Slap on the Wrist for Spine Crackers – ASA Kick Ass

August 7, 2008 at 5:35 pm (Alternative Medicine, Bad Science, Remedies, Woo) (ASA, BPSDB, CAM, Chiropractors, Foundation for Integrated Health, sCAM, Spine-Crackers, Unsubstantiated Evidence, Untruthful)

[BPSDB] Well, here’s my first post for BPSDB: There’s an ASA judgement on the website at the moment relating to an advert by some manipulators called Gonstead Clinic of Chiropractic. The issue? The General Chiropractic Council challenged whether the claim “The Gonstead System of Chiropractic … remains the leader in Chiropractic techniques due to the lengthy training a Gonstead Doctor receives” was misleading and could be substantiated. The response? None. That’s right – the ASA made enquiries to this clinic, but they didn’t even have the decency to respond. That’s how much they care about regulation. Which would be funny, if it weren’t for the fact that woos like chiropractors are currently involved in pretending they want to be properly regulated [**]. Prince Charles has the Foundation for Integrated Health, which is involved in the plans for regulation. Don’t worry CAMsters – it won’t be proper regulation, it will be a gentle, alternative regulation. That won’t work, so quite appropriate for AltMed really… FIH have been given £37,000 and £900,000 by the Department of Health to write some guides and some nonsense for Ofquack. D’oh indeed!

The result of the complaint?

Upheld
The ASA was concerned by Gonstead Clinic of Chiropractic’s lack of response and apparent disregard for the Code, which was a breach of CAP Code clause 2.6 (Non-response). We reminded them of their responsibility to respond promptly to our enquiries and told them to do so in future.

In the absence of any response or evidence to substantiate the claim made in the ad, we considered that the claim had not been proven. We therefore concluded that the ad was misleading.

The ad breached CAP Code clauses 2.6 (Non-response), 3.1 (Substantiation), 7.1 (Truthfulness) and 19.1 (Other comparisons).

I’ve seen a link to another ASA judgement recently – this one, in fact: British Chiro Clinics. Issue: 1: The Carlton Clinic challenged whether the ad misleadingly implied that the practitioners listed held general medical qualifications. 2: The ASA challenged whether the ad offered treatment for serious medical conditions without the supervision of a doctor or suitably qualified health professional. Assessment: Upheld. That’s two-for-two now – if there’s any untruthful and unsubstantiated chiropractors out there, they must be fearing a call from the ASA at any moment. Do I feel sorry for them? No – all they have to do to avoid a knuckle rap or wrist slapping from the ASA is to tell the truth and substantiate claims. It’s not rocket science. In fact, it’s not even science.*

David Colquhoun has reported on FIH and chiropractors here: “Ernst points out that the FIH guide suggests that chiropractic is effective in asthma, and that acupuncture is good for addiction, whereas the evidence says the opposite” [Quacktitioner Royal] and recently wrote an excellent piece for the New Zealand Medical Journal about Chiropractors, which includes a link to the ASA judgement I’m writing about here [the link was in a comment by Blue Wode, and was also posted on the Bad Science forum by Dr T – H/T to both].

[*] There are several Cochrane Reviews looking at the evidence for chiropractic:

This review of 33 trials did not favour manipulation or mobilisation done alone or in combination with various other physical medicine agents. It was unclear if manipulation and mobilisation performed in combination were beneficial, but when compared to one another, neither was superior. [For mechanical neck disorders]

There is no evidence that spinal manipulative therapy is superior to other standard treatments for patients with acute or chronic low-back pain.

Overall there is no evidence to suggest that spinal manipulation is effective in the treatment of primary and secondary dysmenorrhoea.

There was weak evidence to support the use of hypnosis, psychotherapy, acupuncture and chiropractic but it was provided in each case by single small trials, some of dubious methodological rigour. Robust randomised trials are required with efficacy, cost-effectiveness and adverse effects carefully monitored.
[For nocturnal enuresis in children. It says there was ‘weak evidence to support the use of chiropractic’ and this was the absolute best I could find on Cochrane for Chiropractic – doesn’t exactly fill you with confidence does it?]

[**] EDIT: Regarding regulation of chiropractors, Blue Wode has clarified this here.

This post is aggregated on BPSDB and badscienceblogs.net.