Chiropractic Refusal to Engage

June 2, 2009 at 5:03 pm (Alternative Medicine, Chiropractic) (Bassett Chiropractic, Bassett Chiropractic Clinics, British Chiropractic Association, Chiropractic, Chiropractic Research, Chiropractors, Kings Langley Chiropractic Clinic, St Albans Chiropractic Clinic, The Hertford Chiropractic Clinic, Watford Chiropractic Clinic)

[BPSDB] You may recall my recent correspondence with Bassett Chiropractic Clinics (the chiropractors whose website claims to be able to help with whiplash, contrary to the guidance given by the ASA – their clinics include St Albans Chiropractic Clinic, The Hertford Chiropractic Clinic, Watford Chiropractic Clinic, and Kings Langley Chiropractic Clinic). My most recent post is here and I have now received an email responding to my latest missive. It took this chiropractor three days to come up with this response:

You have my response, andI am not prepared to engagein further
correspondence with you on this matter.

I don’t know about you, but I am distinctly unimpressed with this response from Bassett Chiropractic Clinics. Given that they are refusing to engage with any of the points I have made, I see no point in attempting to contact this group of chiropractors in future and I have concluded that if I have any outstanding issues with Bassett Chiropractic Clinics it would be a better use of my time to inform the GCC of my views rather than send an email to someone who has already stated that they will not respond.

Science progresses through people criticising and reevaluating or reformulating ideas. Chiropractors such as those in charge of Bassett Chiropractic Clinics seem to be uninterested in this process of criticising, reevaluating, and reformulating ideas and I can only assume that they are therefore similarly uninterested in the progress of science. That many chiropractors still believe in vitalistic, pseudoscientific explanations for ill health [“Traditionally, chiropractic assumes that a vertebral subluxation or spinal joint dysfunction interferes with the body’s function and its innate intelligence”, according to Wikipedia.] does little to dispel this feeling I have that chiropractors are uninterested in the progress of science.

Anyway, I have now written an email to the GCC asking them to clarify section C 1.6 of their code of practice:

Dear Sirs/Mesdames,

I am writing to you in order to clarify whether chiropractors are allowed to publicise their clinics by making claims that are inconsistent with ASA guidance. I note that C1.6 in the GCC code of practice states that members are allowed to “publicise their practices or permit another person to do so consistent with the law and the guidance issued by the Advertising Standards Authority”. I further note that Advertising Standards Authority ruled against BritChiro due to a claim they made to be able to help with whiplash.[1] Finally, I note that Bassett Chiropractic Clinics claim on their website to be able to help with whiplash.[2]

Kind regards, [name]

[1]http://www.asa.org.uk/asa/adjudications/Public/TF_ADJ_44999.htm
[2]http://www.bassettchiropractic.co.uk/

I look forward to receiving a response from the GCC. Their code of practice is here as a PDF: http://www.gcc-uk.org/files/link_file/COPSOP_Dec05_WEB(with_glossary)07Jan09.pdf

More

I recently received a 3,116 word comment from somebody who I can only assume is a chiropractor (“Dr Pat”). According to another commenter, they had simply copied and pasted from the works of an anti-vaccination chiropractic lecturer, researcher and publisher (without crediting their source). This chiropractic lecturer, researcher and publisher (Tedd Koren, DC) had cited onference presentations, case reports, non-peer-reviewed books, articles published in journals not indexed on Pubmed, articles that do not refer to the effectiveness of chiropractic and as such should be considered irrelevant, rather small clinical trials, and self-reported improvements in patients rather than improvements on objective measures.

There seemed to be no awareness on the part of this chiropractic lecturer, researcher and publisher (or the plagiarist who reproduced this work in the comments section of my blog post) that the evidence they provided was, frankly, weak. I can only assume that when it comes to appraising evidence, chiropractors such as Tedd Koren DC and Dr Pat are unskilled and unaware of it*, as they have provided rather weak evidence to support chiropractic and have failed to cite robust evidence – e.g., systematic reviews.

These PDFs should help to explain what I mean by “unskilled and unaware of it”: Kruger-Dunning; Ehrlinger et al. Alternate link for the Ehrlinger paper: Ehrlinger_et_al_2008

Like Koren and Dr Pat, Bassett Chiropractic Clinics have also failed to properly cite decent evidence in favour of chiropractic: despite their referring to “numerous studies” supporting chiropractic treatment for headache and whiplash, only three studies were mentioned. No full citations (let alone links to the papers) were provided. A request for proper citations went unanswered. A systematic review that I referred to (that had found that there were no RCTs for chiropractic treatment of whiplash) was simply ignored (http://www.ncbi.nlm.nih.gov/pubmed/15782244).

Despite Bassett Chiropractic’s failure to engage with my criticism, to comment on a systematic review, or to provide any full citation to any peer-reviewed, publicly published evidence (the best they managed was a mangled link to some guidelines produced by the New South Wales Motor Accidents Authority – PDF), the claim to be able to help with whiplash is still there on the front page of their website (cached url).

I have informed them of the weakness of the evidence for chiropractic in treating whiplash. I have informed them that the ASA stated that they “instructed an independent expert to assess the evidence BritChiro submitted in support of the treatment of whiplash and arthritis. Our expert concluded however that the studies were not sufficient to support efficacy claims for either condition.” Despite being informed of the weakness of the evidence for chiropractic in the treatment of whiplash, the claim still appears on their website and they refuse to enter into further discussion with me. Bassett Chiropractic Clinics, in spite of everything they have been told, still claim to be able to help with whiplash injuries. In future I shall refrain from engaging with individual chiropractors, as I am not interested in banging my head against a brick wall. The GCC seem like a better bet to me.

*EDIT 5th June: blogger apgaylard has now also referred to the inability of chiropractors to handle evidence objectively and notes that in his opinion it is likely an honest incapacity (he has also very kindly linked to my posts on the BCA and my recommended reading for chiropractors).