTC)
I support the reversion to previous version, poorly sourced (primary etc.) material given undue weight and overly credulous. - - MrBill3 (talk) 01:09, 25 July 2014 (UTC)
I agree. His edits added far too much for this article. It's better suited for one of the sub articles. This version (edit 22:48, July 24, 2014 Jim1138) seems to be good, and it includes a minor grammatical improvement made in the mean time. Let's keep this version. -- Brangifer (talk) 01:51, 25 July 2014 (UTC)
I made a revert simply because sourced material was deleted per "unsourced material". For example:
In the United States, each jurisdiction requires candidates for chiropractic licensure to have passed various parts of a national examination administered by the National Board of Chiropractic Examiners (NBCE).[6]
or
The number of required continuing education credit hours varies per jurisdiction. In the United States, this ranges from a minimum of twelve (12) hours up to fifty (50) hours per year [7]
The edit summary said "unsourced material". If there is some other issues with original research / primary sources etc., that's another thing. Jayaguru-Shishya (talk) 09:31, 25 July 2014 (UTC)
As per diff 617808208[116], you removed sourced content under an edit summary: "shorten long section and organise text; remove unsourced text". Not a word about OR or any other stuff. As I have already told you, the text section is not too long in my opinion. Should you have any other issues with original research / primary sources etc. etc., please discuss them separately. Cheers and please have enjoy your Friday night everyone! ;) Jayaguru-Shishya (talk) 17:37, 25 July 2014 (UTC)
It seems that all your diffs are after I made the revert. I don't see any consensus before the time I made the revert. The rest is explained above. Cheers. Jayaguru-Shishya (talk) 18:54, 25 July 2014 (UTC)
Kshilts' addition is poorly sourced. If Kshilts wishes to restore it, it should be done in parts, with appropriate sources, after reaching consensus here. Jim1138 (talk) 21:55, 26 July 2014 (UTC)
I don't think there is a WP policy saying that edits should be done in parts. If there is, please let me know. It seems that here (and in many articles) edits are done as mass-edits. We can't demand anything different form Kshilts or any other editor. The first revert was made under "unsourced material", so if there are any other concerns, we will deal with them separately. So far, sourced material was removed, as stated above. Cheers. Jayaguru-Shishya (talk) 22:11, 26 July 2014 (UTC)
Repeating yourself does not address the issues raised of 1) poor quality sources 2) undue weight 3) original research and 4) lack of consensus. It is good practice to perform a series of smaller edits when content has been challenged, alternatively in keeping with policy once content is challenged getting consensus on talk before restoring that content. So far it seems there is no consensus support for the changes and substantial policy based objections have not been addressed. Your objection to the original edit summary has been noted and we are dealing with the aforementioned issues. There is no policy saying if the edit summary used when content is first challenged is not entirely correct the content should be restored against consensus. - - MrBill3 (talk) 12:48, 27 July 2014 (UTC)
Mr. Bill3:
The information I provided under the chiropractic licensing and regulatory section of the "chiropractic" WP page includes basic information about the actual regulatory bodies and examination entity that oversee the chiropractic profession. I did not see anyone suggest that this information includes "poor quality sources" or excessive weight. Frankly, the omission of this essential regulatory-based material was surprising to me. I have not heard you or anyone else say that the information I provided is inaccurate, not germane to this section or inappropriate. If we're going to have a discussion about the merits of the information, please do so. I find the avoidance of such - other than a re-hashing of inconsistent and inaccurate statements of process somewhat sophomoric. So please, I invite your comments on the merits of the information. Kshilts (talk) 15:10, 28 July 2014 (UTC)
Now here is the current version. It is much longer. The section was already expanded. Maybe if consensus permits you could move the text (without the original research) to the main article. If there is a particular sentence that you think will improve the section please discuss it here to gain consensus. QuackGuru (talk) 00:31, 29 July 2014 (UTC)
The amount of content is undue. The sources are a the commercial website of a company that sells continuing education and the NBCE a self regulatory testing non profit. If this is "essential regulatory-based material" it should appear in a third party uninvolved source. What independent reliable source considers this information "essential" enough to publish it? A short summary is what is appropriate on WP, preferably based on an independent secondary source. The WP policies on this are clear, if reliable secondary sources don't consider it important enough to cover something, it certainly isn't encyclopedic. There is a lack of consensus support for including this level of detail. It verges on original research to synthesize information from primary sources to create content. This material is not due the weight of this amount of detail as evidenced by the lack of prominence in published reliable sources. I find the need to explain things clearly spelled out in the three core policies tedious and personal attacks offensive. See WP:NPOV, WP:V, WP:OR and WP:CON for further explanation WP:RS, WP:FRINGE and WP:TEND also WP:CIVIL and WP:NPA. - - MrBill3 (talk) 09:52, 29 July 2014 (UTC)
