Talk:Chiropractic/Archive 28

Archive 25

Archive 26

Archive 27

Archive 28

Archive 29

Archive 30

→

Archive 35

ArbCom restrictions

FYI, according to discussions at the administrators' noticeboard, there appears to be a rough consensus among uninvolved editors and admins that the Chiropractic article falls within the scope of the Pseudoscience arbitration case. This means that uninvolved administrators could be empowered to use discretionary sanctions to reduce the disruption to this article. The exact scope of these potential sanctions is listed on the case page. There has not yet been any move to actively place any restrictions on the editing here, though discussion about the best way to proceed is ongoing at the noticeboard thread. No restrictions may end up needed, either, depending how it goes... At this time, what is needed is for everyone to be aware of the case, and to work together to edit as carefully and congenially as possible. Thanks, --Elonka 00:43, 26 September 2008 (UTC)

I can't understand all the wikilegalese from those links? What does this mean for us editing the article? We are now under 1RR? --Surturz (talk) 00:55, 26 September 2008 (UTC)

Hopefully, no. Basically, it means that officially "uninvolved admins", some of whom have helpfully listed themselves on /Admin log (such as myself), are able to impose editing sanctions such as blocks, 1RR restrictions, etc. to editors in order to generally keep the peace and make sure most people can edit the article in peace. Hopefully we won't have to do anything, though. Cheers. lifebaka++ 01:05, 26 September 2008 (UTC)

What Lifebaka said. :) There are no current restrictions, though 1RR is being discussed at WP:AN#Chiropractic. To try and put the discussion into context: It's been recognized that there's been a dispute here at Chiropractic for some time. Sometimes longrunning disputes like these can be handled through normal dispute resolution procedures, but others are more complex. In some areas of Wikipedia that are subject to frequent disputes, the arbitration committee has authorized administrators to take stronger action than they might at other articles (normally admins are just janitors, but sometimes they have more authority). The debate at the admin noticeboard, was whether or not the Chiropractic article fell into the scope of one of those "increased supervision" areas. The general consensus appears to be "yes", so that's the first step. The next step is figuring out if any further action is needed. If the dispute resolves itself and everyone manages to figure out a way to work together, then no other restrictions will probably be needed. If the dispute continues or escalates, then further restrictions may be put in place. But right now, there are no restrictions. That help?  :) --Elonka 01:08, 26 September 2008 (UTC)

The Wikipedia community has been notified of Elonka's involvement in edit war and a content dispute regarding this article. QuackGuru 02:00, 26 September 2008 (UTC)

Thanks that clears things up for me. If we're good, bad things won't happen to us. Check. :-) --Surturz (talk) 03:53, 26 September 2008 (UTC)

Excellent! This will hopefully keep edit wars to a minimum and stop them quickly. When controversial edits are made by regulars, they should be discussed here first. If they are made anyway without discussion, that is grounds for a serious warning or worse. BOLD, Revert, Discuss (BRD) will apply as always for simple, uncomplex, uncontroversial edits. IOW, if an edit is reversed, discussion is the next step, not reinstatement of that edit. (Reinstatement would be edit warring.) Complex edits with many changes may be reverted as the simplest way to ensure consensual agreement of each edit. It's best to avoid them. Make an edit, save it, make a new edit, save it, etc.. New editors who happen by and treat this article as if it was just any uncontroversial article and get into edit wars can be warned quickly and made aware that this is not the place for BRD.

Having several admins who function as a referee committee will be good. Let's give this a chance, and I'd appreciate it if QG would lay off Elonka. Give her a chance. I suspect that she is wise enough to discuss possible sanctions with the other admins before acting single-handedly. -- Fyslee / talk 01:13, 27 September 2008 (UTC)

I note QG has been cautioned on his talkpage on this issue, although he has since deleted the text. --Surturz (talk) 03:55, 30 September 2008 (UTC)

Uninvolved adminstrators willing to serve

I'm happy to serve as a back-up admin in the event that there are any difficulties, either with normal editing or (probably more importantly) with the application of the discretionary sanctions. In that capacity I'm happy to receive notifications on my talk page with a ten-word précis linking to a discussion here. - brenneman 01:06, 29 September 2008 (UTC)

Welcome to the party pal! Uninvolved adminstrators can sign up at Talk:Chiropractic/Admin log. QuackGuru 01:11, 29 September 2008 (UTC)

Thank you for that link. However, since I like to start from first principles, what purpose are we (collectivly) anticipating that page to serve? It looks like paperwork to me. - brenneman 01:17, 29 September 2008 (UTC)

More info is at User talk:Elonka#Notification, which explains the philosophy behind it. If you don't want to use it though, that's fine. Each admin has their own style.  :) As it is, since the editing of the article has calmed down quite a bit, it looks like no restrictions may be required after all, which is a Good Thing. :) --Elonka 01:34, 29 September 2008 (UTC)

Nice to have more eyes on this. So far nothing's needed to be done, which with luck will continue to be the case. Elonka put some links up at the top of /Admin log, which may be useful. Cheers! lifebaka++ 01:14, 29 September 2008 (UTC)

I'll help out if I can, I'm also willing to provide copies of sources if people e-mail me with citations for the articles that they can't access to. Tim Vickers (talk) 22:00, 30 September 2008 (UTC)

Recent undiscussed changes to Vaccination

This edit by an IP address had some good ideas, but it had some problems as well:

• It inserted the claim that most chiropractic writings on vaccination claim that vaccination is "unnecessary". But the cited source (Ernst 2001, PMID 11587822) does not make this claim. It says the chiropractic literature "repeatedly stresses that immunisation is hazardous and ineffective", but it doesn't mention "unnecessary". We do have a reliable source that supports all 3 of the points (hazardous, ineffective, and unnecessary), namely Campbell et al. 2000 (PMID 10742364), so that source can be substituted for Ernst 2001.
• It removed the claim that vaccination is "one of the most cost-effective forms of prevention against infectious disease", but this claim is supported by the cited source (Busse et al. 2005, PMID 15965414) and is an important part of that source's point.
• It changed "original chiropractic philosophy traces diseases to causes in the spine and states that diseases cannot be affected by vaccines" to "original chiropractic philosophy traces disease to barriers to the optimal functioning of the nervous system, which controls immune-system function". The cited source does not support the revised claim: it says "The basis seems to lie in early chiropractic philosophy, which, eschewing both the germ theory of infectious disease and vaccination, considered disease the result of spinal nerve dysfunction caused by misplaced (subluxated) vertebrae.", "Although B. J. did not dispute the existence of germs, he rejected the proposition that they were the causes of infectious disease.", and "Another tenet of early chiropractic was that drugs were poisons that interfered with the natural healing mechanisms of the body. Vaccines were anathema, because chiropractic adjustments were considered to be all that were necessary to correct most disease conditions." but there's nothing there about immune function. In reviewing the source, it does appear that it does not directly support the claim that "diseases cannot be affected by vaccines" either, so this should be changed to something that is supported, such as "vaccines interfere with healing".

I made this further edit to try to address the points mentioned above. Eubulides (talk) 03:32, 27 September 2008 (UTC)

Please provide a quote from Busse that supports the statement "one of the most cost-effective forms of prevention against infectious disease" as you claim it does. DigitalC (talk) 07:49, 27 September 2008 (UTC)

The quote is found in the full text version:

• "Although most public health authorities would agree that vaccination constitutes one of the most cost-effective infectious disease control measures of the last century, few, if any, would argue that there are no problems associated with their use."

It's partially a direct quote. -- Fyslee / talk 15:30, 27 September 2008 (UTC)

"Partial" is correct. In its partiality, the content is taken out of context to create an original argument; one which the source does not assert. The "although" refers to second clause that most health authorites agree that there are problems associated with vaccines. However, we are taking the first clause out of context by setting the "although" against the focus of chiropractic writings on the negative aspects of vaccine. This is a WP:NOR violation. -- Levine2112 ^discuss 21:52, 28 September 2008 (UTC)

I don't agree that there is a WP:OR violation, but it's easy enough to fix the perceived WP:OR violation by removing the "Although" and do minor rewording to fix up afterwards. I made this change to do that. Eubulides (talk) 07:26, 29 September 2008 (UTC)

"most public health authorities would agree..." means that some public health authorities would NOT agree, which puts it into the realm of opinion. Again, we should not be stating opinions as fact. DigitalC (talk) 09:09, 29 September 2008 (UTC)

I'd like to see one who doesn't agree. Vaccination happens to be one of the greatest advances in medical history, and that is undisputed in mainstream circles. Only fringe elements would dispute that. The "most" is the chiropractic author's careful way of writing (after all, nothing is absolute), whereas public health authorities wouldn't write so cautiously. We could just as well choose to quote from the same source: “The CCA accepts vaccination as a cost-effective and clinically efficient public health preventive procedure for certain viral and microbial diseases, as demonstrated by the scientific community” (Policy Manual; Motion 2139/93)., although that just says "a" cost-effective, and suffers from the lack of the word "most" cost-effective, leaving it up to straight chiros to treat it like just any other medical procedure, instead of like the amazing thing it is. It's right up there with hand washing, penicillin, and clean water. -- Fyslee / talk 13:31, 29 September 2008 (UTC)

I am not disputing that vaccination is one of the greateast advances in medical history. What I am saying is that we need to follow the source more closely, and that we need to attribute opinions when we use them. DigitalC (talk) 08:44, 1 October 2008 (UTC)

(outdent) "Most" chiropractors support vaccination, too. It's funny how you are not quite so strenuous in defending that concept. --Surturz (talk) 01:56, 30 September 2008 (UTC)

I sure hope you are right, but that is not an established fact. Significant minorities both oppose and support vaccination, with a third group who is somewhere in between, without us knowing for sure if they are opposed or supportive. I would think they are most likely somewhat oppositional, since their education and the history of the profession will have trained them to be so, but we just don't know. If I'm right, then a majority of the profession opposes vaccinations. The ACA has taken a step backwards from nearly positive to noncommital in a way that aids those who oppose vaccination, and the ICA and WCA are of course against. -- Fyslee / talk 04:34, 30 September 2008 (UTC)

Unfortunately reliable sources suggest that only a minority of chiropractors support vaccination. For example, a survey in Alberta in 2002 found that 25% of chiropractors advised patients for, and 27% against, vaccinating themselves or their children; see Russell et al. 2004 (PMID 15530683). I am unaware of any reliable source saying that a majority of chiropractors support vaccination. Eubulides (talk) 05:51, 30 September 2008 (UTC)

Recent undiscussed changes to Safety

This edit by an IP deleted a sentence that was difficult to understand but supported by the reference. The average reader is not going to understand this sentence but we should leave it in the article for now. QuackGuru 18:29, 28 September 2008 (UTC)

I agree that the wording in that sentence is a bit hard to follow. Suggestions for making it clearer are of course welcome. Eubulides (talk) 07:26, 29 September 2008 (UTC)

This controversial edit deleted well sourced text that made a very important point. No explanation has been made for this edit. QuackGuru 00:59, 29 September 2008 (UTC)

The original reference (a literature review of hundreds of chiro patients) drew no conclusions about frequency of serious adverse events. The replacement reference (which already has consensus for inclusion, as it is used elsewhere) was a study of thousands of chiro patients and concluded that the incidence of serious events is low or very low. This matches the preceeding sentence which says such events are "Rare". The two references are contemporary (the replacement ref being slightly more recent). I don't think anyone here would put forth the argument that chiropractors are causing death or disability in a large number of their patients, underreporting or no. --Surturz (talk) 01:58, 29 September 2008 (UTC)

It matches the preceeding sentence which explains such events are Rare. That means it was duplication to add this edit. The important conclusions were deleted and then replaced with duplication. QuackGuru 02:04, 29 September 2008 (UTC)

So are you saying the entire sentence should be deleted, or would you prefer it trimmed to mention underreporting only? --Surturz (talk) 03:49, 29 September 2008 (UTC)

I prefer the entire sentence be expanded. Your edit added duplication and deleted an important point without any valid reason. Do you agree you added duplication anyhow. QuackGuru 04:15, 29 September 2008 (UTC)

Underreporting

I agree that the edit was controversial. It's better to discuss edits that delete well-sourced material here first. The replacement reference (Thiel et al. 2007, PMID 17906581) is a primary study, and as per WP:MEDRS the original source Ernst 2007 (PMID 17606755), which is a review, should be preferred. Furthermore, Thiel et al. do not contradict Ernst's claims that underreporting is a very real possibility and a potential source of bias in their results: on the contrary, they explicitly agree with Ernst on this point. With this in mind, we should not remove the text or the citation to Ernst 2007. Eubulides (talk) 07:26, 29 September 2008 (UTC)

Theil et al however DO contract Ernst in saying that the risk is unknown. Instead, they state that it is low to very low. DigitalC (talk) 09:13, 29 September 2008 (UTC)

To a degree the risk is unknown in part because of the unreporting and the rarity of some of the incidences. This information is giving context to the reader. Low to very low is duplication. Please explain why you want duplication. QuackGuru 18:10, 29 September 2008 (UTC)

Thiel et al. do not contradict's Ernst's point that the risk is unknown due to underreporting. Their results apply only to reported cases. They make this point abundantly clear in their paper. Eubulides (talk) 20:38, 29 September 2008 (UTC)

The risk is unkown because of the underreproting bit is a valid point and adding duplication has not been explained. QuackGuru 00:11, 30 September 2008 (UTC)

'Underreporting' is just an opinion and a weak theory at that. . . we should not present thoughts like that as though they were statements of facts. . . we do know that incidence is incredibly low making chiropractic one of the safest health professions around according to all major insurers. The risk is known. . . but it may be too small to pinpoint. . . we are talking fractions of percentages here.TheDoctorIsIn (talk) 00:13, 30 September 2008 (UTC)

This is not correct. First, the fact that underreporting is an issue is agreed by multiple reliable sources. For example, Thiel et al. write that underreporting is a very real possibility and a potential source of bias in their results. Second, the underreporting mentioned by Ernst 2007 (PMID 17606755) is not merely an "opinion": that source is a reliable review that cites several primary studies, which agree that underreporting is at very high levels (approaching 100%). No reliable sources disagree with these studies. It's not right to delete well-sourced material with weak justification like it's "one guys opinion". We need reliable sources for changes like this. I restored the deleted text and citation. Eubulides (talk) 00:30, 30 September 2008 (UTC)

Following up on my own comment: the text already says that serious adverse effects are rare. The (now-reverted) text would alter this to say that it's not only rare, the incidence of these complications is low to very low. It would be OK to mention "low to very low" in addition to rare. But it's not OK to omit all discussion of the well-sourced and important issue of underreporting. Eubulides (talk) 00:35, 30 September 2008 (UTC)

I see underreporting as a separate issue to the incidence of severe adverse effects. Removing the underreporting part was probably a mistake on my part. However, quoting Ernst to say that the incidence is 'unknown' is misleading; really all it means is that Ernst didn't do enough research to give the incidence a number. I don't think Ernst was trying to say that chiropractors might be killing or injuring large numbers of people without any of us knowing about it. All of us know that chiropractic cervical adjustments can and have killed a small number of patients in the past; I am sure you don't need to look very hard to find chiropractors that don't perform cervical adjustments because of this risk. You and Fyslee's reversion of the change (rather than the more sensible course of re-adding the underreporting text) just shows that you prefer the POV-pushing hatchet job version of the Safety section, just as you both prefer the POV-pushing hatchet job version of the vaccination section. Ernst says that to enable informed consent for chiropractic, a large prospective study should be done. Thiel et al is such a study, and it is indicative of your POV-pushing that you don't want it included, when it clearly represents what everyone knows about the incidence of death or disability caused by chiropractic; that the incidence is low or very low. --Surturz (talk) 01:47, 30 September 2008 (UTC)

When there is underreporting the incidence will be unknown to a degree. Both are related. QuackGuru 03:36, 30 September 2008 (UTC)

I'd estimate that what is in there now. . . what my edit was reverted to by an editor claiming ownership of this article. . . is more misleading and untruthful. . . it promotes an opinion as though it was a fact. . . which is unacceptable. Surturz's estimation about POV-pushing is frighteningly close to accurate.TheDoctorIsIn (talk) 04:15, 30 September 2008 (UTC)

This edit added attribution against WP:ASF. For example: "some researchers" gives an impression there is serious disagreement among reliable sources when no evdience has been presented. QuackGuru 05:09, 30 September 2008 (UTC)

Please see #Underreporting again below. Eubulides (talk) 05:51, 30 September 2008 (UTC)

Underreporting again

• I agree with QuackGuru that this edit, which is the second that TheDoctorIsIn has applied without previous discussion within a space of five hours, is also a change for the worse.
• The edit undermines a reliable source about underreporting. It introduces the POV text "Some researchers claim", a phrase that casts unwarranted doubt on a claim that is undisputed among reliable sources. The edit also uses "theorized" to cast unwarranted doubts on the results of studies, even though the underreporting was not theorized: it was measured. There is no disagreement among reliable sources that underreporting is a real problem and that the true (as opposed to the reported) incidence of serious complications is therefore not known; we should not introduce text into Chiropractic that incorrectly implies that there is doubt about this.
• Again, please propose potentially-controversial edits first here, on the talk page, so that they can be discussed.
• Perhaps it would help to make the following changes to the article to help address the problems sparking these undiscussed edits. Italics mark additions.

The true incidence of these rare complications is unknown, due to high levels of underreporting and to the difficulty of linking manipulation to adverse effects such as stroke, a particular concern.

The idea here is to reemphasize the "rare" here, which I hope addresses TheDoctorIsIn's concerns a bit better; and to add the word true to distinguish the true incidence from the reported incidence and to help explain why underreporting is relevant here.

Eubulides (talk) 05:51, 30 September 2008 (UTC)

QG/Eubilides are you saying that the incidence of death or disability is genuinely unknown? i.e. it could be greater than 'rare', 'low' or 'very low'? There is a big difference between saying 'we can't put a number on it' and 'we don't know what it is'. When Ernst says 'Currently the incidence of such events is unknown', he is summarising the section that reviews incidence studies then says At present, there is no sufficiently large and rigorous prospective study to generate reliable incidence figures so I would argue that Ernst is merely saying that he cannot put a number on it. --Surturz (talk) 06:00, 30 September 2008 (UTC) P.S. I do agree that the recently added 'some researchers' text is a bit weasel-wordy, but that is what we get when editors insist on reverting back to POV text. --Surturz (talk) 06:00, 30 September 2008 (UTC)

Ernst is not merely saying he cannot put a number on it; he is saying nobody can put a number on it, since the underreporting rate is so large. Eubulides (talk) 08:21, 30 September 2008 (UTC)

I have fixed it and provided the ref from the CMAJ, which is what we've been referring to, but amazingly we weren't using it as a source! Now it's fixed. -- Fyslee / talk 06:25, 30 September 2008 (UTC)

I disagree with citing Ernst 2002 (PMID 11800245). It's a dated opinion piece, it's less reliable than the source we were citing, Ernst 2007 (PMID 17606755), a systematic review. There's no reason to cite the older, less reliable source when the newer, more-reliable source also supports the claim in question. Let's remove the citation to Ernst 2002; we have not been referring to it, and we don't need to refer to it. Eubulides (talk) 08:21, 30 September 2008 (UTC)

I was going to remove the older oudated reference but I had an edit conflict. I was making edits one at a time to prevent my edits from being bulk reverted. QuackGuru 21:00, 30 September 2008 (UTC)

Alas, as you've found recently, some editors bulk-revert anyway, and remove even uncontroversial changes, in order to undo a controversial change that they disagree with. Eubulides (talk) 06:38, 1 October 2008 (UTC)

At the crossroads

Relevant discussion at

→ Talk:Chiropractic/Archive 27#At the crossroads...

There are still improvements to be made. The crossroads bit has to do more with a historical perspective and can be added to the history section and the combines aspects bit is an accurate description for the scope of practice section. There is also a discussion at the NPOV board about all the unecessary attribution added to this article. See Crossroads of Chiropractic. An archived discussion about asserting facts can be found here. QuackGuru 19:19, 28 September 2008 (UTC)

On this page you have people arguing that it is pseudoscience. . . I don't think the crossroads statement is a fact. . . I like it though because it is a far nicer description than the this place typically gives to chiropractic.TheDoctorIsIn (talk) 00:00, 30 September 2008 (UTC)

It is a sourced opinion about what I personally believe is a fact. Keating believed that the profession was a mixture of science, pseudoscience, and antiscience. -- Fyslee / talk 06:18, 30 September 2008 (UTC)

I believe it to be true, but I agree with you that it "is a sourced opinion", and as such it should be attributed. DigitalC (talk) 08:56, 30 September 2008 (UTC)

Per WP:ASF, please provide evidence it is an opinion. No serious disagreement exists. No evidence of an opinion has been presented.

Per WP:ASF, By value or opinion, on the other hand, we mean "a matter which is subject to dispute." This is Wikipedia's definition of an opinion. QuackGuru 21:11, 30 September 2008 (UTC)

And again, per WP:ASF, this is a statement is one that "clearly express values or opinions." DigitalC (talk) 08:50, 1 October 2008 (UTC)

Wikipedia's definition of a value or opinion is: "a matter which is subject to dispute." per WP:ASF.

No evidence of a dispute has been presented. That means we cannot claim it is disputed. When no dispute exists we are free to assert it. QuackGuru 17:44, 1 October 2008 (UTC)

Outside view believes spinal manipulation is relevant

Wikipedia:No original research/noticeboard#Chiropractic section on evidence basis.

Editors have discussed this for about six months now but we should remember we had an outside view who believes SM is relevant for this article. Me thinks we should drop this discussion and remove the tag. Going around in circles with the debate is not productive at this point. QuackGuru 20:25, 30 September 2008 (UTC)

An editor diagrees with the outside observers view. Should we support the view of the outside observer or ignore comments made by uninvolved editors. QuackGuru 20:55, 30 September 2008 (UTC)

Perhaps I'm wrong, but it looks like the general consensus above is that OR is happening. However, it could be that I simply mis-counted. But the tag, I think, is still very much justified. ——Martin^phi ☎ Ψ Φ—— 22:05, 30 September 2008 (UTC)

Based on your preferred version of policy you think there is OR but the outside observer concluded spinal manipulation research is relevant. QuackGuru 22:18, 30 September 2008 (UTC)

We have heard from several outside observers at this point at several different forums including NORN and two RfC. At this point, the majority of outside observers say that there is an OR issue. Your removal of the tag today (something which you have attempted to remove several times in the past) can be viewed as premature at best. -- Levine2112 ^discuss 22:22, 30 September 2008 (UTC)

Some of the editors you have claimed to be outside observers are actually involved editors.

Most outside observers believe there is no OR and the editors who claim there is OR are unable to provide any proof. QuackGuru 01:35, 1 October 2008 (UTC)

Just a note, but the most recent edits to the section of WP:OR/N referenced above appear to be from early September. Cheers. lifebaka++ 01:56, 1 October 2008 (UTC)

Mass edits

I have reverted QuackGuru's mass edits which were not only done without consensus, but fly in the face of on-going discussions. I advise QuackGuru to be patient and not get frustrated by long discussions. We are working on establishing a consensual version of the content of this article. This is a delicate procedure as each side has strong opinions. The fragility of this proceedings are disrupted every time you launch into these kinds of mass edits done against our agreement here: to talk first, establish consensus second, and edit last. Please abide and help create a better functioning edit environment. Thank you. -- Levine2112 ^discuss 18:30, 22 September 2008 (UTC)

Some of QuackGuru's edits reflect what so far seems to be consensus; others were not, and revert changes that were introduced here without consensus. It's better to make edits like these one at a time, rather than all at once; that makes it easier for editors who disagree with some edits, but not with others, to revert only the edits they disagree with. Of course this strategy relies on having other editors be selective about what they revert, which has not always been the case recently, unfortunately. Eubulides (talk) 23:49, 23 September 2008 (UTC)

Consensus is growing for QuackGuru's improvements when editors do not have a valid reason for deleting content that is referenced and more accurate. For example, there were improvements to the vaccination section. Levine2112 did not provide any specfic objection to QuackGuru's mass improvements. How many references did Levine2112 delete without explanation? Hmmm. QuackGuru 05:10, 24 September 2008 (UTC)

Folks, for best results, please try to comment on content instead of contributors, hmm? --Elonka 05:12, 24 September 2008 (UTC)

I am yet to see an explanation by the editor who reverted my mass NPOV improvements. For example, I made improvements to the vaccination section. No explanation for reverting the improvements were made. Please explain what were your objections to the edit. What specifically did you disagree with. QuackGuru 17:44, 25 September 2008 (UTC)

See the past vaccination discussion in which those specific edits were not agreed to. You were attempting to "slow edit war" them into the article, but that tactic failed. Please desist your campaign of gaming the system and whining about how no objections have been presented when everyone else here knows that such objections have been presented in separate discussions. Thanks. -- Levine2112 ^discuss 00:31, 26 September 2008 (UTC)

Please provide specfic objections to the mass NPOV improvements and please stop accusing me of gaming the system. That was an WP:AGF violation. QuackGuru 01:02, 26 September 2008 (UTC)

(outdent) Can we please keep the discussion to the article? The side-comments aren't helpful. Cheers, guys. lifebaka++ 01:07, 26 September 2008 (UTC)

What would be helpful is any specific objection to my mass NPOV improvements. I do not see any specific objections. QuackGuru 01:23, 26 September 2008 (UTC)

See past discussions. I agree with Eubulides: "...revert changes that were introduced here without consensus." and "It's better to make edits like these one at a time, rather than all at once..." -- Levine2112 ^discuss 20:00, 29 September 2008 (UTC)

Just as a point of clarification: the "revert changes that were introduced here without consensus" is talking about part of QuackGuru's changes that I agree with, namely the part that reverts changes that were introduced here without consensus. I still think, though, that the changes should be proposed and discussed here one by one. Preferably in a new section for each change. Eubulides (talk) 20:38, 29 September 2008 (UTC)

I replied to the non-argument. I request specifics about content. No specifc objections to content have been made about my edit. QuackGuru 20:11, 29 September 2008 (UTC)

Specific objections have been made to the majority of your mass edits. You are either forgetting about or ignoring past conversations. If you would like to break down your edits one-by-one here, it may be easier to reply. Otherwise, I agree with Eubulides that you introduced revert changes without consensus and that it would be better to make edits like these one at a time, rather than all at once. -- Levine2112 ^discuss 20:15, 29 September 2008 (UTC)

Levine2112 wrote in part: Specific objections have been made to the majority of your mass edits. I don't see any specific objections to the content of my edit.

Please explain specifically what you disagreed with or are you unable to provide a valid reason for your revert. QuackGuru 20:20, 29 September 2008 (UTC)

Please refer to past discussions for specific objections. I have neither the time nor inclination to rehash all of the past objections without you first putting in the legwork to review those objections. Then, if you'd like, you can list out those past objections versus the content you wish to change. This way, we can all be on the same page and see if those objections still hold water. Otherwise, I'm done with this conversation and you can keep typing that "no objections have been presented" until your fingers are blue; it still won't make it true. -- Levine2112 ^discuss 20:32, 29 September 2008 (UTC)

Past discussions do not explain you reverts. You reverted without explaining your specific objections to the content of my edit. No objections have been presented to the content. Please be specific. What did you specifically disagree with. QuackGuru 20:41, 29 September 2008 (UTC)

Levine2112 wrote in part: Please refer to past discussions for specific objections.

Where in past discussions does it explain your specific objection to adding a ref citation and a ref style. Please explain your specific objection. I would like the article to be referenced. Why did you revert adding a reference citation. Please provide a link to past discussions for specific objections to the ref citation and ref style. QuackGuru 00:04, 30 September 2008 (UTC)

Suggestion: Since this thread seems to be about a revert that happened over a week ago, and the article has been edited by several people since then, it would seem that this particular discussion might not be productive. May I suggest closing this thread, and moving on to other specific points about the article itself? --Elonka 15:09, 30 September 2008 (UTC)

I disagree with your suggestion. Or this could be archived and I could start a new section and have a link to the archive and continue the conversation. Levine2112's disagreed with my edit but is unable to explain his reason for reverting. There are improvements that were made such as adding a ref citation and and improving a ref style. Levine2112 objected to my edit and we are having a discussion. It is irrelevant this article has been edited by several people since. Those edits by several people were not part of Levine2112's revert or my specific edit. Levine2112's particular responses have have not been productive because no specfic objections have been made to the content of my edit. QuackGuru 15:25, 30 September 2008 (UTC)

Is this really something that needs to be discussed on the article talkpage though, or is this a personal discussion between QuackGuru and Levine2112? There are no diffs here to indicate which revert is being talked about, and there are no details that are focused on the article, that I can see. Mostly this discussion is, "Editor A reverted editor B. Editor B disagrees with the revert. Editor A agrees with the revert," and then back and forth without anything really useful coming out of the conversation. There's also nothing specific being discussed that other editors might wish to comment on. So, if this matter is still unresolved, I recommend just moving it to user talkpages. Or, phrase the discussion in a way such that other editors who might wish to comment, are able to do so, by focusing on a specific sentence or section in the article. --Elonka 15:35, 30 September 2008 (UTC)

I agree with Elonka here. I long ago lost track of what this dispute was about. I suggest archiving this section, and starting over, proposing small edits rather than one big edit. Eubulides (talk) 15:49, 30 September 2008 (UTC)

I have explained before about the ref citation and ref style that was removed. I want to restore a ref citation to the treatment techniques section without being repeatedly reverted. Levine2112's claims I should refer to past discussions but no specific objections have been made. QuackGuru 15:51, 30 September 2008 (UTC)

The edit just before that one, you changed the ref name yourself (along with a host of controversial edits). Hiding a host of controversial edits behind one inoccuous one could be interpretted as a WP:GAME violation. I agree with Eubulides. This section should be archived with the substancce (or lack thereof) forgotten, but the pattern of (mis)behavior memorialized. -- Levine2112 ^discuss 17:23, 30 September 2008 (UTC)

Ah, I see. QuackGuru, it does seem that you were doing far more than just changing a citation. Your complete combined edits were as follows.[1] I'm not saying whether Levine2112 was or was not correct in reverting all that, but please don't represent it as just restoring one citation. If that's all you want to do though, go and fix that one cite... I can't see as anyone is going to complain just for changing a ref name (or am I wrong there?). --Elonka 18:05, 30 September 2008 (UTC)

Elonka, I did not misrepresent anything. I was making a small proposal as suggested by Eubulides.

My proposal is restoring a ref citation and I am being accused of gaming the system by Levine2112 and misrepresenting my proposal by Elonka. I have asked Levine2112 to restore the ref citation and this was been ignored. QuackGuru 19:29, 30 September 2008 (UTC)

Another editor disagrees with adding the ref citation. QuackGuru 20:49, 30 September 2008 (UTC)

That edit did two things simultaneously: it removed the ref citation, and it restored a {{SectOR}} tag. I expect that the latter was the intended effect, and the ref change was merely an unexpected side effect. This was unfortunate, as the ref change is not controversial as far as I know. Now that I look at it, that ref is repeated 6 times in the same sentence, with no intervening refs; it's better to just cite the ref once, at the end of the sentence. I made this edit to do that. Eubulides (talk) 06:38, 1 October 2008 (UTC)

Back to the subject of mass edits. It's just a bad practice that often causes problems in controversial articles. If a large mass edit that contains otherwise excellent bits and pieces contains even a few parts that are controversial, it is justifiable and easier to simply revert the whole mess. Any limitations on making such reversions can have pretty far reaching consequences, since an editor can make a series of mass edits, and if other editors are expected to justify reversions of each little part of each mass edit, that editor will have succeeded in introducing lots of controversial, non-consensus material in a few minutes, and the next few months will be wasted on dealing with just those edits.

Experienced editors should know not to make such mass edits, especially QG who has a habit of doing this, and has been advised and warned numerous times not to do it. Such editing shows a careless disregard for whether an (any) editor really wants all his edits to stick, or whether he doesn't mind getting into an edit war that often follows such mass edits. Such editing is disruptive editing. If we want our edits to stick, make a small edit, save it, make another small edit, save it, etc.. It's really not that hard! -- Fyslee / talk 01:10, 2 October 2008 (UTC)

I made each edit one at a time such as this edit which Fyslee claims is a "careless disregard" based on the above comment. There was no consensus to add a ref citation. QuackGuru 03:54, 2 October 2008 (UTC)

Yes, that time you did an isolated edit, and you've been consistently doing isolated edits like that for the past 10 days or so. However, this thread was prompted by edits like this one, which is indeed a mass edit that incorporates several unrelated changes. That's the most recent mass-edit that I see of yours; thanks for refraining from that sort of edit in the past 10 days or so. Eubulides (talk) 08:13, 2 October 2008 (UTC)

A serious misquoting problem

For context: Ernst comment about Meeker/Haldeman

Levine2112 has been misquoting Edzard Ernst many times here and elsewhere, and it needs to stop. I am copying a bit of an exchange from my talk page where it happened yet again:

I replied to Levine2112:

Just as I suspected, you once again misquote Ernst when you write:

• "In the face of Edzard Ernst stating that the majority of spinal manipulation RCTs for lower back pain are in fact not related to chiropractic, ..." - Levine2112

You have been doing this time and time again on Talk:Chiropractic by leaving out the last two words - "spinal manipulation". You even know the exact quote because you occasionally quote it right, but insert your own opinion and OR when you misquote him by leaving out the SM part. Let's compare the real quote and your misquote:

• "... do not relate to chiropractic spinal manipulation."- Edzard Ernst
• "... Edzard Ernst stating ... not related to chiropractic." - Levine2112

You are making a talk page OR violation when you do that, because you interpret him as meaning chiropractic, when he says and means chiropractic "spinal manipulation". Now please stop doing this not so subtle manipulation of his quote for your own purposes.

This has been going on for far too long. I don't believe that Ernst would say that spinal manipulation was not related to chiropractic. It is extremely relevant to chiropractic, and Levine2112 knows it. This manipulation of Ernst needs to stop. Whenever Levine2112 does this, he needs to be confronted with it. -- Fyslee / talk 04:18, 30 September 2008 (UTC)

You don't believe Enrst would. . . or you don't know? More conjecture doesn't help here. It seems this debate is about a section dealing with the effectiveness of chiropractic. . . chiropractic spinal manipulation is the chief therapy chiropractors prescribe to our patients. . . not spinal manipulation but chiropractic spinal manipulation. . . a.k.a. spinal manipulation. So if Enrst says that not all spinal manipulation studies are related to chiropractic spinal manipulation then why the hell would they be related to chiropractic?TheDoctorIsIn (talk) 04:22, 30 September 2008 (UTC)

I just looked at your talk page, and Levine2112 quotes Ernst fully, including "spinal manipulation"? I fail to see any 'serious misquoting problem'... Ernst's letter says that studies of non-chiro SM should not be used to draw conclusions about chiropractic SM... which is what Levine2112 (and I) have been saying all along. --Surturz (talk) 04:33, 30 September 2008 (UTC) P.S. Unless you are trying to say studies of non-chiro SM should not be used to draw conclusions about chiro SM but those same studies of non-chiro SM *can* be used to draw conclusions about chiropractic in general?? I don't understand your complaint. --Surturz (talk) 04:35, 30 September 2008 (UTC)

Fyslee is right. Ernst's letter is being misquoted. It was misquoted in the prvious comment: Ernst does not say "studies of non-chiro SM should not be used to draw conclusions about chiropractic SM", or anything like that. What Ernst says is that one should report one's data sources clearly, to avoid misleading the reader. Ernst himself goes on (in Ernst 2008) to draw conclusions about chiropractic treatment from SM studies that incorporate some non-chiro data, and he takes pains to report his data sources clearly when he does that. Eubulides (talk) 05:51, 30 September 2008 (UTC)

You need to look at what he wrote before my comments, and the comment of his I quote. He has been doing this many times on this talk page, and it only confuses the issues, as well as being a gross misuse of Ernst to support his personal OR opinion. -- Fyslee / talk 05:43, 30 September 2008 (UTC)

The full quote is The authors also claim that 43 randomized, controlled trials of spinal manipulation for back pain have been published, but they fail to mention that most of them do not relate to chiropractic spinal manipulation. I think Levine2112's interpretation of that is correct and yours is false. If studies of non-chiro SM could be used to make conclusions about chiro SM then Ernst would never have made the comment, since chiro SM and non-chiro SM would be synonymous. Ernst clearly believes that chiro SM is different from non-chiro SM, which is why he separates them in this literature review of his. --Surturz (talk) 06:11, 30 September 2008 (UTC)

This section isn't about interpretation, but about his OR misquoting to further his personal interpretation. Without the misquoting, Ernst's words don't support his belief. The misquoting is the primary issue in this section. It needs to stop. Interpretations are being argued endlessly in other sections, and if he continues to misquote there, it needs to be mentioned. -- Fyslee / talk 06:16, 30 September 2008 (UTC)

But Levine2112 hasn't misquoted. He put the full quote on your talk page. His point was that Ernst distinguishes between chiro SM and non-chiro SM, and it is clear from that letter, and the article I quote above, that Ernst does. --Surturz (talk) 06:23, 30 September 2008 (UTC)

Thanks for pointing out the obvious, Surturz and TDII. I provided a full quote here and on Fyslee's talk page. Suggesting that I am misquoting is clearly a semantic distraction from the real issue: Edzard Ernst clearly distiguishes non-chiropractic spinal manipulation therapy for chiropractic spinal manipulation by stating that there is not a 1:1 relationship between the research of the two. Eubulides is trying also to turn Ernst's quote into something else. I mean, I agree with Eubulides in that Ernst was, yes, lamenting the fact that Meeker/Halderman didn't disclose that most of the research they looked at was not related to chiropractic SM. But in saying so, Ernst is also telling us that most spinal manipulation RCTs for LBP are not related to chiropractic SM. And if something is not related, then it certainly is not directly related - the criteria to satisfy WP:NOR. This is clearcut policy, irrefutable scientific evidence, and Fyslee and Eubulides are trying to do everything to misdirect the conversation from this. I have asked a simple "yes" or "no" question many times and they never give a straight answer. Nevertheless, let's try one more time. Do you agree that Ernst - in his response to Meeker/Halderman - stated that most SMT RCTs for LBP are not related to chiropractic SM? -- Levine2112 ^discuss 07:23, 30 September 2008 (UTC)

Surturz and TDII, he has misquoted a number of times, even if he then quotes correctly after he is asked to do so. I'm talking about the misquoting, as the heading of this thread states, not about the other times, so please don't change the subject.

Levine2112, we're talking about your first sentence in the thread on my talk page, and about other instances on this page where you do the same. You only quoted Ernst in full after I asked for a precise quote: "And just where does he state exactly that?" Your first sentence in the thread on my talk page is like several others you have made, where you quote him without adding the SM part, and that's where you are making the OR to suit your own purposes. You are making Ernst do a synthesis, when he isn't doing so. You describe a synthesis ( A, B, C) which you say is improper, but neither Ernst or the rest of us are making that synthesis.

SM is related to chiropractic (A <--> B), whether you like it or not. Ernst wasn't even discussing that point, only that someone included chiropractic SM research without making it clear. You're trying to make him say something he didn't say, and Eubulides has called you on that one before, and does it once again in this thread. Even after you grudgingly admit Eubulides is right, you again try to twist Ernst when you write "But in saying so, Ernst is also telling us..." by implying that he means that that particular SM research was not related to chiropractic SM (true), and thus not related to chiropractic (false). It is related to chiropractic. There is no A, B, C synthesis here. It's a direct correlation A <--> B. -- Fyslee / talk 13:50, 30 September 2008 (UTC)

The exact quote from Ernst:

The authors also claim that 43 randomized, controlled trials of spinal manipulation for back pain have been published, but they fail to mention that most of them do not relate to chiropractic spinal manipulation.

I agreed with Eubulides from the start that it is obvious that Ernst is criticizing Meeker/Haldeman ("the authors") for their failure to mention something. But what is that something which they failed to mention? Answer please. -- Levine2112 ^discuss 17:11, 30 September 2008 (UTC)

Ernst criticized them for not mentioning that some of the included research was research on chiropractic SM, for excluding contradictory research, and for making "biased interpretations". We all know that. No problem. I don't recall that he said anything that would indicate he considered it wrong for them to include that research, only that the inclusion of positive chiropractic research and the omission of mainstream negative research resulted in "biased interpretation[s]" by them. The omission was his point. Chiropractic research alone can't be trusted, and the readers of such research should be forewarned by making it clear that such one-sided research was included, while contradictory research was left out. THAT is "that something which they failed to mention?" which you ask about. They were stacking the deck by selective inclusion and exclusion:

• " TO THE EDITOR: The article by Meeker and Haldeman (1) on chiropractic is highly informative on several issues but equally misleading on other points, particularly research. For instance, the authors state that there is no evidence of publication bias in the chiropractic literature. We have recently shown that, in the United Kingdom, nonpublication of severe adverse effects of chiropractic seems to be close to 100% (2). The authors also claim that 43 randomized, controlled trials of spinal manipulation for back pain have been published, but they fail to mention that most of them do not relate to chiropractic spinal manipulation. ... (important content related to this discussion) ... This is just some of the evidence in this article that suggests biased interpretation. Readers deserve a more objective evaluation of chiropractic, which remains a highly controversial subject."

Eubulides has also dealt with this matter above:

• "Neither Shekelle nore Ernst contradicts this. Shekelle is talking about confusing SM with chiropractic, which is a different issue. Ernst is criticizing Haldeman & Meeker for not clearly identifying sources. Ernst later does exactly what Haldeman & Meeker do, except that he clearly identifies the sources (see Ernst 2008, PMID 18280103). It is the identification of the sources that Ernst is concerned with, not the sources themselves. Eubulides (talk) 19:27, 19 September 2008 (UTC)"

I think Eubulides summed that up nicely. -- Fyslee / talk 02:01, 1 October 2008 (UTC)

Fyslee, you are now intentionally obfuscating the point by "playing the man, not the ball". Levine2112 has added "SM" to your talk page in deference to your concerns. You still have not addressed the substantive issue; if Chiropractic SM and Non-Chiropractic SM are the same thing, why does Ernst distinguish between them? Answer please. --Surturz (talk) 00:21, 1 October 2008 (UTC)

AGF. For a newcomer here you are pretty bold in pretty much everything you do. A bit of humility wouldn't hurt a bit. I am not "intentionally obfuscating" anything. That would be pretty stupid in an open environment like this, and I am neither stupid nor dishonest. (I'm not perfect either ;-) This is a complex matter so please be careful about making such personal attacks. They can get you blocked, and under the sanctions that apply here you are considered to have already been warned and can be given a short block immediately without further warning by any admin with the courage to do so. Since this isn't anything new, it might be good idea to prevent further such attacks and give you a chance to think things over.

