My last post about the BCA included their response to my emails. You may recall that they claimed not to comment on systematic reviews – then commented that many systematic reviews are flawed. Following their reply to my earlier messages, I emailed them with some further questions. This was nine days ago. I get the feeling that I am not going to receive any further response from them.
Here is the text of my most recent email to the shy and retiring folks at the British Chiropractic Association:
Dear Ms Wakefield,
In response to your email of 27th May, I would like to ask some further questions of the BCA:
1. You state that: “While spinal manipulation is one of the widely used treatment techniques used by chiropractors it is by no means the only one.” What treatment techniques other than spinal manipulation are used by chiropractors?
2. Have these other techniques been tested? If so, what kind of tests have they been subjected to and what results have been found?
3. You state that: “it is not, and never has been our practice to comment on systematic reviews of chiropractic, particularly when many of these have been demonstrated to be flawed”. What flaws have been demonstrated in systematic reviews of chiropractic?
4. Why don’t the BCA comment on systematic reviews? Is this official policy? (Surely if there are flaws in systematic reviews it would be better to discuss these flaws and look at whether these flaws can be eliminated from future reviews?)
5. Why do you dismiss an important tool in evidence-based medicine, the systematic review, but at the same time assert that outdated guidelines, which have been withdrawn, are “an important publication”? Do you believe that guidelines are more reliable than systematic reviews?
One would hope that a regulatory body would find the time to answer questions such as these. It is disappointing that the BCA have not, as yet, managed to do so. If they have opinions, I would like to hear them.
As a further point of interest, you may recall that I noted that the BCA research page was headed “Research Supports Chirorpactic” (cached url – here). It is now headed “Research and Chiropractic”, which would seem to be an improvement. However, I note that the amended page has (just below the headline) the text “Research supports chiropractic – numerous studies throughout the world have shown that chiropractic treatment, including manipulative therapy and spinal adjustment, is both safe and effective. Below is a selection of research papers and reports of relevance and interest.” While I am pleased to see that the BCA are willing to make changes to their webpage, it is disappointing that these changes do not extend to: citing more robust evidence (e.g., systematic reviews); or rewording their “Research supports chiropractic” claim to something more precise like “Some research supports chiropractic”.
Note: I may add to this post later. I will flag any changes I make.
Edit 7.30pm: the page seems to have reverted to the previous version now. I will contact the BCA to ask them about this. The Google cached page is here: *cough*. I have emailed the BCA to ask them about this change/reversion business and to enquire as to whether they are going to respond to my last email. Email text follows:
Dear Ms Wakefield,
I have a couple of questions for you. Firstly, I wondered if the BCA were planning on responding to my email of 28th May. Secondly, when I visited your research page earlier on today, I noticed that some superficial changes had been made to this page. The page now seems to have reverted to the original version. Can I please ask why the page was changed and why it has now reverted to the original? (Assuming that this was not some glitch.)
EDIT 2: I think I’ve just realised the situation regarding the changing/reverting pages. See my comment of 9th June for details.