Mr. Bill3's statement that the FCLB is a "commercial website of a company that sells continuing education" is not only incorrect but absurd. It suggests he is ill-informed or ignorant to legal regulatory oversight of a licensed profession. Similarly, the NBCE is not a self-regulatory entity. NBCE examinations are legally required to obtain a chiropractic license in every U.S. jurisdiction. 74.61.206.183 (talk) 14:46, 2 August 2014 (UTC)
Please see the guideline Identifying reliable sources, "Articles should be based on reliable, third-party, published sources with a reputation for fact-checking and accuracy." Note the linked term. Content should not be based on involved sources which practice advocacy and have a conflict of interest in regards to the subject. Content should reflect proportionately the significant views published in reliable sources. This type of content if it is important information will be covered by independent sources. The proportion of content published in reliable sources about this information guides our consideration of due weight. Acceptance of a self regulatory professional organization's tests as a requirement for licensure by state regulatory agencies does not change the fact the profession itself devised these tests, that is self regulation. There is nothing wrong with self regulation, but WP discussion of it should be based on the explanation, evaluation and analysis of independent third parties with academic/scientific/journalistic credibility. Content should not give undue weight to advocates. - - MrBill3 (talk) 11:13, 3 August 2014 (UTC)
MrBill:
Your perception of a self-regulation is a uniquely Canadian concept, utilized in most but not all of the Canadian provinces. So you're obviously Canadian or at least Canadian-minded; Aye? Jurisdictions within the United States do not employ the Canadian model in regulating their professionals, with the exception of a few of the lawyer boards. And even with these exceptions, the required bar examination is independently developed and operated. So again your assertion that the FCLB is an advocacy organization for chiropractic professionals is totally wrong. The FCLB is a public protection entity comprised of statutorily-enacted licensing boards. There are dozens of these regulatory organizations within the US alone. The Federation of State Medical Boards (FSMB) is but one example. I believe the American Chiropractic Association (ACA) and the International Chiropractic Association (ICA) are the American advocacy organizations for chiropractic professionals - just as the American Medical Association (AMA) is the allopathic physician equivalent. Your second assertion that the National Board of Chiropractic Examiners (NBCE), the testing organization for chiropractors within the US, is self-regulated and therefore biased, is stupid. Almost every profession which uses pre-licensure examinations utilize a Delphi process where the examinations are built from instructors who teach at the very institutions where these professional graduate. I believe nearly all professions employ this process, even the Canadian Chiropractic Examining Board (CCEB). So Bill, you have two choices. You could become better informed by actually researching what you wish to render an opinion, or, refuse to broaden your understanding and remain ignorant. And finally, it seems to me that your extraordinary keen interest on the "Chiropractic" WP page is askew to the fundamental intention of Wikipedia. Let's talk some more. Kshilts (talk) 22:42, 8 August 2014 (UTC)
The key issue is these sources are primary sources for the information. Where is the secondary source that summarizes, analyzes and comments on the information? The organization that regulates is primary for regulations, the organization that composes and administers testing is primary for testing. You've asserted this is essential information, if so it is certainly covered in secondary sources.
My "extraordinary keen interest" in this article is a mischaracterization, my interests and edits on WP are actually rather broad. I stand by my edit history warts and all. While discussing editors rather than content is generally frowned upon, since you brought up the subject, it would seem your interest in contributing to WP is both recent and very limited. Your participation is very narrow and focused in scope and includes several incidents that drew warnings. I am led to wonder if there is an undisclosed conflict of interest. I would suggest caution in making characterizations and aspersions regarding other editors (see WP:BOOMERANG). I take offense to your assertion that my behavior is "askew to the fundamental intention of Wikipedia". - - MrBill3 (talk) 20:25, 9 August 2014 (UTC)
MrBill:
I have reviewed your contributions (primary comments) to the WP Chiropractic page. It should appear to everyone, including yourself, that your focus has consistently been to promote a skeptical bent on this profession. Go back and refresh your memory.