I am not "playing the man" in any improper manner, because the man's method of arguing is THE subject here, and interpretation is only secondary to that.

To answer your question, Ernst does not make the comparison you mention. He isn't even talking about "Chiropractic SM and Non-Chiropractic SM", but about the unbalanced inclusions and exclusions of sources in one research project, and the deceptive comments made in it. Read the source and my comment immediately above. He doesn't discuss it in that manner at all. He was concerned with other matters.

As to your straw man "if" assumption/implication(?) ("if Chiropractic SM and Non-Chiropractic SM are the same thing"), I don't recall saying that they are "the same thing", except that many of the same HVLA techniques are used in the same ways by DCs and non-DCs, but with differing intentions/motives, and are therefore metaphysically not the same. (Only DCs believe in and treat fictional vertebral subluxations, and reform DCs totally eschew that ancient Palmerian dogma.) Those HVLA techniques are physically and biomechanically identical, regardless of intentions/motives. A blinded patient wouldn't know the difference. Those techniques are shared by many professions and some of them predate chiropractic and even osteopathy - which Palmer learned before starting his trade. The terminology is used interchangeably by chiropractors and chiropractic researchers, so we are only following their example and not committing OR when doing the same thing. They call chiropractic "adjustments" SM in their research. Only straight chiropractors consistently call SM "adjustments", while other DCs use both or only SM terminology. -- Fyslee / talk 06:02, 1 October 2008 (UTC)

Though I don't agree with the manner in which he/she stated it, I do agree that Surturz is making a good point about obfuscation here. I'm reading the quote and the context over and over, with an open mind and I don't see how anyone can draw the conclusions which Fyslee is making. Here is the quote once again:

The authors also claim that 43 randomized, controlled trials of spinal manipulation for back pain have been published, but they fail to mention that most of them do not relate to chiropractic spinal manipulation.

It just seems plainly obvious to me that Ernst is stating 2 things: 1) That most of the 43 RCTs of SM for LBP don't relate to chiropractic SM. 2) That the authors fail to mention this fact.

So from the first part of the statement, we know that mainstream researcher Ernst considers there to be a difference (in terms of scientific research) between general spinal manipulation and chiropractic spinal manipulation. This is clearly what Ernst is saying. The interpretation which Fyslee has provided is twisted logic which dances around the obvious (most likely because it blows his position in this disagreement out of the water). -- Levine2112 ^discuss 21:33, 1 October 2008 (UTC)

I am not basing my comments on an isolated quote, but from reading the whole source, which isn't that long. No wonder you are having trouble understanding my parsing of that source. Try reading the whole thing. If he is making any point about a difference, it would be that chiropractic research isn't as reliable because it tends to publish the positive studies and ignore the negative (which is what Haldeman and Meeker did). You'll get a different picture if you read the whole source a few times. It is not "plainly obvious" (except to you) that Ernst is saying what you claim.

Meeker and Haldeman's reply is also revealing, and it does undermine your point:

• "We agree that many of the randomized trials we described were on spinal manipulation rather than specifically on chiropractic manipulation itself, but we believe that this is not a significant point. Chiropractors use all forms of manipulation. In the United States, more than 90% of all spinal manipulation services are provided by chiropractors, and research on spinal manipulation, like that on any other treatment method, is equally of value regardless of the practitioner providing it."

They specifically make the point that research on spinal manipulation, no matter who performs it, is relevant ("equally of value") to chiropractic. It "is not a significant point" who performs it. It's still relevant to chiropractic. -- Fyslee / talk 01:48, 2 October 2008 (UTC)

I have read the whole shebang a couple of times now. I can recite some parts verbatim. And I agree with you, Fyslee, about what Meeker and Haldeman are saying in their defense. So here's my question, why are M and H defending their position that clinically there is no difference between SMT and chiropractic SM? I mean, are they not defending this position because Ernst criticized them for having that view? Isn't the clinical difference between SMT and chiropractic SM exactly what Ernst had in mind when he stated: The authors also claim that 43 randomized, controlled trials of spinal manipulation for back pain have been published, but they fail to mention that most of them do not relate to chiropractic spinal manipulation. Most of the 43 randomized, controlled trials of spinal manipulation for back pain do not relate to chiropractic spinal manipulation. So why are we at Wikipedia assuming they not only relate, but rather directly relate? For if they don't directly relate and we are including unrelated SMT research in this article, then we are violating WP:OR: ...to demonstrate that you are not presenting original research, you must cite reliable sources that are directly related to the topic of the article... -- Levine2112 ^discuss 06:38, 2 October 2008 (UTC)

They are defending themselves against the charge of not stating clearly that much of their data came from non-chiropractic sources, by saying that the data are of equal value regardless of source. Ernst doesn't disagree with the equal-value claim; he just thinks they should state clearly where the data came from. That is why Ernst in his 2008 paper (PMID 18280103) does exactly what Meeker & Haldeman do, except that he states clearly where the data came from. Eubulides (talk) 08:13, 2 October 2008 (UTC)

I tend to disagree with your interpretation of what Ernst and M/H are saying. M/H agree with Ernst that many of the RCTs they looked at were on spinal manipulation rather than specifically on chiropractic manipulation. However, where they differ from Ernst is that M/H don't think that this is significant because they believe that all spinal manipulation research is of equal value in terms of research regardless of which practitioner is performing it. They are stating this in their defense because Ernst has criticized them by stating Ernst's own oppositie beliefs: that most of the spinal manipulation RCTs are not related to chiropractic spinal manipulation (thus the practitioner does matter). To mean, this seems like the clear reading of what each party is saying, and requires none of the complex interpretations and inferences which you are drawing.

Are general spinal manipulation as performed by other practitioners and chiropractic spinal manipulation equal in terms of reseach? The truth is, I don't know. And neither do you. And given the disagreements which we have already highlighted, there doesn't seem to be any consensus whatsoever in the scientific community. Remember, in order to demonstrate that you are not engaged in original research, you must show that the general spinal manipulation research sources (such as Murphy) are directly related to the topic of this article: Chiropractic. Thus far, I don't feel that this has been demonstrated. -- Levine2112 ^discuss 19:21, 2 October 2008 (UTC)

(outdent) Look, rather than try some car mechanic analogy, why don't we pick a more relevant one like drugs. Sure, there are illicit drugs and medicinal drugs and even drugs that don't do anything. They are all 'drugs'. However, it is a bit nonsensical to make sweeping statements about the safety of drugs in general. It depends on which ones are being used, the manner they are prescribed, etc. Same for Spinal Manipulation. --Surturz (talk) 21:09, 2 October 2008 (UTC)

Yes, and further it matters which kind of professional is doing the diagnosis and the consequent presciption. Just like we can't judge MDs based on research studying drugs prescribed by DOs, we can't judge the DCs based on research studying spinal manipulation performed by DOs or PTs.

Again, this is just my opinion though. And it means very little in terms of Wikipedia. However, we have shown that opinions on this vary among real-world scientific researchers. So why we can talk about those opinions in the article, we cannot include material based on our application of those opinions. That's where the OR comes in. -- Levine2112 ^discuss 21:58, 2 October 2008 (UTC)

Misleading sentence

The way this sentence is written is misleading. QuackGuru 01:38, 1 October 2008 (UTC)

I'm afraid this comment is not very specific. In what way is the phrase misleading? What incorrect implications might a reader plausibly draw from that phrase? Better yet, what rewording of the phrase would make it not misleading? For reference, here's the phrase you tagged: "Some of this research has been criticized as being misleading for failing to mention incorporation of data derived from studies of SM that do not relate to chiropractic SM;". Eubulides (talk) 06:38, 1 October 2008 (UTC)

I won't pretend to know what QG is thinking of, but he's got me thinking about it, and maybe there is some truth to the matter. I have written something about the matter that might be relevant. There are several issues that are the basis for the criticism, and only one is mentioned in the current sentence, and I don't recall that it is one of Ernst's criticisms. He is concerned about three issues which should be mentioned:

Ernst criticized them (1) for not mentioning that some of the included research was research on chiropractic SM, (2) for excluding contradictory research, and (3) for making "biased interpretations". The inclusion of positive chiropractic research and the omission of mainstream negative research resulted in "biased interpretation[s]" by them. The omission was his point. Chiropractic research alone can't be trusted, and the readers of such research should have been forewarned by making it clear that such one-sided research was included, while contradictory research was left out. They were stacking the deck by selective inclusion and exclusion and then made misleading statements. Here's the source.

I'm not sure how to solve this problem without a rewording of that paragraph. -- Fyslee / talk 13:41, 1 October 2008 (UTC)

I'd certainly be open to reword the paragraph. Any specific suggestions for rewording? Or perhaps QuackGuru can give it a shot? So long as the current point continues to be made, I don't see why we can't improve its wording for clarity, or add the additional points. Eubulides (talk) 16:06, 1 October 2008 (UTC)

I'd reword it to state that "One review of this research has been criticized for not distinguishing between studies of SM in general, and studies on chiropractic SM in particular; however the chiropractors who wrote the review stated that they did not consider this difference to be a significant point as all research on SM is equally useful and does not depend on which practitioner provides it." Tim Vickers (talk) 20:45, 1 October 2008 (UTC)

That sounds like a useful way to go, but the proposed wording has some problems:

• The usual style in Chiropractic would be to say "A 2002 review of randomized clinical trials of SM" rather than the relatively-vague "One review of this research".
• Meeker & Haldeman did not write "all research on SM is equally useful" and would not agree with such a claim; they wrote "research on spinal manipulation, like that on any other treatment method, is equally of value regardless of the practitioner providing it."
• It's not necessary here to state that the reviewers were chiropractors; it's not important to this point, and it is a bit ad hominem to bring it up here.
• "has been" should be "was".
• Comma after "however".
• Here is a proposed rewording to address the above points:

A 2002 review of randomized clinical trials of SM was criticized for not distinguishing between studies of SM in general, and studies on chiropractic SM in particular; however the review's authors stated that they did not consider this difference to be a significant point as research on SM is equally useful regardless of which practitioner provides it.

Eubulides (talk) 07:11, 6 October 2008 (UTC)

This proposal works for me and is consistant with the current writing style of the article. QuackGuru 02:01, 9 October 2008 (UTC)

Public Health

The International Chiropractors Association states that citizens around the world are facing complex issues with respect to drinking water. The ICA is against fluoridation of the nation's municipal drinking water supplies because they conclude public water fluoridation is not proven safe and could possibly be harmful to the body. Some chiropractors provide fluoride information to families including websites, books, and research papers so that parents can make their own decision for their children. In the U.S., chiropractics have supported fluoridation and also opposed it.

Traditionally, chiropractic focuses on the individual patient rather than on public health issues. Although chiropractic has had several external barriers, it has become more involved within public health activities.

Comments on Public health

Here is a proposal to expand the Public health (Vaccination) section. QuackGuru 01:39, 4 October 2008 (UTC)

Alas, QuackGuru installed the version directly into Chiropractic. That is not a good practice. QuackGuru, would you please revert that? It's better to discuss the proposed change first. Thanks. Eubulides (talk) 07:41, 4 October 2008 (UTC)

Commenting on the above draft:

• The claim "Some chiropractors provide fluoride information to families including websites, books, and research papers so that parents can make their own decision for their children." is not supported by the cited source. It doesn't say anything about what some chiropractors do, as far as I can see.
• The ICA is a relatively small group; its position statement should not be taken as representing chiropractors.
• The Jones et al. 1989 source is better, but it's quite old (1989) and describes just one case.
• All in all, the 1st paragraph depends on primary sources and is too weak to appear in Chiropractic. We need better sources; they should be secondary sources.
• The 2nd paragraph uses the best source of all. But the summary is too generic: it doesn't tell us much about chiropractic and public health. It needs to say specifically what's going on with chiropractic and publich health.
• After seeing the draft merged into Chiropractic #Public health, I'm afraid that I see several problems. The resulting section does not hang together: it's just the concatenation of three paragraphs. There is no topic sentence, and nothing tying the section together. It needs to be reworded to be coherent. Again, please revert and let's work on the draft here, first.

Eubulides (talk) 07:41, 4 October 2008 (UTC)

I went ahead and reverted it since he doesn't usually heed such requests. His changes were made without consensus in spite of a clear warning not to do so, which is definitely disruptive editing. I really don't see any hope for any change from him in this regard because he has been warned numerous times by many different editors on all sides of the issues, yet he persists. Numerous edit wars and long discussions have been caused by this common editing style he favors. It's pretty tiring and something needs to be done. "Consensus" and "collaboration" don't seem to find lodging in his brain. -- Fyslee / talk 14:51, 4 October 2008 (UTC)

We edit as individuals and work together towards consensus as a team. WP:GA is possible.

It would be helpful if Wikipedians would edit the proposal to public health. Feel free to edit.

We can start by removing all the primary references. We can expand the 2008 reference if editors have any ideas. QuackGuru 04:02, 5 October 2008 (UTC)

• Support as long as it is understood that the ICA website is then considered a reliable source for this WP article. --Surturz (talk) 10:49, 5 October 2008 (UTC)

We could include the ICA's position as long as we have a major group's position such American Chiropractic Association statement on fluoride. We need to find references that represent the majority view first before we include the minority view. See WP:WEIGHT. QuackGuru 19:15, 5 October 2008 (UTC)

The ICA website has always been a reliable source for their viewpoints. They don't speak for all chiropractors, and that should be made clear, but they do represent the traditional chiropractic POV, and their influence is far larger than their membership numbers would indicate. -- Fyslee / talk 03:01, 6 October 2008 (UTC)

Here is an article that touches on public health issues. QuackGuru 19:29, 5 October 2008 (UTC)

• I agree that the ICA website is a reliable source for the ICA's viewpoints, but they represent only a minority of chiropractors and are fringe (in the sense of WP:FRINGE). They should not be treated as a reliable source for chiropractic in general or for public health.
• The article QuackGuru mentions is a reliable source for this topic, and it would be reasonable to write better text based on it. I can volunteer to do that at some point (my time is a bit limited, though, so I hope someone else does it...). Unfortunately, the current draft is too weak to go in as-is, for reasons described above.

Eubulides (talk) 07:11, 6 October 2008 (UTC)

• Then no I do not support. It's either a reliable source or it isn't. You should not be allowed to cherry-pick content that supports your POV. If you are using it as a primary source for the fluoride stuff, then it is WP:OR - you should find a reliable secondary source that mentions the fluoridation policy (to establish notability). If you can't do that, then you are clearly pushing a POV. --Surturz (talk) 09:19, 6 October 2008 (UTC)

• I think you are confusing "pushing a POV" with "documenting a POV" (the ICA's POV). The last is what we do here. If we were to include the ICA's POV as if it were a legitimate, non-fringe POV, we would be pushing their POV. Maybe you wouldn't object if we were doing that? -- Fyslee / talk 14:11, 6 October 2008 (UTC)

• BTW, what POV do you think we are pushing? -- Fyslee / talk 14:26, 6 October 2008 (UTC)

• There are books covering this subject that might be useful. QuackGuru 16:58, 6 October 2008 (UTC)

Topic ban

This discussion has been closed. Please do not modify it.
The following discussion has been closed. Please do not modify it.
Would any editor on this page object to me topic-banning User:QuackGuru from chiropractic articles (broadly defined) for one week? (see notice on his talkpage). Tim Vickers (talk) 15:39, 4 October 2008 (UTC) Yes,in all fairness, maybe a stern warning to cease and desist should be made before a topic ban is applied?--Ramdrake (talk) 16:13, 4 October 2008 (UTC) While a topic ban is perhaps not a big deal, I agree that it would be much better to start with a very clear warning. It may or may not be effective; but it seems worth trying. --Hans Adler (talk) 16:37, 4 October 2008 (UTC) See his takpage history, for example this warning 3 days ago and this warning last week. These followed this polite request to discuss edits. Tim Vickers (talk) 18:00, 4 October 2008 (UTC) I didn't mean to question the way you are handling this in principle, sorry if it sounded that way. --Hans Adler (talk) 18:08, 4 October 2008 (UTC) No problem, that wasn't how I read your question. I welcome discussion on this, since I haven't been commenting on this talkpage for very long and need input from those directly involved. Tim Vickers (talk) 18:10, 4 October 2008 (UTC) (ecX2) Oppose ban. Warnings need to specify the behaviours that need to be changed. I asked for clarification about the warning from Lifebaka, and I'm not convinced that QuackGuru has violated the conditions of that. In the discussion above, Fyslee says "clear warning not to do so" with a diff which does not look to me like a clear warning, but an implied request from an individual editor. I think QuackGuru's participation in editing this article is an important ingredient of achieving NPOV. I encourage QuackGuru to adopt a more collaborative pattern of editing.(12:38, 5 October 2008 (UTC)) ☺ Coppertwig (talk) 18:22, 4 October 2008 (UTC) OK, thanks for the comment. What specific changes in how he edits would you wish to see Coppertwig? Tim Vickers (talk) 18:50, 4 October 2008 (UTC) I have no complaints which I wish to bring against QuackGuru at this time about recent editing behaviour related to this or any other article. I don't have time to follow all discussions. I apologize to QuackGuru for my vague allegation unsupported by evidence, above, and am striking it out. I appreciate the many good things about the behaviour of QuackGuru and many other editors on this page, including civil and respectful wording of comments. Coppertwig (talk) 12:38, 5 October 2008 (UTC) While I wouldn't oppose a short topic ban after seeing the diffs, I personally would tend to err on the side of caution, based on the fact that one warning didn't include the consequence of a topic ban, and the two that were clearer were 1)telling him not to beat a dead horse (rather vague, IMHO), and the second was about removing sourced material. The latest complaint is about him editing without discussing his edits first, which, on the face of it, is a different problem. Ideally, it might be best to list the all the recent disruptive behaviours observed, and issue a last warning for all these behaviours. However, we're not in an ideal world and I acknowledge that the accumulation of various disruptive behaviours may warrant a short topic ban. Ultimately, I'd say either call is justified.--Ramdrake (talk) 19:01, 4 October 2008 (UTC) I suggested a page ban a couple days ago,[2] and still back that idea. I would also support a one week topic ban from the Pseudoscience topic area. It's also worth pointing out that the discretionary sanctions authorized by ArbCom in the Pseudoscience case state that any uninvolved admin can make this decision... It doesn't require a community consensus. This is particularly important in this topic area, which is known for Tag team editing. In other words, if one editor is disruptive, other allies will often jump to his or her defense to try and block any consensus about sanctions. Which doesn't mean that consensus-building is bad, but I just wanted to point out that it's not entirely necessary in this particular case. --Elonka 23:51, 4 October 2008 (UTC) I see this as a way to support the editors working on this article, if they think this will be useful, I'll do it - but its ultimately up to them. Tim Vickers (talk) 00:00, 5 October 2008 (UTC) I'd agree to a short topic ban to let things reset and clear the air. MBisanz talk 00:10, 5 October 2008 (UTC) I agree with Coppertwig, who is the only other recent Chiropractic editor who has commented so far, and I second each point that Coppertwig made. A clear and specific warning to QuackGuru would be more helpful than a topic ban without a clear warning. Eubulides (talk) 00:25, 5 October 2008 (UTC) Support short topic ban. I'm not sure why people are so hung up on my wording here. Instead of focusing on one word, look at what's really going on here. It was a reminder/warning/call-it-what-you-will for him to refrain from behavior he has exhibited many times. This is far from the first time he has received such reminders/warnings/call-it-what-you-will. The effect is the same. He ignores them and refuses to edit in a collaborative manner when he does something he has been requested numerous times not to do. He's had lots of similar reminders/warnings/call-it-what-you-will, yet he doesn't seem to listen. A one-week topic ban might wake him up (for a few days...). Note. Since this discussion has started he has shown no signs of penitence or change of attitudes, but just continues as if nothing has happened. Such arrogance is unwelcome. -- Fyslee / talk 07:04, 5 October 2008 (UTC) Hi. Please move this discussion to arbitration enforcement. The club of editors involved in editing this article are definitely not the ones who should decide on topic bans. Per the Arbitration Committee policy, all requests for application of remedies under ArbCom decisions are to be heard at WP:AE. Jehochman Talk 16:11, 5 October 2008 (UTC) I think that would be premature. This is primarily a discussion on whether the editors of this article think a topic ban would be useful. They are the people directly involved and if they think this would be a good idea I'll make this formal and list it at WP:AE for review. However at the moment there seems to be no clear consensus that this will help and I'm not going to act hastily in a complex dispute where I'm not familiar with all the history. Tim Vickers (talk) 16:27, 5 October 2008 (UTC) Since this article falls within the scope of the Pseudoscience ArbCom case, there is no need to go to WP:AE. ArbCom has already specifically authorized administrators to take action to reduce disruption to the project: "Any uninvolved administrator may, on his or her own discretion, impose sanctions on any editor working in the area of conflict (defined as articles which relate to pseudoscience, broadly interpreted) if, despite being warned, that editor repeatedly or seriously fails to adhere to the purpose of Wikipedia, any expected standards of behavior, or any normal editorial process. The sanctions imposed may include blocks of up to one year in length; bans from editing any page or set of pages within the area of conflict; bans on any editing related to the topic or its closely related topics; restrictions on reverts or other specified behaviors; or any other measures which the imposing administrator believes are reasonably necessary to ensure the smooth functioning of the project." QuackGuru has already been warned, by multiple admins, so any uninvolved administrator may impose a ban at any time. For review, the only thing usually necessary is to log it at Wikipedia:Requests for arbitration/Pseudoscience#Log of blocks and bans. These things happen routinely on articles all over Wikipedia, and don't require special oversight. For example, see WP:ARBPIA#Log of blocks and bans or Wikipedia:Requests for arbitration/Digwuren#Log of blocks and bans. The Pseudoscience case itself is fairly new, but the concept of discretionary sanctions is not. --Elonka 21:38, 5 October 2008 (UTC)

Since the majority view seems to be that QuackGuru's editing, while sometimes problematic, is not seriously disruptive, I'll give him some clear guidance on how to work more effectively with other editors of this article and avoid the need for editing restrictions. If this warning is not heeded, action will follow swiftly. Tim Vickers (talk) 17:04, 6 October 2008 (UTC)

For reference purposes, here is a diff to the guidance discussion. Read the "Editing Chiropractic" section on that version of his talk page. -- Fyslee / talk 03:43, 8 October 2008 (UTC)

Updated systematic review

The health benefits for chiropractic manipulation treating pediatric health conditions has low levels of supportive scientific evidence.

Comments on updated systematic review

Here is a new reference that might be useful for the article. Thoughts? QuackGuru 04:02, 5 October 2008 (UTC)

Gotlib & Rupert 2008 (PMID 18789139) is an excellent source: it's up-to-date, it's a systematic review, and it's highly relevant. Thank you for bringing it up. I propose to work its claims into Chiropractic as follows:

• After the sentence "Many controlled clinical studies of SM are available, but their results disagree, and they are typically of low quality.", insert:

Health claims made by chiropractors about using manipulation for pediatric health conditions are supported by only low levels of scientific evidence.

• Replace "baby colic," with "baby colic,".
• After "fibromyalgia,", add "kinetic imbalance due to suboccipital strain (KISS) in infants,".

Eubulides (talk) 07:11, 6 October 2008 (UTC)

Good suggestions. Feel free to add the improvements to the article. QuackGuru 02:01, 9 October 2008 (UTC)

Unnecessary comma and redundant word

A recently added comma seems unnecessary. QuackGuru 02:01, 9 October 2008 (UTC)

This recently added word seems redundant. QuackGuru 16:50, 9 October 2008 (UTC)

Generally speaking I wouldn't worry about minor editorial changes like that as a single comma or word that is unnecessary to you may help some other reader get the gist of what is after all a complex bit of prose. Eubulides (talk) 17:12, 9 October 2008 (UTC)

Relevancy

Relevant discussion at

→ Talk:Chiropractic/Archive 27#Recent undiscussed changes to Effectiveness

Without any change to content, we can move the information to the most relevant section. See Chiropractic#Treatment techniques. QuackGuru 16:44, 3 October 2008 (UTC)

I disagree. The content in question seems to be more about Research rather than Treatment techniques. Thus I think right now it is aptly placed. -- Levine2112 ^discuss 17:18, 3 October 2008 (UTC)

• Certainly the 1st part of the content "Most research has focused ... research is equally of value regardless of practitioner" is aptly placed under Chiropractic #Evidence basis.
• However, QuackGuru makes a reasonable point about the 2nd part of the content "There is little consensus as to who should administer the SM ... treating backs and necks". This sentence is about the turf war between chiropractors and other professions over who should do SM. It's certainly a notable issue, but Chiropractic #Evidence basis is not a good place for this issue. Chiropractic #Treatment techniques looks like a better home for it. But exactly where in Chiropractic #Treatment techniques should it go? QuackGuru (or anyone else), do you have a suggestion? Eubulides (talk) 17:37, 3 October 2008 (UTC)

I recommend placing all the information I mentioned after the first paragraph at Chiropractic #Treatment techniques and then we can add a bit of context to the effectiveness section if necessary. QuackGuru 04:00, 4 October 2008 (UTC)

Please see my comment "We do have a section..." below. Eubulides (talk) 07:41, 4 October 2008 (UTC)

The information is in the Effectiveness section and we don't have a section called Research. It would be reasonable to move the information about research of a treatment technique to the appropriate section. The research is about the spinal manipulation treatment technique. The information does not describe the effectiveness of chiropractic. We can move the information and then add a little context about the research to the Effectiveness section if editors agree it would be appropriate. It can be expanded upon in the appropriate section. QuackGuru 17:46, 3 October 2008 (UTC)

• We do have a section Evidence basis, which is a reasonable synonym for "Research". If text is talking about research that is relevant to effectiveness or safety, Evidence basis is the best place for it now. There is a lot under Evidence basis that is relevant to spinal manipulation; I don't think we should move all that to another section. (If we did that, we'd be doing a giant refactoring of the article, and it's not at all clear it would be an improvement.) The 1st part of the content is about effectiveness research, so it's appropriate to put it under Chiropractic #Effectiveness.
• I'm afraid I'm not understanding all the suggestions here. There are too many. It'd be better to see specific wording changes.

Eubulides (talk) 07:41, 4 October 2008 (UTC)

Speaking of the turf war mentioned above, we don't even touch that topic. It includes lawsuits filed by the profession against other professionals who have used generic spinal manipulation without any intention to treat "vertebral subluxations", which is chiropractic's motivation for using SM. These lawsuits reveal a clear aim to limit all forms of spinal manipulation, regardless of intention, for the chiropractic profession. Here is something from an ACA press release that is quite relevant to this subject:

• “ACA President James A. Mertz, DC, DACBR, said, "With the latest response from HHS, the ACA's lawsuit against the Health Care Financing Administration (HCFA) has reached a critical point. While the ACA views the decision on physical therapists as a victory in itself, our fight is certainly not over. Nobody but a doctor of chiropractic is qualified to perform manual manipulation to correct a subluxation-not a medical doctor, not an osteopath. We will continue to pursue this lawsuit until we're assured that only doctors of chiropractic are allowed to provide this service to Medicare + Choice beneficiaries." [3] (For the APTA's reaction to this, see the corresponding Practice Policy news brief "APTA Responds: PTs Will Continue to Perform Manipulation.")” [4]

The ACA’s precise and correct choice of wording here is critical to an understanding of their meaning and intent. They pit two very different things against each other, quote:

• spinal manipulation performed by medical doctors, osteopaths, physical therapists, and other providers, in lieu of
• spinal manipulation to correct a subluxation performed by chiropractors.

The two purposes for manipulating, as well as the two groups who practice it, are contrasted. “Chiropractors”, with their roots in Palmerian biotheology, using manipulation "to correct a subluxation" (fiction), are pitted against “medical doctors, osteopaths, physical therapists, and other providers”, with their roots in evidence based medicine, performing “spinal manipulation” for real problems.

While the lawsuit mentioned in the press release seems to only limit their case to an attempt to reserve the right to manipulation performed by them "to correct a subluxation", later lawsuits have been filed (and even won)[5] against others who did not perform manipulation for that purpose, thus revealing the profession's true motives. They want to take generic manipulation for any purpose - including legitimate ones - and which happens to predate chiropractic and has been used for centuries, and annex/steal it, by making it their own exclusive property. -- Fyslee / talk 01:10, 4 October 2008 (UTC)

I'm afraid the above discussion doesn't have an action item at the end. Could you please boil it down to a specific wording proposal? Certainly the turf-ware topic is notable and relevant. Presumably the wording would incorporate the one turf-war sentence we already have. Eubulides (talk) 07:41, 4 October 2008 (UTC)

Okay, here's a quick proposal that needs work. This is only a sketch with a few sources! I think we could logically include this as a subsection at the end of "Scope of practice":

Turf war over scope of practice 1

There is little consensus as to who should administer the SM, raising concerns by chiropractors that orthodox medical physicians could "steal" SM procedures from chiropractors; the focus on SM has also raised concerns that the resulting practice guidelines could limit the scope of chiropractic practice to treating backs and necks.

Proposals for limiting the scope of practice have been made by now-retired reform chiropractor Samuel Homola:

A suggestion that chiropractic be defined as a specialty in the care of neuromusculoskeletal problems of mechanical origin, with emphasis on back care. (Homola S. Chiropractic as a neuromusculoskeletal specialty. Chiropractic Tech. 1995;7:147-148.)

"Concerned that the chiropractic profession "has failed to define itself in a way that is understandable, credible and scientifically coherent," a group of evidence-based chiropractors offered a model for "spine care" that focuses primarily on treatment for back pain. The purpose of the plan is to "help integrate chiropractic care into the mainstream delivery system while still retaining self-identity for the profession" (Nelson 2005). The plan was not well-received by the chiropractic profession at large, which is loathe to restrict chiropractic treatment to back pain, preferring instead to claim a broad scope of health problems as its purview."

"On June 15, 2005, the World Federation of Chiropractic, at its Eighth Biennial Congress, unanimously agreed that chiropractors should be identified as "spinal health care experts in the health care system . . . with emphasis on the relationship between the spine and the nervous system" (World 2005). This definition fails to place proper limitations upon chiropractors who use spinal adjustments to treat general health problems, plunging the profession deeper into pseudoscience and away from establishing an identity for chiropractors as back-pain specialists. Most states continue to define chiropractic as a method of adjusting vertebral subluxations to restore and maintain health, allowing chiropractic treatment of almost any ailment." [6]

More sources:

• http://jmmtonline.com/documents/HomolaV14N2E.pdf
• http://archfami.ama-assn.org/cgi/content/full/7/1/20

Other chiropractors have made similar proposals:

How can chiropractic become a respected mainstream profession? The example of podiatry

Chiropractic as spine care: a model for the profession

The profession has resisted such proposals:

"It has long been the contention of FCER that to position chiropractors as "back doctors" would be disastrous for the future of the chiropractic profession and would only serve to limit the choice of treatments available to patients. Based on substantial anecdotal evidence supporting chiropractic intervention, FCER is funding research that investigates chiropractic treatment for the very ailments that Dr. Homola recommends that we back away from: colic, dysmenorrhea, and ear infection. It simply doesn't make good sense to deny the efficacy of chiropractic in these instances just because the preponderance of published data is on back pain." (Seater S. Letters to the Editor. Chiropractic Tech. 1996;8:93-94.)

The profession has even waged lawsuits designed to prevent other professions from using SM:

• Lawsuit against the Health Care Financing Administration (HCFA)

“ACA President James A. Mertz, DC, DACBR, said, "With the latest response from HHS, the ACA's lawsuit against the Health Care Financing Administration (HCFA) has reached a critical point. While the ACA views the decision on physical therapists as a victory in itself, our fight is certainly not over. Nobody but a doctor of chiropractic is qualified to perform manual manipulation to correct a subluxation-not a medical doctor, not an osteopath. We will continue to pursue this lawsuit until we're assured that only doctors of chiropractic are allowed to provide this service to Medicare + Choice beneficiaries." [7] (For the APTA's reaction to this, see the corresponding Practice Policy news brief "APTA Responds: PTs Will Continue to Perform Manipulation.")” [8]

Lawsuit againt a Physical Therapist:

• Arkansas Chiropractic Board Trying to Stop Physical Therapists from Manipulating

• Chiropractors, Therapists Keep Battling 9/8/03 By Mark Friedman, Arkansas Business. Chiropractors declare "It's time to take the gloves off" in an attempt to limit the scope of physical therapy practice. Lot's of V & RS listed to document this.

How does that sound for starters? Let's discuss it and hammer it out into a consensus version. Its placement is also up for debate. -- Fyslee / talk 15:30, 4 October 2008 (UTC)

I have stricken this old version as it is only of historical relevance here. See the latest version below. -- Fyslee / talk 04:34, 8 October 2008 (UTC)

• The above discussion presents convincing arguments that this topic is more relevant to Chiropractic #Scope of practice than it is to Chiropractic #Treatment techniques. As I understand it, the basic idea is that Scope of practice should mention two notable issues:

• Whether chiropractors' scope of practice should be limited to backs and necks.
• Whether non-chiropractors' scope of practice should be limited to exclude spinal manipulation.

• However, the above proposal has only one sentence that is well-sourced, namely the "There is little consensus as to who should administer the SM..." sentence, which is already in Chiropractic but which would be moved to the new discussion, and which is sourced to Villanueva-Russell 2005 (PMID 15550303), a high-quality secondary source. The other text in the proposal is supported only by lower-quality primary sources (e.g., Homola, Seater, lawsuits). Two relatively high-quality sources were given, namely Murphy et al. 2008, PMID 18759966) and Nelson et al. 2005 (PMID 16000175), but they weren't used to support any claims. I suggest rewriting the proposal based on the three PMIDs mentioned in this bullet, dropping material that is less well-sourced (unless we can find better sources, of course).
• I expect that the two points can be made relatively briefly, in (say) a 3-sentence paragraph which could be appended to Chiropractic #Scope of practice. I suspect it wouldn't need to be a new subsection. Of course this is just a guess; we'd need to see the new material.
• I could try to propose something along the above lines, though I hope someone else will volunteer.

Eubulides (talk) 07:11, 6 October 2008 (UTC)

• If your arguments for not using some of the sources is based on WP:MEDRS, then I think it's a misapplication of MEDRS where it isn't relevant. It applies to scientific medical information, not political struggles, turf wars, and significant opinions, which is what this section is about. Here the relevant policies are V & RS. They justify inclusion of such sources in most of this article. MEDRS only applies to the nitty gritty details of scientific matters. I'm not saying that we should use all the sources I proposed, since I wrote that rather quickly, as I wrote in my introduction to the proposal. Significant views by Homola, other chiropractic sources and researchers, and non-chiropractic sources should be included if they are in V & RS, irrespective of MEDRS, since it doesn't apply here. -- Fyslee / talk 14:18, 6 October 2008 (UTC)

• I agree that WP:MEDRS is not applicable to turf wars per se: it's more for medical facts and figures. However, WP:RS does not justify the inclusion of primary sources such as the now-expired self-published advocacy website defendphysicaltherapy.com (one of the sources you cited). On the contrary, WP:RS #Primary, secondary, and tertiary sources says primary sources "must be used with extreme caution in order to avoid original research", and WP:RS #Self-published sources says "Self-published sources may be used only in limited circumstances, with caution." Now defendphysicaltherapy.com is an extreme case, but even Homola is iffy, as Homola is just one retired chiropractor who is expressing one person's viewpoint. It's much better to use sources such as Murphy et al. 2008 (PMID 18759966) and Nelson et al. 2005 (PMID 16000175), which are by multiple chiropractors and express less idiosyncratic viewpoints.
• Here are two other reliable secondary sources in this area that I just now found via a search:

• Theberge 2008 (PMID 18254831). This is specialized to sport medicine but has valuable comments to make in that area.
• Hilliard JW, Johnson ME (2004). "State practice acts of licensed health professions: scope of practice". DePaul J Health Care Law. 8 (1): 237–61.

• No doubt other reliable sources could be found. The point, though, is that we should prefer secondary sources, such as the four mentioned in this comment.

Eubulides (talk) 17:27, 6 October 2008 (UTC)

I fully agree that defendphysicaltherapy.com can't be used, but it does have some sources that could be of help. Homola is a very notable reform chiropractic author. He is what amounts to the Luther of chiropractic. His membership in the ACA was removed when he wrote his epic book Bonesetting, Chiropractic, and Cultism in 1963. Some thirty years later his dire predictions had been fulfilled, and the ACA restored his membership. Maybe they realized that history was catching up with them. No other chiropractor besides DD and BJ Palmer has been so controversial. Many of his writings are published in V & RS, and we can use those sources. Fortunately he is THE chiropractor who has earliest and most consistently represented the mainstream scientific POV within chiropractic, as his calls for legitimizing the profession by getting it to focus on a scientific and limited approach to treating back problems testifies. He has consistently sided with mainstream medicine, science, the insurance industry, and the law regarding their criticisms of quackery and healthfraud within the profession. As I mentioned above, my proposal was a quick attempt and it does need improvement, but not execution and amputation. The points made are legitimate, but may need some more and better sources. -- Fyslee / talk 03:38, 7 October 2008 (UTC)

Another reference from a very V & RS, and written by chiropractors, is related to the one above regarding sports chiropractic:

• "Australian chiropractic sports medicine: half way there or living on a prayer?" Pollard, et al, Chiropractic & Osteopathy 2007; 15: 14. Published online 2007 September 19. doi: 10.1186/1746-1340-15-14. PMCID: PMC2042981
• Abstract: "Sports chiropractic within Australia has a chequered historical background of unorthodox individualistic displays of egocentric treatment approaches that emphasise specific technique preference and individual prowess rather than standardised evidence based management. This situation has changed in recent years with the acceptance of many within sports chiropractic to operate under an evidence informed banner and to embrace a research culture. Despite recent developments within the sports chiropractic movement, the profession is still plagued by a minority of practitioners continuing to espouse certain marginal and outlandish technique systems that beleaguer the mainstream core of sports chiropractic as a cohesive and homogeneous group. Modern chiropractic management is frequently multimodal in nature and incorporates components of passive and active care. Such management typically incorporates spinal and peripheral manipulation, mobilisation, soft tissue techniques, rehabilitation and therapeutic exercises. Externally, sports chiropractic has faced hurdles too, with a lack of recognition and acceptance by organized and orthodox sports medical groups. Whilst some arguments against the inclusion of chiropractic may be legitimate due to its historical baggage, much of the argument appears to be anti-competitive, insecure and driven by a closed-shop mentality.sequently, chiropractic as a profession still remains a pariah to the organised sports medicine world. Add to this an uncertain continuing education system, a lack of protection for the title 'sports chiropractor', a lack of a recognized specialist status and a lack of support from traditional chiropractic, the challenges for the growth and acceptance of the sports chiropractor are considerable. This article outlines the historical and current challenges, both internal and external, faced by sports chiropractic within Australia and proposes positive changes that will assist in recognition and inclusion of sports chiropractic in both chiropractic and multi-disciplinary sports medicine alike."

This is all a different aspect than my proposal above, but can be added to it as something having a very limited and tangential relationship to turf wars, since it mainly deals with how chiropractors are still treated by mainstream professions, regardless of the issue involved. The major turf war is still over the fundamental treatment method of the profession - spinal manipulation. -- Fyslee / talk 04:04, 7 October 2008 (UTC)

Turf war over scope of practice 2

• Here's a newer version:

Turf wars have been waged by the profession over who should administer spinal manipulation (SM) because of concerns by chiropractors that orthodox medical physicians could "steal" SM procedures from chiropractors; the focus on SM has also raised concerns that the resulting practice guidelines could limit the scope of chiropractic practice to treating backs and necks. Proposals for limiting the scope of practice to the care of neuromusculoskeletal problems of mechanical origin, with emphasis on back care, have been made by now-retired reform chiropractor Samuel Homola and other chiropractors.

The profession has resisted such proposals:

"It has long been the contention of FCER [Foundation for Chiropractic Education and Research] that to position chiropractors as "back doctors" would be disastrous for the future of the chiropractic profession and would only serve to limit the choice of treatments available to patients. Based on substantial anecdotal evidence supporting chiropractic intervention, FCER is funding research that investigates chiropractic treatment for the very ailments that Dr. Homola recommends that we back away from: colic, dysmenorrhea, and ear infection. It simply doesn't make good sense to deny the efficacy of chiropractic in these instances just because the preponderance of published data is on back pain."

The profession has waged lawsuits designed to prevent other professions from using SM. One was against the US Goverment's "Health Care Financing Administration" (HCFA):

“ACA President James A. Mertz, DC, DACBR, said, "With the latest response from HHS, the ACA's lawsuit against the Health Care Financing Administration (HCFA) has reached a critical point. While the ACA views the decision on physical therapists as a victory in itself, our fight is certainly not over. Nobody but a doctor of chiropractic is qualified to perform manual manipulation to correct a subluxation - not a medical doctor, not an osteopath. We will continue to pursue this lawsuit until we're assured that only doctors of chiropractic are allowed to provide this service to Medicare + Choice beneficiaries."

The Arkansas Chiropractic Board has also filed a lawsuit against a Physical Therapist.

