It’s true. I’m baffled by the statement that has been issued by the British Chiropractic Association. I suspect I am not the only one.
Apparently, “the BCA had no wish for its dispute with Simon Singh to end up in the courtroom”. I found this claim surprising, given that the BCA were offered right of reply by the Guardian at the time the original article was published. If they didn’t want to end up in the courtroom, then why didn’t they simply respond by to Singh’s article by making their case for chiropractic – perhaps by publishing the plethora of evidence that they claim backs up the use of chiropractic for colic, asthma etc?
The BCA also claim that “there is evidence for the BCA to have made claims that chiropractic can help various childhood conditions” and point out that they never claimed that chiropractic could cure these conditions. Regardless of the BCA’s distinction that chiropractic will “help” rather than “cure”, I’ve yet to see evidence that chiropractic will help these childhood conditions. The evidence that the BCA have listed below their statement appears to be deeply unimpressive, an impression confirmed by the Lay Science and Improbable Science blogs. (The Lay Science blog includes links to other bloggers covering this farcical statement.)
It “is the BCA’s case that there is good evidence” for chiropractic helping various childhood disorders. This is, unfortunately for the BCA, manifestly untrue. As shown by the Lay Science blog, the one paper that they list that looks at the efficacy of chiropractic as a treatment for asthma turns out to be a letter to the editor, which contains no actual evidence.*
Perhaps the most interesting element of the BCA’s latest statement is their remarkable claim that “the BCA welcomes full, frank and open scientific debate”. I think this is bullshit. If they welcomed full, frank and open scientific debate then they would at least respond to emails from members of the public who wanted to discuss the “research” page on their website. They would debate Singh – not sue him. Having written to the BCA and received a wholly inadequate response, I wrote again to the BCA on the 28th May (full text below). They have failed to respond, despite my contacting them on the 6th June to ask if they intended to answer my questions.
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?
Regards, James Cole.
Given that the BCA stated in an email to me 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” and that they have subsequently refused to answer my requests for clarification of their stance (or any other element of my email of 28th May), how credible is the BCA claim in their latest statement that they “welcome full, frank and open scientific debate”? How credible is it in the light of their decision to sue Simon Singh rather than take up the Guardian’s offer of a right to reply? I find it incredible. I’m actually a little shocked that they expect anybody to believe their statement. I’m surprised that they had the brass neck to put something so inaccurate into the public domain. Frankly, I doubt that the BCA are capable of telling us the truth. I say this because I don’t think they are capable of judging what is true and what is not.
Jack of Kent on the BCA statement. Another general look at the BCA’s statement comes from the Thinking is Real blog. I have decided not to look at the BCA’s evidence myself but will leave it to those better qualified to do so. I think that Gimpy and Lay Science will be listing those bloggers that take a critical look at this “evidence”.
*The author of the Lay Science blog had already dealt with Chronic pediatric asthma and chiropractic spinal manipulation: a prospective clinical series and randomized clinical pilot study. The abstract is available here: http://www.ncbi.nlm.nih.gov/pubmed/11514813. The authors note that “There were no important changes in lung function or hyperresponsiveness at any time.” The only positive results appear to be the children’s own assessments of their asthma severity and quality of life and even then, the authors state that “The observed improvements are unlikely as a result of the specific effects of chiropractic SMT alone, but other aspects of the clinical encounter that should not be dismissed readily.”
EDIT: Relevant to my above comment about ‘deciding not to look at the BCA’s evidence myself but leaving it to those better qualified to do so’ and the reference to the BCA’s asthma evidence, here is Evidence Matters with their take on the British Chiropractic Association and the plethora of evidence for paediatric asthma.