Your argument that the chiropractic regulatory agencies and chiropractic testing agencies require some sort of secondary overview for inclusion on the Chiropractic WP page is as silly as it is ridiculous. I included these references within the Chiropractic page's, "Education, licensing and regulation" section. If you had bothered to review the FCLB page for instance, you would have found that it provides primary regulatory information from each jurisdiction in a comprehensive manner which makes it easier for readers to get pertinent and factual information about the topic.
My focus has been to include pertinent and informative regulatory info. to the chiropractic WP page. My expertise is in this arena. Your action has been to prohibit this information. As your history shows, conflict on this WP page would seem to emanate more from your end than mine.
But Mr. Bill, let's put all of that aside. Like you, I love Canadians - including some of their regulatory constructs. My intent is to re-post my previous edits about the topic of chiropractic regulation. within the so-named section. I also though of doing this for the other health profession's WP pages as well for consistency. Will you join me in supporting this narrow focus using a template across most all of the regulated health professions? Kshilts (talk) 15:29, 16 August 2014 (UTC)
Controversial changes to lede
The text was "A large number of". Now is it "Some"... This edit replaced sourced text with OR. So what does the source say? "Today, a substantial number of chiropractors are anxious to sever all remaining ties to the vitalism of innate intelligence."[121]
This edit added low level details using a dated source. We have more recent sources covering safety, anyhow. The edit was also not a summary of the body. The same edit replaced unproven with the word deny which is also OR.
This edit replaced the word controversy with the word dispute but the source says controversy. "There is controversy about the level of risk of stroke from cSMT,..."[122] The same edit deleted the word many which was accurate. Now the text is vague. Going back to this version will fix the problems. Anything other than sourced text is quackery. QuackGuru (talk) 03:54, 2 August 2014 (UTC)
Semi-protected edit request on 8 August 2014
This edit request to Chiropractic has been answered. Set the |answered= or |ans= parameter to no to reactivate your request.
I would think that chiropractic is a primary healthcare profession rather than a alternative medicine. Below are the definition of chiropractic by WHO at page 3. Thanks
Definition of Chiropractic by WHO
A health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual techniques, including joint adjustment and/or manipulation with a particular focus on subluxations.
Not done This has been discussed at length in the past - Please see above on this page and the 37 archive files. - Arjayay (talk) 08:48, 8 August 2014 (UTC)
Etymology
The article used to have [123] an etymology section which featured the following information (sourced from the Oxford English Dictionary): "from Greek χείρ, cheir "hand" and πρακτικός praktikos, "concerned with action."" Cf. Talk:Chiropractic/Archive_15#Etymology. Is there any objection inserting again this piece of information in the article? It could be placed either in the lead section or (in order to avoid cluttering) in a separate "etymology" section. Most Wikipedia articles on medical and non-medical disciplines alike contain such a section since the titles of disciplines are often an encyclopedic subject themselves (cf. Cardiology, Chemistry#Etymology and WP:WORDISSUBJECT). --Omnipaedista (talk) 21:16, 9 August 2014 (UTC)
I don't have anything against it. But I think the lede is already pretty long, so maybe an Etymology section of its own. I am not familiar with the former discussion though (I'll try to take a look with better time!) Jayaguru-Shishya (talk) 09:25, 10 August 2014 (UTC)
Well, I am not sure why you placed it in a box.[124] This is against standard Wikipedia practice. Etymologies go either in the lead or in a separate section. I have not come across an etymology box anywhere in Wikipedia. I am also not sure why you said it is not in citation given. The formulation I gave above is a trivial concatenation of information from three lemmas of the OED. Do you seriously believe that it is some kind of violation of WP:SYNTH? --Omnipaedista (talk) 03:08, 11 August 2014 (UTC)
(1) CHIROPRACTIC: "[f. Gr. χειρο- + πρακτικός: see CHIRO- and PRACTIC a.]"; (2) CHIRO-: says "Gr. χειρο- combining form of χείρ hand …"; (3) PRACTIC: "ancient Greek πρακτικός concerned with action, practical, active, effective".