• Is that better? -- Fyslee / talk 06:09, 7 October 2008 (UTC)

I have stricken this old version as it is only of historical relevance here. See the latest version below. -- Fyslee / talk 04:36, 8 October 2008 (UTC)

Comments on Turf war over scope of practice 2

Could you provide a quote from a reference that states that Homola is a Chiropractor (he is not), let alone a reform Chiropractor? DigitalC (talk) 00:27, 8 October 2008 (UTC)

Homola is a retired chiropractor. See: Homola S (2008). "Chiropractic: a profession seeking identity". Skept Inq. 32 (1): 37–43. Retrieved 2008-10-08. This is one of the sources cited above. (I haven't yet had time to review the above proposal; I'm just responding to the previous comment.) Eubulides (talk) 00:43, 8 October 2008 (UTC)

I see that Eubulides beat me to it. I am baffled that a chiropractor can claim that Homola isn't a chiropractor. He is a second generation DC and the profession's most notorious chiropractor (from the profession's POV). He is the first to have significantly challenged the basis for the profession (Vertebral subluxation), and to expose the quackery that is so fundamental to much of what happens in the profession. That cost him his membership in the ACA. He has written many books, most notably Bonesetting, Chiropractic, and Cultism (1963) and Inside Chiropractic: A Patient's Guide (1999). I suggest you read "Bonesetting...", it's free on-line. I have an original hard bound copy received from Homola himself. You will never be able to fully understand the profession until you have read it, not that that will do it alone, but it is very significant must reading. I suggest you also read The movement toward scientific reform. -- Fyslee / talk 02:03, 8 October 2008 (UTC)

No, Homola is not a retired chiropractor (he does not maintain retired licensure). He may have been a Chiropractor (when he was licensed), but his is no longer a Chiropractor. By legal definition, a Chiropractor is someone who is legally licensed as such. Chiropractors can in some locations maintain "retired licensure", which costs less. DigitalC (talk) 02:10, 8 October 2008 (UTC)

That's certainly a new twist on things, which is totally irrelevant to what is being dealt with in this section. Maybe you are describing some idiosyncracy in chiropractic regulations, but in medicine an MD is always an MD, even if (s)he is no longer licensed. (S)he is always justified in being addressed as "doctor" and in using "MD" after her/his name. I would think the same applies to chiropractors, since they are legally classified as physicians in many, but not all, states in the USA. I believe retired chiropractors can call themselves chiropractors, but not practice without a current license, just as with MDs. Whatever the case may be, it's irrelevant here. He was a chiropractor at the time he wrote and practiced, was defrocked and refrocked. -- Fyslee / talk 02:21, 8 October 2008 (UTC)

This is not a twist on things, and it is not new. It has been brought up here before. This is not an idiosyncracy in chiropractic regulations. An MD is always an MD, even if no longer licesned - as is a DC. However, an unlicensed MD is NOT free to refer to oneself as a Physician, just as a DC is not free to refer to oneself as a Chiropractor. I have yet to see any evidence that the source states that he is a "reform chiropractor". DigitalC (talk) 02:37, 8 October 2008 (UTC)

I would certainly dispute your claims above, and I don't recall we have discussed this here before. Please provide a diff to previous discussions. I'm willing to learn.

I'm not sure the source states it that way, but other ones make it clear he is a (retired) "reform" chiropractor, even if they don't juxtapose the words in exactly that manner. Are you disputing that he is a retired reform chiropractor (thus revealing possible ignorance of the subject), or are you just disputing the documentation? If the latter is the case, then your objections are just disruptive wikilawyering over technicalities regarding what is general and common knowledge in the chiropractic community, but that can easily be fixed by adding more references. (If that happens, please don't complain that we're using too many refs.) We can't assume that all readers are informed on these matters, and since we are dealing with bytes, not paper, we can clarify what a reform chiropractor is, and how Homola is a/the key person in the movement towards reform. The profession's vociferous opposition and criticism of him has provided plenty of documentation. Would you like to start the article on him? We can work together on it, just like Dematt and I have worked together. It's really great to collaborate in that manner.

But... this is getting us off-track here. The subject isn't about Homola, but about the history of propositions to limit the scope of chiropractic practice, and in that way we must name him and provide refs to his writings on the subject. -- Fyslee / talk 03:33, 8 October 2008 (UTC)

See [9] and [10]. I do believe you were active on the page in May and June of this year, but perhaps you missed that discussion. I am not "disputing" anything, I am asking for a quote from one of the sources that states that he was a "reform Chiropractor". I am not saying that it isn't true, what I AM saying is that it needs to be verifiable. This is NOT wikilawyering, and I would request that you refactor your comment above that implies that it is. DigitalC (talk) 11:23, 9 October 2008 (UTC)

Thanks for the explanation. I have stricken through that comment. Sorry about that.

Here are a couple searches where he is mentioned as a reformer, or in connnection with the word "reform" 1 2, and a general search. [11] Of course searches are not the only method of finding information, since they also turn up false positives, but they are an interesting place to start. -- Fyslee / talk 03:31, 10 October 2008 (UTC)

Relevant Florida statute: "The term "chiropractic medicine," "chiropractic," "doctor of chiropractic," or "chiropractor" shall be synonymous with "chiropractic physician," and each term shall be construed to mean a practitioner of chiropractic medicine as the same has been defined herein." and "Chiropractic physician" means any person licensed to practice chiropractic medicine pursuant to this chapter.". and "Using the name or title "chiropractic physician," "doctor of chiropractic," "chiropractic medicine," or any other name or title which would lead the public to believe that such person is engaging in the practice of chiropractic medicine, unless such person is licensed as a chiropractic physician in this state." Anyone refering to themselves as a chiropractor while not licensed is in violation of the law, as they are technically practicing without a license. Homola does not hold a license, and to describe him as a chiropractor gives the appearance that he is licensed. DigitalC (talk) 02:46, 8 October 2008 (UTC)

Interesting, but irrelevant to the subject above. This is a technicality. Should we refer to him and all other retired chiropractors as "XXX, formerly known as chiropractor"? We aren't dealing with Prince here. I really doubt that anyone will prosecute him IF he mentions that he is a retired chiropractor. That says nothing about his current status, which is what the statutes mentioned above are dealing with. They aren't dealing with historical facts. "Retired" means someone who has "formerly practiced as", and is clearly not misleadingly implying current practice.

Can you document that any retired chiropractor who is truly retired and not practicing, has ever been rebuked or prosecuted for stating that they are a "retired chiropractor"? I'm not even sure if Homola does it, but lots of others call him that, and they cannot be prosecuted for doing so. Neither can we. I'm pretty sure many retired chiropractors who are speakers at chiropractic conventions have been introduced as "retired chiropractor", and no one blinked an eye, but applauded them. Let's not get pedantic here. -- Fyslee / talk 03:33, 8 October 2008 (UTC)

The proposed text did not call him a retired chiropractor or former chiropractor, it referred to him as a reform chiropractor. This is false. DigitalC (talk) 04:03, 8 October 2008 (UTC)

Interesting point. That can be easily fixed. I'll do it below. -- Fyslee / talk 04:32, 8 October 2008 (UTC)

It turns out that my new version below doesn't have this problem. Thanks for pointing out the possibility though. -- Fyslee / talk 05:00, 8 October 2008 (UTC)

"Limited scope of practice" (version 3)

I am proposing a different subheading, since this belongs under the "Scope of practice" heading. -- Fyslee / talk 03:02, 8 October 2008 (UTC)

In the early 1940s, C.O. Watkins, DC, Chairman of the Board for the National Chiropractic Association, wrote: "If we will not develop a scientific organization to test our own methods, organized medicine will usurp our privilege. When it discovers a method of value, medical science will adopt it and incorporate it into scientific medical practice." Some twenty years later, shortly after the death of B.J. Palmer in 1961, Samuel Homola, a second generation chiropractor, echoed those sentiments and wrote extensively on the subject of limiting the use of spinal manipulation, proposing that chiropractic could function as a medical specialty with special focus on conservative care of musculoskeletal conditions. Homola's membership in the newly formed American Chiropractic Association was not renewed, and his position was rejected by both straight and mixer associations. Other chiropractors have also aired similar ideas.

Because of concerns by chiropractors that orthodox medical physicians could "steal" SM procedures from chiropractors, turf wars have been waged by the profession over who should administer spinal manipulation (SM); the focus on SM has also raised concerns that the resulting practice guidelines could limit the scope of chiropractic practice to treating backs and necks.

The profession has resisted such proposals:

"It has long been the contention of FCER [Foundation for Chiropractic Education and Research] that to position chiropractors as "back doctors" would be disastrous for the future of the chiropractic profession and would only serve to limit the choice of treatments available to patients. Based on substantial anecdotal evidence supporting chiropractic intervention, FCER is funding research that investigates chiropractic treatment for the very ailments that Dr. Homola recommends that we back away from: colic, dysmenorrhea, and ear infection. It simply doesn't make good sense to deny the efficacy of chiropractic in these instances just because the preponderance of published data is on back pain."

The profession has waged lawsuits designed to prevent other professions from using SM. One was against the US Goverment's "Health Care Financing Administration" (HCFA):

“ACA President James A. Mertz, DC, DACBR, said, "With the latest response from HHS, the ACA's lawsuit against the Health Care Financing Administration (HCFA) has reached a critical point. While the ACA views the decision on physical therapists as a victory in itself, our fight is certainly not over. Nobody but a doctor of chiropractic is qualified to perform manual manipulation to correct a subluxation - not a medical doctor, not an osteopath. We will continue to pursue this lawsuit until we're assured that only doctors of chiropractic are allowed to provide this service to Medicare + Choice beneficiaries."

The Arkansas Chiropractic Board has also filed and won a lawsuit against a Physical Therapist.

Another source to add:

• "... if we are to thrive in the future, it will be as NMS specialists, and not anything else."

We could just add the reference itself. -- Fyslee / talk 06:12, 9 October 2008 (UTC)

Comments on "Limited scope of practice" (version 3)

What is the relevance of "shortly after the death of B.J. Palmer in 1961"? - DigitalC (talk) 03:09, 8 October 2008 (UTC)

You can ask Dematt. He wrote the article, and that is taken from this section: The movement toward scientific reform. I see its relevance since we are talking about history and this provides perspective. -- Fyslee / talk 03:36, 8 October 2008 (UTC)

Content about BJ Palmer's death in 1961 belongs in Chiropractic history where it is relevant, not in the scope of practice section. DigitalC (talk) 10:44, 9 October 2008 (UTC)

Where is this section being proposed to be added? DigitalC (talk) 03:53, 8 October 2008 (UTC)

Please read the above discussions and versions. It's stated there. Please do your homework instead of shooting from the hip without focusing on where your target is located. It's tiring and disruptive -- Fyslee / talk 04:41, 8 October 2008 (UTC)

I have read the discussions above, and was confused by the fact that you mentioned the we are "talking about history", yet as far as I could see this wasn't proposed for the history section. For you to assume that I did NOT read the above discussions is not assuming good faith, and your comment above could certainly be more civil. DigitalC (talk) 10:44, 9 October 2008 (UTC)

You asked "Where is this section being proposed to be added?" That's all I had to go on in my reply. Well, I had previously (immediately above at the very top of this whole section) written this:

• "I am proposing a different subheading, since this belongs under the "Scope of practice" heading."

That's why I replied as I did. Sorry if it came off badly. Maybe you hadn't noticed my statement, so I really do apologize. I was only responding to your one question, and thinking of my previously-made clear statement.

As to the "history" remark, the quote does touch on history and then leads to the present, but we can't relegate everything written in V & RS (IOW everything here is "history") to history sections. That would be very impractical. -- Fyslee / talk 02:52, 10 October 2008 (UTC)

What is the relevance of "Homola's membership in the newly formed American Chiropractic Association was not renewed" ? Unless we have something to state that the reason of his membership not being renewed was DUE to his position, it doesn't belong in this section. DigitalC (talk) 03:53, 8 October 2008 (UTC)

We are documenting the history of proposals to limit the scope of practice and its reception by the profession. Dematt is an honorable chiropractor and highly respected editor here, and he wrote that since it is a very relevant fact. Are you suggesting we censor Wikipedia of relevant historical facts? BTW, Homola's membership renewal was not disallowed because of any offense other than writing his 1963 book. Read it on-line and you'll see why they wouldn't allow him to renew his membership. Some 30 years later he received what amounted to an apology and was allowed to renew his membership. In spite of this treatment he remained a legitimately and legally practicing reform (IOW EBM) chiropractor in Florida until his retirement. He practiced what he preached and won the respect of local MDs as a skilled, science-based chiropractor who eschewed the quackery and unethical marketing practices that are so common in the profession. -- Fyslee / talk 04:41, 8 October 2008 (UTC)

I did not suggest any censorship, and I don't know how that could be construed from my comments. I am suggesting that the relevance was not clear to me, and therefore would not likely be clear to the average reader. I also agree with Eubulides that this proposal spends too much time on history, which should be dealt with in Chiropractic history. I was trying to work through the proposed section line by line, but only had a limited amount of time. DigitalC (talk) 11:00, 9 October 2008 (UTC)

Ah! Sorry about that. My apologies. -- Fyslee / talk 02:55, 10 October 2008 (UTC)

Although I agree with the idea of covering limited scope of practice and turf wars, this draft has some real problems:

• It spends way too much time on old history. Generally speaking, Chiropractic should discuss the current state of chiropractic, except that its History section should of course discuss history. Any source older than 10 years old is questionable as a description of the current state of chiropractic.
• It spends way too much time on Homola. While Homola's story is compelling, it's a tale of history and belongs in Chiropractic #History if it belongs anywhere in the article.
• WP:WEIGHT suggests that any discussion of scope-of-practice limitations should focus on more-recent, more-mainstream sources such as Murphy et al. 2008 (PMID 18759966), Nelson et al. 2005 (PMID 16000175), Theberge 2008 (PMID 18254831), and Hilliard & Johnson 2004, all mentioned above.
• It cites only 3 secondary sources and gives short shrift to two of them, namely Murphy et al. 2008 (PMID 18759966) and Nelson et al. 2005 (PMID 16000175). The only secondary source that is given much play is Villanueva-Russell 2005 (PMID 15550303), and even that is given only 1 sentence.
• It devotes way too much to isolated cases, as opposed to overall themes.
• The claim "The profession has waged lawsuits designed to prevent other professions from using SM" is unsourced.
• The claim "The profession has resisted such proposals" is a stretch, given the source. The FCER is not the profession.
• Overall, it's way too long. Turf wars are a real issue, but we don't need 5 long paragraphs about it. 1 paragraph should do. We shouldn't need a subsection header for this.
• The paragraph should follow the framework established by reliable secondary sources here; we shouldn't be reaching down into primary sources for this sort of thing.

Thanks for tackling the problem; hope this review helps. Eubulides (talk) 07:50, 8 October 2008 (UTC)

Thanks for the critique. Please tweak it and let's see what your version looks like. -- Fyslee / talk 02:49, 9 October 2008 (UTC)

I am trying to shake loose some time to read the sources I mentioned, and find some other sources. It won't happen right away; sorry. Eubulides (talk) 06:50, 9 October 2008 (UTC)

I agree here. I don't think Homola is all that notable and I question how much he is mentioned or references in this article and wonder if he should be given less or no space at all. -- Levine2112 ^discuss 18:36, 8 October 2008 (UTC)

I suggest you do some searching and reading of chiropractic literature. You'll discover he's quite notable. We could easily have a nice article about him. -- Fyslee / talk 02:47, 9 October 2008 (UTC)

Nah. I'd say he is of mediocre notability at best. Even within chiropractic. -- Levine2112 ^discuss 04:30, 9 October 2008 (UTC)

He's either notable or not notable. "Mediocre" is your opinion, unsurprisingly enough. It has no bearing on Wikipedia policies nor on inclusion criteria. You need to do more homework.

Here's an interesting series of quotes compiled by Terry Rondberg, President of the WCA. Note that Homola is quoted five times, more than any other single source. -- Fyslee / talk 05:09, 9 October 2008 (UTC)

What does Levine need to "do more homework" on? How is this a constructive comment that helps the development of the article? Homola's notability or non-notability is irrelevant unless you are planning on creating an article on him. What does matter is undue weight, which the current proposal is giving him. DigitalC (talk) 10:49, 9 October 2008 (UTC)

You should ask him if his comments were "constructive". His objections to Homola were bringing us off-track, but I replied anyway. You can fault me for that. My comments were directed at his obvious lack of knowledge about Homola's notability ("notoriety" in the profession). That's why I suggested he needed to do more homework. This requires some simple knowledge of the history of chiropractic controversies. Instead of being so cocky in his statements, he should do more homework and ask before commenting. I guess he could have asked on my talk page to avoid distracting this discussion with comments that weren't "help[ing] the development of the article". -- Fyslee / talk 02:41, 10 October 2008 (UTC)

A rude explanation to a rude comment. My discussion of Homola was on track. I was speaking of Notability in terms of WP:WEIGHT, clearly as I was in agreement with Eubulides' similar comment. You assumed bad faith and made an aspersion about my knowledge of chiropractic. And then followed it up with an even ruder rationale to justify such an aspersion. Just go back and read what is plainly obvious. You made this personal. Not me. Remember WP:NPA. Please. And peace. -- Levine2112 ^discuss 17:29, 10 October 2008 (UTC)

Following up on my recent comment: in looking at the more-reliable sources it appears that we'll need to do some surgery on the existing Chiropractic #Scope of practice section as well, as some of its current sources suffer from the same problem as the problems mentioned above. I'll open up a new thread to talk about this sometime soon. In the meantime, here's a draft of text that summarizes what one of the newly-discovered reliable secondary sources says about turf wars:

Spinal manipulation (SM) is also practiced by physical therapists. Some U.S. states prohibit physical therapists from performing SM, some states allow them to do it only if they have completed chiropractic training, and some states allow only chiropractors to perform SM, or only chiropractors and physicians. Bills to further prohibit non-chiropractors from performing SM are regularly introduced into state legislatures and are opposed by physical therapist organizations.

Eubulides (talk) 17:27, 9 October 2008 (UTC)

#Scope of practice 4 below contains some further thoughts on this subject. Eubulides (talk) 07:36, 11 October 2008 (UTC)

Fixing first paragraph under EFFICACY

I think the order of information should be rearranged here based on importance. Below is how I'd rework it. While I take issue with several claims here, I've kept the sentences the same along with their citation numbers, and just inject transitional language for smooth reading.

Many controlled clinical studies of SM are available, but their results disagree,[87] and they are typically of low quality.[88]. Although a 2008 critical review found that with the possible exception of back pain, chiropractic SM has not been shown to be effective for any medical condition, and suggested that many guidelines recommend chiropractic care for low back pain because no therapy has been shown to make a real difference,[90] a 2008 supportive review found serious flaws in the critical approach, and found that SM and mobilization are at least as effective for chronic low back pain as other efficacious and commonly used treatments.[91] In addition, most research has focused on spinal manipulation (SM) in general,[85] rather than solely on chiropractic SM,[12] so some of this research has been criticized as being misleading for failing to mention incorporation of data derived from studies of SM that do not relate to chiropractic SM;[86][not in citation given]. That said, given that there is a wide range of ways to measure treatment outcomes, [83] opinions differ as to the efficacy of chiropractic treatment; many other medical procedures also lack rigorous proof of effectiveness.[13]

Chiropractic care, like all medical treatment, benefits from the placebo response.[84] [14] Still, it is hard to construct a trustworthy placebo for clinical trials of spinal manipulative therapy (SMT), as experts often disagree about whether a proposed placebo actually has no effect.[89] In any event, the efficacy of maintenance care in chiropractic is unknown.

I believe the next paragraph should not be under the Efficacy section. I personally don't think it's relevant enough for the article, but should other disagree, perhaps we could move to a a controversy section who who should be practicing SM. Anyway, I modified the order of sentences in that paragraph as follows; I also had to change the sentences a little to make it work:

There is little consensus as to who should administer the SM, raising concerns by chiropractors that orthodox medical physicians could "steal" SM procedures from chiropractors. Those physicians argue that SM research is equally of value regardless of practitioner.[85] The chiropractors, however, have raised concerns that the focus on SM will result in practice guidelines that could limit the scope of chiropractic practice to treating backs and necks.[12]

Jordanotto (talk) 22:13, 3 October 2008 (UTC)

• Unfortunately those numbers in brackets change whenever someone edits Chiropractic. Let me try to restate your proposal with actual references. I'll try to improve it as I go, putting my changes in italics (for inserted words) and strikeouts (for deleted words). But first, some comments:

• The phrase "defenders have replied that SM research is equally of value regardless of practitioner" is not relevant to the "administer the SM" sentence. It is relevant to the "Some of this research has been criticized" sentence.
• Phrases like "In addition" shouldn't be needed. For one thing, they tend to introduce POV. For another, they're a sign of weak writing. Well-written text shouldn't need "In addition" linkage.
• "The chiropractors, however, have raised concerns..." actually, it's not chiropractors in general, just some chiropractors.
• The rewritten version starts off right away with SM. But chiropractic is more than just SM; this should be made clearer.

• With the above comments in mind, the revised proposal is to replace the first two paragraphs of Chiropractic #Effectiveness with the following:

Opinions differ as to the efficacy of chiropractic treatment; many other medical procedures also lack rigorous proof of effectiveness. Many controlled clinical studies of spinal manipulation (SM) are available, but their results disagree, and they are typically of low quality. Although a 2008 critical review found that with the possible exception of back pain, chiropractic SM has not been shown to be effective for any medical condition, and suggested that many guidelines recommend chiropractic care for low back pain because no therapy has been shown to make a real difference, a 2008 supportive review found serious flaws in the critical approach, and found that SM and mobilization are at least as effective for chronic low back pain as other efficacious and commonly used treatments. In addition, Most research has focused on spinal manipulation (SM) in general, rather than solely on chiropractic SM. so Some of this research has been criticized as being misleading for failing to mention incorporation of data derived from studies of SM that do not relate to chiropractic SM; defenders have replied that SM research is equally of value regardless of practitioner.

That said, given that There is a wide range of ways to measure treatment outcomes. Opinions differ as to the efficacy of chiropractic treatment; many other medical procedures also lack rigorous proof of effectiveness. Chiropractic care, like all medical treatment, benefits from the placebo response. Still, It is hard to construct a trustworthy placebo for clinical trials of spinal manipulative therapy (SMT), as experts often disagree about whether a proposed placebo actually has no effect. In any event, The efficacy of maintenance care in chiropractic is unknown.

and to move the following text out of Chiropractic #Evidence basis, inserting it after the 2nd paragraph of Chiropractic #Treatment techniques appending it to Chiropractic #Scope of practice:

There is little consensus as to who which profession should administer the spinal manipulation (SM), raising concerns by chiropractors that orthodox medical physicians could "steal" SM procedures from chiropractors. The chiropractors, however, have raised concerns that the focus on SM will result in A focus on evidence-based SM research has also raised concerns that the resulting practice guidelines that could limit the scope of chiropractic practice to treating backs and necks.

Eubulides (talk) 07:41, 4 October 2008 (UTC)

We can move the 2nd part to Treatemnt techniques or Scope of practice. Both sections are appropriate. QuackGuru 04:02, 5 October 2008 (UTC)

Yes, thanks, that sounds reasonable. I've revised the above proposal accordingly. Eubulides (talk) 07:11, 6 October 2008 (UTC)

Nice edits. Transitional language makes for smoother reading, which is why I added it, but it's not a big point for me. The sentences still need serious cleaning. Jordan 20:58, 6 October 2008 (UTC) —Preceding unsigned comment added by Jordanotto (talk • contribs)

As for the 2nd part, I recommend it be moved to the appropriate section whenever an editor has an idea which part of Scope of practice would work best. QuackGuru 02:01, 9 October 2008 (UTC)

The above proposal is to simply append the 2nd part to Chiropractic #Scope of practice. As mentioned in #Comments on "Limited scope of practice" (version 3) below, I plan to propose further changes to Scope of practice soon; I expect that these further changes will move text around but the above text would be retained somewhere in Scope of practice. Eubulides (talk) 20:27, 9 October 2008 (UTC)

Please see #Scope of practice 4 for the proposed further changes. Eubulides (talk) 07:36, 11 October 2008 (UTC)

See also

I recommend we add the article List of pseudosciences and pseudoscientific concepts to a new see also section. QuackGuru 17:49, 10 October 2008 (UTC)

I disagree with that recommendation. -- Levine2112 ^discuss 19:24, 10 October 2008 (UTC)

I also disagree. I don't think it would be helpful or that relevant to this subject. Eubulides (talk) 07:36, 11 October 2008 (UTC)

I too disagree. We need to stick with more specific things. -- Fyslee / talk 15:09, 11 October 2008 (UTC)

uncontroversial edits

Relevant discussion at

→ Some comments on uncontroversial parts of the text

I like this edit, especially replacing the bit about anatomical boundary with "not so far as to dislocate or damage the joint": I can understand it better now! ☺ Coppertwig (talk) 14:58, 11 October 2008 (UTC)

Gallup Poll revisited

We have already cited the Gallup Poll in this section. I have found a chiropractic reference to it. While the poll results are devastating, it is also encouraging that these chiropractors are not denialists or wagon circlers, but admit the real and true causes for the poll results, and they want to do something about it:

• 1. Public image reform - Chiropractors are the most disrespected and mistrusted health care practitioners, as demonstrated in a recent CNN/USA Today/Gallup Poll,1 regarding people's opinions about the honesty and ethics of various professions. We must respond firmly to the fraud, abuse, charlatanism and quackery, as we feel that this is likely the primary reason for our low ranking in the public's perception of honesty and ethics among health care providers.

We should add this reference (not the whole quote) to the mention. It's already formatted. The primary reference is good, but this is (1) a chiropractic source and it's (2) not a primary source, so it should also be used. What think ye? -- Fyslee / talk 05:58, 9 October 2008 (UTC)

This reference appears to be an earlier and not-peer-reviewed version of Murphy et al. 2008 (PMID 18759966), which is already cited in Chiropractic. Shouldn't we stick with the more-recent and more-reliable version? Eubulides (talk) 06:50, 9 October 2008 (UTC)

They are two different documents, with the 2008 document only mentioning the earlier one. Both sources should be used. We only prefer peer-reviewed sources and follow MEDRS when dealing with the nitty gritty details of scientific matters. Other sources are fair game the rest of the time, even when dealing with scienfic matters, though it is then we would like to use (may prefer) good peer-reviewed sources as well. Wikipedia's policies require that sources be V & RS, not that they are peer-reviewed. We shouldn't use MEDRS to violate or nullify V & RS. Non-peer reviewed sources that are V & RS are still allowed. It's just a matter of editorial discretion when we use what, and with this type of information (political, news, public opinion, etc.), peer-review is hardly relevant (but I wouldn't turn down such a source if it existed, and it does here ;-). Murphy et al (not exactly the same group of editors) only make a weak reference to the earlier mention. The earlier mention is written to chiropractors and contains significantly stronger language. It thus covers the subject better than the later document. This isn't an either/or situation, but if I had to choose, I'd choose the previous document. Let's just use both refs. -- Fyslee / talk 13:37, 9 October 2008 (UTC)

The later document does not merely "only mention" the earlier one; it covers the same point as the one quoted above, except with more temperate and solid language, which is exactly the sort of thing that one would expect from peer review. Here's the more-temperate language:

• "However, in spite of this, the profession has not gained a level credibility and cultural authority in mainstream society that is required to establish itself on equal ground with other healthcare professions. The profession still finds itself in a situation in which it is rated dead last amongst healthcare professions with regard to ethics and honesty..."
• "Patients place their faith in the professional, and trust that they will not be subject to fraud, abuse or quackery. This is the social contract as it applies to chiropractic physicians."
• "The chiropractic profession has an obligation to actively divorce itself from metaphysical explanations of health and disease as well as to actively regulate itself in refusing to tolerate fraud, abuse and quackery, which are more rampant in our profession than in other healthcare professions."

Perhaps the non-peer-reviewed source makes some important points that the later, peer-reviewed source does not cover. In that case we may need to cite to the non-peer-reviewed source. But we should take great care in doing so: the non-peer-reviewed source is less reliable. It would be better to cite a more-reliable source. Eubulides (talk) 14:55, 9 October 2008 (UTC)

The only part from the later source that relates directly to the Gallup Poll is this mild statement (contrasted with the previous statement):

• "The profession still finds itself in a situation in which it is rated dead last amongst healthcare professions with regard to ethics and honesty."

• Chiropractors are the most disrespected and mistrusted health care practitioners, as demonstrated in a recent CNN/USA Today/Gallup Poll,1 regarding people's opinions about the honesty and ethics of various professions. We must respond firmly to the fraud, abuse, charlatanism and quackery, as we feel that this is likely the primary reason for our low ranking in the public's perception of honesty and ethics among health care providers.

The two statements are so different that they could be written in one paragraph, without any serious repetition. Just read the first and continue reading the second, without pausing. You get the whole story right there.

The previous version, written at the time and just as "reliable" a source for this type of stuff (in any sense, including Wikipedia's definition), is much more honest and straightforward. It doesn't smother itself and whitewash its language in politically correct terminology. They tell it like it is, and it's very refreshing. Normally, political correctness is a tool used to sweep the truth under the carpet, and we should avoid such sources when better ones are available.

This is all written by chiropractors, not evil anti-chiropractic science zealots, or pseudoscientific skeptics, as one of our editors here would like to think. Much to his chagrin, real, very influential chiropractors are admitting that the charges that chiroskeptics have made for years are true, and they wish the profession would do something constructive about it. -- Fyslee / talk 01:14, 10 October 2008 (UTC)

Now that I've read the sources again, I think the parts you have quoted, while not directly related to the Gallup Poll, make important points that could be mentioned in the article here. -- Fyslee / talk 01:46, 10 October 2008 (UTC)

• The statements "Chiropractors are the most disrespected and mistrusted health care practitioners, as demonstrated in a recent CNN/USA Today/Gallup Poll,1 regarding people's opinions about the honesty and ethics of various professions" and "The profession still finds itself in a situation in which it is rated dead last amongst healthcare professions with regard to ethics and honesty" are on exactly the same topic, and are supported by exactly the same source; it's just that the latter statement more accurately summarizes the source, is more recent, and is peer-revered. We should prefer the more-reliable source on this point.
• The statement "We must respond firmly to the fraud, abuse, charlatanism and quackery" is a vague piece of advocacy. Much more concrete is "The chiropractic profession has an obligation to actively divorce itself from metaphysical explanations of health and disease as well as to actively regulate itself in refusing to tolerate fraud, abuse and quackery, which are more rampant in our profession than in other healthcare professions." The latter is more recent and is peer-reviewed. The latter is advocacy as well, and as advocacy would require in-text attribution, but why cite the earlier, vaguer, and lower-quality source when we have something far better?
• "Patients place their faith in the professional, and trust that they will not be subject to fraud, abuse or quackery. This is the social contract as it applies to chiropractic physicians." is indeed a new point in the latter source, and could also be summarized here.

Eubulides (talk) 04:14, 10 October 2008 (UTC)

I believe "advocacy" is the wrong word here, at least in the Wikipedia sense. I think you mean "opinion". It's an opinion expressed by very notable chiropractors, and since it is in a V & RS, it's quite acceptable as a well-sourced opinion (and should be attributed to the very notable chiropractors). I fear we are getting too bogged down by misapplications of MEDRS and we are overly restricting ourselves to peer-reviewed sources when not required to do so. This is really impeding progress here and deviates from Wikipedia's overall policies that allow V & RS, regardless of source. Only in situations where there is a clear discrepancy or disagreement should peer-reviewed sources be required to trump other sources, and then only if they are dealing with nitty-gritty scientific matters. We aren't allowed to make our own rules that overrule the V & RS policies. I think you are so used to editing mainstream medical and scientific articles, where MEDRS and peer-reviewed sources are used much more, that you are forgetting we are dealing with chiropractic, a subject that is only partially scientific, and concerns much subject matter of a fringe and political nature. This means we need to include many other types of information from many other types of sources.

Having said all that, the other quotes you mention are certainly acceptable.

Let me make something clear: I have not (originally) been advocating an addition of words, but only an addition of the more original ref alongside the newer ref. Since then I now favor some tweaking of the wording to enlarge the statement describing the situation, using wording from both sources. Let's just improve what we have with a few more words and include both refs. There is no policy that forbids it, it is standard practice to do so, and it will help our readers understand the situation better. Some readers will actually benefit from reading the refs we provide. -- Fyslee / talk 04:58, 10 October 2008 (UTC)

As a side note, the 2008 article is clearly written by reform chiropractors, as one of their closing paragraphs clearly describes the NACM position, which was radical when first proposed by the NACM, and indicates that that position will (if the author's wishes prevail) become the sole chiropractic mainstream position in the future, with straights and subluxationists becoming extinct dinosaur artifacts:

"We must finally come to the painful realization that the chiropractic concept of spinal subluxation as the cause of "dis-ease" within the human body is an untested hypothesis [27]. It is an albatross around our collective necks that impedes progress. There can be no unity between the majority of non-surgical spine specialist chiropractic physicians and the minority of chiropractors who espouse metaphysical, pseudoreligious views of spinal subluxations as "silent killers" [47]. The latter minority group needs to be marginalized from the mainstream majority group, and no longer should unrealistic efforts be made toward unification of these disparate factions within the profession.

Conclusion: Reform of the chiropractic profession is long overdue." [12]

That quote would be good in the Vertebral subluxation article. When their wish becomes public and official chiropractic policy, and actually gets effectuated, then, and only then, will the profession be in a position to achieve the acceptance and cultural authority it desires. This quote from another source is poignant here:

"We lament efforts to generate unity within the profession through consensus statements concerning subluxation dogma, and believe that cultural authority will continue to elude us so long as we assert dogma as though it were validated clinical theory." [13]

-- Fyslee / talk 05:26, 10 October 2008 (UTC)

• I agree that the newer source is a good source and makes good points. It would be helpful to make specific wording suggestions to improve Chiropractic along the lines that you mention. (I hope it wouldn't involve long quotes from the source. :-)
• However, the older source is not needed for that. This is not merely a matter of WP:MEDRS; it is a matter of WP:SOURCES. The newer source, Murphy et al. 2008 (PMID 18759966), published in the peer-reviewed journal Chiropr Osteopat, is far more reliable by the standards of WP:SOURCES than is the older source, Murphy et al. 2005, published in the trade magazine Dyn Chiropr. The older source is by the same group, and expresses similar points, but does so in a lower-quality and less-reliable way; it is completely dominated by the newer source on the points at hand. Citing multiple and duplicative sources on the same points, from the same group, would raise WP:WEIGHT issues as well. Let's just stick with the better source.
• More generally, we should not settle for just any reliable source: we should use the most reliable sources available. And we shouldn't cite lower-quality sources merely because they use stronger words that we happen to like better; that could weaken the credibility of Chiropractic.

Eubulides (talk) 05:47, 10 October 2008 (UTC)

Moving my comments to Eubulides' talk page. -- Fyslee / talk 14:26, 10 October 2008 (UTC)

I'll try to come up with alternate proposed wording, but I haven't yet had time to do this. Eubulides (talk) 07:36, 11 October 2008 (UTC)

Please see #Proposed changes from Murphy et al. 2008 below for the alternate proposed wording. Eubulides (talk) 16:42, 12 October 2008 (UTC)

Manipulation under anesthesia

Manipulation under anesthesia or MUA is a specialized manipulative procedure that typically occurs in hospitals administered under general anesthesia. Typically, it is performed on patients who have failed to respond to other forms of treatment.

Something shorter than the above for brevity about Manipulation under anesthesia might help improve this article. This could be added to the Chiropractic#Treatment techniques if shortened per WP:SUMMARY. QuackGuru 17:52, 11 October 2008 (UTC)

Do chiropractors administer adjustments under anaesthesia? I don't think they do... --Surturz (talk) 18:25, 11 October 2008 (UTC)

Yes they do, and personally I'd like to see the pros and cons about this procedure. My son is trying to arrange this procedure so I'd love to be able to read more about it before it is done. Thanks, --CrohnieGal^Talk 18:39, 11 October 2008 (UTC)

Mentioning MUA, MUJA, and MUESIs would be reasonable, but those are low-quality sources: one merely lists 4 case studies and the other is a proposal. A much better source is Dagenais et al. 2008 (PMID 18164462): it's more recent, it's a review article, and it's high-quality. Eubulides (talk) 21:12, 11 October 2008 (UTC)

It's already covered here: Chiropractic treatment techniques. If mentioned in this article's "Treatment techniques" section, it should just be a mention and wikilink to Manipulation under anesthesia . -- Fyslee / talk 21:26, 11 October 2008 (UTC)

• Wiklinking to manipulation under anesthesia sounds dubious, as that article is very low in quality and it's not at all clear to me that it's accurate. Also, MUA is just one of the ways to do medicine-assisted manipulation, and may not be the most-popular way.
• Here's a specific proposal. Let's append the following to the 2nd paragraph of Chiropractic #Treatment techniques:

Medicine-assisted manipulation, such as manipulation under anesthesia, involves sedation or local anesthetic and is done by a team that includes an anesthesiologist.

and insert the following before the last sentence of the Low back pain bullet of Chiropractic #Effectiveness:

A 2008 systematic review found insufficient evidence to make any recommendations concerning medicine-assisted manipulation for chronic low back pain.

Eubulides (talk) 06:28, 12 October 2008 (UTC)

It sounds like your references need to be used on the MUA article. It would be best to improve it first. We don't need too much detail here, and a wikilink should be sufficient to help us avoid bloating that section. -- Fyslee / talk 06:36, 12 October 2008 (UTC)

You can improve another article if you want but editors are not obligated to improve another article first before improving this article. Let's mention manipulation under anesthesia here in this article. QuackGuru 06:47, 12 October 2008 (UTC)

I have refactored my comment. If an article isn't good, it needs fixing. Of course we can improve this one without improving that one, but the details need to go there, not here. We have already dealt with a bloated Treatment techniques" section by eliminating nitty gritty details and starting the section with "main article" links. Let's not go against our previous decision. That article is where the details need to go. That is my main point. I have already made it clear that MUA can be mentioned here, but only briefly. A very short sentence should be enough. -- Fyslee / talk 07:01, 12 October 2008 (UTC)

Unless I'm missing something, the above comments don't disagree with the proposed text. The proposed text mentions medicine-assisted manipulation, a more-general term that includes manipulation under anesthesia as a special case. That is, the proposed text uses a brief summary style and avoids bloating Chiropractic (which is what Fyslee's comment asks for), and it also (indirectly) mentions MUA (which is what QuackGuru asks for). Eubulides (talk) 13:31, 12 October 2008 (UTC)

It doesn't create bloating, but is missing the wikilink, which is standard practice here. Refusing to wikilink to another article because of questions regarding the quality of that article is a POV editorializing decision, and indicates that the article needs improvement, not that we should refuse to wikilink. The MAM terminology is very, very rare compared to MUA, and the more common MUA terminology, especially within chiropractic, should be preferred for chiropractic articles. -- Fyslee / talk 16:23, 12 October 2008 (UTC)

OK, I added the wiklink to the proposed text. That article is bad, and I disagree that one has an obligation to wikilink to bad articles, but I suppose the article could be improved later. Eubulides (talk) 16:42, 12 October 2008 (UTC)

I wouldn't say "obligation to", but it's standard practice here. That article definitely needs improvement, and inclusion of your sources there would help to improve it. Including information and links about the relatively rare MAM terminology would also improve it. The MUA wikilink serves as a substitute for source linking here, since inclusion here is merely an uncontroversial mention of MUA as an interesting technique, which differs from all other chiropractic techniques in that it involves the (for chiropractic forbidden) use of drugs and the direct oversight and involvement of MDs, especially anesthesiologists.

Using wikilinks and very minimal mention helps to avoid bloating the "techniques" section, which was a potentially serious problem before we shortened it. It's all about how to avoid article and section bloat. We chose to move all the nitty gritty details, explanations, and most of the documentary references to their respective articles, and also to add "main article" links. This approach has served readers well by giving them a brief overview of the subject and wikilinks to the relevant articles for those who wish more information. -- Fyslee / talk 18:15, 12 October 2008 (UTC)

Interesting articles

• James J. Lehman, DC, MBA and Paul J. Suozzi, PhD. "Founding Integrative Medicine Centers of Excellence: One Strategy for Chiropractic Medicine to Build Higher Cultural Authority." J Chiropr Educ. 2008 Spring; 22(1): 29–33. PMC 2384195

• William Meeker, DC, MPH, FICC. "Cultural Authority, Best Practices, and Chiropractic Theory: A Dilemma for Chiropractic?." Dynamic Chiropractic – January 29, 2005, Vol. 23, Issue 03

-- Fyslee / talk 04:42, 12 October 2008 (UTC)

Proposed changes from Murphy et al. 2008

Here are some changes proposed as a followup to the above discussion in #Gallup Poll revisited:

• Make the following changes to the last paragraph of Chiropractic #Education, licensing, and regulation (new text in italics):

A 2008 commentary proposed that the chiropractic profession actively regulate itself to combat abuse, fraud, and quackery, which are more prevalent in chiropractic than in other health care professions, violating the social contract between patients and physicians. A study of California disciplinary statistics during 1997–2000 reported 4.5 disciplinary actions per 1000 chiropractors per year, compared to 2.27 for MDs; the incident rate for fraud was 9 times greater among chiropractors (1.99 per 1000 chiropractors per year) than among MDs (0.20).

• Make the following changes to the last sentence of the first paragraph of Chiropractic #Utilization, satisfaction rates, and third party coverage, and break it into a new paragraph instead of being appended to the previous paragraph (new text in italics):

Chiropractic does not have the same level of mainstream credibility as other healthcare professions. Public perception of chiropractic compares unfavorably with mainstream medicine with regard to ethics and honesty: in a 2006 Gallup Poll of U.S. adults, chiropractors rated last among seven health care professions for being very high or high in honesty and ethical standards, with 36% of poll respondents rating chiropractors very high or high; the corresponding ratings for other professions ranged from 62% for dentists to 84% for nurses.

• Make the following change to the last sentence of the first paragraph onf Chiropractic #Philosophy (new text in italics):

However, most practitioners currently accept the importance of scientific research into chiropractic, and most practitioners are "mixers" who attempt to combine the materialistic reductionism of science with the metaphysics of their predecessors and with the holistic paradigm of wellness; a 2008 commentary proposed that chiropractic actively divorce itself from the straight philosophy as part of a campaign to eliminate untestable dogma and engage in critical thinking and evidence-based research.

Eubulides (talk) 16:42, 12 October 2008 (UTC)

X-rays

Chiropractors use them (some critics say "too often"). Historically, the profession is credited with much of the advances in the field of Radiology.

• Could we use a study about chiropractor's use of X-rays in this article? (i.e. to support a statement such as "According to study A, chiropractic use of X-ray is regarded as safe/dangerous"?
• Could we use a study about X-ray use in general (not necessarily performed by chiropractors) in this article? (i.e. to support a statement such as "According to study A, the use of X-rays is safe/dangerous")?

I am thinking about this in terms of WP:NOR, but I am interested in any input about any policies as well regarding this. -- Levine2112 ^discuss 19:24, 10 October 2008 (UTC)

I think it'd be helpful to put in a brief discussion of chiropractic and X-rays. The topic is already discussed in Chiropractic #History but only from a historical viewpoint, and it'd be helpful to cover it from today's. Sources that we might want to take a look at include French et al. 2003 (PMID 17987210) and Ernst 2002 (PMID 9616232).

I am a bit leery about using Ernst so much. His bias is of concern and with so much from him already going into this article, there is a legitimate WP:WEIGHT concern. Anyhow, while I want to pursue this conversation, I would really like to use this space to discuss my two hypothetical scenarios above. It seems like you would say "Yes" to scenario 1, given your post; but what about scenario 2. Could we put the conclusions of a general (non-chiropractic) X-ray study here and discuss the relative safety of X-rays based on that study? For instance, let's say we found a review of literature which says X-rays are completely safe. Could we include that conclusion in this article where we are talking about chiropractors use of X-rays? -- Levine2112 ^discuss 07:49, 11 October 2008 (UTC)

Lets stay on topic. The Ernst ref is relevant and freely readable too. Click on Begin manual download if it does not go straight to the PDF file. QuackGuru 18:14, 11 October 2008 (UTC)

As a matter of fact,t he topic of this thread is what I defined it to be when I started it. Could you answer it please? -- Levine2112 ^discuss 18:29, 11 October 2008 (UTC)

I will answer your question the the form of a question. Do you think X-rays are strongly associated with chiropractic to the same degree as spinal manipulation according to the expert reviewers? QuackGuru 17:35, 15 October 2008 (UTC)

I don't know. I have not looked at the expert reviewers take on X-rays and chiropractic. Does that really matter in the case of my hypothetical question above? -- Levine2112 ^discuss 17:43, 15 October 2008 (UTC)

It may be best for you to strike your questions. You don't know what experts think about this and you claim: Does that really matter in the case of my hypothetical question above? At this point, I don't see any reason to continue a discussion on this hypothetical question. Time to move on. QuackGuru 17:57, 15 October 2008 (UTC)

I suggest you strike out your repeated hypothetical question too. It serves no purpose to the OR discussion here. The noticeboard is not a policy page or for general discussion. QuackGuru 18:06, 15 October 2008 (UTC)

This is an attempt to discuss policy and people's understanding of such policy. NORN is the perfect place to do that, I think. -- Levine2112 ^discuss 19:16, 15 October 2008 (UTC)

Scope of practice 4

The following proposal builds on the wording proposed in #"Limited scope of practice" (version 3), and also the wording proposed in #Fixing first paragraph under EFFICACY. In #Comments on "Limited scope of practice" (version 3) it was suggested to "Please tweak it and let's see what your version looks like". As I mentioned toward the end of that section, more surgery than a "tweak" is needed. The current proposal (below) make several changes to Chiropractic #Scope of practice, instead of merely appending text to it. Here is the proposal:

• Move the following sentence from Chiropractic #Effectiveness, to Chiropractic #Scope of practice as shown in the proposed (modified) wording below:

No single profession "owns" spinal manipulation and there is little consensus as to which profession should administer SM, raising concerns by chiropractors that orthodox medical physicians could "steal" SM procedures from chiropractors; the focus on SM has also raised concerns that the resulting practice guidelines could limit the scope of chiropractic practice to treating backs and necks.

• Move the following (modified) text from Chiropractic #Scope of practice to the end of 2nd paragraph of Chiropractic#Education, licensing, and regulation, as it talks about education rather than scope-of-practice:

Specialty training is available through part-time postgraduate education programs such as chiropractic orthopedics and sports chiropractic, and through full-time residency programs such as radiology or orthopedics.

• Move the following (modified) text from Chiropractic #Scope of practice to the beginning of 3rd paragraph of Chiropractic#Education, licensing, and regulation, as it is more relevant to accreditation than to scope of practice, and it will then immediately precede text that talks about the U.S., etc.

Chiropractic is established in the U.S., Canada, and Australia, and is present to a lesser extent in many other countries.

• Replace Chiropractic #Scope of practice with the following:

Scope of practice

Chiropractors, also known as doctors of chiropractic or chiropractic physicians in many jurisdictions, emphasize the conservative management of the neuromusculoskeletal system without the use of medicines or surgery, with special emphasis on the spine. Chiropractic combines aspects from mainstream and alternative medicine: although chiropractors have many attributes of primary care providers, chiropractic has more of the attributes of a medical specialty like dentistry or podiatry. It has been proposed that chiropractors specialize on nonsurgical spine care, instead of attempting to also treat other problems; but the more-expansive view of chiropractic is still widespread. Mainstream health care and governmental organizations such as the World Health Organization consider chiropractic to be complementary and alternative medicine (CAM); however, a 2008 study reported that 31% of surveyed chiropractors categorized chiropractic as CAM, 27% as integrated medicine, and 12% as mainstream medicine.

The practice of chiropractic medicine involves a range of diagnostic methods including skeletal imaging, observational and tactile assessments, and orthopedic and neurological evaluation. A chiropractor may also refer a patient to an appropriate specialist, or co-manage with another health care provider. Common patient management involves spinal manipulation (SM) and other manual therapies to the joints and soft tissues, rehabilitative exercises, health promotion, electrical modalities, complementary procedures, and lifestyle counselling.

Chiropractors cannot write medical prescriptions or perform major surgery. In the U.S. their scope of practice varies by state in areas such as conducting laboratory tests or diagnostic procedures, dispensing dietary supplements, and using other therapies such as homeopathy and acupuncture; in the state of Oregon they can become certified to perform minor surgery and to deliver children via natural childbirth. A 2003 survey of North American chiropractors found that a slight majority favored allowing them to write prescriptions for over-the-counter drugs. A related field, veterinary chiropractic, applies manual therapies to animals and is recognized in a few U.S. states, but is not recognized by the American Chiropractic Association as being chiropractic.

Spine care is offered by several other professions, including massage therapists, osteopaths, and physical therapists. No single profession "owns" spinal manipulation and there is little consensus as to which profession should administer SM, raising concerns by chiropractors that orthodox medical physicians could "steal" SM procedures from chiropractors. A focus on evidence-based SM research has also raised concerns that the resulting practice guidelines could limit the scope of chiropractic practice to treating backs and necks. Some U.S. states prohibit physical therapists from performing SM, some states allow them to do it only if they have completed chiropractic training, and some states allow only chiropractors to perform SM, or only chiropractors and physicians. Bills to further prohibit non-chiropractors from performing SM are regularly introduced into state legislatures and are opposed by physical therapist organizations.

Eubulides (talk) 07:38, 11 October 2008 (UTC)

That sounds pretty good to me. There is one point at which I hesitate, and that is where the word "steal" could be understood to mean that chiropractic already owns SM, which is not the case. They are seeking to own it by preventing other professions from using it. It's a Liebensraum political move. One cannot steal something from someone who doesn't own it. SM predates chiropractic and has been used by other professions for a long time, in some cases before chiropractic came into existence. The Villanueva cite should include a URL to the whole article, if possible. -- Fyslee / talk 00:14, 12 October 2008 (UTC)

Thanks for catching that. The proposal doesn't talk about stealing SM, it talks about stealing SM procedures. To make this point clearer I replaced "There is little consensus as to which profession should administer spinal manipulation," with "No single profession "owns" spinal manipulation," in the proposal. The cited source supports both wordings, but the latter is clearer on this point (and is much easier to read to boot). Eubulides (talk) 06:28, 12 October 2008 (UTC)

The wording change is confusing. It sounds as if there is a concern over who owns SM. QuackGuru 06:55, 12 October 2008 (UTC)

Sorry, I don't see the confusion. There is a concern over who "owns" SM. Some chiropractic groups do want to "own" it; after all, SM is chiropractic's core treatment form, and it's the reason chiropractic exists. Conversely, PTs, MDs, DOs, etc. dispute the "ownership", and say they can do SM as well. The mainstream consensus is that no group "owns" SM, which is what the new text says. However, if the new text is confusing to you, perhaps we should go back into the old text. It's been that way in the article for months, and I'd rather not have this overall edit be sidetracked by a question over whether this particular change is confusing. Eubulides (talk) 13:31, 12 October 2008 (UTC)

I think we should keep the updated version. The attempts to gain "ownership" by chiropractic goes against the grain of how medicine historically works. Mainstream, authorized professions have always reserved the right to use or adopt any method that is effective or has some legitimacy, or even if not totally proven yet, using it as an experimental treatment, with MDs having absolute rights in this regard, and subordinate professions like PTs choosing to concentrate on methods within their scope of practice, which is why SM is a logical part of their armamentarium of treatment techniques. Any method, including currently alternative medicine methods, ceases to be "alternative" and becomes mainstream if proven effective, and thus becomes legitimate game for mainstream professions. If I had access to the full text version I'd be able to contribute more effectively here. -- Fyslee / talk 18:35, 12 October 2008 (UTC)

Me thinks we should keep the original version and if editors agree we can add the new material No single profession "owns" spinal manipulation. right before the old material for context. QuackGuru 02:30, 13 October 2008 (UTC)

OK, thanks for the suggestion, I did that. Eubulides (talk) 07:06, 15 October 2008 (UTC)

Proposed addition re X-ray safety

There's been some discussion on procedural grounds about a hypothetical example involving chiropractors and X-rays. That topic is clearly relevant and notable to Chiropractic, so I propose to append the following text to Chiropractic #Safety, as a new paragraph. This is not intended to be a hypothetical example: this is a real proposal to improve the article.

Chiropractors sometimes employ diagnostic imaging techniques such as X-rays and CT scans that rely on ionizing radiation; practice guidelines aim to reduce unnecessary radiation exposure, which causes cancer in proportion to the amount of radiation received.

Eubulides (talk) 20:45, 15 October 2008 (UTC)

Network Chiropractic

Is network chiropractic sufficiently noteworthy to be mentioned?

http://www.associationfornetworkcare.com/whatisnsa.shtml Campingcar (talk) 13:12, 19 October 2008 (UTC)

Currently Chiropractic #Treatment techniques lists only adjustive procedures received by more than 20% of patients of licensed U.S. chiropractors in the survey reported in Christensen & Kollasch 2005 (PDF), and neither Network Chiropractic Technique nor Network Spinal Analysis make that cut. There are a whole bunch of chiropractic techniques and we don't have room here to list them all. According to Table 10.12 of that source, Pierce-Stillwagon and Meric (which also didn't make the cut) are more popular than NCT or NSA (which I assume are are lumped into "other"). Eubulides (talk) 06:30, 20 October 2008 (UTC)

Thanks for the explanation.Campingcar (talk) 14:26, 20 October 2008 (UTC)

You might consider starting a separate article just for Network chiropractic. See if you can find third-party sources (not just ones promoting Network chiropractic) which discuss the topic. If you are able to find some good ones, then it might pass the WP:N threshold for article creation. -- Levine2112 ^discuss 02:12, 22 October 2008 (UTC)

Sounds like a good idea. There might be enough V & RS, so give it a try Campingcar. You could start it in a sandbox in your userspace and seek help and comments there. Then when it seems good enough to pass muster without immediately getting nominated for deletion, you can "go public" with it. Here's a sandbox for you to start with, if you wish:

• Network Spinal Analysis

Just start adding what you find there and format it like any other decent article. Good luck. -- Fyslee / talk 04:48, 22 October 2008 (UTC)

Possibly misleading text or a weight violation from a source was added without discussion or consensus

Please revert and discuss major changes to the text. Or are we back to being WP:BOLD for this article. We can remove the controversy template that is towards the top of the talk page if editors agree. QuackGuru 01:53, 18 October 2008 (UTC)

• No, the usual style for Chiropractic is that we discuss possibly-controversial changes on the talk page, giving other editors adequate time to think and comment about the changes, before installing them. That was done for the previous version of the text in question: in Talk:Chiropractic/Archive 28 #Misleading sentence, four editors discussed an older version, proposed and refined the previous version over a period of eight days, achieved consensus, and eventually installed the change.
• In contrast, the edit you refer to simply installed a controversial change without discussion. This isn't a good way to proceed, for obvious reasons. I reverted the edit and am copying it here for further discussion (inserted text in italics):

A 2002 review of randomized clinical trials of SM was criticized for not distinguishing between studies of SM in general, and studies on chiropractic SM in particular chiropractic SM in particular and studies of SM in general - most of which do not relate to chiropractic SM;

• The inserted text incorrectly summarizes Ernst 2002 (PMID 12379081), the cited source, for two reasons:

• Ernst 2002 nowhere says that these 43 trials are "studies of SM in general".
• As was explained repeatedly[14][15][16][17] in #RfC comments, Ernst 2002 is not referring to "most" of the "studies of SM in general"; it is clearly referring to just the 43 SM randomized controlled trials cited by Meeker & Haldeman (PMID 11827498).

• Levine2112 originally claimed Ernst wrote that most studies of SM are not relevant to chiropractic SM,[18] and responded to the explanations to the contrary (documented in the previous bullet) at first by disputing them[19][20] and then by saying "As you know, I continue to disagree with you on this point. Enough said."[21]
• Given that Levine2112 knew that the edit was controversial, it is disappointing to see that the edit was installed anyway, despite consensus on the talk pages that potentially-controversial changes should be discussed here first. I urge that we stick with that consensus; otherwise, editing on Chiropractic will degenerate back to the revert-war-happy state that it had not so long ago.
• I don't see an easy way to repair the edit above, other than by reverting. Perhaps another editor can come up with better wording. But please propose it here first, rather than installing it; this is a controversial area.

Eubulides (talk) 05:59, 18 October 2008 (UTC)

I read the source and what Levine wrote is documented in the source. . . may be we should just quote the source. . . that way there is no room for interpretation.TheDoctorIsIn (talk) 20:35, 18 October 2008 (UTC)

This edit is very misleading. The source does not support the change. Please specify where in the source documented this or revert your edit. QuackGuru 23:11, 18 October 2008 (UTC)

The way to settle this needs to start with an analysis of the source and the two conflicting edits. See below and comment there. -- Fyslee / talk 04:01, 19 October 2008 (UTC)

Analysis of the source and other versions

• "... The authors also claim that 43 randomized, controlled trials of spinal manipulation for back pain have been published, but they fail to mention that most of them do not relate to chiropractic spinal manipulation." - Original Annals of Internal Medicine source

Various versions:

• "... has been criticized as being misleading for failing to mention incorporation of data derived from studies of SM that do not relate to chiropractic SM;..." - Previous version
• "... was criticized for not distinguishing between studies of SM in general, and studies on chiropractic SM in particular;..." - Consensus version
• "... was criticized for not distinguishing between studies of chiropractic SM in particular and studies of SM in general - most of which do not relate to chiropractic SM;..." - version proposed by TheDoctorIsIn and Levine2112

Analysis comments

• Again, the source is not referring to "most" of the "studies of SM in general"; it is clearly referring to just the 43 SM randomized controlled trials cited by Meeker & Haldeman (PMID 11827498). This has been explained several times.[22][23][24][25] in #RfC comments. No explanation to the contrary has been presented.
• I see that the incorrect version has again been installed, again without discussion here in advance, with the only comment being that the claim is "documented in the source". This claim is clearly not at all documented in the source; the source does not at all say that "most" "studies of SM in general" "do not relate to chiropractic SM".
• Again, the usual style for Chiropractic is that we discuss possibly-controversial changes on the talk page, giving other editors adequate time to think and comment about the changes, before installing them. Please do that here. It is not helpful to repeatedly apply this incorrect change.
• By the way, it's not correct to call the first version "Eubulides' version". That text was originally proposed by TimVickers here, and was the product of a consensus of four editors arrived at during a discussion over a period of several days (see Talk:Chiropractic/Archive 28 #Misleading sentence). More accurate would be "consensus version".
• For reference, here's the version that was in place before the consensus version was installed. Perhaps it can be used to come up with a compromise version.

"... has been criticized as being misleading for failing to mention incorporation of data derived from studies of SM that do not relate to chiropractic SM;..."

Eubulides (talk) 07:21, 19 October 2008 (UTC)

Noted and changed. -- Fyslee / talk 16:23, 19 October 2008 (UTC)

Sorry if my edit seemed WP:BOLD, but I figured that we had discussed Ernst's quote ad nauseum, so making the tweak to reflect what I feel he is saying was no more controversial than what leaving what another editor interprets Ernst to mean. I saw it suggested - I believe in TDII's edit summary - that we simply quote Ernst rather than interpret what he is saying in his criticism. Clearly we disagree with what he is saying and we may never agree. Perhaps quoting is the best solution. How about this?

A 2002 review of SM was criticized because it claimed "that 43 randomized, controlled trials of spinal manipulation for back pain have been published," but failed "to mention that most of them do not relate to chiropractic spinal manipulation"; however the review's authors stated that they did not consider this difference to be a significant point as research on SM is equally useful regardless of which practitioner provides it.

Reasonable? -- Levine2112 ^discuss 02:08, 22 October 2008 (UTC)

At first glance this seems like a good solution. What say others? -- Fyslee / talk 04:38, 22 October 2008 (UTC)

Stricken in lieu of Eubulides correct analysis of the situation. My comments were indeed a quick "first glance"! -- Fyslee / talk 19:32, 22 October 2008 (UTC)

The current writing style for this article is it to avoid quotes. Stating it claimed is not the way I would write the sentence. What is the point to say "most of them do not relate to chiropractic spinal manipulation"? That point can easily be misleading if the reader reads it wrong. The reader could think it means that most SM research does not relate to chiropractic spinal manipulation when we know that is false. The neutrally written and consensus version is: A 2002 review of randomized clinical trials of SM[35] was criticized for not distinguishing between studies of SM in general... QuackGuru 04:55, 22 October 2008 (UTC)

• Certainly the quote marks are not necessary. Worse, in the proposed wording the quote marks are quite misleading, since they imply that the quote "43 randomized, controlled trials of spinal manipulation for back pain have been published," comes from Meeker & Haldeman 2002, which is certainly not the case. (Also, as a quibble, the Wikipedia style is to not put wikilinks in direct quotations.)
• Furthermore, this proposal seems to be ignoring Talk:Chiropractic/Archive 28 #Misleading sentence, the talk-page discussion that established consensus for the current wording. The earlier discussion said that the earlier wording "Some of this research has been criticized as being misleading for failing to mention incorporation of data derived from studies of SM that do not relate to chiropractic SM" was confusing, which it was. And yet this proposal merely resurrects the confusing wording, albeit with some misleading quote marks added to it (which makes things even more confusing). That is a step in the wrong direction. We need a better proposal, not one that is worse than what we had before the current wording.

Eubulides (talk) 06:22, 22 October 2008 (UTC)

Let's see. What could possibly be more misleading? A direct quote or an editor's interpretation of the quote? This material is contentious because we each have different interpretations of what it means. So let's just quote it and be done with it. It really is the most reasonable course of action here which will ensure that no editor is putting a POV twist on the quote's meaning. -- Levine2112 ^discuss 07:56, 22 October 2008 (UTC)

Certainly a direct quote can be more confusing if (as is the case here) it is cited so poorly that it appears to be from a different source than what it's really from. And there is nothing inaccurate or confusing about the consensus summary in Talk:Chiropractic/Archive 28 #Misleading sentence of what the source says. That summary is much briefer and clearer than the proposed replacement, and is therefore better suited for an encyclopedic article. Eubulides (talk) 08:11, 22 October 2008 (UTC)

I disagree that the summary is more accurate or clearer than the quote. I don't agree that the summary is an accurate depiction of the source. Can you explain how the quote is cited poorly and how it appears to be from a different source than what it's really from? Can you suggest any improvements using the quote? -- Levine2112 ^discuss 17:09, 22 October 2008 (UTC)

• The consensus in Talk:Chiropractic/Archive 28 #Misleading sentence is that the currently-installed text is clearer. If we can further improve it, that would be good, but simply reverting to the previous version (even with a couple of quote marks added) would go against that consensus.
• The proposed revision starts off this way:

'A 2002 review of SM was criticized because it claimed "that 43 randomized, controlled trials of spinal manipulation for back pain have been published,"...'

• This proposed wording makes it appear that the 2002 review of SM contains the text "that 43 randomized, controlled trials of spinal manipulation for back pain have been published". But it doesn't contain that wording.
• If words along the lines of the proposal are to be included, I suggest starting with the wording that was present before the consensus version was installed. This wording does not use the misleading quote marks. Here's the previous wording:

'A 2002 review of SM has been criticized as being misleading for failing to mention incorporation of data derived from studies of SM that do not relate to chiropractic SM;...'

• The problem with this previous wording, as mentioned in Talk:Chiropractic/Archive 28 #Misleading sentence, is that it's confusing.
• Part of the confusion, I think, is that the surrounding discussion is quite general and then all of a sudden the text breaks into a very specific criticism of one relatively-old review. It would be better if we could keep the discussion general, always of course citing reliable sources. (This problem of confusion also exists in the current consensus wording, but it's a smaller problem there.)
• Perhaps you can think of a way to merge the clearer wording in the Talk:Chiropractic/Archive 28 #Misleading sentence consensus with the point discussed in the previous-to-consensus wording.

Eubulides (talk) 18:36, 22 October 2008 (UTC)

Please do me a favor so that I know you and I are on the same page. Please provide the quote of Ernst's in full which you believe I have quoted in part above. -- Levine2112 ^discuss 19:12, 22 October 2008 (UTC)

I did not state that the quote was from Ernst 2002 (PMID 12379081), nor have I checked whether the quote came from Ernst. The problem is that, with the proposed wording, the quote appears to come from Meeker & Haldeman 2002 (PMID 11827498), which it does not. At any rate, please think over the comments and suggestions above. Eubulides (talk) 20:51, 22 October 2008 (UTC)

Please proposed rewording so that the qoute is depicted more faithfully then. -- Levine2112 ^discuss 21:27, 22 October 2008 (UTC)

I disagree with having quotes. QuackGuru 21:34, 22 October 2008 (UTC)

(outdent)If a verbatim quote is seen as confusing by some editors, summary text cannot be agreed on, and even the meaning of the quote cannot be agreed on, then perhaps there is no consensus for inclusion? Why not just leave it out? --Surturz (talk) 11:27, 22 October 2008 (UTC)

There is consensus for the current version. The current version was included due to consensus and is much clearer. The new proposal is misleading. I disagree with deleting the consensus version. QuackGuru 16:04, 22 October 2008 (UTC)

There may have been consensus for that version, but consensus can change. It appears that there is no longer consensus for that version. DigitalC (talk) 01:02, 23 October 2008 (UTC)

So what version do you think has consensus? I think consensus has not changed. The current version is the consensus version IMHO. QuackGuru 01:07, 23 October 2008 (UTC)

I am not sure that consensus currently exists for any version. DigitalC (talk) 06:08, 23 October 2008 (UTC)

Most editors prefer the current version IMHO. QuackGuru 06:12, 23 October 2008 (UTC)

A majority opinion and a consensus are not the same thing. Consensus develops from agreement of the parties involved. You should know this by now. DigitalC (talk) 06:39, 23 October 2008 (UTC)

There was broad consensus for the current version. See Talk:Chiropractic/Archive 28 #Misleading sentence. Consensus has not changed. QuackGuru 06:43, 23 October 2008 (UTC)

3 editors does not make a broad consensus, and editors that did not respond then have responded now, so consensus HAS changed. Are you misrepresenting this on purpose? I believe a quote, or something more verbatim would be better. DigitalC (talk) 06:50, 23 October 2008 (UTC)

There were 4 editors back then, not just 3. Clearly the consensus that existed back then no longer exists, but there is no consensus for a new version either. Let's work together here in coming up with a new version. Eubulides (talk) 07:29, 23 October 2008 (UTC)

There were 4 editors, but one did not provide any comments towards a consensus other than that the paragraph should be reworded, which is hardly support for the current version. I may have missed this editors support for the current version ELSEWHERE, but it doesn't exist at the link provided. In fact, only one editor responded to the version you provided, and that was QuackGuru. I agree that we need to work together to a mutually agreeable version. DigitalC (talk) 09:55, 23 October 2008 (UTC)

Consensus has not changed to a different version and most editors are against the quotes. DigitalC, what is the problem with the current version and why would you think the quotes taken out of context is better? I don't think we need to continue to work towards a newer version when the current version is accurate and nothing proposed is as good as the current version. No problems have been pointed out with the current version but the quotes are problematic. QuackGuru 17:20, 23 October 2008 (UTC)

No one is stating that consensus has changed to a different version, however you are ignoring consensus that we need to work towards a better version. I don't believe that the quotes are taken out of context, and I do believe the current version is an inadequate summary. I believe it is very important that we include "most of them do not relate to chiropractic spinal manipulation", because this is quite relevant. You have not replied to my question as to whether you were misrepresenting the "broad consensus" on purpose. DigitalC (talk) 21:50, 23 October 2008 (UTC)

We don't need to work towards changing the current version when no problem with the current has been shown and no better version has been proposed. The better version is the current version. It was already worked on and improved. See Talk:Chiropractic/Archive 28 #Misleading sentence. The suggestions made here are not improvements. We have established consensus for the current version and I disagree with the proposed changes. QuackGuru 22:54, 23 October 2008 (UTC)

Consensus does not exist for the current version, please do not misprepresent that it does. You have still failed to answer whether you were purposely misrepresnting the "broad consensus". DigitalC (talk) 00:57, 24 October 2008 (UTC)

More potentially controversial edits

Here is the next possibly controversial edit for today. This changed or added text without a reliable reference. However, that section of the article has always been difficult to find highly reliable references. QuackGuru 23:22, 18 October 2008 (UTC)

Here are the conflicting edits:

• "Straight chiropractors believe that vertebral subluxation leads to interference with an "Innate Intelligence" within the human nervous system and is a primary underlying risk factor for almost any disease. Straights view the medical diagnosis of patient complaints (which they consider to be the "secondary effects" of subluxations) to be unnecessary for treatment." - Original

• "Straight chiropractors believe that vertebral subluxation leads to interference with an "Innate Intelligence" normally communicated through the human nervous system. This interference creates a state of dis-ease (loss of homeostasis) within the body and is a primary underlying risk factor for almost any disease. Straights view the medical diagnosis of patient complaints (which they consider to be the "secondary effects" of subluxations) to be unnecessary in providing chiropractic care." - New version by anon IP

Let's analyze these and figure out which is closer to the truth of the straight position, and if it is justified by the source that has been used (). I have emphasized the changes in bold letters. -- Fyslee / talk 04:10, 19 October 2008 (UTC)

• The first change, '"Innate Intelligence" within normally communicated through the human nervous system', has some justification but is not quite right. The source says "Innate, he [D.D. Palmer] believed, was an intelligent entity which directed all the functions of the body, and used the nervous system to exert its influence." A better change would be 'Innate Intelligence" within exerted via the human nervous system'.
• The second change, "This interference creates a state of dis-ease (loss of homeostasis) within the body and is a primary underlying risk factor for almost any disease." is not supported by the cited source: it mentions "dis-ease" as the result of inflammations, but does not connect it to homeostasis. Also, the second change would modify Wikipedia so as to appear to endorse the theory of the straights, which we can't do.
• The third change, "unnecessary for treatment in providing chiropractic care" is I guess distinguishing chiropractic treatment from medical treatment, which has some justification. However, here's a shorter and better change: "unnecessary for chiropractic treatment".

Eubulides (talk) 06:30, 20 October 2008 (UTC)

• I for one am sad to see this edit removed. I laughed, anyway. --Surturz (talk) 02:25, 24 October 2008 (UTC)

General comments and observations

I'm beginning to notice a pretty disturbing pattern on this page. Conscientious editors are being thwarted at almost every turn by certain editors who keep using consensus (or supposed "lack" of consensus) as a bludgeon prevent others from working together collaboratively. Things have gotten so bad that entire sections of this talkpage are devoted to utterly inane discussions of whether an certain number of opinions for/against an idea constitute a "consensus". Dumb.

I think a moratorium on discussing what is/isn't "according to consensus" needs to be put in place with enforcement by administrators. I think Shell would be a good choice for doing this. I suggest that every comment about the "consensus" should be removed, redacted, or hidden from this page so as to encourage people to be able to discuss content and edits on the merits of their sourcing, reliability, verifiability, neutrality, and prominence. Those are the Wikipedian principles that should govern the writing of an article. Attempting to write an article "by consensus" is a recipe for creating a terrible article and encourages the kind of gaming I see evident all over this talk page.

ScienceApologist (talk) 17:26, 26 October 2008 (UTC)

Welcome to the circus. Glad you noticed. Can you enlist help? We're stuck in a vicious circle that needs to be broken through massive outside intervention, probably of the hardhanded variety. -- Fyslee / talk 19:18, 26 October 2008 (UTC)

I'll cross-post to WP:FTN, but arbitration may be your best bet. ScienceApologist (talk) 19:45, 26 October 2008 (UTC)

Yes, we should stop arguing about it, as long as claims of consensus are not used as a bludgeon for trying to force change in the article. In such a case it is relevant whether or not there is consensus, and for what. But consensus is necessary to edit in Wikipedia. If that makes terrible articles, we're stuck with that. ——Martin^phi ☎ Ψ Φ—— 21:06, 26 October 2008 (UTC)

NB, arbitration (WP:ArbReq) is not intended to solve editorial differences:

The committee accepts cases related to editors' conduct (including improper editing) where all other routes to agreement have failed, and makes rulings to address problems in the editorial community. However it will not make editorial statements or decisions about how articles should read ("content decisions"). Please do not ask the committee to make these kinds of decisions, as they will not do so.[]

Since, as far as I can see this really is an editorial content dispute there is no choice but to continue discussion. Malcolm Schosha (talk) 21:13, 26 October 2008 (UTC)

Me and Shell are just fine at reading consensus where necessary, as far as I can tell. I'm not inclined to ban the use of consensus as an arguing point, but I'm perfectly happy to give a hand reading consensus if asked (preferably at my talk page). I agree that consensus has been used as a bludgeon on this article to prevent forward movement, and this behavior needs to stop (I prefer not to single out which editors have been doing it). Overall, I very highly suggest working towards some sort of compromise or discussing very specific situations rather than this large meta- issue is the way to move forward; there is a lack of consensus overall on the meta- issue of OR at this article, and this does not seem likely to change, as editors here have deeply seated views on the subject. Cheers, everyone. lifebaka++ 20:28, 27 October 2008 (UTC)

How about a compromise on the SM issue?

As far as I can tell from the time I've spent watching this page, there isn't a strong consensus as to whether or not general SM reviews can be used in this article without violating WP:OR. Mostly there are two camps on this: the first says that any use of general SM reviews is OR and not acceptable, the second says that any use of these reviews is not OR and is acceptable. Depending on which RFC or section is pointed to, the rough consensus appears to change; this is usually a strong sign that actual consensus on the issue isn't present. So, how about a compromise? It seems to me that there must be a middle ground between the two stances, and if an acceptable middle ground can be found everyone should be happy (at least marginally).

From what I've read, I believe that the following is a reasonable compromise. Keep in mind that this is only my editorial opinion and is in no way official. I also apologize if it is worded poorly.

My suggested compromise is to determine which exact types of SM chiropractors use, and then allow general studies about those forms of SM to be used in this article. In the most recent RFC, it was stated that when chiropractors and other professionals use the same technique, there are not significant differences between them. It therefore seems appropriate that these techniques specifically are considered directly related to chiropractic, and only general SM reviews (or parts thereof) which are about these techniques can be used in the article.

Anyways, I'm sure the regulars here can come up with a better compromise, I just thought I'd prime discussion with one of my own. Cheers, guys. lifebaka++ 19:44, 22 October 2008 (UTC)

• As far as we know all the spinal-manipulation sources currently cited in Chiropractic are based on data derived from techniques used by chiropractors. So I'm afraid we can't partition the studies in the way that you suggest. That is, the controversy arises here because some of the data was generated by non-chiropractors, not because some of the data was generated by techniques that chiropractors don't use.
• Furthermore, as far as we know there are no scientific studies on the effectiveness of individual SM techniques.
• In this respect, SM is like many other treatments. For example, acupuncture is used both by professional acupuncturists and by other professions (including MDs), and there are a zillion different acupuncture techniques (Lemington 5, Japanese Meridian, Korean Constitutional, French Energetic, etc., etc.), but reliable sources routinely amalgamate data from all professions and techniques to come to conclusions about the effectiveness of acupuncture in general. See for example, Furlan et al. 2005 (PMID 15674876).
• I agree that it would be nice to come up with some sort of compromise.

Eubulides (talk) 20:51, 22 October 2008 (UTC)

Copied from above, since it's relevant here. Levine2112 seems to miss the point of the "not exclusively an evaluation of chiropractic" quote.(Emphasis added.) The important point is the word "exclusively", ergo not 100%. Yes, most SM research includes a very, very small amount of non-chiropractor performed SM. Since chiropractors perform 90%+ of SM, and most of these studies include the SM performed by these chiropractors, the studies say much, much, much, much, more about chiropractic SM (and therefore chiropractic, and the efficacy and safety of chiropractic SM), than it says about the miniscule numbers from the few others whose numbers were included. Excluding such studies would be to exclude major sources of the existing research on the subject. There are some studies that clearly state that no chiropractor performed manipulations were included, and those might be excluded, but they are a small minority of studies. Since those aren't included at present, we have no real problem. -- Fyslee / talk 00:44, 24 October 2008 (UTC)

I feel that you are missing the point, Fyslee. If these studies are not exclusively about chiropractic (according to Ernst), then we shouldn't be using them to evaluate chiropractic. They are however exclusively about spinal manipulation. Thus it makes more sense to use them at that article. Anyhow, I am in favor of reaching a compromise. I will work my best at suggesting one and discussing other ones. -- Levine2112 ^discuss 00:50, 24 October 2008 (UTC)

My point is that you are demanding that we exclude studies that are usually about 95% chiropractic spinal manipulation (IOW "adjustments"), because they might include an extremely insignificant 5% or less non-chiropractor performed SM. To claim that they are not about or related to chiropractic SM is rather puzzling, since these are the highest quality studies that exist.

Are you really advocating that we reject the high quality studies in favor of the few low quality studies (5% more chiros) produced by chiropractors who have grown up in a tradition where rigorous scientific research skills and experience are lacking, as has been the case until very recently? There are even a few who don't understand scientific methodology and are clinging to those poor research skills, and they are producing (and publishing in) the JVSR.

Using your reasoning, it's interesting that the way to make a high quality study (5% non-DCs) into a low quality study is to just replace them with 5% DCs. Hmmm... food for thought. I guess that could imply that having no DCs in the study at all could make them astronomically high quality, but it takes more than that to make a high quality study. It takes a long tradition for producing high quality scientific research, and that is one thing the chiropractic profession lacks. Fortunately some DCs are learning (with the notable absence of the JVSR, ICA, and WCA crowd) from the medical establishment's long experience in this regard. -- Fyslee / talk 05:30, 24 October 2008 (UTC)

It doesn't matter how high quality the study is; if it doesn't specifically address chiropractic in its conclusions, we cannot apply those conclusions to chiropractic. If the researchers intent was that their study was about chiropractic, then they would've mentioned it in their conclusions. If they don't mention it in their conclusions, then we can't assume that it can be applied to chiropractic. I can find you the highest quality research on palm trees, but it doesn't mean that we should include that in an article about icebergs. So you see? I am not demanding that we exclude studies because the might include non-chiropractic performed SM (as you state above). Rather, I am suggesting that we exclude studies that make no conclusions specifcally about chiropractic (you know, the subject of this article). If the conclusions are only about spinal manipulation in general, then let's put it in that article. -- Levine2112 ^discuss 07:10, 24 October 2008 (UTC)

Since we just completed an RfC that showed a clear consensus that SM is relevant to this article, its not helpful to continue the argument that they studies aren't relevant for that reason. If you have specific concerns about text or studies being used in the article currently other than "the study was on SM, not specifically chiropractic" then please state them and give other editors a chance to address those concerns. Shell ^babelfish 07:30, 24 October 2008 (UTC)

I continue to disagree that there was a "clear consensus". I urge you to read the latest comments by Surturz and DigitalC which assert your misunderstanding of their positions. Regardless, the RfC wording made it clear that it was not about SM studies being used in this article. And further note that even some who agree that SM is relevance, qualified their response by saying that it shouldn't mean that non-chiro specific SM content should be included in the article. So my(and several other editors) concern remain that if the study made no conclusions specifically about chiropractic, then we should not be citing that conclusion in our article. If the conclusion was only about SM in general, then it would be more appropriate to cite it at Spinal manipulation. -- Levine2112 ^discuss 07:45, 24 October 2008 (UTC)

Shell Kinney, the RfC clearly stated that it was not about OR. Please do not attempt to use that RfC to quash OR arguments. If that RfC had been about OR, my response would have been much more strongly that I disagree that they are "directly related". Other responses, such as those involving personal experience, also show that the comments likely would have been different had the RfC been about OR. DigitalC (talk) 22:11, 24 October 2008 (UTC)

Agreed- the RfC said it was about a question, now people are trying to act like it was another RfC about the OR question. The Original Research policy trumps any RfC, anyway. We don't violate policy because editors want to- not that they did. They were just answering the question. Of course it's relevant, that's only common sense. (Just how it's relevant is not something we know, which is why this it is OR to use it.) Such a conclusion, the opinion of editors, isn't relevant here. ——Martin^phi ☎ Ψ Φ—— 05:34, 26 October 2008 (UTC)

Sorry if I wasn't clear, I am not suggesting that the RfC covered the OR question, what I'm asking is that arguments that say "SM isn't relevant here" or "this doesn't relate" stop. There are clearly other issues at hand and other parts of the OR discussion that need to be resolved, but the "SM doesn't belong here" argument should be put to bed. Shell ^babelfish 05:39, 26 October 2008 (UTC)

Yes, it's relevant to the extent sources say it's relevant. ——Martin^phi ☎ Ψ Φ—— 06:28, 26 October 2008 (UTC)

The argument that all the SM techniques are used in Chiro doesn't seem to address the problems of whether Chiro uses them in conjunction with other things, in different amounts etc. That's why I'd have to hear the sources saying just how relevant they are to Chiro. Surely there is one extremely good source which discusses the relationship between Chiro specifically and SM studies in general? Fyslee says "Since chiropractors perform 90%+ of SM" Is this true? I don't really think that if a study uses Chiro SM for its data that we can say that it isn't directly relevant to Chiro. The burden of evidence seems to tilt toward having to prove that they are not relevant in that case. In such a case we tell the reader the percentages in the study, perhaps. IOW, if the study was done only on chiro SM it's about Chiro SM, whether or not it says so. But we have to know what the study took into account and whether all studies were treated the same.

In such a case, what you have here is an issue of names. We don't care about the name given, that is, we can cite a study of palm trees from a country which calls palm trees "bigshrooms." If all the data for the studies is Chiro, then the studies are about Chiro. ——Martin^phi ☎ Ψ Φ—— 06:28, 26 October 2008 (UTC)

We do have reliable sources saying U.S. chiropractors do over 90% of SM. For example, see Meeker & Haldeman 2002. (Other sources could be cited.) Meeker & Haldeman also say that "research on spinal manipulation, like that on any other treatment method, is equally of value regardless of the practitioner providing it", which pretty much demolishes the argument that general SM research is irrelevant to chiropractic because it might be tainted by some non-chiropractic data. Eubulides (talk) 20:43, 28 October 2008 (UTC)

What if a group of editors disputed the assumption that palm trees and bigshrooms are the same thing? A more appropriate analogy would be if editors were including "koala bear" research in the "brown bear" article. Although they are both called bears, koala bears are marsupials and quite different from brown bears. Any non-koala "bear research" would need consensus before inclusion in an article about koalas. Similarly, chiro SM and non-chiro SM are seen to be different entities by a group of editors here. If a study shows that physios are harming their patients with a particular SM technique, it must first be proved that chiropractors are using the exact same technique before that study can be included in this article. --Surturz (talk) 00:11, 27 October 2008 (UTC)

Yes, exactly, that's correct. Let's determine those things and go from there. ——Martin^phi ☎ Ψ Φ—— 02:02, 27 October 2008 (UTC)

No, that's not quite correct. Since we don't try to determine truth, but only follow the sources, if reliable sources discuss a particular SM technique and apply this discussion to chiropractic, then so can we. We do not try to "prove" anything, we can only report what the sources say and follow their example. Tim Vickers (talk) 20:46, 27 October 2008 (UTC)

So, TimVickers, you are in favor of the strict version of WP:OR (Per Levine), in that we must only use in this article as much of the SM research as specifically states it is related to Chiro? ——Martin^phi ☎ Ψ Φ—— 22:35, 27 October 2008 (UTC)

If sources apply general SM research to chiropractic (and they do) then so should we. However, listing particular sources that you feel are a problem would be more constructive than talking in generalities. Tim Vickers (talk) 22:59, 27 October 2008 (UTC)

I thought there was basically a dispute about how much it applied. A way forward might be to explain that debate. But I cannot deal with the technical issues of this article. I'm here to try and make sure policy is followed and that we maintain calm consensus editing. As I saw it, there is a dispute about whether one can use SM studies which 1) use mostly chiro data but which include some other data and 2) don't say outright that they apply to chiro. That kind of thing I can deal with. ——Martin^phi ☎ Ψ Φ—— 23:12, 27 October 2008 (UTC)

I think Martinphi has summarized the general concern pretty well here. If a piece of spinal manipulation research which either relied on non-chiropractic data or on a mixed bag of professional data doesn't outright say that it is applicable to chiropractic, then who are we to make such an application here at Wikipedia? If the researcher didn't have the intent of making a comment on chiropractic with their research, then we should not use their research in a way which was not intended. From WP:NOR: Take care, however, not to go beyond what is expressed in the sources or to use them in ways inconsistent with the intent of the source, such as using material out of context.