For the record, the style I used above is the style of presentation used wikiwide. Reproducing a dictionary lemma verbatim is not what is usually done on Wikipedia. We can ask advice from other members of WikiProject Etymology. --Omnipaedista (talk) 03:17, 11 August 2014 (UTC)
I agree with Omnipaedista here. I've never encountered such a practice in Wikipedia, whereas an Etymology section is a well-known practice. Bobrayner also agreed that it belongs to the body. I don't really understand QuackGuru's edit summary "nonsense and failed V, why is it nonsense and failed v? I'd like to suggest restoring the last version by Omnipaedista[125]. Jayaguru-Shishya (talk) 11:01, 11 August 2014 (UTC)
There are different ways of rendering praktikos to English. LSJ gives "concerned with action, practical, active, effective" [126], while the online version of the OED gives just "concerned with action" [127]. Also there are different versions of OED itself. In any case, let us just use the online OED definition as QuackGuru suggested. However, I strongly recommend we give the etymology of chiro- (from cheir) since it is not a common suffix (at least not as common as mega- or tetra-) and our readers should be able to track down its ultimate derivation (also sourced from the OED). Please note that Greek here means 'Ancient Greek' (a piped link is needed) and that the original Greek script is placed before its transliteration according to standard lexicographic practice. I just edited the article to reflect the considerations above [128]. --Omnipaedista (talk) 18:50, 11 August 2014 (UTC)
Unnecessary on what grounds? This is common Wikipedia practice. The previous version of the etymology was quite short; this is why it could easily be placed in parentheses. The current version is 18 words long. We can no longer have it in parentheses; it would cause way too much cluttering. The 'etymology box' is just unheard of. An alternative solution would be to place the etymology at the bottom of the lead (above the table of contents) as a stand-alone sentence. In any case, I strongly recommend we have a separate section. This is common practice and this is what the other two editors suggested above. --Omnipaedista (talk) 03:06, 12 August 2014 (UTC)
It is unnecessary for one sentence to have a stand alone section. This is not the common practice and this is not what the other two editors agreed to above. Only one other editor agreed with you for a separate section but there was consensus previously for the quote box. Either it should go in the quote box as before or it can be added to another section like Chiropractic#Conceptual basis. User:Bobrayner suggested it could be in the body but he never said it should be in a stand alone section. Bobrayner has not specifically commented on the quote box versus the unnecessary separate section. QuackGuru (talk) 16:19, 12 August 2014 (UTC)
You did not cite a single example of an etymology box on Wikipedia. As I said above, it is unheard of. For the record, this was my original edit. Then, another editor messed it up and I had to rewrite it following what the source said. Regarding common practices, see Physics (ety. in the lead), Chemistry (ety. in a separate section) and Rhetoric (ety. as a stand-alone sentence above the table of contents). --Omnipaedista (talk) 17:08, 12 August 2014 (UTC)
Don't worry, that's QuackGuru. He gives a lot of diffs that don't really address the question at hand. I'd say that let's follow the Wikipedia's common practice.
Ps. As far as I am concerned, bobrayner replied to my post saying that: "I agree; it belongs in the body, not the lede." So he agreed to what I said, and then it's in the body, right? Jayaguru-Shishya (talk) 18:23, 12 August 2014 (UTC)
It is in the lede in another article added or approved by Omnipaedista. So why it is not in a separate section at the Osteopathy article? Is it because it is only one sentence? It is also in the lede at the Physics article.
I did give an example of an etymology box on Wikipedia. The etymology was originally in the lede for this article. Then it was switched to a quote box. A quote box is an improvement over having it part of the first sentence. For years it was in the lede until January 2013.[130]. Then in February 2013 the quote box was deleted from the lede. No justifiable reason was given to have a separate section for one short sentence. For chemistry, there is an entire paragraph on the subject. See Chemistry#Etymology. on a separate matter, how about you create a List of etymologies box? You can add each article to a box and add each box to each article. See below Chiropractic#External links for the boxes for this article. QuackGuru (talk) 02:24, 13 August 2014 (UTC)
I believe Jayaguru and Ominpaedista have valid points. It seems unreasonable that QuackGuru's substantiation is based on referencing what has been done rather than what could be done. Kshilts (talk) 18:27, 16 August 2014 (UTC)
I think we should move to the lede
That (a) no-one has ever found a subluxation, and (b) the founder was jailed for practicing medicine without a license. Right now I think the page gives far too much credit to what is a WP:FRINGE, anti-science, idea. Djcheburashka (talk) 07:44, 11 November 2014 (UTC)
Agreed. I've seen quite a few edit wars regarding this going on here. Considering the size of the chriopratic industry, it wouldn't surprise me that there are chriopratic PR firms editing here full time.Smk65536 (talk) 21:40, 6 January 2015 (UTC)
Not done: as you have not requested a change.
-- Brangifer (talk) 05:45, 18 July 2014 (UTC)
Not done This has been discussed at length in the past - Please see above on this page and the 37 archive files. - Arjayay (talk) 08:48, 8 August 2014 (UTC)