I think Shell, lifebaka, and Tim Vickers make good points about discussing specifics rather than generalities. We had tried discussing some specifics in the past (like with the Murphy research), but perhaps we can frame these discussions differently. If need be, we could go sentence by sentence, source by source, and discuss each one individually to see if they comply with WP:NOR by staying consistent to the intent of the source. So in general, we will be looking for sources which are not clearly intended as evidence of the efficacy of chiropractic (the subject of the tagged section in this article). Specifically, we will be looking at each source any editor thinks may violate OR. The question is, if we follow this plan, should we take it one sentence/source at a time or list out all of the problematic content at once? Either way, I am happy to try a new method of dispute resolution here. -- Levine2112 ^discuss 23:37, 27 October 2008 (UTC)

I would think that sentence by sentence would be the better way to go. It might take longer, but it would be more manageable as there is bound to be heavy discussion even around a single source. DigitalC (talk) 23:56, 27 October 2008 (UTC)

Yes, that does sound more sensible. -- Levine2112 ^discuss 00:24, 28 October 2008 (UTC)

For the record, I had raised some specific problems in #Time_to_remove_tags above, without much response, and Levine has raised a separate problem source (Murphy) previously, without any resolution. Part of this is that if there is no agreement on the generality (should we use sources that don't make statements about chiropractic or chiropractic spinal manipulation), then there cannot be agreement on whether it is suitable to use a specific source based on that reasoning. DigitalC (talk) 23:32, 27 October 2008 (UTC)

After the previous comment was made, I responded in #Time to remove tags above. Eubulides (talk) 20:43, 28 October 2008 (UTC)

We might try a "doubt" test. I'd say "reasonable doubt," but that depends on editor's reason, and that's too fungible. If there is doubt about whether the sources applies to chiro, leave it out. However, if the source uses 100% chiro data but doesn't say the word "chiropractic," that is not actually doubt. Levine technically has it right per NOR. NOR is really absolute about things, and it should be. But at the same time, I try to be reasonably inclusive in my interpretation of it. It might very well (I don't know myself) be a good argument that "one bad apple spoils the bunch," in that even a small amount of non-chiro data might in some known or unknown way make a study less applicable to chiro. I tend to think that SM probably applies, but I would not violate NOR in a meaningful way to push that POV. ——Martin^phi ☎ Ψ Φ—— 01:29, 28 October 2008 (UTC)

You do raise an interesting and valid point that if all the data is based on chiropractic SMT, then invariably the conclusions must be relevant to chiropractic even if they don't specifically mention chiropractic manipulation. Unfortunately, the article is currently using sources like Ernst & Canter 2006, which both incorporates non-chiropractic data (or unspecific data) as well as not making statements about chiropractic spinal manipulation. DigitalC (talk) 02:10, 28 October 2008 (UTC)

I had hoped that my suggestion would prime discussion to find some sort of compromise between the two groups, but so far I haven't seen any other ideas brought forward. Feel free to continue discussion in this section if you come up with an idea, but it doesn't seem that this is in fact going to move the discussion forward at this time. Shell suggested editors making specific lists about what they feel should be corrected in the article below; this seems to be a more viable solution to the current issue. Cheers, everyone. lifebaka++ 20:35, 27 October 2008 (UTC)

Clarification of manipulation/adjustment

The article needs a short explanation of the similarities (plural) and difference (singular) between spinal manipulation (SM) and chiropractic spinal adjustment (SA). The issue is sufficiently clouded even among expert editors here that it must be even more unclear to readers, and therefore we need to make sure they understand the matter.

There are multiple physical similarities between SM/SA performed by DCs and SM by non-DCs. There is only one difference between SA performed by straight DCs, and SM performed by non-DCs, mixer DCs, and reform DCs, and that is the mental intention to "correct a subluxation". It's a philosophical distinction, not a physical one.

We need to show that chiropractors and published chiropractic research often use the terms interchangeably as synonyms, and that it is only straight chiropractors who insist on using the "adjustment" terminology, since they are the only ones who consistently adhere to the "subluxation correction" principle. Yes, other DCs may use the term, but not consistently, and pretty much never in quality research.

There are currently multiple examples of uses of the terms in the article, with a vast overweight of SM in relationship to SA, which is proper since SA is a special and esoteric term used primarily by straight chiropractors.

There are two places in the article where this can be addressed:

• Schools of thought and practice styles

• Treatment techniques

-- Fyslee / talk 05:59, 24 October 2008 (UTC)

I am concerned with how you are starting this off. It seems to be weight heavily by your own opinion rather than by reliable sources. I have already presented several non-chiropractic reliable sources which suggest that there are more than just one difference between spinal manipulation as performed by chiropractors and spinal manipulation as performed by other practitioners. For instance, Villanueva-Russell 2005 (PMID 15550303) draws the distinction between chiropractic adjustments and general manipulation:

It should be noted that chiropractors consider the technique of "adjustment" to be exclusive to their profession, and distinguish the clinical procedure as separate from the more general medical term of "manipulation," which is a more generic, often long-lever movement of joints, not restricted to the spinal vertebrae, alone.

We might also want to consider Haneline (Association of internal carotid artery dissection and chiropractic manipulation from The Neurologist 2003) where we learn the violent long-lever manipulation technique that has lead to some injuries is actually used by other practitioners and is not taught in chiropractic schools:

Violent long-lever manipulation, commonly used by untrained manipulators, is not taught in any of chiropractic institutions in the United States. This may be the reason nonchiropractic providers have been responsible for a disproportionate share of reported cases of manipulation following ICAD. CMT is a highly specialized procedure that is the focal point of the educational process of chiropractic physicians. Some would argue that osteopathic physicians are comparably trained in manipulation, yet, according to the Policy Statement on Spinal Manipulation published by the American Chiropractic Association, most osteopathic schools only offer spinal manipulation on an elective basis. This compares with chiropractic education, which devotes approximately 52% of its 4-year education to diagnosis and manipulation.

CMT encompasses short-lever, low-amplitude thrusts that are directed segmentally, and simultaneous neck extension with rotation are minimized, whereas less-formal cervical manipulation may consist of long-lever thrusts, with contact only applied to the patient’s head.

Ernst 2008 also describes the uniqueness of chiropractic spinal manipulation compared to the other numerous forms of spinal manipulation:

Numerous forms of spinal manipulation exist but "the short-lever technique-touching the vertebrae directly at high velocity and low amplitude, i.e., by moving a small distance-with the spinal or transverse process as a fulcrum, is considered the typical chiropractic manoeuver.

Chiropractic researcher Gregory Plaugher also makes this long-lever vs. short-lever distinction in his letter to the Annals of Internal Medicine following the Shekelle 2003 research ([26]):

In their excellent meta-analysis of the literature on spinal manipulation for the treatment of low-back pain, Shekelle and colleagues distinguish between long-lever rotational manipulations of the lumbar spine and the specific short-lever arm techniques more common to chiropractic practice. All studies in the meta-analysis were done in the medical or physiotherapeutic setting, and most appeared to involve long-lever rotational manipulation of the lumbar spine. The implication that all manipulation has equal value is not consistent with the diverse techniques available.

With regards to Fyslee's proposal, I hope reliable sources like these are factored in more, and editors' opinions are factored in less (if at all). -- Levine2112 ^discuss 07:35, 24 October 2008 (UTC)

It's a bit hard to know where to start, but I'll start with the easiest target, the Haneline reference, which falsely states that "Violent long-lever manipulation, commonly used by untrained manipulators, is not taught in any of chiropractic institutions in the United States." The whole article is very promotional and clearly partisan in its approach. It's a piece of damage control propaganda. The use of "violent" and "uneducated" is pretty far out well poisoning, which also ignores and diverts attention from the fact that highly educated non-DCs use short and long lever techniques in gentle and specific manners, similar to the way DCs do, but with a different - non VS - intent. It is also a fact that chiropractic institutions do teach long lever techniques, such as the lumbar roll. It also focuses on what could be construed as a straw man, the ICAD matter, which is hardly ever discussed when dealing with cervical spine injuries and strokes. Why? Because the real problem is rarely with the internal carotid artery, but with the vertebral artery, which has been implicated as a risk factor because of its intimate relation to the spine and manipulation/adjustment of the cervical spine, and in which chiropractors have long and often been implicated when documenting serious injuries and even lethal events. [27] [28]

Levine2112's claim that "long lever" techniques aren't used or taught by chiropractors is out of touch with reality. I have multiple times observed chiropractors using long lever techniques. Here are a few references that are more than enough to falsify his claim and the claims of Haneline, thus showing the Haneline reference to be an "un"Reliable Source.:

• "Manual force, mechanically assisted articular chiropractic technique using long and/or short level contacts." [29]

• "Chiropractors use all forms of manipulation." [30] Meeker & Haldeman, 2002

• "SPINAL MANIPULATION: THE CORE CHIROPRACTIC ACT ... The vertebrae can be moved by direct contact—the "short-lever" technique—or through a distant linkage, or the "long-lever" method." [31]

• Fuhr AW. Presentation to the Panel on Short & Long Lever, Non-Specified Contact Chiropractic Adjusting. In: Proceedings of the California Chiropractic Foundation's Seventh Annual Conference on Research and Education, Palm Springs, CA, June 19-21, 1992, pp.256-7.

• "Manipulation: A primary chiropractic therapeutic application that involves applying a specific amount of force vectored through a specific plane of motion of a spinal or peripheral joint, in order to reduce joint restriction and facilitate normal range of motion. Long-lever manipulation uses the femur, shoulder, head, or pelvis to affect larger sections of the spine in a non-specific manner. Specific short lever, dynamic thrusts utilize a specific contact on a transverse spinous process of vertebra, muscle, or ligament. Point pressure manipulation includes the gouging or manual stimulation of specific points without attempting to actually massage a muscle or move a joint." [32]

• "Long lever techniques" (p. 117) in "The Foot and Ankle", by A.L. Logan, DC. [33]

• Both long and short lever mentioned in "Principles and Practice of Chiropractic" By Scott Haldeman, Simon Dagenais

No one is questioning that short lever techniques are "typical" and widely used by chiropractors, but long lever techniques are also used, and both long and short lever techniques are used by other professions. As a PT I have learned multiple long and short lever techniques as a matter of course, with nothing especially "chiropractic" being attached to any of them, since they are taught by several professions.

In summation: "Chiropractors use all forms of manipulation." [34] Meeker & Haldeman, 2002 -- Fyslee / talk 07:17, 25 October 2008 (UTC)

Here are the issues. Fyslee keeps confounding the POV of the sources which I present as representational of my POV. He needs to assume good faith and realize that's not what we are here to do. We are here to look at each source and apply the standards of V, RS, and NPOV, and see how they can best be used in the article. Instead, Fyslee is using Wikipedia as a soapbox where he can debunk chiropractic. Wikipedia is not a soapbox. That's what blogs are for. Finally, all this is evidenced by the way he refuses to accept sources which goes against his own personal POV of chiropractic. For instance, I have provided sources above which describe the differences between chiropractic SM and non-chiropractic SM. Rather than recognizing that these are legitimate reliable sources (published in The Neurologist, the Annals of Internal Medicine, and Social Science & Medicine no less.), Fyslee makes it his mission to "debunk" the sources, claiming that they are biased or that they are propaganda or that their claims are easily refuted. Debunking is not what we are here to do at Wikipedia. I recognize that often there are sources with POVs that butt heads, but let the sources do the head butting, not the editors and their POVs. So, it would be enough for Fyslee to simply present the sources above and say that they stand in contrast to the sources which I have presented. And then we can just agree that there are different POVs out there on the subject; some researchers recognize that there are physical differences between the spinal manipulation techniques of chiropractors and that of non-chiropractors, and some researchers do not recognize such a difference. Essentially, that is what we have in terms of sources. We can't say that this source trumps that source, because in this case what we truly know is that there is a real disagreement in the world of spinal manipulation research about whether non-chiropractic SM techniques are clinically the same as chiropractic SM techniques. As Wikipedians, we cannot take sides and say that this opinion is right and that opinion is wrong, when both opinions have wide support in various reliable sources. I am quite certain that Fyslee is a reasonable fellow and if he can just take off his chiropractic debunking hat for merely a moment, he will see what is best for this article; chiefly, that we present what is verifiiable. And what is verifiable is that there is a disagreement in the sources; some researchers say CMT and GMT are physically the same and some say that there is a difference. -- Levine2112 ^discuss 07:50, 25 October 2008 (UTC)

I have no problem accepting that sources disagree and that we should present that disagreement as it is. Keep in mind that I'm an inclusionist, not a deletionist. I want the whole story to be told, not that the article present just the straight version of chiropractic as being the "correct" version. The immediate disagreement here isn't directly related to the original subject of this thread (synonymous terminology), but is only tangentially related since it's about a claim that long lever techniques aren't part of chiropractic. That claim has one source above (Haneline), and it is clearly wrong, and the other sources are only telling one part of the story (thus not technically wrong), without mentioning or excluding the possibility that long lever techniques are taught and used by chiropractors. Thus those sources are being misused above to further an exclusive and false claim.

Since Haneline's claim is patently false, we shouldn't use it at all, or if we use it, we should show that it is contradicted by many other sources. This isn't just about what one source falsely says, but about actual facts (supported by several other sources) which contradict that false claim. Haneline's claim is extremely fringe and many chiropractors would object if we quoted it as if it had any weight at all. This is the first time I've read anything in chiropractic writings that openly denied such a basic and common fact about the profession. It makes one wonder if Haneline is even a chiropractor! Does Haneline write something somewhere else in that document, that isn't being presented here, which modifies his statement above? His statement is as easy to falsify as an ignorant statement by someone who has never seen a red apple claiming that all apples are green or yellow.

To find out if there is a difference between what Levine2112's personal POV really is and if it coincides with the Haneline source and the way he (Levine2112) has framed and used the other sources (he indicates that his POV could be different than the sources), I'll just ask bluntly:

• Do you admit that chiropractic uses and teaches long lever techniques, or do you deny that "[c]hiropractors use all forms of manipulation"?

Your statements above seem to indicate that you don't believe so and would deny Meeker's "all forms" quote, and you have presented sources to back up your personal POV. It also appears you have found one unusual quote from Haneline that very clearly and unequivocably backs up your POV. If I'm misunderstanding something here, please explain. I really want to understand you correctly. -- Fyslee / talk 14:53, 25 October 2008 (UTC)

You seem to be still missing the point here, Fyslee. It's not about what I believe. My personal POV (which you really don't know) is irrelevent. As is yours. I know that it is hard to set that aside when you (the editorial "you") are so passionate about a subject, but truly your personal POV is a hinderence when it comes to article writing. What is relevant here are the POVs given by reliable sources. I am glad that you recognize that both POVs exist in the sources which we have presented above. Now it's not our job to say one is false and one is true; that one "disproves" the other one. It is not our job to "debunk" any of the sources. Our job is merely to present the different POVs in a neutral light. Does that make sense to you? -- Levine2112 ^discuss 16:35, 25 October 2008 (UTC)

When it comes to article content, I agree. It's not our personal POV that should be included and sourcing is everything. When discussing matters on talk pages personal POV are mentioned and discussed, accusations fly, misunderstandings occur, and such like. Be careful about directing your "personal-POV-being-a-hindrance" arrow at me. We can both be guilty of that one.

Instead of allowing you to divert attention from the immediate point here, I request that you deal with it so we can move on. You have made some specific claims and I want to hear your real POV, since you seem to be hedging about what they really are. If we are to be able to collaborate here, it is important that we understand each other. It seems like you are stalling and avoiding stepping up to the plate. You claim to be a skeptic, so you know that making claims obligates one to document them when they are challenged. I'm not asking for anything unusual or improper, so a simple answer will do. I just want to know if it is or is not your POV that chiropractic does or does not teach and use long lever techniques. What do you believe jibes best with reality and what do you believe the sources are saying? We seem to have a difference of opinion here, and the sources (well one does) seem to differ, and we need to settle it. -- Fyslee / talk 21:44, 25 October 2008 (UTC)

First, I meant "you" in the editorial, general sense above when I said, "I know that it is hard to set that aside when you are so passionate about a subject, but truly your personal POV is a hinderence when it comes to article writing. Sorry for the misunderstanding.

No attention diverting is going on here. This thread is about the difference(s) between spinal manipulation and chiropractic's spinal adjustment. I have done nothing but provide sources which highlight the physical differences, and when you attempted to debunk those sources, I pointed out that this is not proper Wikipedian behavior. Each of the source which I provide support the POV that there are physical differences between non-chiropractic SM and chiropractic SM. The sources which you provide support the POV that there are no physical differences. There is a difference of opinions here for sure, but it exists among the reliable sources which we presented. And that's all that is relevent here. Whether or not you and I have a difference of opinions with regard to this topic is irrelevant. My personal POV about whether or not there are physical differences is irrelevant. As is your POV. Each is a hinderance to the editing process, so I'd just as soon not bring up the way I feel on this subject (and I'd suggest you do the same). If you want to call that stalling or avoidance, fine. I call it "checking your POV baggage at the door". I find that it helps to keep me neutral and better able to access and apply NPOV. As a skeptic, this shouldn't be a new concept to you. In order to analyze something from a true skeptical point-of-view, you should sluff off all of your preconceived notions and just observe the evidence given rationally; without passion or prejudice. If you really want to discuss my personal POV, we can do that outside of Wikipedia. It's not proper to do so here. Wikipedia is not a forum or a soapbox. You and I should have no difference of opinions here at Wikipedia other than the interpretation and application of Wikipedia policy. -- Levine2112 ^discuss 02:39, 26 October 2008 (UTC)

• waves a white flag This discussion is heading into bad territory. Lets try to focus on issues we can discuss and find solutions for and avoid discussion other editors/their motives/etc. Thanks. Shell ^babelfish 03:11, 26 October 2008 (UTC)

• Agreed! -- Levine2112 ^discuss 03:31, 26 October 2008 (UTC)

• Yes, it started into bad territory with Levine2112's first comment in this thread. Since he is still copping out by refusing to answer my simple question, I'll ask him on his talk page. We can't collaborate very effectively if we are misunderstanding each other and coming to opposite conclusions after reading the same sources (all the ones presented by both of us in this section). -- Fyslee / talk 07:30, 26 October 2008 (UTC)

No, that discussion is not starting again. Drop it, walk away, and don't point fingers. lifebaka++ 20:30, 27 October 2008 (UTC)

Agreed. -- Levine2112 ^discuss 23:38, 27 October 2008 (UTC)

I took a brief break from looking at this talk page and am happy to see that this section can be ignored. It's hard to keep up with all the comments! Eubulides (talk) 20:43, 28 October 2008 (UTC)

If you choose to ignore this exchanges, that's fine. However, be aware that it does contain some useful discussion about two verifiable POVs: one which says there is a physical difference between non-chiropractic spinal manipulation and chiropractic spinal manipulation, and one which says that there is no difference. The conversation spilled over onto my talk page where several other reliable sources which support the POV that there is a physical difference were presented. I think this is a viable conversation which we could/should have here, provided we steer clear of discussing other editors and their motives. -- Levine2112 ^discuss 23:48, 28 October 2008 (UTC)

I have replied, and if Levine2112 agrees, we can copy it here. I think it has helped that we have discussed things. -- Fyslee / talk 06:44, 29 October 2008 (UTC)

"Ownership" of SM revisited

PHYS THER Vol. 80, No. 8, August 2000, pp. 820-823

Letters and Responses

Spinal Manipulation

To the Editor: We are writing to discuss a matter of importance to the physical therapy profession, namely, the practice of spinal manipulation by physical therapists. We are concerned by the attempts of other disciplines to introduce legislation that would exclude spinal manipulation from physical therapy state practice acts.1,2 Having reviewed 2 often-cited publications concerning spinal manipulation, we have found strong support for spinal manipulation being part of the professional practice of chiropractors, medical doctors, osteopaths, and physical therapists, rather than being the exclusive domain of any one of these professions.

(......)

In reviewing the AHCPR5 and RAND6 documents and the 27 cited reports of clinical trials,7–33 we noted that a variety of health care professionals served on the expert panels that evaluated clinical trials of spinal manipulation. We believe that the multidisciplinary composition of the panels was used in an effort to protect against bias in the selection and interpretation of these clinical trials. The expert panels in the RAND and AHCPR publications adopted nearly identical definitions of spinal manipulation, and each panel used a systematic article selection process. Therefore, we considered all of the 27 reports cited. We identified the profession of those who provided spinal manipulation and control interventions for each clinical trial. Various combinations of 4 health professions (chiropractors, medical doctors, osteopaths, and physical therapists) provided the interventions for the trials, but physical therapists provided both spinal manipulation and other interventions in more clinical trials than did any other profession. For these reasons, we conclude that the AHCPR and RAND publications support spinal manipulation as being part of the professional practice of chiropractors, medical doctors, osteopaths, and physical therapists, rather than being the exclusive domain of any one of these professions.

(......)

In summary, clinical trials of spinal manipulation performed by physical therapists provide the major source of evidence supporting the AHCPR and RAND findings and recommendations. However, three other professions also contributed to that evidence. The multidisciplinary expert panels that produced the AHCPR and RAND documents recognized spinal manipulation to include many different techniques, including both long-lever and short-lever, high-velocity methods. Most importantly, these landmark publications support spinal manipulation as being part of the professional practice of chiropractors, medical doctors, osteopaths, and physical therapists, rather than being the exclusive domain of any of these professions.

http://ptjournal.org/cgi/content/full/80/8/820

-- Fyslee / talk 07:23, 25 October 2008 (UTC)

This all makes sense, but I don't see any specific suggestion for improving the article here. The article already says 'No single profession "owns" spinal manipulation'; is that enough? Eubulides (talk) 20:43, 28 October 2008 (UTC)

I didn't make any specific suggestion here. This was just a posting of relevant information for possible use, or if not, at least for further thought. -- Fyslee / talk 05:37, 29 October 2008 (UTC)

Copyedit suggestions from IP edit

This edit, which was soon reverted because it mostly contained unsourced POV-pushing, contained some stylistic improvements which are helpful. I propose adding the following changes, where are taken from that edit, or are inspired by it.

• ... differentiating chiropractic medicine from conventional medicine ...

→

... differentiating chiropractic from conventional medicine ...

• The practice of chiropractic medicine involves a range of diagnostic methods ...

→

Chiropractic involves a range of diagnostic methods ...

• counselling

→

counseling

• Many other treatment forms are used by chiropractors for treating ...

→

Many other procedures are used by chiropractors to treat ...

• chiropractic's gradual acceptance of medical technology

→

chiropractic's gradual acceptance of technology

Eubulides (talk) 23:50, 29 October 2008 (UTC)

The spelling change and the "treatment forms => procedures" seem acceptable. The others seem not to be stylistic, but rather POVish. I would recommend against making those changes. -- Levine2112 ^discuss 00:36, 30 October 2008 (UTC)

McTimoney

A new user added McTimoney to the treatment techniques section, but this was reverted by Lifebaka because it wikilinked to a now deleted article that was a copyright violation. Regardless, McTimoney shouldn't be included in this section, as it is not within the source used (which demonstrates the 20% threshold used to determine WP:weight for this section). DigitalC (talk) 00:08, 1 November 2008 (UTC)

Trim vaccination section

I would like to remove the following text from the vaccination section:

A survey of Canadian Memorial Chiropractic College students in 1999–2000 reported that seniors opposed vaccination more strongly than freshmen, with 29.4% of fourth-year students opposing vaccination.

These are my reasons:

• It infers that antivaccination views are propagated by the College, when the article clearly states that this is not the case - antivaccination views were obtained from sources outside the curriculum.
• The sentence refers to a chiropractic students, not actual chiropractors. The preceding sentence talks about the policies and practices of actual Canadian chiropractors, and as such talking about Canadian chiro students is redundant
• The study did not follow a cohort through their studies, it compared seniors with freshmen. i.e. it did not measure an ACTUAL change in vaccination views - it assumed one.
• If certain editors want to push the line that chiro study teaches anti-vaccination, then they should say it outright and reference the assertion appropriately. I do not believe that it can be verified that any chiropractic curriculum teaches anti-vaccination views.

--Surturz (talk) 11:52, 22 October 2008 (UTC)

Well argued. I am persuaded to agree with you here, Surturz. -- Levine2112 ^discuss 17:19, 22 October 2008 (UTC)

I disagree. The current version accurately summarizes the reference. Editors can always make a rewrite proposal to improve on any sentence. We don't delete a sentence if it needs improvement. If improvements are needed, then make a proposal to improve it. QuackGuru 17:29, 22 October 2008 (UTC)

• Chiropractic students are not redundant; they are a different topic. The topic is, how do chiropractors come by their antivaccination attitude?
• There is no desire to "push a certain line". There is a desire to summarize what reliable sources say.
• The summary does not say that the study followed a cohort. On the contrary, it says that the survey was done in one school year, which means that the study cannot have followed a cohort. This point can be made more clearly by adding the phrase "cross section" to the summary.
• Certainly it can be documented by reliable sources that some chiropractic colleges teach a negative view of vaccination. For example, Campbell et al. 2005 (PMID 10742364), a reliable source already cited by Chiropractic, states that most colleges (presumably including CMCC) try to instill a responsible attitude toward vaccination, but: "Nevertheless, several colleges had faculty who seemed to stress a predominantly negative view of the role of immunization in public health."
• Rather than simply remove this well-sourced material, how about expanding it to cover the points you mention? Something like this, perhaps:

Although most chiropractic colleges try to teach about vaccination responsibly, several have faculty who seem to stress negative views. A survey of a 1999–2000 cross section of students of Canadian Memorial Chiropractic College, which does not formally teach antivaccination views, reported that seniors opposed vaccination more strongly than freshmen, with 29.4% of fourth-year students opposing vaccination.

Eubulides (talk) 18:36, 22 October 2008 (UTC)

Surturz, it's time to stop your endless campaign to delete this section because you don't like it. This article (and thus you) are under ArbCom-determined increased scrutiny and possible sanctions if certain conditions are violated, such as:

• "... [an] editor repeatedly or seriously fails to adhere to the purpose of Wikipedia,..."

Disruption is such a violation, and these attempts of yours have been repeated again and again and again and are thus way beyond disruptive. Disruption here is sanctionable, and this type should lead to an article ban for a short period of time. You need to drop it and start collaborating instead of obstructing.

We don't delete content because of supposed imperfections, we improve it. In this case improvement will most likely mean better coverage, so if you insist on objecting more, we can always enlarge the section, because it must need it. Maybe you should read about what a Pyrrhic victory means and reconsider your strategy. Wikipedia history shows that whenever fringe POV have been pushed in alternative medicine articles like this one, it has inevitably resulted in the mainstream position being strengthened, since it has more credibility and far more and enormously better V & RS. In so doing it gets the weight it deserves. -- Fyslee / talk 03:25, 23 October 2008 (UTC)

I support the removal of this sentence. There is currently too much weight given to the vaccination sentence, and trying to ADD to it (as Eubulides suggested) would only add more weight. We already have information about the views of Chiropractors, so why include the views of Chiropractic students (from 10 years ago)?? DigitalC (talk) 06:14, 23 October 2008 (UTC)

We are using the most reliable sources available per WP:MEDRS. Surturz has concerns and the proposal addresses these concerns. The proposal adds context and makes it clearer to the reader. QuackGuru 06:19, 23 October 2008 (UTC)

My objection to the material has nothing to do with the reliability of the source, it has to do with the weight of the section. Adding more "context" does not reduce the weight of the section, but I also disagree that this information gives any more context. DigitalC (talk) 21:54, 23 October 2008 (UTC)

It makes is much clearer to have the new sentence in the article. QuackGuru 23:16, 23 October 2008 (UTC)

Can someone point to me a reason why this was removed from the vaccination section though? "A relatively small number of authors continue to disseminate antivaccination views." I believe THAT adds context, and should be paired with "the majority of writings", as has been agreed upon in the past. DigitalC (talk) 22:00, 23 October 2008 (UTC)

There was never any agreement for that sentence. It was no consensus. I believe it did not add context. QuackGuru 23:16, 23 October 2008 (UTC)

I agree with User:Eubulides when he says "The topic is, how do chiropractors come by their antivaccination attitude?". Clearly the sentence in question is included as an answer to this question (rather than as a comment on the CMCC). Firstly, I don't think the question is noteworthy. However, even if it were, the reference cited does not answer that question, except to say that anti-vaccination views are obtained outside formal course work. User:Eubulides's Campbell et al reference confirms that CMCC and formal course work do not teach anti-vaccination views, although individual faculty members might hold those views. User:Eubulides agrees with me that the study did not follow a cohort, and therefore did not measure an actual change in vaccination views. So what are we left with? A sentence which implies that chiro students are taught anti-vaccination views as part of their formal study when we know that isn't the case. WP:MEDRS was invoked by QuackGuru, but I am sure WP:MEDRS does not advocate the republication of primary research data from an inconclusive study as is happening here. User:Eubulides suggested alternate text does not remove the offending sentence. How about we replace the existing CMCC sentence with this modified version of the first half of User:Eubulides's proposal:

Although most chiropractic colleges teach a responsible attitude toward vaccination, several have faculty who seem to stress negative views.

--Surturz (talk) 04:49, 28 October 2008 (UTC)

The best proposal is to improve the existing sentence and to add the new sentence for context and clarity.

Although most chiropractic colleges try to teach about vaccination responsibly, several have faculty who seem to stress negative views. A survey of a 1999–2000 cross section of students of Canadian Memorial Chiropractic College, which does not formally teach antivaccination views, reported that seniors opposed vaccination more strongly than freshmen, with 29.4% of fourth-year students opposing vaccination.

Per WP:NPOV, we can include both sentences. QuackGuru 15:06, 28 October 2008 (UTC)

• I don't have a strong feeling about the CMCC sentence. As I wrote when the sentence was first introduced, it's a bit of a wobbler, on WP:WEIGHT grounds. The material is already present in Vaccine controversy #Alternative medicine and this section is a summary of that.
• That being said, I don't see how the longer version (quoted by QuackGuru above) "implies that chiro students are taught anti-vaccination views as part of their formal study" (Surturz's criticism above). On the contrary, the longer version clearly states that CMCC "does not formally teach antivaccination views", and that "most chiropractic colleges try to teach about vaccination responsibly".
• One other possibility would be to remove the sentence and replace it with a hatnote at the start of the section, which looks like this:

Further information: [[:Vaccine controversy and alternative medicine]]

We'd also remove the wikilink in the paragraph to Vaccine controversy, as it would no longer be needed.Eubulides (talk) 20:43, 28 October 2008 (UTC)

I have already stated that I don't think the sentence belongs, based on WEIGHT. However, another problem with the most recent proposal is that is uses American terms for a Canadian institution. Freshmen and seniors are American concepts which are not used elsewhere in the world. That is, CMCC does not have freshmen or senior students - they have first year and fourth year students. DigitalC (talk) 21:59, 28 October 2008 (UTC)

Thanks for spotting that "freshman"/"senior" glitch; I fixed it. Eubulides (talk) 20:45, 29 October 2008 (UTC)

The hatnote idea seems good. It is used elsewhere to insert a type of "see also" link in the precise spot where it is relevant, and this one is quite relevant. -- Fyslee / talk 05:34, 29 October 2008 (UTC)

So I have consensus to delete the CMCC survey and replace it with the hatnote? --Surturz (talk) 15:26, 29 October 2008 (UTC)

So far, yes, but please wait for a few days to let other editors comment. This is stable text and there's no rush. Eubulides (talk) 20:45, 29 October 2008 (UTC)

Done. Thanks all. --Surturz (talk) 10:59, 3 November 2008 (UTC)

Fine. That looks better. I do have a suggested improvement, which I'll bring up in a new section below. 06:43, 4 November 2008 (UTC)

Awkward wording

In the Philosophy section is found this wording:

• "A philosophy based on deduction from irrefutable doctrine helped distinguish chiropractic from medicine,..."

which I find to be rather awkward. Can we find a better choice of words? I can imagine that wikilinking "irrefutable doctrine" might help, since that happens be true, but does the source imply this? -- Fyslee / talk 02:19, 3 November 2008 (UTC)

• Another editor, without discussion, made this edit to replace the above wording with the even-more-awkward:

"A philosophy based on deduction from vitalistic first principles rather than induction helped distinguish chiropractic from medicine,..."

• But neither of the cited sources say anything about induction. Keating, which is one cited source, says the following, which supports the original but not the revised wording:

• "Ralph W. Stephenson, a philosophy instructor at the Palmer School in the 1920s, provided a codification of B.J.'s principles in his 19270 Chiropractic Textbook, a volume that went through many printings and was required reading at the Palmer School and several other chiropractic colleges for decades. Stephenson declared chiropractic a 'deductive science' that eschewed the empirical observations and inferential reasoning of other scientific fields in favor of deduction from a true first principle." (p. 80)
• "B. J. Palmer developed the idea of philosophy as irrefutable doctrine by which not only health care, but life itself, seemed to be explained." (p. 84)

• That same edit wikilinked "inferential" to Empirical, which is dubious; surely Inference would be a better article to wikilink to.
• For now, I reverted the edit. It has some good suggestions but it needs work.
• Rather than wikilink separately to Falsifiability and Doctrine, I suggest wikilinking the phrase "irrefutable doctrine" to Dogma, since that's the Wikipedia article that is most relevant to "irrefutable doctrine".
• To summarize the above comments, I suggest mostly adding wikilinks (plus the word "first"), by replacing this:

A philosophy based on deduction from irrefutable doctrine helped distinguish chiropractic from medicine, provided it with legal and political defenses against claims of practicing medicine without a license, and allowed chiropractors to establish themselves as an autonomous profession. This "straight" philosophy, taught to generations of chiropractors, rejects the inferential reasoning of the scientific method, and relies on deductions from vitalistic principles rather than on the materialism of science.

with this:

A philosophy based on deduction from irrefutable doctrine helped distinguish chiropractic from medicine, provided it with legal and political defenses against claims of practicing medicine without a license, and allowed chiropractors to establish themselves as an autonomous profession. This "straight" philosophy, taught to generations of chiropractors, rejects the inferential reasoning of the scientific method, and relies on deductions from vitalistic first principles rather than on the materialism of science.

Eubulides (talk) 08:24, 3 November 2008 (UTC)

Interestingly enough, I had played with that possibility, and that may be the best solution. Dogma is basically what it was, since most chiropractic research since then has been conducted with an eye for confirming the truth of the dogma, and not to determine the facts, regardless of whatever they might turn out to be. The Journal of Vertebral Subluxation Research carries on this unscientific tradition. -- Fyslee / talk 06:51, 4 November 2008 (UTC)

RfC: Is the "subject" of spinal manipulation relevant to chiropractic?

Subject and "Rules of engagement"

• Is the "subject" of spinal manipulation relevant to chiropractic?

• I contend that it is, and that the profession and its top researchers think so too. So far no reliable mainstream or chiropractic sources have been mentioned here that dispute this point. What think ye, honored ladies and gentlemen? -- Fyslee / talk 05:00, 9 October 2008 (UTC)

Nota bene! Please follow these "Rules of engagement":

1. This RfC is NOT about "research" (we are discussing that elsewhere), only the "subject" of spinal manipulation and its relation to the chiropractic profession. More discussion of that matter can occur after and outside of this RfC.

2. This RfC is NOT about any relation between generic spinal manipulation and chiropractic spinal manipulation. We are also discussing that elsewhere. More discussion of that matter can occur after and outside of this RfC.

If these subjects are mentioned here, the comment will likely be removed and the contributor requested to resubmit the comment without such mentions. Such comments will only derail the discussion and be a repetition of other discussions. This discussion is delimited by well-defined and narrow boundaries. It must remain focused. Your cooperation will be appreciated. -- Fyslee / talk 05:00, 9 October 2008 (UTC)

The words "relevant" and "related" are synonyms, and "relevant" is used in that sense above. If this is a problem for some, then that can be discussed. It is already mentioned below because of the use of the word "related" in the OR policy, even though this RfC is not about the OR policy or other policies.

This RfC is limited to the bare question, as it reads. This is about logic and about knowledge of chiropractic and its main treatment method. -- Fyslee / talk 14:21, 9 October 2008 (UTC)

ADDENDUM: Invalid "vote(s)". As originally noted immediately above, "this RfC is limited to the bare question, as it reads." The question is a stand-alone question. If other contexts are influencing your decision, then your "vote" doesn't count and is invalid. Either answer the question, or don't vote at all. Deal with the other issues elsewhere or later. -- Fyslee / talk 13:45, 17 October 2008 (UTC)

RfC comments

• Agree, as stated above. -- Fyslee / talk 05:00, 9 October 2008 (UTC)

• Agree that spinal manipulation is directly related to chirorpractic, and is relevant to chiropractic. Eubulides (talk) 07:00, 9 October 2008 (UTC)

• Comment. Since WP:OR consistently uses the words "directly related" rather than "relevant", I suggest that you rephrase the question by uniformly substituting the words "directly related" for "relevant". Otherwise, other editors might say that even if the conclusion is that SM is relevant to chiropractic, that doesn't mean that it's directly related to chiropractic. Eubulides (talk) 05:36, 9 October 2008 (UTC)

• I had thought of that, but since they are synonyms (and "relevant" sounds better in that question), we might be better served to get the word "relevant" added to the language of the OR policy. Do you see a significant difference -- relevant<-->related. "Definiton: Relevant: Related to the matter at hand." Anyone who disputes my wording can take it up with the dictionaries. Is this a solid argument, or am I wrong here? -- Fyslee / talk 06:21, 9 October 2008 (UTC)

• WP:OR recently went through some sort of dispute over whether it should use "relevant" or "directly related", so I expect that some editors think there's an important difference between the two terms. In that case, why not just stick with the terms that WP:OR uses? It might avoid future confusion. Or, if you prefer, we can mention both terms in the RfC. Eubulides (talk) 06:50, 9 October 2008 (UTC)

• I have added a comment about the terminology matter above. Anyone who has already commented is welcome to refactor or enlarge their comments accordingly. I see that the RfC bot hasn't picked up this RfC yet, but it should do so within the next 24 hours, so this will already be a part of what outside commentators will find here. -- Fyslee / talk 14:21, 9 October 2008 (UTC)

• The RfC bot cannot handle more than two RfCs on the same talk page. It lists only the first one on the page. This is a longstanding bug in the bot which has not been fixed. I have added this RfC manually to Wikipedia:Requests for comment/Maths, science, and technology. Eubulides (talk) 14:55, 9 October 2008 (UTC)

• If it helps, we can archive the older RfC on this page. I think that one has been milked long past its expiration. -- Levine2112 ^discuss 23:28, 9 October 2008 (UTC)

• I wasn't aware of that glitch. Maybe that is a good idea to archive the old RfC. -- Fyslee / talk 04:33, 10 October 2008 (UTC)

• Done. Eubulides (talk) 04:48, 10 October 2008 (UTC)

• BTW, this RfC isn't about OR or other policies. It is limited to the bare question, as it reads. This is about logic and knowledge of chiropractic. -- Fyslee / talk 06:24, 9 October 2008 (UTC)

• Disagree. No such conclusion can be made, because the question is too vague and due to the constraints put on the discussion. Further, you state that this RfC is not about research, but then state that its "top researchers" think it is relevant. Overall, the answer is "not necessarily". DigitalC (talk) 07:49, 9 October 2008 (UTC)

::* Comment about invalid "vote(s)". The question is a stand-alone question. IF other contexts are influencing your decision, then your "vote" doesn't count and is invalid. Either answer the question, or don't vote at all. Deal with the other issues elsewhere or later. -- Fyslee / talk 13:42, 17 October 2008 (UTC) ^{Stricken to please Coppertwig. -- Fyslee / talk 15:51, 18 October 2008 (UTC)}

• Comment. The opinions of others are welcome here, including the opinions of researchers about the "subject". It is the circular discussions about research itself we wish to avoid here. It should be easy to answer the above question. It's a no-brainer. There is nothing wrong with answering more than once, or adding qualifiers to an "agreed" answer. This isn't a deletion discussion, or other type of discussion where "voting" twice is not allowed. You can make multiple comments after making your one "agree" or "disagree" remark. You can even make a "yes and no" type answer, so go for it. Your understanding of this matter is valued. -- Fyslee / talk 14:30, 9 October 2008 (UTC)

• Agree. My personal experiences with this term has been with using chiropractic care, so I associate this to a chiropractor. --CrohnieGal^Talk 11:38, 9 October 2008 (UTC)

• Agree that spinal manipulation is directly related to chiropractic, and is relevant to chiropractic.--—CynRN ^(Talk) 18:38, 9 October 2008 (UTC)

• Agree SM is the main mode of treatment in Chiropractic, while other things are related to Chiropractic as well, SM forms the core of this form of medical practice and is therefore directly related to the topic. Tim Vickers (talk) 18:53, 9 October 2008 (UTC)

• No. In terms of Wikipedia, spinal manipulation is not "relevant" to chiropractic. Chiropractic spinal manipulation is relevant to chiropractic. Disagree. The profession and its top researchers don't necessarily agree either. In fact, we have highlighted reliable sources demonstrating such disagreement in the professional and research worlds. -- Levine2112 ^discuss 20:46, 9 October 2008 (UTC)

::* Comment about invalid "vote(s)". The question is a stand-alone question. If other contexts are influencing your decision, then your "vote" doesn't count and is invalid. Either answer the question, or don't vote at all. Deal with the other issues elsewhere or later. -- Fyslee / talk 13:42, 17 October 2008 (UTC) ^{Stricken to please Coppertwig. -- Fyslee / talk 15:51, 18 October 2008 (UTC)}

• Comment:I see nothing invalid about Levine2112's vote. This is Wikipedia, so it would be nonsensical and off-topic to ask people to answer separately from the context of Wikipedia. Since you've cited the opinions of unnamed "top researchers" supporting your side of the question, Fyslee, it's only fair that Levine2112 be able to do the same to support the other side. If Levine2112 has included off-topic information (e.g. about "chiropractic spinal manipulation") in addition to a valid vote, I think it would be counterproductive to discount the entire vote on that basis. What is it about the vote that leads you to state that it's invalid, Fyslee? ☺ Coppertwig (talk) 18:06, 17 October 2008 (UTC)

• He is not answering the question as it is stated, which is the problem. This is a question of logic and knowledge of chiropractic, not just about Wikipedia. It is fundamental knowledge that colors most editors' way of editing, and we need to find out their views on the subject. While there is nothing overtly and openly stated in his statement above that would make it invalid, his motivations for not answering in a clear manner, but in a convoluted manner, are plainly evident from the myriad discussions that have led up to this RfC. He is plainly afraid to answer directly. Your statement indicates that you may not have followed these discussions as closely as the rest of us, which is okay. We happen to have learned his way of thinking quite well now and we don't have to assume bad faith or anything of that kind when we address his way of dealing with this issue. This is simple, very civil plain talk, and a request for straightforward and simple answers. Note that I wrote: "IF other contexts are influencing your decision...", which leaves it up to him to refactor his comments IF other contexts are at work here. I want him to be honest and to refactor, providing a straightforward answer that is not influenced by other factors. I want to find out about his basic knowledge of chiropractic.

• The "unnamed researchers" are known to all the regular editors here. I was just stating my reasons for starting this RfC. The opinions of others isn't the direct issue here, and no rebuttal naming others is necessary to answer the simple question. Naming others would only bring in other issues that are not part of this RfC, as stated above.

• This RfC mustn't get bogged down with the other issues which he has used to keep us going in circles for months, and which his recent comments below are doing. Such comments are specifically not allowed here, as stated above. That's why I have worded this RfC as simply as it's possible to word it. We need honest answers, not politically driven answers. A simple answer to a simple question is what is needed. Leave the qualifiers for other discussions. -- Fyslee / talk 20:11, 17 October 2008 (UTC)

• I don't understand "he is not answering the question as stated". What part of "No" do you not understand? The word "No" seems to me to be a simple, direct answer to the question as stated.^{(01:50, 18 October 2008 (UTC))} ☺ Coppertwig (talk) 01:10, 18 October 2008 (UTC)

• Basically there is only one correct answer, unless one is very ignorant about chiropractic, its writings, research, and history. That is a resounding "yes". A "no" answer indicates that hidden agendas are at play. That's what I should have stated right from the start. Those hidden agendas were mentioned in the "rules of engagement" and were specifically excluded from this RfC. Your answer below is quite enlightening and fair enough. I'll comment there. -- Fyslee / talk 05:55, 18 October 2008 (UTC)

• Maybe I have confused you by too many words regarding esoteric knowledge here among the regular editors. You are excused for not understanding it. The question is not qualified by "In terms of Wikipedia". It is a real, very simple question presented without connection to Wikipedia policies or issues being discussed elsewhere here. It is a question designed to test the basic logic and basic knowledge of chiropractic possessed by anyone who answers the question. Of course this still has relevance to our editing here since the answers provided can used to further our understanding of each other's thinking, which makes it easier to collaborate and avoid misunderstandings. It is thus of direct relevance to our editing here and isn't a waste of time. If the answers here are later used in other connections, so be it, but right now we need to concentrate on the question at hand, without making qualifications, exceptions, etc. -- Fyslee / talk 01:31, 18 October 2008 (UTC)

• I apologize for the tone of my response and have struck out some of my words and replaced them with different ones. ☺ Coppertwig (talk) 01:50, 18 October 2008 (UTC)

• No reliable source has been presented saying that spinal manipulation is not relevant to chiropractic. Apparently this comment is referring to Ernst 2002 (PMID 12379081). However, Ernst doesn't say that SM is irrelevant to chiropractic; he says that some studies of SM (presumably, studies of osteopathic SM, or whatever) are not relevant to chiropractic SM. Nowhere does Ernst say or imply that the topic of SM is irrelevant to chiropractic. The claim that Ernst says SM is irrelevant to chiropractic disagrees with pretty much every paper Ernst has written about chiropractic. Eubulides (talk) 23:18, 9 October 2008 (UTC)

• I am glad that you are finally acknowledging that Ernst did in fact say that some (Ernst says "most") studies of SM are not relevant to chiropractic SM. I think this acknowledgment is a good step in resolving this dispute and if nothing else comes from this rather innocuous RfC, I'm happy with at least getting this much. -- Levine2112 ^discuss 23:26, 9 October 2008 (UTC)

• Ernst did not say that "most" studies of SM are not relevant to chiropractic SM. He merely said that most of the randomized controlled trials of SM for low back pain cited in Meeker & Haldeman 2002 (PMID 11827498) do not relate to chiropractic SM. Chiropractic #Evidence basis does not cite any of those randomized controlled trials; as far as I know, it doesn't cite any RCTs at all. It cites general reviews. Eubulides (talk) 23:52, 9 October 2008 (UTC)

• That's still not entirely accurate. Ernst states that most of the published RCTs of SM for back pain are not related to chiropractic SM. He did not limit it to just those Meeker and Haldeman cited. But again, I am glad you are finally acknowledging at least this much. -- Levine2112 ^discuss 00:44, 10 October 2008 (UTC)

• I think you are really nitpicking on this one, and it's getting us nowhere. This is so trivial, as is all nitpicking. I hope you are satisfied with this supposed "acknowledgment". Can you leave the poor nit alone now so it can sleep a bit? The poor thing is getting tired, and this type of trivial stuff gets very poor mileage and reflects poorly on the one who keeps it going. -- Fyslee / talk 00:55, 10 October 2008 (UTC)

• Not only is it nitpicking, it is incorrect nitpicking. The "them" in the Ernst 2002 (PMID 12379081) comment "most of them do not relate to chiropractic spinal manipulation" clearly refers to the "43 randomized, controlled trials of spinal manipulation for back pain" that were cited by Meeker & Haldeman 2002 (PMID 11827498). Eubulides (talk) 01:27, 10 October 2008 (UTC)

• One man's nitpicking is another man's thorn in his side. I apologize if I keep pointing out Eubulides' errors, but when you keep making them and are editing based on these errors, I feel they should be brought to light for others to consider. For instance, Ernst does not limit RCTs to just the ones cited by Meeker & Haldeman. He says that of the 43 RCTs which M & H claim to exist in publication, most of them do not relate to chiropractic spinal manipulation.SM added later. Eubulides thus is in error when he says that Ernst is limiting to his comment to just those that were "cited" by M & H. -- Levine2112 ^discuss 17:24, 10 October 2008 (UTC)

• The previous comment is incorrect. All 43 RCTs were cited by Meeker & Haldeman 2002 (PMID 11827498). They are the RCTs in citations 48 and 51–94 of their paper; see the first three rows in Table 2, page 221, of Meeker & Haldeman. (I expect that the number of citations slightly exceeds the number of studies because some studies were reported in more than one paper.) Ernst is clearly referring to just the 43 SM RCTs cited by Meeker & Haldeman: he is not referring to any of the sources cited in Chiropractic, and he is not referring to any reviews of SM. Eubulides (talk) 17:44, 10 October 2008 (UTC)

• As you know, I continue to disagree with you on this point. Enough said. -- Levine2112 ^discuss 19:28, 10 October 2008 (UTC)

Levine2112's previous statement repeats, once again, one of his frequent misquotings of Ernst, and attributes a statement to Ernst which he never made:

• "most of them do not relate to chiropractic" - Levine2112
• "most of them do not relate to chiropractic spinal manipulation." - Ernst

This fundamental error has been repeated by him many times now and he's been called on it several times, including here (NORN) and here (misquoting problem). When will this stop? He thinks he's "pointing out Eubulides' errors", but is using fallacious arguments based on misquotings in such attempts. It's getting tiresome. -- Fyslee / talk 19:26, 10 October 2008 (UTC)

• NOTE: Levine2112 has refactored his incorrect statement without comment or edit summary. I have added a link to it in the interest of openness so no one who reads his and my statements will get confused. -- Fyslee / talk 19:49, 10 October 2008 (UTC)

• Fyslee, you know this wasn't intentional. I have explained this to you several times now. Who is the one nitpicking now? -- Levine2112 ^discuss 19:52, 10 October 2008 (UTC)

• Did I say it was intentional? I think not. To make sure readers here understand the background of this, I'll just repeat what I wrote to you at NORN: "I don't want to call this deliberate dissembling on his part because it really is complicated, but the effect on Wikipedia is the same. It games the system and fools people into believing his OR interpretation, and it keeps Talk:Chiropractic hostage to a very long discussion that drags on forever and goes in circles." -- Fyslee / talk 21:13, 10 October 2008 (UTC)

• WP:POT --Surturz (talk) 11:00, 17 October 2008 (UTC)

• Agree. Of course spinal manipulation is relevant to Chiropractic. While it's not the beginning and end of the field, it is their signature treatment. Just imagine this article trying to write this article without mentioning spinal manipulation -- and yes, that's exactly what you'd have to do, if you decided that spinal manipulation was actually irrelevant to Chiropractic. WhatamIdoing (talk) 18:21, 10 October 2008 (UTC)

• Agree. The majority of editors agree there is no OR violation and the editors who claim there is OR are aware top researchers are doing the same thing we are doing. We are following the lead of the top researchers. Chiropractic is strongly associated with spinal manipulation. It can't be original research when we are following the lead of expert reviewers. QuackGuru 17:30, 15 October 2008 (UTC)

• Disagree. While I would agree with the statement stand-alone without any context, I disagree because of previous discussions on this talk page. There is a difference between chiro SM and non-chiro SM and the generalisation "SM is relevant to chiropractic" should not be used to insert material about non-chiro SM into the article. --Surturz (talk) 11:00, 17 October 2008 (UTC)

• Comment about invalid "vote(s)". Well, the question is a stand-alone question. IF other contexts are influencing your decision, then your "vote" doesn't count and is invalid. Either answer the question, or don't vote at all. Deal with the other issues elsewhere or later. This likely applies to the other two dissenting "votes" as well.

• In this case, you are openly stating that your "vote" is influenced by other considerations, so it really is invalid. Please refactor your response and answer the question as is, or remove or strike through your comments.

• As to your personal attack above (WP:POT), I suggest you remove it, as also requested here.. -- Fyslee / talk 13:42, 17 October 2008 (UTC)

• See my comment below to Coppertwig, where I comment on your convoluted reply. -- Fyslee / talk 06:15, 18 October 2008 (UTC)

• My vote above stands. The previous chiro SM vs. non-chiro SM discussions are obviously relevant to this RfC. --Surturz (talk) 01:05, 19 October 2008 (UTC)

• Since that is not the subject of this RfC, and is specifically excluded as a factor in making replies here, your "vote" is off-topic and unhelpful. Your reply is fine outside of this RfC and after it, but not here. Take a look at Coppertwig's method if voting and see if you can give us a clear answer that is on-topic.

• Carefully wording an RfC in an attempt to back-door non-chiro-SM text into the article helps no-one. The issue that has been argued in this talk-page ad infinitum is chiro SM vs. non-chiro SM. To discuss the relevance of SM in general while banning any discussion about the differences between chiro SM and non-chiro SM is inherently biased. --Surturz (talk) 05:19, 20 October 2008 (UTC)

• So now you violate WP:AGF in addition to your violation of WP:NPA. This is really quite simple. Do you understand chiropractic or not? I'm not asking for the Straight chiropractic answer, just the plain common sense version as understood by chiropractors and non-chiropractors alike. Leave all other matters out of it unless and/or until it becomes relevant. It isnt' relevant here at all. Think of this as a closed room, and nothing outside of it matters. Just answer the question and do something about your policy violations. Strikethroughs (it's too late to remove them now) and apologies would be appropriate. They are evidence that will be used against you, but apologies will mitigate the situation. I'm giving you a chance. Please take it. -- Fyslee / talk 06:16, 20 October 2008 (UTC)

• I see you haven't removed your distracting personal attack above. -- Fyslee / talk 04:15, 19 October 2008 (UTC)

• Question and comment. Question: Would someone please cite sources that support the position that spinal manipulation is relevant to chiropractic? Comment: I agree with Surtuz's statement that ""SM is relevant to chiropractic" should not be used to insert material about non-chiro SM into the article." ☺ Coppertwig (talk) 18:06, 17 October 2008 (UTC)

• Lots of reliable sources support the position that spinal manipulation is relevant to chiropractic. (SM is not merely "relevant": it's core to chiropractic and is the reason that chiropractic exists.) Here are a few sources off top of my head (more could easily be cited):

• Principles and Practice of Chiropractic 3rd ed. (ISBN 0-07-137534-1), the leading textbook on chiropractic. For example, see chapters 1, 8, 9, 19, 37, 38, 43, and 57.
• Christensen & Kollasch 2005 (PDF)
• NCCAM 2005 (PDF)
• American Chiropractic Assn 2003 (PDF)
• Cooperstein & Gleberzon 2004 (ISBN 0443074135)
• Villanueva-Russell 2005 (PMID 15550303)
• Meeker & Haldeman 2002 (PMID 11827498) and their 2002 followup letter (PDF)
• Ernst 2008 (PMID 18280103)
• Council on Chiropractic Guidelines and Practice Parameters 2007 (PDF)

• In contrast, no reliable source claims that spinal manipulation is irrelevant to chiropractic.
• In its coverage of effectiveness and safety, Chiropractic neither discusses nor cites research that is specifically about "non-chiro SM". It does discuss and cite research about SM in general, but that's fine: SM is identified with chiropractic, and chiropractors do over 90% of SM.

Eubulides (talk) 19:11, 17 October 2008 (UTC)

Can you help me out here? I just perused Christensen & Kollasch 2005 (PDF) and I can't find where it says that spinal manipulation is relevant to chiropractic. Can you please provide a direct quote?

The same goes for NCCAM 2005 (PDF) where instead of seeing the relevance of one to another, I see the source drawing a clear distinction between chiropractic "adjustments" and spinal manipulation as performed by practitioners other than chiropractors.

Villanueva-Russell 2005 (PMID 15550303) also draws the distinction between chiropractic adjustments and general manipulation: "It should be noted that chiropractors consider the technique of "adjustment" to be exclusive to their profession, and distinguish the clinical procedure as separate from the more general medical term of "manipulation," which is a more generic, often long-lever movement of joints, not restricted to the spinal vertebrae, alone."

I am of the belief that spinal manipulation is somewhat relevant to chiropractic in the same way that X-rays are somewhat relevant to chiropractic. However, just as a general X-ray study which makes no conclusions about chiropractors use of X-rays (termed here as a nonchiropractic x-ray study) is irrelevant to the Wikiepdia chiropractic article, so irrelevant is a general spinal manipulation study which makes no conclusions about chiropractors use of spinal manipulation (termed here as a non-chiropractic spinal manipulation study). Just as the non-chiropractic X-ray study would be more appropriate at the X-ray article, so would the non-chiropractic spinal manipulation study be more appropriate at the Spinal manipulation study. -- Levine2112 ^discuss 19:28, 17 October 2008 (UTC)

• The first source you mention, Christensen & Kollasch 2005 (PDF), says in Table 10.12 (page 135) that 96% of chiropractors use the Diversified technique, and that most chiropractors use other spinal-manipulation techniques such as Gonstead.
• The second source you mention, NCCAM 2005 (PDF), leads its section 2 (page 2) with the sentence "Chiropractic is a form of spinal manipulation, which is one of the oldest healing practices."
• That quote from Villanueva-Russell 2005 (PMID 15550303) makes it clear that chiropractic adjustment is an important special case of manipulation. This supports the position that manipulation is relevant to chiropractic. Other parts of the same source (e.g., page 553) talk at length about the turf war over SM between chiropractic and other professions. For example, page 553 quotes Sportelli 1995 as saying "Chiropractic must lay claim and full ownership to what the general public already associates with chiropractors—spinal manipulation." This also supports the position that SM is relevant to chiropractic.
• The other 6 sources, which you didn't mention, also clearly support the position that SM is relevant.
• The claim that spinal manipulation is merely "somewhat relevant" to Chiropractic is incorrect, just as a claim that X-rays are "somewhat relevant" to Radiography would be incorrect. X-rays are core to radiography and are the reason for radiography's existence. It's perfectly reasonable for Radiography to cite sources about X-rays. Likewise for spinal manipulation and Chiropractic.
• Clearly SM is directly related to Chiropractic. No credible argument to the contrary has been presented here. Let's move on.

Eubulides (talk) 20:31, 17 October 2008 (UTC)

Christensen & Kollasch 2005 (PDF) never mentions the word "manipulation". So I don't see how we can infer it is drawing the conclusion that spinal manipulation is relevant to chiropractic. Again, I am not sure what "relevance" is going to give us. IF this is a discussion about WP:OR violation, then the standard is "directly related". NCCAM 2005 (PDF) certainly tells us that chiropractic is a form of spinal manipulation. Form is the operative word. Chiropractic is not spinal manipulation, but rather employs some form of spinal manipulation which differs from other forms. And yes Villanueva-Russell 2005 (PMID 15550303) makes it clear that the chiropractic adjustment is a special case of manipulation; "special case" because it is different from other forms of spinal manipulation. So from just those sources, we know that there are sources which positively identify "chiropractic spinal manipulation" (spinal adjustments) as different from "non-chiropractic spinal manipulation". I stopped there and didn't go into the other sources as I felt that enough has been presented for us to make this conclusion. But if you want to look into Ernst 2008, for instance, he too differentiate chiropractic spinal manipulation from other forms of spinal manipulation: Numerous forms of spinal manipulation exist but "the short-lever technique-touchingthe vertebrae directly at high velocity and low amplitude, i.e., by moving a small distance-with the spinal or transverse process as a fulcrum, is considered the typical chiropractic manoeuver. "Somewhat relevant" is a realistic claim; whereas "directly related" is the burden needed to satisfy WP:OR and thus far, that burden has not been upheld by those supporting inclusion of non-chiropractic specific spinal manipulation research. You say that "SM is directly related to Chiropractic". Show us that in terms of sources. Remember, "relevant to" and "direct related to" are not equivilent. Beyond that, the OR discussion goes to more detail and you must show that non-chiropractic-specific spinal manipulation research is directly related to chiropractic (the topic of this article). Thus far, just the opposite has been shown (with quotes from leading researchers such as Ernst stating that the majority of spinal manipulation RCTs for LBP are not related to chiropractic SM. And if something isn't related, then it certainly is not directly related. -- Levine2112 ^discuss 22:18, 17 October 2008 (UTC)

• Levine2112, you write: "If this is a discussion about WP:OR violation..." No, it isn't, as clearly stated above, and your comments are dragging this RfC back into your endless discussions of matters not related to this RfC. Please stop or your comments will be moved to a different thread. This is an off-topic discussion.

• Other editors, please do not participate in this type of off-topic diversion. -- Fyslee / talk 01:39, 18 October 2008 (UTC)

• Diversified is the most widely used form of SM. As Christensen & Kollasch state, 96% of chiropractors use Diversified; most of them also use other SM techniques. Clearly SM is directly related to chiropractic.
• If chiropractic is a form of SM, then SM is directly related to chiropractic.
• Whether chiropractic SM differs from non-chiropractic SM is irrelevant to this topic.
• The topic is whether SM is directly related to chiropractic. Which it clearly is. The Ernst 2008 quote is another quote supporting this position.
• Our last few comments in this subthread have not made any progress. Please feel free to have WP:THELASTWORD.

Eubulides (talk) 23:49, 17 October 2008 (UTC)

I appreciate that. All I ask is that you look at your use of the word "form" in your last response and realize that if chiropractic is just a form of SM then it is to that form of SM which chiropractic is DIRECTLY related. The other forms of SM may possibly be somewhat related to chiropractic, but they certainly aren't directly related. For instance, the form of use of a hypodermic needle which medical doctors employ is directly related to Medical doctors. However, a heroin addict's form of use of a hypodermic needle is plausibly somewhat related to Medical doctors, but it certaily isn't directly related. Therefore the topic "Hypodermic needles" is somewhat related to Medical doctors, but certainly not directly related. After all, if there was a study documenting the dangers of heroin addicts' use of hypodermic needles, you would expect to find that study on the Medical doctor article in the context of "Medical doctors use hypodermic needles a great deal. According to research studying heroin addicts, hypodermic needles are dangerous." Take some time. Step back. Think about it. I promise I'll do the same. -- Levine2112 ^discuss 00:35, 18 October 2008 (UTC)

Please stop this off-topic discussion. -- Fyslee / talk 01:39, 18 October 2008 (UTC)

I'd say that a discussion of "knowledge and logic" outside of the realms of a Wikipedia application of such knowledge and logic is a discussion which is off-topic. From WP:Talk#How_to_use_article_talk_pages: Talk pages are for discussing the article, not for general conversation about the article's subject... Keep discussions on the topic of how to improve the associated article. Irrelevant discussions are subject to removal. -- Levine2112 ^discuss 02:02, 18 October 2008 (UTC)

No one forced you to participate in this RfC. If information that can help us understand each other and help us to collaborate better doesn't interest you, you can (continue) to stand outside that collaboration. Your continued stonewalling and gaming the system is not welcome anyway and it's very disruptive and tiring. Please stop dragging us around in circles and admit that you have not gathered a consensus behind your OR POV, a POV not supported by views in the profession. OTOH, you are welcome to strike through your comments, but please leave them in place, since many other comments only make sense because of them.

There is another option, and that is to strike through your previous comments and then answer the question honestly and simply as Coppertwig has done below. That way you can at least make some semblance of attempting to stay within sight of collaboration, instead of disrupting this RfC. -- Fyslee / talk 06:05, 18 October 2008 (UTC)

• Agree, qualified by Surtuz' comment that ""SM is relevant to chiropractic" should not be used to insert material about non-chiro SM into the article." (Apologies for the repetition.) A narrow question has been asked and my answer pertains only to that, not to other questions.
  Thank you very much for the list of references, Eubulides. Based on those references, I found the following some of which in my opinion support the RfC question:

  • Principles and Practice: I'm not sure if I have easy access to this book.
  • Christensen & Kollasch 2005: does not contain the string "spinal m"
  • NCCAM: "Chiropractic is a form of spinal manipulation".
  • American Chiropractic Association: The mere fact that they published a document entitled "Spinal Manipulation Policy Statement"; also the section heading "Spinal Manipulation Therapy is a Chiropractic Science"; also the quote "The general description, spinal manipulative therapy, has long been used to broadly describe theprimary manual techniques utilized by a doctor of chiropractic (chiropractic physician)." and the quote "This supports the premise that by far the providers currently best qualified by education and practical skill and testing to perform spinal manipulation are doctors of chiropractic (chiropractic physicians)."; incidentally, the phrase "chiropractic spinal manipulation" also appears several times.
  • Villanueva-Russell: (This quote tends to contradict the RfC question) "The existing scientific research refers to spinal manipulation generally and without reference to specific technique or practitioner."
  • Villanueva-Russell quotes Sportelli: "Chiropractic must lay claim and full ownership to what the general public already associates with chiropractors-spinal manipulation. (1995, p. 39; emphasis added)"
  • Meeker and Haldeman: "Much of the positive evolution of chiropractic can be ascribed to a quarter century-long research effort focused on the core chiropractic procedure of spinal manipulation."
  • Ernst 2008: "This article attempts to critically evaluate chiropractic. The specific topics include ... the concepts of chiropractic, particularly those of subluxation and spinal manipulation;..."; and also "The core concepts of chiropractic, subluxation and spinal manipulation," and "Recent definitions of chiropractic:" of 12 definitions, 3 mention "spinal manipulation"; the phrase also appears in a summary of the "The three main hypotheses of modern chiropractic"; there's also this quote: "Chiropractors therefore developed spinal manipulations to correct such subluxations,... "
  • Council on Chiropractic Guidelines...: Inconclusive; I didn't find "chiropractic" and "spinal manipulation" in the same sentence.

• ☺ Coppertwig (talk) 02:08, 18 October 2008 (UTC)

• Thank you Coppertwig for a straightforward answer. Your qualification afterwards doesn't disturb me, since it reveals that you do have other thoughts, and that's quite legitimate. At least you don't launch into more discussion of that particular subject, which is good since we are discussing that elsewhere. You know how to keep things separate, an admirable quality.
• Interestingly enough Surturz does what you do, except he (contrary to the rules of engagement) allows those other agendas to affect his answer. If he had done as you have done, then we'd have had fewer problems here. -- Fyslee / talk 06:15, 18 October 2008 (UTC)

• My answer is affected by the totality of my life experience; that's why not everyone's answer is the same. I don't understand why you think I'm allowed to also have other thoughts while you've marked some other editors' votes as invalid. Given the way you marked others' votes, to be consistent I think you should mark mine as invalid, too. I said "Agree, qualified..."; Levine2112 said "No." with a period after it. How can you call my answer "straightforward" and Levine2112's "invalid"? ☺ Coppertwig (talk) 15:30, 18 October 2008 (UTC)

• Just to please you, I have stricken two spots above. To explain esoteric discussions isn't worth the grief. -- Fyslee / talk 15:51, 18 October 2008 (UTC)

• DISAGREE Chiropractic is a profession. . . which uses a specific kind of spinal manipulation called the "adjustment". The adjustment is relevant to chiropractic.TheDoctorIsIn (talk) 20:32, 18 October 2008 (UTC)

• Comment Request for comment is about requesting comments. It is not about voting. No votes are valid as no vote is taking place.--ZayZayEM (talk) 09:58, 21 October 2008 (UTC)
• Comment This RfC has clearly been loaded in an attempt to push through information clearly not entailed in the request for comment. Full context should be provided with any RfC. Do not abuse editors good faith.--ZayZayEM (talk) 09:58, 21 October 2008 (UTC)
• Quibble per other editors statements above. Not all spinal manipulation is relevant to Chiropractic. Spinal manipulation may be a core concept of chiropractic, and be directly associated with a chiropractor - however only chiropractic spinal manipulation is relevant to this article. It is kind of obvious. To use a illustrative concept: movement through water is clearly directly related and central to swimming - however not all in-water motion is directly related to swimming, and would therefore be irrelevant to that article. Any mention of boat motion through water, or fish motion through water, or a quad-amputee's body sinking downwards in a lake (live human motion in water) would need to be in direct relation to the concept of swimming - or would be not relevant (and unencyclopedic) on the topic.--ZayZayEM (talk) 09:58, 21 October 2008 (UTC)

  Comment: No offense to any quad-amputees, but I concur with ZayZayEM's first of two^{(14:35, 22 October 2008 (UTC))} comments and quibble above. Fyslee, thank you very much for striking out some of your comments. ☺ Coppertwig (talk) 14:03, 21 October 2008 (UTC)

  Comment It would help if you provided evidence if you are insinuating that general spinal manipulation research is not relevant. BTY, editors have provided evidence that it is directly related. QuackGuru 22:23, 21 October 2008 (UTC)

• Obvously no "voting" is taking place, which is indicated in my frequent use of quotation marks when using the word. An RfC is more of a straw poll with no real consequences, in contrast to a AfD, where articles actually get deleted. You aren't dealing with newbies here. After giving a short and clear "vote", your comments (including quibbles not already covered in the discussions outside this RfC) are welcome. This RfC generally functions like most others, but it can be seen as more focused, getting to the core of the subject by excluding distractions included in other RfCs. Those "contexts" aren't part of this one. This one is pretty much "contextless" by excluding them.
• As a non-regular here I'll excuse you to some degree, but you are still obviously assuming bad faith in your "loaded" accusation and will give you a chance to refactor, now that you have been warned. The context you mention is all around you here, and this RfC is "un"loaded specifically to exclude those discussions. There would be no point in another RfC on the same subject. This one is designed for a specific purpose, which is clearly stated. That's it. -- Fyslee / talk 14:01, 21 October 2008 (UTC)

As perhaps only an outsider can do, ZayZayEm has analyzed this without passion or prejudice and has stated that not all spinal manipulation is relevant to chiropractic. ZZM's swimming analogy is spot on. It's simple logic, easy to follow and I thank this editor for their outside perspective. -- Levine2112 ^discuss 02:52, 22 October 2008 (UTC)

Agree SM is directly relevant to Chiropractic. This is my opinion, and has no relevance to editing Wikipedia, as "direct relevance" per WP:OR must be drawn explicitly by the sources. "Even with well-sourced material, however, if you use it out of context or to advance a position that is not directly and explicitly supported by the source used, you as an editor are engaging in original research." Since such a question of editor opinion is irrelevant to editing Wikipedia, I fail to discern the reason for this RfC. ——Martin^phi ☎ Ψ Φ—— 05:02, 26 October 2008 (UTC)

Review of RFC

It's time to move on and remove the OR tag when no evidence of WP:OR has been presented.

In order to stop the continued OR discussion we may need a specific topic ban on editors who never stop claiming there is OR when we are doing exactly what researchers outside of Wikipedia are doing. The topic ban would be anything directly related to the original research discussion. This would not be an article ban but only a ban on this specific topic. We could have an article ban on any editor who continues the original research discussion if editors believe it to be necessary. Note. Consensus can easily be gamed when editors attempt to block consensus and improvements without a valid reason. WP:IDONTLIKEIT or misunderstanding policy is not a reason to exclude neutrally written information using highly reliable references.

DigitalC has not provided a reason to disagree other than DigitalC thinks the question is too vague but wrote Overall, the answer is "not necessarily". Not neceessarily is trying to have it both ways.

Surturz wrote: While I would agree with the statement stand-alone without any context, I disagree because of previous discussions on this talk page. There is a difference between chiro SM and non-chiro SM and the generalisation "SM is relevant to chiropractic" should not be used to insert material about non-chiro SM into the article. Surturz agrees but then asserts there is a difference between chiro SM and non-chiro SM but that is not a reason to exclude directly related research. We should stick to Wikipedia policy and not decide on personal wishes not based on anything at Wikipedia.

Levine2112 wrote: No. In terms of Wikipedia, spinal manipulation is not "relevant" to chiropractic. Chiropractic spinal manipulation is relevant to chiropractic. Disagree. The profession and its top researchers don't necessarily agree either. In fact, we have highlighted reliable sources demonstrating such disagreement in the professional and research worlds. According to Levine2112, top researchers don't necessarily agree either but no evidence by Levine2112 has been presented. Levine2112 has read comments indictating chiropractic is directly related or is relevant to chiropractic. Levine2112 has been informed that chiropractic is strongly associated with spinal manipulation according to the reliable references presented.

ZayZayEM wrote in part: Spinal manipulation may be a core concept of chiropractic, and be directly associated with a chiropractor - however only chiropractic spinal manipulation is relevant to this article.

The comments by ZayZayEM is good a reason to include SM research because we using references that are directly related to chiropractic. ZayZayEM is aware that spinal manipulation may be a core concept of chiropractic. Coppertwig agrees with ZayZayEM about quibbling. Coppertwig has been informed it is not productive to continue to support there is original research when no evidence of OR has been presented.

Per WP:OR:

Wikipedia does not publish original research or original thought. This includes unpublished facts, arguments, speculation, and ideas; and any unpublished analysis or synthesis of published material that serves to advance a position. This means that Wikipedia is not the place to publish your own opinions, experiences, or arguments. Citing sources and avoiding original research are inextricably linked: to demonstrate that you are not presenting original research, you must cite reliable sources that are directly related to the topic of the article, and that directly support the information as it is presented.

When spinal manipulation research is directly related to chiropractic there can't be any original research and the editors who claim there is original research should read policy again. No evidence of orginal research has been presented but editors continue to claim there is OR. Please show and not assert your view based on policy. These comments provided additional context for uninvolved editors and uninvolved admins. QuackGuru 18:50, 21 October 2008 (UTC)

Closing the RFC

After a couple of weeks of discussion it appears that a general consensus has formed. On the specific question of "Is the "subject" of spinal manipulation relevant to chiropractic?" the majority of editors and discussion agreed that it is. Also, as was pointed out during the discussion, this scope of the RfC didn't cover whether or not any particular information should be included in the article, just that spinal manipulation is relevant to the subject of the article. Shell ^babelfish 06:08, 22 October 2008 (UTC)

I partially disagree with Shell Kinney's observation. Also, as was pointed out during the discussion, this scope of the RfC didn't cover whether or not any particular information should be included in the article, is incorrect. It does cover what particular information should be included. The relevant and/or directly related spinal manipulation information that is currently in the article. QuackGuru 15:55, 22 October 2008 (UTC)

While the result of the RFC implies that the inclusion of general SM material is not an OR violation, I would hesitate to point to it as such. The RFC specifically did not discuss whether or not such an inclusions is an OR violation. Cheers. lifebaka++ 16:37, 22 October 2008 (UTC)

I don't think that a 8-5 "vote" (as the author of this RfC calls it) tells us anything in terms of consensus; especially since one of those 8 supporting "votes" qualified their response by agreeing with the reason for dissention. Also, since the author specifically stated that this RfC has nothing to do with the OR tag currently in place or the application of the relevance of the two subjects in terms of research, this RfC really tells us nothing in terms of how to proceed with any edits to the article. -- Levine2112 ^discuss 17:16, 22 October 2008 (UTC)

??? "... since the author specifically stated that this RfC has nothing to do with the OR tag currently in place or the application of the relevance of the two subjects in terms of research, .."

I don't recall saying any such thing. I excluded those subjects and contexts as a specific part of the RfC. That's all. The RfC comments certainly did cover subjects that are of continued relevance to editing here, but the RfC did not address how that should happen. I tried to be clear about that. Such discussions are quite legitimate, but are not part of the RfC. -- Fyslee / talk 03:36, 23 October 2008 (UTC)

This is not a vote and when editor's arguments are extremely weak with no further arguments beyond "SM isn't chiropractic" then, this discussion has bearing on the original research issues including the original research tag, especialy when no evidence of OR has been presented. QuackGuru 17:50, 22 October 2008 (UTC)

Editors have been discussing whether it is relevant and it is time to move on. QuackGuru 16:50, 22 October 2008 (UTC)

No QuackGuru, the wording of the RfC was very clear and concise (thanks Fyslee). There was nothing in the RfC question about whether or not material was OR nor about whether or not material should be included in the article, so most responders obviously didn't comment on those issues but instead only on the direct question asked. Now, if editor's who wish to have the OR tag in the article didn't have any further arguments beyond "SM isn't chiropractic" then yes, this consensus has bearing on that issue; otherwise, that issue needs to be worked out seperately (with this as a basis for starting). Shell ^babelfish 17:14, 22 October 2008 (UTC)

Thanks Shell Kinney and Lifebaka. The wording was indeed very clear. Further discussion about other - possibly related - matters was not within the scope of the RfC. Such comments should be taken elsewhere in a new thread. They may well be relevant to this article, but they should NOT be a part of this RfC. -- Fyslee / talk 19:27, 22 October 2008 (UTC)

(outdent)

• I agree with Lifebaka's comments here. The RfC establishes consensus that spinal manipulation is relevant and directly related to chiropractic, but it did not specifically endorse or oppose any material that is currently in Chiropractic.
• Levine2112's '8-5 "vote"' is an incorrect count: there were 8 Agrees and 4 Disagrees.
• I agree that it was not a vote. Both the Agree and the Disagree comments had qualifications, in some case major ones. The result, however, clearly established the consensus that Lifebaka refers to.

Eubulides (talk) 18:36, 22 October 2008 (UTC)

Recount them. It is 8-5. Regardless, even 8-4 doesn't establish a consensus. Notice that the main qualification is that while spinal manipulation is somewhat related to chiropractic, chiropractic spinal manipulation is certainly directly related to chiropractic. This is the main contention underlying this whole OR dispute. If we were to look at the "votes"! which considered this distinction, the numbers are closer to 7-6 in just this RfC. Perhaps we should create an RfC which factors this qualification into it and open it to just outsiders. Thoughts? -- Levine2112 ^discuss 19:26, 22 October 2008 (UTC)

While I would be more than happy to discuss the reasons for the close and the outcome I posted, please don't assume that any sort of vote-counting goes into determining consensus. Also, its a bit of a concern that you're considering counting comments like DigitalC's as disagreeing with the premise, when in fact, his comment was a dislike for the wording of the RfC and not any kind of a comment on the actual issue at hand. That seems to be, at the very least, quite a stretch. Shell ^babelfish 19:40, 22 October 2008 (UTC)

Please do not discount my contributions as being a dislike for the wording of the RfC. I very clearly stated that the only answer that CAN be given is "not necessarily", as it depends on context. In some situations, it may be related. In other situations, it is not related. This IS commenting on the issue at hand. DigitalC (talk) 00:51, 23 October 2008 (UTC)

In some situations, it may be related? In other situations, it is not related? I disagree. Please provide the evidence in what situations it is not related or it is time to move on. QuackGuru 01:11, 23 October 2008 (UTC)

I have previously given context in situations where it is not related. For you to demand that I repeat myself is tiresome. One example would be when a Physiotherapist is performing spinal manipulation. It is obviously not related to chiropractic. Unless it is stated that it IS related to Chiropractic, one cannot assume that it is. 118.208.203.101 (talk) 05:57, 23 October 2008 (UTC) —Preceding unsigned comment added by DigitalC (talk • contribs)

We are not using specifically Physiotherapist SM references in this article. So, that makes your argument irrelevant. QuackGuru 06:07, 23 October 2008 (UTC)

The RfC stated that this was "limited to the bare question, as it reads", not about the sources currently used. Again, since you have a habit of WP:IDHT violations, I will repeat, in bold, the last line from the comment your replied to. Unless it is stated that it IS related to Chiropractic, one cannot assume that it is. The article currently DOES use references that do not state they are related to Chiropractic. - DigitalC (talk) 06:22, 23 October 2008 (UTC)

This is not the RFC. This is the closing of the RFC. We are here to improve this article and when the only arguments are opinions without any evidence such as references to support the comments then we should move on and remove the OR tag. The article uses references that are directly related to chiropractic. SM is core to chiropractic and I'm sure you know this. QuackGuru 06:30, 23 October 2008 (UTC)

Note: DigitalC is unable to provide any evidence that the current references or text in the article is original research. Specific examples are needed. DigitalC, please provide evidence of OR or it it time to move on. QuackGuru 23:00, 23 October 2008 (UTC)

If there are problems with particular sources or parts of the article, please bring those up elsewhere - as we've said numerous times now, this RfC was not about either of those issues. Maybe it would help to discuss specific issues with the current text one at a time instead of generalizing? Shell ^babelfish 23:27, 23 October 2008 (UTC)

As Shell Kinney said, this is not the place. This RfC was not about OR, and the closing of this RfC is not about OR. DigitalC (talk) 00:54, 24 October 2008 (UTC)

I have commented in another section too. QuackGuru 00:58, 24 October 2008 (UTC)

Understood. However, I think DigitalC's answer of "not neccessarily" is precisely in line with my dissention here, TheDoctorIsIn's and ZayZayEm's. Please consider outsider respondent ZayZayEm's comment which, IMHO, analogizes the issue swimmingly. -- Levine2112 ^discuss 21:46, 22 October 2008 (UTC)

As you said, DigitalC's comment is more along the lines of "not necessarily" as is Surturz's. ZayZayEM mentioned that some but not all would be relevant and there were a number of comments made that even if SM was relevant, this didn't mean a free for all on article content. These comments were the reason that I reminded editors in my closing that this didn't mean a license for dramatic article changes.

As far as the line of dissension, your comments were particularly against assigning any sort of relevance, as were your later arguments when discussing some of the agree comments. All of the comments you mentioned, with the exception of yours, can be handled by discussing the actual article content in detail. Your comment seems to be the only one that indicates that you would not be content with any mention of spinal manipulation in the article.

And that's part of why consensus can be so difficult - even those people who seem to agree (or maybe just disagree with the same people) may not really be saying the same things - reaching an agreement with "some but not all" or "not necessarily" is very different than reaching an agreement with "no, absolutely not". Shell ^babelfish 00:51, 23 October 2008 (UTC)

The problem seems to be that it was about editor opinions. Before, it was about whether there was OR. Yes, there is OR, or was at the time. So my question is, So what if it's directly relevant? We don't edit WP out of our own opinion. Can we agree that if a source does not state its relationship to Chiro that we don't use it? If not, then we have an editor behavior issue, as WP:OR clearly states that we don't do our own thinking in this kind of matter. If we can agree, then all we need to do is go over the sources, and remove any which don't state their relation to Chiro. Then using those sources, we write the section. ——Martin^phi ☎ Ψ Φ—— 05:11, 26 October 2008 (UTC)

This is like asking "Can we agree that if a source does not state its relationship to automobile safety, then Automobile safety cannot use it?" No, that's not a reasonable restriction, and Wikipedia articles are not constrained to follow restrictions like that. Automobile safety routinely refers to sources that do not state their relationship to automobile safety: the very first source it cites, the WHO report on road traffic injury prevention, never mentions automobile safety. But this is OK. Road safety is obviously directly relevant to the automobile safety, and the WHO source should not be excluded merely because it doesn't state its relevance to automobile safety. Similarly for other Wikipedia articles, including Chiropractic. Eubulides (talk) 20:43, 28 October 2008 (UTC)

Apples and oranges. We don't know that Automobile safety : road safety :: spinal manipulation research : chiropractic spinal manipulation research. This sounds like a strain of the WP:OTHERCRAPEXISTS argument. -- Levine2112 ^discuss 23:29, 28 October 2008 (UTC)

Actually this is the best comparison we have seen so far. We have seen others that were so off-base that they didn't deserve comment, but this one shows how proper editing occurs without violating NOR. -- Fyslee / talk 05:31, 29 October 2008 (UTC)

What would be unreasonable about that, Eubulides? No one said they had to use the exact word. But if you are using stats from England to draw conclusions about the US, you have to take care, as the traffic laws are different. ——Martin^phi ☎ Ψ Φ—— 08:34, 31 October 2008 (UTC)

I don't think it is unreasonable for Automobile safety to cite the WHO report on road traffic injury prevention, even though the WHO report is on road safety, not on automobile safety. This is not a question of England vs. the U.S.; it's a question of automobiles vs. roads. Nobody claims that automobile safety is identical to road safety, but most people would agree that road safety is highly relevant to automobile safety. Similarly, nobody here is claiming that chiropractic is identical to spinal manipulation, but most of us agree that spinal manipulation is highly relevant to chiropractic. Eubulides (talk) 08:24, 3 November 2008 (UTC)

The England comparison is more along the lines of what we have here. Driving in England is very much different from driving in the U.S. Yet, it is still driving. Some of the same rules apply, some don't. Therefore, in an article about U.S. driving safety, you wouldn't expect to find conclusions about driving safety in England. -- Levine2112 ^discuss 20:10, 3 November 2008 (UTC)

The WHO report is not about England. It is about road safety world-wide. Automobile safety is not about automobile safety in the U.S.; it is about automobile safety world-wide. So the comments about U.S. versus England are not relevant to this particular example. Eubulides (talk) 21:35, 3 November 2008 (UTC)

We are only proposing a hypothetical which would make your example relevant. As it stands now, your example is irrelevant because it doesn't demonstrate a direct comparison. -- Levine2112 ^discuss 22:41, 3 November 2008 (UTC)

(outdent) The example I gave is not hypothetical: it is a real example, in a real article. And it is entirely relevant, as Fyslee stated. Eubulides (talk) 20:51, 5 November 2008 (UTC)

Editors should abide by the recent RFC

Note: An editor has ignored the closing of this RFC that has direct impact on how we proceed with spinal manipulation. I request clarification on how to proceed on this matter. According to the closing of this RFC, we should conclude that spinal manipulaton is directly relevant to chriopractic. Per WP:OR, research that is directly related is permittable. Therefore, editors should stop claiming it does not relate to chiropractic or general spinal manipulation research is OR when this RFC has been closed with a consensus about the subject of SM is relevant. QuackGuru 00:44, 25 October 2008 (UTC)

Three editors has are not fully complying with the consensus of the recent RFC. Editors need to abide by the closing of the RFC. Here are more comments from the closing administrator.[35][36]

DigitalC (talk · contribs) [37]

Levine2112 (talk · contribs) [38][39]

Surturz (talk · contribs) [40]

This requires administrative assistance. QuackGuru 17:07, 25 October 2008 (UTC) I made a comment here at another talk page. QuackGuru 17:24, 25 October 2008 (UTC)

The RfC was clearly defined to have a very narrow focus: only whether spinal manipulation was relevant to chiropractic, not whether chiropractic spinal manipulation is different from other kinds of spinal manipulation; not whether spinal manipulation research that uses non-chiropractic manipulation is relevant to chiropractic; not whether the article contains OR; not whether any particular material should or should not be included in the article. If you want an RfC that decides whether there is OR or whether to include certain material in the article or not, run an RfC that asks that question. ☺ Coppertwig (talk) 22:03, 25 October 2008 (UTC)

Coppertwig, please abide by consensus. QuackGuru 22:46, 25 October 2008 (UTC)

I believe we've already discussed that matter for the last six months. Some are listed in the next section. Can you suggest a wording for a new RfC that would help us avoid repetition and running in circles once again in a new RfC? -- Fyslee / talk 22:07, 25 October 2008 (UTC)

RfC conclusions are not bludgeons. QuackGuru, this needs to stop - the RfC was quite specific in its scope, so discussions about specific text, how its relevant and how it should be used should not be short-circuited by whacking people with the decisions from this particular RfC. In response to other comments, I don't believe any generalized RfC is going to solve the problem. Unless everyone here is willing to start discussing specifics I think its very unlikely that this dispute will ever end. Look at it this way - while you may get everyone to agree on a compromise for wording of a specific area, there is little to no chance you're ever going to get everyone to agree to some broad principle that affects multiple aspects and areas of the article.

Would everyone here be willing to try an experiment? Can we make a list of very (very, very) specific concerns people have with the article? Not things like SM is OR in this article, things like This statement "blah blah blah" should be changed to "blah blah blah" to better reflect the source/current research or even The statement "blah blah blah" should be removed from the article because "very specific reason". These statements should be as concise and specific as possible with the intent to expand more on them later and deal with them in detail - this is just to get a list of things that need to be addressed.

The next step in this experiment would be to address the problems one at a time through discussion, polls, RfC's or whatever is needed to either get everyone agreeing or develop a reasonable consensus from editors who respond to the issue. This would mean asking people not to open additional discussions that aren't about this particular issue and hopefully, to avoid making any contentious edits to the article to avoid making the list longer.

Thoughts, comments, is this something you could agree to or would like to try? Shell ^babelfish 03:05, 26 October 2008 (UTC)

Excuse me if I'm not up to speed- it's very hard to jump in. The RfC above is rather silly, I believe. It seems to be about whether editors think SM is relevant to Chiro. Sure, I think it probably is. That's irrelevant to the actual situation. I deduce that no one would have bothered with the question if it didn't mean anything for the article. If it means anything for the article, then it should not: what we think doesn't matter. It's purely a matter of sourcing. We also have an SM article. To the extent that the sources tell us that SM relates to Chiro, and to that extent only, can we have SM in this article. The RfC is obviously focused on the wording of WP:OR "directly related", but forgets that it is the sources which must draw the direct connection, not the editors. Shell has given a good way to proceed. It would also help editors such as myself to be able to comment. ——Martin^phi ☎ Ψ Φ—— 05:04, 26 October 2008 (UTC)

Time to remove tags

Discussion seems to have died down about the two maintenance tags in Chiropractic. It's time to fix this as discussed.

First, Chiropractic #Effectiveness has a {{Mergeto}} tag that has been discussed in great detail in #Relevancy and in #Scope of practice 4 above. It can be removed by applying the change discussed in #Scope of practice 4.

Second, Chiropractic #Evidence basis has a {{SectOR}} tag that has been discussed in enormous detail, in several places, including:

• RfC: Effectiveness of chiropractic care (April 24)
• RfC: Effectiveness of chiropractic care (May 12)
• Its followup Improved version RfC (May 14)
• Chiropractic section on evidence basis (July 29)
• Request for Comment, Possible OR violation at Chiropractic Effectiveness (September 10)
• Request for Comment: Excluding treatment reviews (September 16)
• Outside view believes spinal manipulation is relevant (September 30)
• RfC: Is the "subject" of spinal manipulation relevant to chiropractic? (October 9)

While there is not universal agreement in the above threads, there is a consensus that the text in question is not original research. Further reopening of RfCs and NORN issues is likely to be not useful, as we've reached the point of RfC exhaustion. It's time that we brought this discussion to a close, removed the tag, and moved on to further improving the article. Eubulides (talk) 07:06, 15 October 2008 (UTC)

There is no consensus that the text in question is not a violation of WP:OR. Saying so is a gross distortion of the truth. I'd say that it is time to remove the text in question and move on to further improving the article. However, I am not going to suggest that until this conversation is truly over. As of now, the conversation is hardly over. I still plan on opening the new RfC and continuing with WP:DR. How come you never answered my X-ray questions above? -- Levine2112 ^discuss 17:21, 15 October 2008 (UTC)

We are doing the same thing experts outside of Wikipedia are doing and you know this. I'm sure of it. On Wikipedia we do not lead but follow the latest references carefully. That's exactly what we are doing. QuackGuru 17:51, 15 October 2008 (UTC)

Actually, Levine, consensus is relatively clear in the RFC. Further discussion there may yet be useful to come up with suggestions on how to minimize perceived WP:OR violations, but I highly doubt that consensus will change due to it. Cheers. lifebaka++ 19:02, 15 October 2008 (UTC)

Which RfC are you referring to? We've had several. Some editors who responded in earlier ones did not respond in newer ones. And some of the newer RfC don't really discuss whether or not the OR tag is appropriate. -- Levine2112 ^discuss 19:07, 15 October 2008 (UTC)

The one above at #RfC: Is the "subject" of spinal manipulation relevant to chiropractic? was what I was referring to specifically. If you have links to older RfCs on the topic, I'll be happy to look over them. It is true that this specific RfC does not directly address the issue of OR, and perhaps another RfC based on its outcome would be appropriate. Cheers. lifebaka++ 19:12, 15 October 2008 (UTC)

Thanks for the response. Yes, that RfC does not address the possible OR violation directly. Whereas, this one does. You will note that the majority (if not all) of the outside respondents agreed that there was an OR violation. -- Levine2112 ^discuss 19:14, 15 October 2008 (UTC)

Editors claimed there was OR but specific exmples are needed. See Talk:Chiropractic/Archive 27#Examples needed. The OR concerns are only concerns. No evidence of OR has been presented. For this article, Wikipedians are doing the same thing top researchers are doing. Time to move on. QuackGuru 20:06, 15 October 2008 (UTC)

Interesting, but I don't see consensus either way in that one. Outside participation in the linked RfC was very low, though you are correct that it favored the position that an OR violation had been committed. Cheers. lifebaka++ 22:36, 15 October 2008 (UTC)

What is more interesting is that the editors who claim OR are unable to produce any evidence of OR. Outside participation was very low. Some of the editors are involved editors and not outside observers. Hmm. QuackGuru 04:39, 16 October 2008 (UTC)

Indeed, Lifebaka. I'd say there was a very clear consensus that no OR is involved in following the literature and using these references in the same way as other publications on the topic. Tim Vickers (talk) 19:10, 15 October 2008 (UTC)

And I would disagree. When one looks at the totality of the discussion (including here), no clear consensus exists. DigitalC (talk) 08:07, 16 October 2008 (UTC)

• The totality of the discussion includes all 8 threads I listed at the start of this section. The thread that you and Levine2112 cite is the one most-favorable to the contention that OR exists. And that particular thread is a slender reed indeed: the RfC itself is vaguely worded and contains no specific examples, outside respondents' opinions contain statements like "I have not digested the section in question" which make it clear that their opinions are uninformed, and the resulting comments don't establish consensus either way. And that's the thread most-favorable to the contention that OR exists; the other 7 threads listed above are unfavorable to the contention.
• Levine2112 has stated multiple times an intent to continue this months-long campaign of opening RfCs and other dispute-resolution options, with comments like "The conversation is hardly over" (e.g., [41], [42]). As part of this campaign, for example, there's a currently-open thread at WP:NOR/N #A hypothetical which raises a hypothetical question about X-rays within chiropractic. The questions in this campaign are vague or hypothetical questions, sometimes contain inaccurate summaries of what is actually in Chiropractic, and do not propose specific changes to the wording in the article. Such questions are unlikely to result in any improvements to Chiropractic. Much better would be specific wording proposals, such as the one in #Proposed addition re X-ray safety below.

Eubulides (talk) 17:02, 16 October 2008 (UTC)

This comment seems irrelevant IMHO. This is how consensus policy can easily be gaming the system. The editors who claim OR have not presented any evidence of OR. Should we respect the opinion of editors who make a claim of OR when they refuse to demonstrate any evidence of OR exists or should we move on to other parts of the article? This is when admins may want to step in an make an executive decision. Should editors continue to argue (continue to recycle old arguments) or move on to bigger and better things (possibility of WP:GA)? QuackGuru 18:08, 16 October 2008 (UTC)

Me thinks we should remove the tag after about a half of a year (six months) of discussion, especially when I request references and no evidence of OR was presented. Again, please provide evidence of OR or it is time to remove the tag. QuackGuru 16:53, 22 October 2008 (UTC)

I have done a lot of reading over the past few days and focused specifically on the RfCs listed above because this same issues seems to be going around in circles and frustrating many of the participants here. Since there are disagreements over what did and what did not have consensus, I'm going to give an uninvolved look at the points that gained consensus during those discussions pointed out above:

The claim center to these discussions is that spinal manipulation (SM) should not be included in this article or that the use of SM studies is original research.

• The recent RfC was clear that SM is relevant to Chiropractic. While this did not address any specific text in the article, this does mean that information about SM should no longer be challenged only on the basis that it is about SM.
• Several past RfC's dealt with whether or not the use of SM research in this article qualified as original research. The majority of editors, especially those who were uninvolved in these regular disputes and informed on the subject agreed that the scientific community and even the chiropractic community regularly accept this research as relevant, thus the Wikipedia article should follow.

There is a point at which further discussion or argument of the same issues becomes unproductive and even disruptive - I believe this issue is well past this point. I understand that not everyone may be able to agree as they would in a true consensus, but on Wikipedia a super-majority of editors in agreement is enough for our purposes and should be respected as such. Shell ^babelfish 17:40, 22 October 2008 (UTC)

Shell, I respect your input here but disagree with you when you state that the super-majority of editors agree that the scientific community and even the chiropractic community regularly accept this research as relevant, thus the Wikipedia article should follow. If this comes down to sheer numbers in "votes" then I would request a formal tally of all respondents and their positions. -- Levine2112 ^discuss 18:05, 22 October 2008 (UTC)

If we decide based on the merits of the arguments or lack of arguments then there is broad consensus for inclusion of SM research. QuackGuru 18:10, 22 October 2008 (UTC)

Consensus on wikipedia is not about vote counting, nor should determining consensus rely on a simple numerical representation of "sides" of a debate. Clear, well thought out comments, especially discussion that stands up to criticism or sways the opinions of other editors are vastly preferable to simple drive-by voting. So, Levine, while I understand that you, being on the other side of the fence, may be unhappy at the outcome of the discussions, please consider that your interest in the subject and preconceived notions may lead you to see a different result for any discussion on the subject. This is why we let uninvolved editors close RfCs and help write their conclusions, just like we let uninvolved editors close deletion debates and other formats that require determining consensus. Shell ^babelfish 19:36, 22 October 2008 (UTC)

I can respect your opinion on this; however, I don't understand how you've arrived at stating that there is a clear consensus either way in this dispute. I and others have made well-reasoned objections to the material in terms of WP:OR which I have yet to see challenged in any meaningful way. For instance, we have shown that leading researchers do NOT agree that all spinal manipulation research is directly related to chiropractic and chiropractic spinal manipulation. There is clear disagreement on the subject. Despite this disagreement, we are applying the opinions of some of those researchers to pieces of research which they never mention as being related (much less directly related) to the subject of this article; chiefly chiropractic. That is where the OR violation lays. We have no problem including research which makes conclusions specifically about chiropractic. We have no problem including the analysis of a researcher who has taken non-chiropractic research and applied it to chiropractic. However, we do have a problem when we take non-chiropractic research and apply it to chiropractic on our own. That we base our rationale for making such an original application on the opinions of some researchers who say it is okay to do so, flies in the face of those researchers who say that it is not okay to do so. That we are basing our rationale for using material in an original way on the opinions of disputed third-party sources is precisely why this may be a WP:SYN violation. Based on your understanding of this dispute, Shell, how would you address this argument? -- Levine2112 ^discuss 21:40, 22 October 2008 (UTC)

I'm sorry Levine, but I'm not here to debate with you or get involved in the dispute - I thought an outside view might be helpful to moving forward and gave what insight I could from an outsider's view into prior discussion. Its a bit worrisome that you continue to say "we" as if there is a great deal of support for your position; when reading these RfCs and prior discussions it is clear that a majority of the objections you refer to are actually coming mostly from you. It might help to resolve this and other disputes if you could work on finding a way to modify your position so that more editors could agree with you - that's how we work towards finding a consensus. If there are good arguments for and good arguments against a particular solution, that's usually a sign that a different solution can be found. However, there are times when no solution will appease everyone and in order to continue moving forward on articles, we allow the majority consensus to stand. Shell ^babelfish 03:51, 23 October 2008 (UTC)

Again, I still don't see the majority consensus you speak of, and if it comes down to that, I will ask for a formal tally. What I am asking for above is your outsider's perspective of the argument of OR and SYN which has not only been levied by myself, but several other editors. If you don't wish to address the merits of specific arguments, I can respect that. -- Levine2112 ^discuss 03:14, 24 October 2008 (UTC)

I can tell you a couple of things based on my reading of the discussions and the RfCs, including the recently closed issue. You say "we have shown that leading researchers do NOT agree that all spinal manipulation research is directly related to chiropractic and chiropractic spinal manipulation" however, the RfC pretty clearly indicated that many other editors disagree with you on this matter, in fact, even those who didn't believe it was as simple as saying "SM is related to Chiro" disagreed on how and to what extent it was. That was a pretty overwhelming response in favor of SM being related, even if there wasn't perfect agreement on to what extent and though you disagree, its incumbent upon you to respect the consensus of that RfC.

As far as the discussions on OR, your contention appears to be that taking research on SM and using it to support statements in Chiro is original research (please let me know if I'm misreading). Again, I think this issue has been touched on repeatedly in discussions and RfCs and overwhelmingly the answer from other editors was that yes, this was appropriate sourcing for the article and very typical to how scientific research is handled. However, as Surturz mentions below, there is room for discussion on a case by case basis of particular sources and statements. I think this would be vastly more productive to resolving the dispute than these meta arguments that are unlikely to gain a complete consensus and just as unlikely to actually be meaningful to actual article text.

Would it be possible to walk through the items that are of concern in the article one at a time and discuss these specific instances and sources? Shell ^babelfish 07:44, 24 October 2008 (UTC)

• User:Levine2112 certainly is not the only one with WP:OR concerns (User:DigitalC and myself are at least two more). It is just User:Levine2112 has a thicker skin than the rest of us and is willing to put up with the other editors that feel they WP:OWN the article. The key issue on this talk page is the relevance of non-chiro SM studies vs. chiro SM studies. There is unanimous agreement for the inclusion of all studies from reliable sources that relate to chiro SM. There is not, however, unanimous agreement for the inclusion of studies that study non-chiro SM. Now, okay, consensus is not the same as unanimous agreement - but it aspires to it. Common sense would dictate that all chiro SM studies should be included, and the inclusion of non-chiro SM studies should seek consensus on the talk page on a case-by-case basis. However, that is not what is happening... instead certain editors are pushing to have all non-chiro SM studies included. Worse still, to do this they are gaming the talk page by starting crafted RfCs, threatening editors with opposing views with arbitration, and of course, flooding the talk page with the same arguments over and over. There is no attempt by these editors to seek a middle ground or even seek a working relationship. Instead, they work towards banning dissenting editors. --Surturz (talk) 03:57, 24 October 2008 (UTC)

• Chiropractic #Evidence basis does not cite any "non-chiro SM studies". All the studies it cites are based on chiropractic data. Some of the studies also incorporate a bit of data from non-chiropractic sources, but that is not at all the same thing as a "non-chiro SM study". Nobody is pushing to "have all non-chiro SM studies included". Eubulides (talk) 09:15, 24 October 2008 (UTC)

section break (specific OR arguments here)

DigitalC is unable to provide any evidence that the current references or text in the article is original research. Specific examples are needed. DigitalC, please provide evidence of OR or it it time to move on. Exactly which sentence and or reference is original research? QuackGuru 23:38, 23 October 2008 (UTC)

Sure, lets start at the beginning of the Chiropractic#Effectiveness. I am not going to go through this line by line, however lets start with "Many controlled clinical studies of spinal manipulation (SM) are available, but their results disagree,[85] and they are typically of low quality.[86]". The first reference used (Ernst & Canter, 2006) does not make any specific conclusions about chiropractic spinal manipulation. In fact, looking at Table 1 of the study, we see "Any type of SM" and "Physiotherapy and/or Spinal manipulation". It is original research to use this reference in Chiropractic#Effectiveness, as this reference does not make any claims about Chiropractic effectiveness, yet its use here implies that it is relevant to Chiropractic effectiveness (which is an implication the author does not make, and is therefore OR). I don't have access to the full-text of the second reference used, but it is also being used inappropriately, as it is being used out of context. It does NOT support the claim that many controlled studies are available but they are of low quality. In fact, it states that there are FEW (not many) RCTs investigating the effectiveness of TTH/CeH/M, and that the methodological quality of THESE papers is low. To further extrapolate this is OR because this is NOT a claim the author is making. Please also strike your comment that I am "unable to provide any evidence that the current references or text in the article is original research", because I have just done so. DigitalC (talk) 01:13, 24 October 2008 (UTC)

• The statement in question is "Many controlled clinical studies of spinal manipulation (SM) are available, but their results disagree, and they are typically of low quality." The cited sources directly support this statement, thus satisfying WP:OR. The second citation is actually to two sources, Fernández-de-las-Peñas et al. 2006 (PMID 16596892) and Johnston et al. 2008 (PMID 18404113), and they clearly support the claim about low quality; for example, the former says "In addition, the methodological quality of these papers is typically low".
• There is no requirement in WP:OR that a cited source must support implications that could be drawn from the claim that the source supports. All that's required is that the cited source must support the claim.
• It's OK that the statement in question does not mention chiropractic. There is no requirement in WP:OR that every claim in Chiropractic must have the word "chiropractic" in it. All that's required is that every claim be directly relevant to chiropractic. We have a consensus that spinal manipulation is directly relevant to chiropractic; see #RfC: Is the "subject" of spinal manipulation relevant to chiropractic?, which merely ratifies common sense. (struck at DigitalC's request about not "whacking"; see below) This claim about spinal manipulation is directly relevant to chiropractic and it does not violate WP:OR.

Eubulides (talk) 09:15, 24 October 2008 (UTC)

• The cited sources do NOT directly support this statement. The statement that "the methodological quality of these papers is typically low" IS not referring to "Many controlled clinic studies of spinal manipulation", but rather the FEW RCTs investaging the effectiveness of TTH/CeH/M. This is a clear SYN violation.
• There is a requirement in WP:OR that a cited source must be directly related to the subject of an article. This source is NOT directly related to the article.
• The RfC had nothing to do with the OR claim that spinal manipulation was directly relevant to chiropractic, and was clear about that in its instructions. Please don't attempt to game that RfC.

DigitalC (talk) 22:25, 24 October 2008 (UTC)

• The claim (that controlled clinical studies of SM are typically of low quality) is not supported by just that quote. There are others; for example, the second cited source, Johnston et al. 2008 (PMID 18404113), says that none of the trials made use of an expertise-based randomized trial design, an important factor in an intervention like SM. If there is serious doubt about the low quality of the sources in this area, we can easily add more sources; this is not a controversial issue among reliable sources.
• The source in question, Fernández-de-las-Peñas et al. 2006 (PMID 16596892), is about methodological quality of published randomized controlled trials that used spinal manipulation and/or mobilization to treat patients with tension-type headache, cervicogenic headache, and migraine. They did a literature search of all studies published in peer-reviewed journals and indexed in MEDLINE, AMED, CINHAL, etc., through June 2005, searching for terms like "chiropractic manipulation" and "cervicogenic headache", and following the references of all the papers they found. Of the many studies they looked at, they found only 2 that had good methodological quality. Obviously this source is not about all of chiropractic (headache treatment is maybe 5 or 10% of chiropractic care), nor is it exclusively about chiropractic (some studies were about physical therapy, for example), but it is directly relevant to the evidence basis for chiropractic, which is the section in question.
• I don't know what is meant by "The RfC had nothing to do with the OR claim that spinal manipulation was directly relevant to chiropractic". The title of the RfC is #RfC: Is the "subject" of spinal manipulation relevant to chiropractic?. The RfC was not about the OR policy, but it was about whether SM is "relevant" or "related" (synonyms, according to the RfC) to chiropractic. It is quite a stretch to say that the RfC has nothing to do with the claim that SM is directly related to chiropractic; the RfC has everything to do with that claim.

Eubulides (talk) 20:43, 28 October 2008 (UTC)

• . Please find a quote that you feel verifies the wording in question. The sources currently used do not support that statement. From NOR, "Take care, however, not to go beyond what is expressed in the sources". Currently we are going beyond what is expressed in the sources. Saying that none of the trials made use of an expertise-based randomized trial design is NOT saying that they are "TYPICALLY of low quality". Neither of these sources are making the claim that "Many controlled clinical studies of spinal manipulation (SM) are available" and that they are "typically of low quality".
• The RfC was clearly not about OR policy, please do not misrepresent it as if it were about OR policy. If the RfC was about OR policy, and whether, in respect to OR policy general spinal manipulation research is directly related to chiropractic, it might be relevant. However, that isn't what the RfC was. Please also abide by the comments by the closing admin, that "discussions about specific text, how its relevant and how it should be used should not be short-circuited by whacking people with the decisions from this particular RfC.".

DigitalC (talk) 22:30, 28 October 2008 (UTC)

• I don't think I misrepresented the RfC as being about OR policy (on the contrary, I said it wasn't about OR policy). To try to get past this problem, though, I struck out the comment that I think you were objecting to; it was not a crucial part of the argument anyway.
• I think the sources do support the statement. Here are two more sources, which could be added to the article if needed:

• Assendelft et al. 1995 (PMID 8568990). Sample quote: "strong conclusions were precluded by the overall low quality of the reviews"
• Koes et al. 2005 (PMID 15949774). Sample quotes: "There were no improvements in median overall methodological quality over time from 1960 to 2004." "The publication of a substantial number of RCTs of relatively low methodological quality in recent years is disappointing. One would assume that given the knowledge and expertise available researchers and clinicians could have done a better job." That source's Table 3 showed the median quality score for SMT RCTs was 45%, which was toward the low end for the interventions investigated.

If more sources are needed they can easily be provided. Eubulides (talk) 20:45, 29 October 2008 (UTC)

What we need here is a source that clearly supports the statement that controlled clinical studies of SM (or even better, chiropractic) are "typically of low quality" (not just the studies that they looked at in their research, but typically). As much as I hate the over-use of Ernst that this article relies on, I do believe you provided a quote from either Ernst 2008 or Ernst 2006 a while back, which commented on the "many clinical trials of chiropractic". Would it be relevant here (I can't seem to find it). DigitalC (talk) 22:31, 29 October 2008 (UTC)

(outdent) Sorry, I don't recall that quote. A quick Google Scholar search found this quote, though. Surely it's good enough.

"In spite of urgent calls for improved methodological quality of RCTs on spinal manipulation, it appears that even the most recently published RCTs have been of discouragingly low quality. Fifty-two (75%) of the 69 RCTs in this review exhibited relatively low quality (validity scores less than 50). Of the 43 trials accepted into evidence, 29 (67%) also had relatively low validity scores (6 to 44)." Bronfort G, Haas M, Evans RL, Bouter LM (2004). "Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis". Spine J. 4 (3): 335–56. doi:10.1016/j.spinee.2003.06.002. PMID 15125860.{{cite journal}}: CS1 maint: multiple names: authors list (link)

Eubulides (talk) 23:50, 29 October 2008 (UTC)

That quote would support the statement that "the most recent published RCts are of low quality", or something along those lines, but again, it doesn't state that the RCTs are typically low quality. It would also still be original research on this article, because it is discussing RCTs on spinal manipulation, not discussing chiropractic. We need to present the evidence basis for chiropractic as it is presented in reliable sources. DigitalC (talk) 02:05, 1 November 2008 (UTC)

The quote itself supports more than that: its "even" supports the claim that published RCTs in general are of low quality. The claim in Chiropractic #Evidence basis is about spinal manipulation, not about chiropractic, so the source is appropriate for that claim. Eubulides (talk) 08:24, 3 November 2008 (UTC)

• No, that quote certainly does not support the claim that published RCTS in general are of low quality. It doesn't make such a claim, and to use it to make that claim would again be OR. They only commented on the RCTs they reviewed, not RCTs in general.
• The claim would be appropriate on Spinal Manipulation, it is not appropriate here. NPOV requires us to present the topic (Evidence basis of chiropractic) the way that it is discussed in reliable sources. DigitalC (talk) 07:46, 4 November 2008 (UTC)

The quote fully supports the claim. DigitalC has acknowledged it would be appropriate on Spinal manipulation. SM is directly related to chiropractic. Therefore, it can't be OR on this article. Moving the sentence to another article would not change the verifiability of the text when we know SM is relevant to chiropractic. The argument that any general spinal manipulation reference in this article is OR should be put to rest. QuackGuru 08:00, 4 November 2008 (UTC)

DigitalC, thanks for even more evidence. We have already presented Murphy as another piece of evidence. Further, the feelings of leading researcher such as Ernst and Shekelle have also been presented as even more evidence that there is OR in the Effectiveness section. That some editors don't agree with this evidence is fine. However, agree with it or not, everyone here knows that evidence of OR has been presented. To deny that evidence has been presented is just foolish. -- Levine2112 ^discuss 04:10, 24 October 2008 (UTC)

Slow down a bit and AGF. There is no doubt that you have presented what you believe to be "evidence". Yes, that's true. When others don't consider it to be proper, sufficient, or accurate "evidence", and even consider it to be misleading "evidence", then they of course will not consider it to be any real and valid "evidence". IOW, they will say "evidence" has not been presented. Sure, they'll admit you have attempted, but that's all. You would do the same in their shoes. I hope that clarifies the difference of opinion. I know this is frustrating to you, but it is also frustrating to the rest of us. Just AGF and be patient. -- Fyslee / talk 05:07, 24 October 2008 (UTC)

Every claim that cites Murphy is directly supported by Murphy, and is directly relevant to chiropractic, so there is no OR there either. Ernst and Shekelle do not say that spinal manipulation is not directly relevant to chiropractic; on the contrary, reliable sources (including Ernst and Shekelle) are all consistent with the fact that SM is directly relevant. Eubulides (talk) 09:15, 24 October 2008 (UTC)

Levine2112 claims it "flies in the face of those researchers who say that it is not okay to do so." Levine2112, please show and not assert your view. Please tell us which researchers support your view that general chiropractic research is not directly related to chiropractic. When spinal manipulation is core to chiropractic it is relevant (and directly related per WP:OR) information for this article. If there are concerns with particular sources or parts of the article, please bring those up here. Maybe it would help to discuss specific issues with the current text one at a time instead of generalizing, per Shell Kinney. QuackGuru 23:38, 23 October 2008 (UTC)

I have requested that Levine2112 give specific examples of OR instead of making vague and general comments or the OR tag must go. When no evidence of OR has been presented it is time to move on. QuackGuru 17:25, 24 October 2008 (UTC)

The link between the Ernst review and chiropractic is clear, and the link is made in a wide variety of tertiary sources, such as Is your back in safe hands?, Chiropractors are offering 'worthless' form of treatment and Junk medicine: spinal manipulation. We need to follow the sources, not argue over our own interpretations of what table 1 might suggest. Tim Vickers (talk) 20:10, 5 November 2008 (UTC)

Where in either of these newspaper articles does it state that all spinal manipulation research can be applied to form conclusions about chiropractic spinal manipulation? -- Levine2112 ^discuss 20:14, 5 November 2008 (UTC)

It forms conclusions about spinal manipulation which is strongly associated with chiropractic. QuackGuru 20:18, 5 November 2008 (UTC)

I was addressing the specific concern about a specific source that was raised by DigitalC. These articles establish that the Ernst and Canter 2006 review of spinal manipulation is regarded by multiple reliable sources as of direct relevance to chiropractic. Arguments that it would be OR for this article to interpret this 2006 review in the same way as these tertiary sources interpret the review are therefore very unconvincing. Tim Vickers (talk) 20:22, 5 November 2008 (UTC)

I am sorry but I don't think that we should be relying on a newspaper to make such an assessment. If we are, however, we can include the newspaper as a source, but not necessarily Ernst and Cantor directly. It is the newspaper which is drawing relevance between E&C and chiropractic, therefore we can cite the newspaper as a source in our article about chiropractic. However, we still cannot cite E&C directly because it is not making any conclusions specifically about chiropractic. That said, I thought we set higher inclusionary standards for our sources at this article than newspapers. -- Levine2112 ^discuss 20:32, 5 November 2008 (UTC)

The newspaper articles address the OR issue, since these sources resolve the question, we can include the source. Indeed, even chiropractors accept the relevance of Ernst's review, with PMID 17224347 stating Innovative ways to select studies and perform regression for meta-analyses are even appearing to cast manipulation (and thus by association chiropractors) in a less favorable light., with the Ernst 2006 review cited to support this statement. If newspapers, chiropractors and scientists all agree that this review of SM is relevant to chiropractic, I think we are entirely safe in coming to the same conclusion. Tim Vickers (talk) 20:46, 5 November 2008 (UTC)

Obviously one can cite a reliable source's conclusions about spinal manipulation in Chiropractic. There is no need to cite a reliable source X (whether newspaper or otherwise) saying "It is OK to cite reliable spinal-manipulation source Y in Chiropractic." That would be an unreasonably high standard for inclusion, and such a standard is not required by Wikipedia policy or guideline; with a standard like that, one could exclude any source whatsoever from Wikipedia. Eubulides (talk) 20:51, 5 November 2008 (UTC)

Yes, the conclusion that this particular review of SM is relevant to chiropractic can be extended to conclude that all general reviews of SM are relevant to chiropractic, since the arguments are the same in each case. The endless wrangling about such reviews is best deal with by showing that other authoritative sources use these general SM reviews to make conclusions about chiropractic. Since authoritative sources use these general SM reviews in this way, so can we. Tim Vickers (talk) 20:58, 5 November 2008 (UTC)

arbitrary break

Nobody has shown that "leading researchers do NOT agree that all spinal manipulation research is directly related to chiropractic". And even if they had shown that, it would not therefore follow that the spinal manipulation research that is cited by Chiropractic #Evidence basis is not directly related to chiropractic. Nobody has demonstrated any source cited by Chiropractic #Evidence basis to be "non-chiropractic research"; as is standard in chiropractic, all the cited sources are derived from data taken either in whole or in large part from chiropractic sources. That is why no OR has been demonstrated in Chiropractic on this point. Eubulides (talk) 23:15, 22 October 2008 (UTC)

I disagree. I believe that Ernst does not agree that all spinal manipulation research is directly related to chiropractic as evidenced by statements in his 2008 paper and in his response to Meeker & Haldeman. I have also demonstrated that sources such as Murphy which - though rely on a mixed bag of practitioners performing spinal manipulation including chiropractors - in its conclusions says nothing specifically about chiropractic spinal manipulation. Despite this, we are using Murphy to say something definite about chiropractic spinal manipulation. That is a WP:NOR violation - using a source to discuss something which it in itself does not discuss. Furthermore, it has not been demonstrated that it is standard or acceptible practice to use generic spinal manipulation research to make conclusions about chiropractic spinal manipulation. In fact, it has been shown that doing so is considered downright unacceptible by leading researchers such as Shekelle and Ernst. -- Levine2112 ^discuss 23:34, 22 October 2008 (UTC)

It's true that there may exist spinal manipulation research that is not directly related to chiropractic. A study that looks only at osteopathic SM would qualify, for example. However, none of the sources in Chiropractic #Effectiveness are like that. Murphy et al. 2006 (PMID 16949948), which is cited by Chiropractic, does rely partly on non-chiropractic data, but also relies on chiropractic data; of the data we've looked at, most of it was chiropractic. Furthermore, Chiropractic takes care to not use Murphy to support any claim about "chiropractic spinal manipulation"; the claims in Chiropractic that cite Murphy are all about spinal manipulation, which is accurate citation. It certainly has not been demonstrated that Shekelle and Ernst would view such citations as OR; on the contrary, Ernst does the same thing himself in Ernst 2008 (PMID 18280103). More generally, Chiropractic #Evidence basis never does "use generic spinal manipulation research to make conclusions about chiropractic spinal manipulation". Eubulides (talk) 23:54, 22 October 2008 (UTC)

This is my point. If all we are using Murphy (an example of generic spinal manipulation research) for is to discuss spinal manipulation, then why include it in this article about Chiropractic instead of Spinal manipulation? Certainly, if all we are using it for is to discuss spinal manipulation, it is better suited for that article than this one. Agreed? If not, why do you feel it is more appropriate to use it here in the manner in which we are currently using it? -- Levine2112 ^discuss 00:04, 23 October 2008 (UTC)

This point is not an OR issue. If this is the point, then we should remove the OR tag, and start a new discussion thread on this point, which I'd be happy to do. Eubulides (talk) 07:29, 23 October 2008 (UTC)

Answer my question and let's read your explanation. Then we can talk about OR. First thing first. -- Levine2112 ^discuss 02:45, 24 October 2008 (UTC)

I just want to be on record that I agree that the OR tag should be removed. From what I have been seeing, most here want the tag removed and see no OR or Syn violations. As for using this information in this article, I personally feel it is helpful. I am not knowledgable about spinal manipulation but when I come to this article I know that SM is used by chiropractors and feel this article should be allowd to tell the story here without making the readers go to another article to learn more about it. --CrohnieGal^Talk 12:01, 23 October 2008 (UTC)

After there was consensus to remove the tag an editor edit warred the OR tag back in the article.[43][44] Now, we have just finished a recent RFC on spinal manipulation. There was consensus that SM is relevant. Editors need to respect the consensus. If editors have any concern they should be specific. The OR tag should be removed because general spinal manipulation research is directly relevant to chiropractic when spinal manipulation is core to chiropractic according to a top researcher. QuackGuru 18:11, 25 October 2008 (UTC)

Tags are there to register a dispute. Till the dispute is resolved, they should remain. For example there is obviously no consensus above that direct relevance of SM, in the opinion of editors, means that there is no OR in the article: those are very different questions. ——Martin^phi ☎ Ψ Φ—— 05:18, 26 October 2008 (UTC)

Tags are not intended to be up indefinitely. Unfortunately, the pattern in Chiropractic is: an RfC is resolved, this tag is removed, a new RfC is then filed on essentially the same dispute, and the tag is put back in. This is not what tags are for. They are not supposed to mark the disapproval of a minority of editors; they are supposed to mark a dispute-resolution process. Eubulides (talk) 20:43, 28 October 2008 (UTC)

Until the dispute is resolved, the tags should remain. The dispute should not remain unresolved indefinitely. DigitalC (talk) 22:44, 28 October 2008 (UTC)

Agree with DigitalC and Martinphi. I posed some questions to Eubulides above (00:04, 23 October 2008) and I would still like an answer if he/she is so inclined: If all we are using Murphy (an example of generic spinal manipulation research) for is to discuss spinal manipulation, then why include it in this article about Chiropractic instead of Spinal manipulation? Certainly, if all we are using it for is to discuss spinal manipulation, it is better suited for that article than this one. Agreed? If not, why do you feel it is more appropriate to use it here in the manner in which we are currently using it? -- Levine2112 ^discuss 23:55, 28 October 2008 (UTC)

Again, that question has nothing to do with WP:OR. This thread is about the OR tag. If you'd like to start a new thread that is unrelated to OR, that would be fine, but in this thread I'd prefer to keep the topic on OR. Eubulides (talk) 20:45, 29 October 2008 (UTC)

The questions do have overarching relation to the OR tag as I feel that the presence of such non-chiropractic specific research is in effect using the research in a way it was not intended. This is by definition of violation of WP:NOR. Os my questions to you remain: If all we are using Murphy (an example of generic spinal manipulation research) for is to discuss spinal manipulation, then why include it in this article about Chiropractic instead of Spinal manipulation? Certainly, if all we are using it for is to discuss spinal manipulation, it is better suited for that article than this one. Agreed? If not, why do you feel it is more appropriate to use it here in the manner in which we are currently using it? -- Levine2112 ^discuss 22:15, 29 October 2008 (UTC)

Again, the question doesn't have anything to do with WP:OR, unless "overarching relation" is talking about so many degrees of separation that it really is a different topic. However, I have started a new thread #Why cite SM sources? below, to discuss the new topic, and have attempted to address the question there. Eubulides (talk) 23:50, 29 October 2008 (UTC)

The questions have a lot to do with WP:NOR. I elaborate below as well. -- Levine2112 ^discuss 00:38, 30 October 2008 (UTC)

Turn it around

Eubulides states above "Nobody has shown that "leading researchers do NOT agree that all spinal manipulation research is directly related to chiropractic". And even if they had shown that, it would not therefore follow that the spinal manipulation research that is cited by Chiropractic #Evidence basis is not directly related to chiropractic. Nobody has demonstrated any source cited by Chiropractic #Evidence basis to be "non-chiropractic research""

But the problem is that no one needs to prove such a thing. Rather, it needs to be proven, by quotes from the sources, that leading researchers DO agree that all spinal manipulation research is directly related to chiropractic. The fact that much of the data was chiropractic does not mean the conclusions apply to Chiro if some of the research was not chiro. If you are using sources about SM just to discuss SM, then you are doing OR by having it in this article on Chiro, as obviously you are stating that it's relevant here. ——Martin^phi ☎ Ψ Φ—— 05:26, 26 October 2008 (UTC)

• There is no requirement in WP:OR that editors need to cite a reliable source X that says "It is OK to cite reliable source Y", as a prerequisite to having an article cite reliable source Y. Such a requirement would be a recipe for excluding any source, no matter how reliable.
• That being said, we do have a quote from two of the top chiropractic researchers (and coeditors of the leading textbook on chiropractic), saying that one should not exclude SM research merely because some of it happens to be derived from non-chiropractic data:

"We agree that many of the randomized trials we described were on spinal manipulation rather than specifically on chiropractic manipulation itself, but we believe that this is not a significant point. Chiropractors use all forms of manipulation. In the United States, more than 90% of all spinal manipulation services are provided by chiropractors, and research on spinal manipulation, like that on any other treatment method, is equally of value regardless of the practitioner providing it."

• In contrast, we don't have a quote from a reliable source disagreeing with this point. We do have a quote from Ernst saying that one should clearly identify the source of data, but that is a point that we all agree on.

Eubulides (talk) 20:43, 28 October 2008 (UTC)

And again, this quote does NOT say "one should not exclude SMT research merely because some of it happens to be derived from non-chiropractic data". It does say "We agree that many of the randomized trials we described were on spinal manipulation rather than specifically on chiropractic manipulation itself, but we believethat this is not a significant point.

DigitalC (talk) 22:44, 28 October 2008 (UTC)

Additionally we have Ernst stating that most of the RCTs which they looked at were not related to chiropractic spinal manipulation.

The authors also claim that 43 randomized, controlled trials of spinal manipulation for back pain have been published, but they fail to mention that most of them do not relate to chiropractic spinal manipulation.

So in fact, we actually do have a reliable source disagreeing with this point. -- Levine2112 ^discuss 23:33, 28 October 2008 (UTC)

Ernst is not disagreeing with the point. The point is whether one should "exclude SM research merely because some of it happens to be derived from non-chiropractic data". Ernst is not saying that such SM research should be excluded, only that it should be labeled. Ernst himself, in Ernst 2008 (PMID 18280103), includes SM research in a review of chiropractic, so it is not credible to assert that Ernst is in favor of excluding such research. Eubulides (talk) 20:45, 29 October 2008 (UTC)

Of course Ernst is disagreeing with the point. That was his criticism. M&H overlooked that the majority of the published 43 RCTs on SM do not relate to chiropractic SM. And no, he didn't say that all SM RCTs don't relate to chiropractic SM. He said not all of them do relate. So of course he uses SM research in his 2008 paper, but he only used the SM research which he felt related to chiropractic SM. But remember, he did say that the majority of the 43 RCTs which M&H said are published do not relate to chiropractic SM. The majority. Just because M&H have a differing POV, does not mean that we should base our inclusion of all non-chiropractic SM research on their POV. That is exactly the rationale which leads to a WP:SYN violation. Again, I am all for using any research which is specifically drawing conclusions about chiropractic. I don't care if the research relied entirely on non-chiropractic SM. If the conclusions which the researchers are drawing are specifically about chiropractic, that it is fair game for usage consideration in this article. -- Levine2112 ^discuss 22:21, 29 October 2008 (UTC)

M&H did not overlook anything; they just didn't think that the fact was worth mentioning. When Ernst challenged them on it, they explicitly said that the source of the SM data doesn't matter. Ernst does not go out of his way in his 2008 paper to use only "the SM research which he felt related to chiropractic SM"; on the contrary, he goes out of his way to mention that systematic reviews usually include trials of SM regardless of who administered it, and that relevant reviews are therefore not exclusively an evaluation of chiropractic. The only disagreement between Ernst and M&H is over whether one should explicitly mention whether sources are partly based on non-chiropractic data. There is no dispute between them over the relevance of general SM reviews to chiropractic. Eubulides (talk) 23:50, 29 October 2008 (UTC)

I continue to disagree with your interpretation of what Ernst is saying. IMHO, he recognizes that all SM studies are not necessarily related to chiropractic SM nor are they exclusively an evaluation of chiropractic. Hence there is a dispute between Ernst and H&M over the relationship between general SM reviews and chiropractic. I guess we have to agree to to disagree here. -- Levine2112 ^discuss 00:17, 30 October 2008 (UTC)

This continues to misrepresent what Ernst says. Ernst 2002 (PMID 12379081) is not referring to general SM reviews when he is criticizing Meeker & Haldeman 2002 (PMID 11827498). Ernst is referring only to the RCTs that M&H cited. Chiropractic does not cite any of these RCTs. There is no dispute between Ernst and M&H over the relevance of general SM reviews such as the reviews cited by Chiropractic. Eubulides (talk) 08:24, 3 November 2008 (UTC)

Again, my opinion is that you are misrepresenting what Ernst says. To me there is a dispute between Ernst and M&H over the relevance of general SM reviews to chiropractic SM (where M&H say it is all related, Ernst says the majority are not related). If you'd like, we can take just Ernst's statement to an RfC and see what other editors feel Ernst is saying. -- Levine2112 ^discuss 20:04, 3 November 2008 (UTC)

Again, Ernst 2002 (PMID 12379081) is not talking about general SM reviews, and it is misrepresentation to claim that it is. Ernst's comments are about 43 randomized controlled trials cited by Meeker & Haldeman. A randomized controlled trial is not at all the same thing as a general SM review. Ernst never says that general SM reviews are not related to chiropractic. I don't see a need to generate an RfC over this elementary point of fact. RfCs should be used for important disputes over specific changes to an article, or for behavior of editors; they should not be necessary for what should be a minor point of fact. Eubulides (talk) 21:35, 3 November 2008 (UTC)

I continue to disagree with your interpretation of Ernst. I think Ernst has show time and time again that he feel that not all spinal manipulation research is related to chiropractic research. He is able to distinguish those which he feels are related and those which he feels are not. However, he doesn't give us the criteria to make such an assessment ourselves. That we are making such an assessment is exactly why this article suffers from a WP:NOR violation. Plain and simple. -- Levine2112 ^discuss 22:39, 3 November 2008 (UTC)

Ernst has shown that SM is core to chiropractic. The recent RFC covers this already. We can assessment ourselves that SM is directly related. There is consensus that SM is directly related. QuackGuru 23:05, 3 November 2008 (UTC)

Why cite SM sources?

In #Time to remove tags above, Levine2112 asks about Murphy et al. 2006 (PMID 16949948):

If all we are using Murphy (an example of generic spinal manipulation research) for is to discuss spinal manipulation, then why include it in this article about Chiropractic instead of Spinal manipulation? Certainly, if all we are using it for is to discuss spinal manipulation, it is better suited for that article than this one. Agreed? If not, why do you feel it is more appropriate to use it here in the manner in which we are currently using it?

This is not a question about WP:OR per se, so it's not that relevant to the tags thread, and I'm starting a new thread here. To answer the question: sources can be suitable for multiple articles. For example, this source:

Newschaffer CJ, Croen LA, Daniels J; et al. (2007). "The epidemiology of autism spectrum disorders". Annu Rev Public Health. 28: 235–58. doi:10.1146/annurev.publhealth.28.021406.144007. PMID 17367287. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)

is best suited for Epidemiology of autism, but it is also suitable for Autism, Autism spectrum, and Causes of autism (all of which cite it). It would not make sense to argue that because Newschaffer et al. is better suited for Epidemiology of autism, it should not be cited by Causes of autism, even though it's a perfectly reasonable source where it is used.

This is just one example; many more could be given. In general, a Wikipedia article should cite the best and most reliable sources on directly relevant topics, even when those sources happen to be more-relevant to other articles. Eubulides (talk) 23:50, 29 October 2008 (UTC)

First, this sounds akin to a WP:OTHERCRAPEXISTS argument. Second, the issue here is that blanket direct relevance between all of the non-chiropractic, general SM studies which we are using in the article and to Chiropractic (the topic of the article) has not been demonstrated by any reliable source. So are we using generic spinal manipulation research such as Murphy to discuss chiropractic or to discuss spinal manipulation? If we are using them to discuss chiropractic, then we indeed have a WP:NOR issue and the question becomes: By what criteria are we justifying the use of these pieces of research in a manner not intended by their authors? If we are using them to discuss spinal manipulation and not chiropractic, then the question remains: Why are we even including these pieces of research which say nothing about chiropractic at the article Chiropractic instead of Spinal manipulation? -- Levine2112 ^discuss 00:34, 30 October 2008 (UTC)

The "other crap" you're talking about includes a featured article. These articles are not crap. The rest of your comment merely repeats arguments made in your earlier comments, and does not address the new point raised in this thread. Eubulides (talk) 08:24, 3 November 2008 (UTC)

"Crap" doesn't refer to the quality of this article. Read that essay. You may find it enlightening. Your autism example above doesn't apply here because there you were dealing with exclusively autism. Thee source was about autism, and the multiple articles which it is used on are about autism. Here, we are dealing with Murphy which is in part about general spinal manipulation (and is not about chiropractic spinal manipulation). Of course we can use Murphy at Spinal manipulation but since Murphy says nothing specifically about chiropractic, we cannot use it at chiropractic. All we are using Murphy to support in this article now are statements about spinal manipulation in general. These statements don't belong in this article. They below at the spinal manipulation article. -- Levine2112 ^discuss 20:00, 3 November 2008 (UTC)

WP:OTHERCRAPEXISTS refers to the argument "there are lots of other bad articles, so it's OK that this is a bad one too". But my example used Autism, a featured article. Autism is not an "other bad article". So my example was not an instance of an WP:OTHERCRAPEXISTS argument. The source in question was about the epidemiology of autism, and obviously is more suited to Epidemiology of autism than it is to Autism; this is an example of why it's OK for a source to be used in an article A even when the source is more suited to another article B. Again, the rest of your comment merely repeats arguments made in your earlier comments, and does not address the new point raised in this thread. I don't sense any progress being made here, so I'll let you have WP:THELASTWORD if you like. Eubulides (talk) 21:35, 3 November 2008 (UTC)

AS I said above... it sounds "akin" to OTHERCRAPEXISTS, which is a policy about articles in general, not about specific content in articles. Your example is still not applicable because it deals with one unified subject: Autism. It would be akin to saying that we have a source which is about efficacy of certain chiropractic techniques which we want to use at Chiropractic and Chiropractic treatment techniques. No problem there. It's a unified subject. However, Spinal manipulation and Chiropractic are not unified subjects. So, IMHO, your analogy is weak and your WP:THELASTWORD point is very childish. (P.S. You still haven't directly answered the questions posed at the top of this thread. I wonder why.) -- Levine2112 ^discuss 22:34, 3 November 2008 (UTC)

We are including research on spinal manipulation because it is directly related to chiropractic. I answered your question. QuackGuru 23:12, 3 November 2008 (UTC)

Spinal manipulation is a technique strongly associated and directly related to chiropractic.[45][46] QuackGuru 01:00, 5 November 2008 (UTC)

The edit summary was misleading. It was not premature to remove the tag. After about six months, no evidence of original research has been shown and evidence that spinal manipulation is directly connected to chiropractic has been presented.[47][48] QuackGuru 03:36, 5 November 2008 (UTC)

References have been provided that spinal manipulation is directly connected to chiropractic.[49][50] Per WP:OR, when SM is directly connected to chiropractic it is okay to cite research that has a direct connection. There is no need to have a tag when no evidence to the contrary has been presented. Hopefully, editors will read my comments when I discuss important issues rather than intentionally ignoring them. QuackGuru 16:51, 5 November 2008 (UTC)

No evidence of original research has been presented. An edit summary is not evidence of OR. QuackGuru 19:41, 5 November 2008 (UTC)

No specific argument about which spinal manipulation research could possibly be original research has been given. Can you tell me which SM research is OR according to what references in accordance with your edit summary instead of deleting my comments. References have been presented that explain SM is directly related to chiropractic.[51][52] QuackGuru 20:04, 5 November 2008 (UTC)

Please discuss your reverts here or anywhere rather than simply deleting my comments would be more helpful. QuackGuru 20:13, 5 November 2008 (UTC)

Please see #OR tag removal and reversion below for more comments. Eubulides (talk) 20:51, 5 November 2008 (UTC)

Is general spinal manipulation (GSM) technically different than chiropractic spinal manipulation (CSM)?

There has been a lot of discussion about original research but what is the difference? Is there any significant difference? According to what source there is any specific difference between GSM and CSM. QuackGuru 05:20, 16 October 2008 (UTC)

To get useful answers you'll need to use standard terminology. Please explain more specifically what you are referring to. Is GSM the same as HVLA spinal manipulation, and is CSM the same, but performed by a chiropractor, and thus if it is a straight chiropractor, will be termed a spinal adjustment? If so, the only difference is the performer and the intention. A chiropractor (especially a straight one) manipulates/adjusts with the intention of "correcting" vertebral subluxations (VS). Regardless of intent, both practitioners are causing the same effect on the structures being manipulated, but will be causing different beliefs about what is happening in the minds of their patients. Physically equal, but mentally different.

If by CSM you are allowing the myriad techniques that are also (in addition to HVLA spinal manipulation) included under the umbrella term spinal adjustment, then the sky's the limit, as techniques vary quite a bit, including mechanical and electrical devices, and including techniques that don't have an earthly chance of having any real effect on a spinal motion segment.

Basically, "adjustment" is a code word for the claimed "correction" of anything any chiropractor claims is a VS, and thus is the manipulation of an imaginary lesion. There is often no known objective method of identifying them. When the original Medicare requirements for objective proof (x-rays) were made, it turned out that such proof was not forthcoming, and finally the requirement was dropped in 2000. Now there is no requirement for proof. Medicare just accepts the subjective word of any chiropractor that they have corrected a VS. -- Fyslee / talk 05:58, 16 October 2008 (UTC)

Yes Chiropractic adjustments are different than other doctors or nondoctors application of spinal manipulative therapies. . . Chiropractors use different technique favoring short lever, high velocity, low amplitude where osteopaths tend to do long lever movements. . . chiropractic adjustments are much more specific than any other kind of smt.TheDoctorIsIn (talk) 20:39, 18 October 2008 (UTC)

Please provided a reference to support your view. Do you have and specific recommendation to improve the article with a reference that supports your position. Without a reference your position is speculation. QuackGuru 23:14, 18 October 2008 (UTC)

I too would like to see proof for that straight chiropractic claim. The claim can be documented from straight chiro literature, but that is not evidence that the claim is true. Apparently User:TheDoctorIsIn/User:DoctorIsOut is not aware that DOs, PTs, and some MDs learn these same techniques, with equal specificity. The one thing that remains different is the intention. Only DCs, especially straight ones, claim to "correct vertebral subluxations". Otherwise the HVLA manipulations/adjustments are physically/biomechanically the same. Keep in mind that Palmer learned from osteopaths, and that spinal manipulation predates both professions, having been used by medical physicians and bonesetters for ages. Both osteopaths and chiropractors have shared their techniques for years with MDs and PTs. Of course the term "chiropractic adjustment" can also include chiropractor-performed long lever movements, and also includes myriad non-HVLA techniques which are performed using instrumentation and electric devices, and some of which don't even touch the body, yet the DC doing it claims to be "correcting subluxations". Go figure....

Yes, I would like to see real published evidence that this claim is true. -- Fyslee / talk 03:29, 19 October 2008 (UTC)

Are you insinuating that TDII is a sockpuppet of the banned user DoctorIsOut? This isn't the proper venue, if so. If not, you should strike that from your comments.

Practitioners rely on "chiropractic adjustments" comprised of quick, forceful thrusts by hand to the spinal vertebrae in order to release an impinged nerve, thus removing a subluxation. It should be noted that chiropractors consider the technique of "adjustment" to be exclusive to their profession, and distinguish the clinical procedure as separate from the more general medical term of "manipulation," which is a more generic, often long-lever movement of joints, not restricted to the spinal vertebrae, alone. Villanueva-Russell 2004

Manipulation, as an abstract concept, was interchangeably used by some researchers and practitioners affiliated with osteopathy, chiropractic, physical therapy and orthodox medicine; whereas chiropractic "adjustments" were more specifically applied using "the spinous and transverse process as levers to restore the misaligned [spinal] vertebra into normal position" Williams 1994

That standard, written in the Mercy report, has reduced the profession of chiropractic to a modality of manipulation. A manipulation technique that is to be prescribed in a limited way for a limited kind of musculoskeltal condition. ACA Journal of Chiropractic 1992

These systematic reviews usually include trials of spinal manipulation regardless of who administered it. Thus, they are not exclusively an evaluation of chiropractic. Ernst 2008

-- Levine2112 ^discuss 02:30, 22 October 2008 (UTC)

The TDII/DIO connection has been noted many times by many people, including admins, and TDII has never denied it to my knowledge. BTW, it would be DIO that would be the sock, not the other way around. Sockpuppetry isn't forbidden here, but misusing them for stacking votes or for seeking to avoid the scrutiny of other editors is forbidden. This isn't the venue to actually make a case for or against possible misuse, but if you wish to investigate, be aware that some of the evidence no longer exists for public scrutiny because of article and list deletions, which also delete user contributions from their contribution histories. Such evidence can be resurrected if necessary, but I have no intentions of doing so at the present time. Certain other socks of another user - like User:CuTop - (note Shot Info's comment on his talk page) have also been under observation for some time, as you well know.

Your choice of quotations is interesting. I suppose they are in response to my last comment above: "Yes, I would like to see real published evidence that this claim is true." To avoid confusion, I am referring to evidence that the "claim" itself is true, not that the claim has been made. There is no doubt about that. Fringe straight chiropractors (and their supporters, like yourself) do that all the time. The Villanueva-Russell quote even mentions that "chiropractors consider" it to be true. Yes, we know they "consider" it to be so, but that's no proof that they are correct. Claims are not proof that HVLA spinal manipulations are physically/biomechanically different than HVLA spinal "adjustments", regardless of performer. I have never seen any evidence that they are, only claims by you and straight chiropractors. Other chiropractors don't normally make such claims.

The Villanueva-Russell descriptions of adjustments and manipulations describe perfectly the types of spinal manipulations performed by DOs, PTs, and some MDs. They use all those types in an identical manner, since they have often taught each other, and even had chiropractors as teachers.

The only difference is in the intention of the performer. Only chiropractors claim to correct non-existent, subjectively-defined-in-a-thousand-ways "vertebral subluxations" (not the same as clearly and objectively verifiable orthopedic subluxations). The intention is the difference, not the technique. I am of course speaking of comparable methods, not HVLA spinal manipulation compared to various totally different "adjustments". I'm speaking of identical methods that when used by a non-chiropractor will be termed "spinal manipulation", and when performed by a chiropractor will be termed "spinal manipulation" (the same terminology) by both chiropractic and non-chiropractic researchers, but will consistently be termed "adjustments" by straight chiropractors.

The Mercy report was an attempt to bring chiropractic into line with scientific evidence, and has been a thorn in the side of straight chiropractors who felt it was a betrayal of the profession's identity as a vitalistic profession dedicated to solely correcting blockages of Universal Intelligence by vertebral subluxations, all metaphysical concepts that are repudiated by mainstream science and progressive chiropractors.

BTW, what is the source of your 2008 Ernst quote?

-- Fyslee / talk 05:26, 22 October 2008 (UTC)

I really don't know the TDII/DIO/Cutop case well enough to comment intelligently on it, but if you would like to share some details with me, I'd love to hear it. It seems like you are implying something there about another editor's behavior and I'm not sure what that is. Just be careful with the personal attacks - even those pointed in my direction (I am not a "fringe" supporter of straight chiropractic and I'd like very much for you to remove the personal attack). As for your comments, well, we are not here to prove that GSM is different from CSM; only that there are reliable sources which make such a claim. I have provided you now with several such sources. The Ernst source which supports such a claim is from his 2008 paper entitled "Chiropractic: A Critical Evaluation". -- Levine2112 ^discuss 08:06, 22 October 2008 (UTC)

I have moved the "fringe" word to make it a more accurate description. Straight chiropractic is the original Palmerian position of what I call "real" chiropractic, and it is still a common and very influential position in the profession, but it is becoming more and more fringe within the profession. As it relates to scientific evidence, it/chiropractic has always been fringe, and you have always championed and defended the straight position here as if it was the "correct" chiropractic position for this article. That's not a personal attack, just an accurate description of your activities here.

As to the documentation that "claims" of a physical difference between GSM and CSM have been made, we can certainly use such documentation, which is a very different matter than what you have been proposing all along, which is that there really is a physical difference. That is an important distinction. You seem to have bought into that claim, which is your right. Since the claim is incorrect, you might wish to reconsider your position and stop repeating the claim as if it were true. I'll outdent the rest of my reply. -- Fyslee / talk 13:53, 22 October 2008 (UTC)

No, I am not a supporter of Straight chiropractic. That is your assumption. Just like you have falsely assumed I am a chiropractor or a chiropractic assistant for years now. I am a supporter of NPOV. That you have mistaken the POVs of the sources which I present as my own POV, is probably just as much my fault as your own. Let me be clear with you now. You don't know any of my personal POVs other than my stance on various Wikipedia policies and their application. Please don't assume anything beyond that.

Yes, claims of physical differences between GSM and CSM have been made. But they have been made by more than just "straight" chiropractors. Several researchers which I have cited many times now have pointed out the physical differences. -- Levine2112 ^discuss 17:06, 22 October 2008 (UTC)

We have been editing here for quite a few years now, and you have myriad times clearly expressed your own personal POV, without mention of sources. Period. That is abundantly clear from your editing history. You have consistently promoted, defended, edit warred over, and supported the POV of straight chiropractic. If you have been playing devil's advocate all this time, then you have certainly fooled all of us and such deception renders anything you say to be untrustworthy. Play with open cards. Denial will get you nowhere. We happen to "know [m]any of [your]my personal POVs other than [your]my stance on various Wikipedia policies and their application," many, many more. If you didn't identify yourself with the straight POV, you wouldn't be so defensive.

I have not "falsely assumed" anything after you clarified things. I have acted in good faith based on what seemed apparent from your own utterances. That's all I have to go on. From the first time you denied being a chiropractor I have believed you. That's many years ago. You have also consistently proven that your originally stated mission here to defend the "good reputation" of chiropractic has proven true. That it doesn't have a good reputation seems to elude you. It has a very poor reputation, so trying to attempt to hide that amounts to whitewashing.

Yes, "claims" have been made. Now who are these researchers who "have been cited many times"? That sounds like you are claiming that such researchers have done more than just claim physical differences. Please elaborate. -- Fyslee / talk 04:10, 23 October 2008 (UTC)

(outdent)

• No reliable source has been presented that supports claims that there are "physical differences" between chiropractic SM and general SM that would significantly affect scientific studies of effectiveness or safety. On the contrary, we have a high-quality reliable source, namely Meeker & Haldeman 2002 (PMID 11827498), which says precisely the opposite, and we have multiple high-quality reviews of chiropractic that do precisely the opposite.
• The quote from Ernst 2008 (PMID 18280103) does not "support such a claim" that "general spinal manipulation (GSM) [is] technically different than chiropractic spinal manipulation (CSM)". Ernst is merely being careful in noting where his evidence came from. This note does not make or or support the point that there is a significant technical difference between chiropractic and non-chiropractic SM.
• I believe Fyslee already addressed the other quotes, so I won't bother.
• It may be helpful to place the Ernst quote in its context. Here is the containing paragraph:

"Numerous controlled clinical studies of chiropractic are now available, but their results are far from uniform. Rather than selecting single studies according to their findings, it is therefore preferable to consider the totality of this evidence. Table 3 gives an overview of the most up-to-date systematic reviews by indication. These systematic reviews usually include trials of spinal manipulation regardless of who administered it. Thus, they are not exclusively an evaluation of chiropractic. Collectively, their results fail to demonstrate that spinal manipulation is effective. The only possible exception is back pain. For this condition, manipulation may be as effective (or ineffective) as standard therapy."

• This paragraph cites the following studies. I've put a * next to the studies that Chiropractic does not cite, as it may be worth considering them as sources for Chiropractic:

• Assendelft WJJ, Morton SC, Yu EI, Suttorp MJ, Shekelle PG (2004). "Spinal manipulative therapy for low back pain". Cochrane Database Syst Rev (1): CD000447. doi:10.1002/14651858.CD000447.pub2. PMID 14973958.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Gross AR, Hoving JL, Haines TA; et al. (2004). "Manipulation and mobilisation for mechanical neck disorders". Cochrane Database Syst Rev (1): CD004249. doi:10.1002/14651858.CD004249.pub2. PMID 14974063. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
• Fernández-de-las-Peñas C, Alonso-Blanco C, Cuadrado ML, Miangolarra JC, Barriga FJ, Pareja JA (2006). "Are manual therapies effective in reducing pain from tension-type headache?: a systematic review". Clin J Pain. 22 (3): 278–85. doi:10.1097/01.ajp.0000173017.64741.86. PMID 16514329.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• * Ernst E (2003). "Chiropractic spinal manipulation for neck pain: a systematic review". J Pain. 4 (8): 417–21. doi:10.1067/S1526-5900(03)00735-1. PMID 14622659.
• Proctor ML, Hing W, Johnson TC, Murphy PA (2006). "Spinal manipulation for primary and secondary dysmenorrhoea". Cochrane Database Syst Rev (3): CD002119. doi:10.1002/14651858.CD002119.pub3. PMID 16855988.{{cite journal}}: CS1 maint: multiple names: authors list (link) (Ernst actually cites the previous issue, issue 2, of this systematic review.)
• Husereau D, Clifford T, Aker P, Leduc D, Mensinkai S (2003). Spinal Manipulation for Infantile Colic (PDF). Technology report no. 42. Ottawa: Canadian Coordinating Office for Health Technology Assessment. ISBN 1-894978-11-0. Retrieved 2008-10-06.{{cite book}}: CS1 maint: multiple names: authors list (link)
• * Balon JW, Mior SA (2004). "Chiropractic care in asthma and allergy". Ann Allergy Asthma Immunol. 93 (2 Suppl 1): S55–60. PMID 15330012.
• * Reid SA, Rivett DA (2005). "Manual therapy treatment of cervicogenic dizziness: a systematic review". Man Ther. 10 (1): 4–13. doi:10.1016/j.math.2004.03.006. PMID 15681263.

Eubulides (talk) 18:36, 22 October 2008 (UTC)

So in essence, Ernst has stated that reviews which include trials of spinal manipulation as performed by practitioners other than chiropractors are NOT exclusively an evaluation of chiropractic. This further supports his position in his critque of Meeker and Haldeman, that the majority of the 43 RCTs for SM in treating LBP are not related to chiropractic SM. Given this, I think it is plainly obvious that Ernst thinks that not all trials of SM are related to chiropractic SM, nor should they necessarily be used as an evaluation of chiropractic. This is further supported by Shekelle's complaint when his spinal manipulation research was being used by chiropractors to validate their version of spinal manipulation. Shekelle distinguished his research as being about spinal manipulation regardless of the practitioner and not necessarily applicable to the form of spinal manipulation which chiropractors employ. -- Levine2112 ^discuss 19:21, 22 October 2008 (UTC)

No, they were not trying to misuse Shekelle's research to "validate their version of spinal manipulation.", but to validate chiropractic - quackery, cultism, metaphysics, false advertising, unscientific claims, and all - including "their version of SM". In fact "their version" wasn't even addressed as a separate matter, since it made up probably 90+% of that research and was placed on an equal footing as any other similar SM studies. Shekelle and other researchers, including chiropractic researchers don't make a difference because there is NO physical difference. -- Fyslee / talk 19:44, 22 October 2008 (UTC)

Ernst never states nor implies that the 43 studies in question should not "be used as an evaluation of chiropractic". He states merely that their sources of data should be identified. Fyslee's characterization of Shekelle's complaint is accurate. Eubulides (talk) 20:51, 22 October 2008 (UTC)

Yes, I know full well of your misunderstandings of both Ernst's criticism of H&M and of Shekelle's rebuke; however, I would like to read more on your understanding of what Ernst meant in his 2008 paper in the quote you provided above. I believe Ernst has stated that reviews which include trials of spinal manipulation as performed by practitioners other than chiropractors are NOT exclusively an evaluation of chiropractic. Do you disagree with that? -- Levine2112 ^discuss 21:32, 22 October 2008 (UTC)

I am not misunderstanding Ernst. I would go even farther than what Ernst says in his 2008 paper. I would say that trials of chiropractic spinal manipulation are not exclusively evaluations of chiropractic, as the two topics are not the same (chiropractic includes many things besides SM). Chiropractic spinal manipulation is highly relevant to chiropractic, though, so there would be no OR violation to cite such trials here. Eubulides (talk) 23:15, 22 October 2008 (UTC)

It would help if editors made a specific proposal rather than arguing over what the sources means. QuackGuru 21:39, 22 October 2008 (UTC)

Proposed wording

Now how can we include that information here? Let's try to formulate something that can be included about the claim, without seeming to endorse it as if it were true. Here's a very rough sketch of an attempt:

• "Straight chiropractors claim that chiropractic spinal adjustments are more specific, careful and safer than spinal adjustments performed by other practitioners, but they have not produced any scientific evidence that such claims are true."

That's very rough, but I think you get the picture. -- Fyslee / talk 13:53, 22 October 2008 (UTC)

What is the source for the last clause? Also, more than just straight chiropractics have claimed that chiropractic spinal adjustments are different from spinal manipulation performed by other practitioners. As such, this statement is misleading. -- Levine2112 ^discuss 17:06, 22 October 2008 (UTC)

• I very much agree with Levine2112 that we need a reliable source. Not only for the last clause, but for the entire sentence.
• Generally, I find that it's better to find reliable sources first, and summarize what they say, rather than writing the text first and then searching for reliable sources to support it. This practice tends to produce text that contains less POV.

Eubulides (talk) 18:36, 22 October 2008 (UTC)

References are needed for a specific proposal. QuackGuru 21:39, 22 October 2008 (UTC)

• I naturally agree with all the comments above (except Levine2112's ;-). My wording was a quick and rough sketch without refs. It was only provided to help us get moving. If such attempts aren't allowed....!?! I certainly don't think that my wording in that form without any refs is at all suitable for inclusion. Why not try to understand what I mean and be constructive, instead of just criticizing?

• The first half of the proposal needs sources that can best be supplied by Levine2112, since he is the one who is fighting for dubious straight chiropractic claims. I believe the claims exist, and he has stated that they can be documented with sources, even from researchers. Let's see the sources and maybe use them. The International Chiropractors Association, World Chiropractic Alliance, and Journal of Vertebral Subluxation Research websites would be good places to start for those types of claims. They are V & RS for such fringe opinions. PlanetChiropractic would also be good, but it's not a RS.

• -- Fyslee / talk 04:36, 23 October 2008 (UTC)

I briefly looked for reliable sources supporting the first half of the above claim, and I'm afraid I came up dry. Editors with access to a high-quality chiropractic library may have better results. I did come up with the following reliable source saying just the opposite, though, if that helps:

"Spinal manual therapy, also known as spinal adjustment or manipulation, is widely recognized as a valid treatment option for low back pain. In the United States, 94 percent of spinal manipulation is delivered by chiropractors." Redwood D (2003). "Spinal adjustment for low back pain". Semin Integr Med. 1 (1): 42–52. doi:10.1016/S1543-1150(03)00008-5.

Eubulides (talk) 07:29, 23 October 2008 (UTC)

I'm not sure how that applies here. We need to distinguish between documenting the factual accuracy/inaccuracy of the straight claim vs. documenting that the claim has been made. It is the last that we need here. The closest one I've found right now is this one from the ultra fringe (but very influential) ICA:

SPINAL ADJUSTMENT AND SPINAL MANIPULATION

The ICA holds that the chiropractic spinal adjustment is unique and singular to the chiropractic profession. The chiropractic adjustment shall be defined as a specific directional thrust that sets a vertebra into motion with the intent to improve or correct vertebral malposition or to improve it juxtaposition segmentally in relationship to its articular mates thus reducing or correcting the neuroforaminal/neural canal encroachment factors inherent in the chiropractic vertebral subluxation complex.

The adjustment is characterized by a specific thrust applied to the vertebra utilizing parts of the vertebra and contiguous structures as levers to directionally correct articular malposition. Adjustment shall be differentiated from spinal manipulation in that the adjustment can only be applied to a vertebral malposition with the express intent to improve or correct the subluxation, whereas any joint, subluxated or not, may be manipulated to mobilize the joint or to put the joint through its range of motion.

Chiropractic is a singular field in the healing arts, and by prior rights, the spinal adjustment is distinct and singular to the chiropractic profession. [53]

It was found in this search of the ICA website. It happens to document that it is the "intention" that is the deciding difference. Similar searches of the other sites might turn up similar statements:

• Search of WCA website

• Search of JVSR website

Note that these searches turn up plenty of examples of how even straight chiropractors use the terms interchangeably! -- Fyslee / talk 14:25, 23 October 2008 (UTC)

The ICA quote defines spinal adjustment (SA) based on subluxation, but that topic is more suited for Chiropractic #Vertebral subluxation than for Chiropractic #Evidence basis. What the proposed text needs first is a source for its talk about claims that SA is "more specific, careful and safer" than spinal manipulation (SM) in general. I guess the ICA quote supports "specific", although I would much prefer a reliable secondary source to a primary source written by a fringe group. However, the ICA quote doesn't support "careful" or "safer". Sorry to be such a stickler here, but if we can't find reliable secondary sources saying that chiropractors claim the superiority of chiropractic SM over other SM, then we probably shouldn't be saying that either. Eubulides (talk) 17:02, 23 October 2008 (UTC)

I wholeheartedly agree, except that primary sources are acceptable for such claims, if they are V & RS for such opinions. They would of course need to be attributed. What I am basically doing is Writing for the enemy, which is a good NPOV, AGF, and collaborative practice for editors of all persuasions. Levine2112 has repeatedly expressed such sentiments (even before this latest RfC), and even claimed that researchers have written things that supposedly back up his POV. I have even requested sources from him. This is actually Levine2112's job, but I was attempting to show some good faith by helping him, since I do believe his claims are made by chiropractic sources, even though I believe they are false claims, like so many other chiropractic claims. I will now pass the baton and leave it up to him if he really does want such information in the article. -- Fyslee / talk 00:35, 24 October 2008 (UTC)

Exclusively?

Levine2112 seems to miss the point of the "not exclusively an evaluation of chiropractic" quote.(Emphasis added.) The important point is the word "exclusively", ergo not 100%. Yes, most SM research includes a very, very small amount of non-chiropractor performed SM. Since chiropractors perform 90%+ of SM, and most of these studies include the SM performed by these chiropractors, the studies say much, much, much, much, more about chiropractic SM (and therefore chiropractic, and the efficacy and safety of chiropractic SM), than it says about the miniscule numbers from the few others whose numbers were included. -- Fyslee / talk 06:13, 23 October 2008 (UTC)

I believe this conclusion is WP:OR on your part. Rather than continue to push for the general inclusion of all SM studies in this article, how about you agree to the compromise proposed elsewhere that only studies that make specific conclusions about chiropractic are assumed relevant, and other studies (that deal with SM but do not draw conclusions specifically about chiropractic) must obtain consensus on a case-by-case basis before inclusion? This would seem a more useful application of everyone's editing energy. --Surturz (talk) 01:40, 28 October 2008 (UTC)

Technically it is OR. Is there reason to doubt these would be applicable to chiro? this seems to indicate that the data might not apply correctly. Further, if there is so much room for editorial disagreement, then that's what OR is for: we don't include it if we can't really tell, or some think we can't. WP errs on the side of caution in these matters. ——Martin^phi ☎ Ψ Φ—— 02:15, 28 October 2008 (UTC)

It is not OR on Fyslee's part; it is merely echoing what Meeker & Haldeman write. WP:OR is not intended to give a minority of editors veto power over material they dislike; it is intended to prevent minority theories from being pushed into Wikipedia. The theory that spinal manipulation is directly relevant to chiropractic is hardly a minority opinion; it's the mainstream. Eubulides (talk) 20:43, 28 October 2008 (UTC)

Meeker and Haldeman were giving their opinion of the research which they looked at. To blanketly apply their opinion to all other research is in fact a breach of WP:NOR, because it is using those sources in a manner in which they were not intended to be used. If Meeker and Haldeman used non-chiropractic studies to determine something about chiropractic, we can still use Meeker and Haldeman's conclusions because they are specifically discussing chiropractic in their conclusions. However, that doesn't give us license to introduce the non-chiropractic studies which Meeker and Haldeman relied on (or even ones which they didn't rely on) outside of the context of Meeker and Haldeman's study. -- Levine2112 ^discuss 23:38, 28 October 2008 (UTC)

• At bottom, this is saying that we cannot cite a reliable source X in Chiropractic unless we can find some other reliable source Y that says "It is OK to cite X in Chiropractic." That is an unrealistically high standard. Wikipedia policy does not require such a standard.
• In this talk page, we are allowed to present arguments that would not be allowed in the article itself, in order to discuss what should be in the article. Unlike article text, these arguments can be based on our analysis and interpretation of sources.
• Clearly Meeker & Haldeman, two of the top experts in the field, are saying that general SM research is highly relevant to chiropractic, and that we shouldn't quibble about the source of data. Their claim is not limited to just the studies they looked at. Their statement "In the United States, more than 90% of all spinal manipulation services are provided by chiropractors, and research on spinal manipulation, like that on any other treatment method, is equally of value regardless of the practitioner providing it." clearly applies to all research on SM, not just to the 43 studies in question.

Eubulides (talk) 20:45, 29 October 2008 (UTC)

This is not what I am suggesting. What I am audaciously suggesting is that we follow WP:NOR. This means that we don't use sources in a way that they were not intended to be used. So if the research was about the efficacy spinal manipulation in general, we should not use that research to discuss the efficacy of chiropractic spinal manipulation specifically. That's all really. You can present any argument you want on the talk page to some degree but Wikipedia is not a forum nor is it a soapbox. That means all of our personal POVs are irrelevant here. We stick to what is verifiable by reliable sources and we author per NPOV. What is verifiable is that there is no agreement in the scientific community that all SM studies can blindly be applied to chiropractic. Therefore, we cannot blindly apply just any SM study to our article about chiropractic. The study needs to be specifically about chiropractic. Given that there is disagreement in the scientific community about whether or not all SM studies can be blindly applied to chiropractic, for us to take sides with Meeker & Haldeman's POV in this debate and include non-chiropractic SM studies on the basis of their contended opinions, would and does amount to a violation of WP:SYN and WP:NPOV. -- Levine2112 ^discuss 22:35, 29 October 2008 (UTC)

• Nobody is arguing that we "blindly apply just any SM study to our article about chiropractic". Chiropractic #Evidence basis is not blindly applying just any SM study. It is applying only studies that are relevant to chiropractic.
• We do not need a reliable source that says "It is OK to cite study X in Chiropractic." Meeker & Haldeman 2002 are mentioned only because they are part of the mainstream opinion that SM, and general SM reviews, are highly relevant to chiropractic.
• Chiropractic should reflect mainstream medical and scientific opinion. Although it should also cover minority and fringe views, it should not censor the main part of its discussion in order to accommodate those views.

23:50, 29 October 2008 (UTC)

With what criteria are you using to determine which SM studies are relevant to chiropractic? No one has shown that SM and general SM studies are "highly relevant to chiropractic", nor has anyone demonstrated that this is the mainstream opinion. Ernst, a mainstream researcher, stated that the majority of the 43 published RCTs on spinal manipulation for LBP are not related to chiropractic SM and that general SM research is not necessarily an evaluation of chiropractic exclusively. Chiropractic should most definitely reflect mainstream medical and scientific opinion. The problem here is that there is not definitive mainstream opinion with regards to using non-chiropractic SM studies to evaluate chiropractic. Some researchers think it is always okay, some researchers think it is sometimes okay, and some researchers think it is never okay. So I repeat: With what criteria are you using to determine which SM studies are relevant to chiropractic? -- Levine2112 ^discuss 00:24, 30 October 2008 (UTC)

(outdent)It is time for Levine2112 and Eubulides to give it a rest on this subject. You two have gone round and round in circles for weeks about the chiro SM vs non-chiro SM topic and it has long since stopped being a useful discussion. --Surturz (talk) 04:41, 31 October 2008 (UTC)

I am glad to give it a rest - but during the respite, the NOR tag would remain. I think we would be closer to resolving this issue if Eubulides could answer my question: With what criteria are you using to determine which SM studies are relevant to chiropractic? -- Levine2112 ^discuss 08:14, 31 October 2008 (UTC)

With what criteria are we using to determine that SM studies are relevant to chiropractic? That's easy. The recent RFC already determined that SM is relevant. According to the closing administrator of the recent RFC: Sorry if I wasn't clear, I am not suggesting that the RfC covered the OR question, what I'm asking is that arguments that say "SM isn't relevant here" or "this doesn't relate" stop. There are clearly other issues at hand and other parts of the OR discussion that need to be resolved, but the "SM doesn't belong here" argument should be put to bed. It is very clear editors should avoid the claim that spinal manipulation is not directly related to chiropractic when the recent RFC determined it is relevant. The reason being, there is a clear consensus that SM is relevant to this article. Another criteria I am using is a top researcher called Ernst. When SM is core to chiropractic it is directly relevant. See WP:OR. QuackGuru 16:24, 31 October 2008 (UTC)

Putting this as bluntly as I can, what Shell meant is that the RFC shows that the reasoning "general SM therefore not Chiropractic" is not generally followed by the community and arguments of that type should stop. Now, if there are any other steps central to the argument ("general SM and blah therefore not Chiropractic" or "general SM therefore blah therefore not Chiropractic") it's still fine, but blanket saying that all forms of SM not specifically stated to be chiropractic SM aren't chiropractic SM appears to be against consensus. Let me know if I need to clarify. Cheers. lifebaka++ 22:41, 31 October 2008 (UTC)

The RfC did not ask whether general SM was relevant to Chiropractic, it only asked of SM was relevant to Chiropractic. Of course it is, as Chiropractors use SM! But, in terms of WP, and WP policy, it isn't necessarily directly related, because other providers also use SM. If a source doesn't state that it relates to Chiropractic, or its data is not based 100% on Chiropractic SM, then we are violating WP:OR by stating that it is directly related. In analogy, the RfC asked "Are fish related to the ocean"? Of course they are! But wait, what about fresh water fish? Could we use sources that talk about goldfish in an article on the ocean, unless the source made it clear that it was relevant to the ocean?. "Wikipedia does not publish original research or original thought" is a core policy of Wikipedia. If an author has used these sources to discuss the evidence basis/effectiveness of Chiropractic, then it isn't an original thought, but to otherwise discuss these studies on Chiropractic is publishing orginal research, as it hasn't been done elsewhere. What we should be doing is looking at reliable sources that explicitly discuss the evidence basis for Chiropractic, and summarize them. We should be at reliable sources that discuss the effectiveness of Chiropractic, and summarize them. If no such sources exist, then we shouldn't be discussing it at all here. DigitalC (talk) 01:57, 1 November 2008 (UTC)

It's correct that "blanket saying that all forms of SM not specifically stated to be chiropractic SM aren't chiropractic SM appears to be against consensus." It's also obvious. The problem is that it doesn't solve any problem that I know of. I think there was an even better analogy above: in a general discussion about automobile safety, you can't combine stats from different countries, even if you use only data from the same kinds of cars, because the traffic laws are different. It is possible that non-chiro data could skew the results, and we may need to have some statement saying just how well these studies apply to chiro. This is especially true if the effect size of treatment is low. If the effect is small, then a small amount of data can have a pretty big effect on the conclusions. Am I right on these points? ——Martin^phi ☎ Ψ Φ—— 02:40, 1 November 2008 (UTC)

A few editors continue to argue against established consensus of the closing of the recent RFC. Clarification by admins is needed. I think this is not going to end until admins make it very clear. Maybe a new template at the top of the talk page may help (When editors continue to argue general spinal manipulation is not related to chiropractic we can direct editors to read a new template at the top of the page). If editors have other concerns about original research I am happy to discuss it but the argument that spinal manipulation research is not related should be put to rest. SM is directly related to chiropractic and editors should comply with the consensus of the recent RFC. QuackGuru 06:11, 1 November 2008 (UTC)

• We've tried gentle reminders and redirection here and that doesn't seem to be working, so let me put this very clearly one more time. Levine, DigitalC (and anyone else I missed making the same argument) the RfC was clear that SM was related to Chiropractic. I understand that you disagree with this outcome, but Wikipedia works by consensus. Any further argumentation along those lines should be dropped post haste or you may find yourself taking a break from the article for continuing disruption. If you have a concern about the specific wording of the section or a concern using a specific study from that section, please discuss that content issue directly. If you continue to stall work on resolving these disputes with another argument that somehow SM may not or can not or isn't good enough for the article, expect a topic ban to come shortly after. Shell ^babelfish 22:03, 5 November 2008 (UTC)

I apologize but I disagree that such a consensus exists. The RfC specifically stated that it had nothing to do with article content yet you seem to be using it as such. In terms of article content, there is no agreement that we can blanketly use any and all non-chiropractic related SM research in our article about chiropractic. That still constituted OR. So instead of trying to enforce an RfC which has nothing to do with article editing, how about suggesting wording for an RfC (or some other dispute resolution process) which you think will help us get past this impasse. We have given many specific examples above, below, and in the archives but it always comes down to the same circular arguments from the opposition. -- Levine2112 ^discuss 22:25, 5 November 2008 (UTC)

As respectfully as possible, I need to point out here that it does not matter whether or not you agree the consensus exists. Clearly, you have other opinions but you are required to respect the consensus that was determined. If you have specific examples of problems in the article, state them clearly and concisely and then stick to those specific items. Shell ^babelfish 04:17, 6 November 2008 (UTC)

References

(The following resolve otherwise-dangling references: )