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There’s no place for pseudo-scientific chiropractic in Australian universities

It’s difficult enough to counter the massive amount of misleading information provided to consumers through the media and online. But the task becomes much harder when tertiary institutes give an undeserved…

Central Queensland University should reconsider its plans to offer a chiropractic degree. Aidan Jones

It’s difficult enough to counter the massive amount of misleading information provided to consumers through the media and online. But the task becomes much harder when tertiary institutes give an undeserved imprimatur to pseudo disciplines by offering them as courses. Central Queensland University (CQU) is the latest to do so, announcing it will offer a Bachelor of Science degree (Chiropractic) from 2012.

I’m one of thirty-four doctors, scientists and clinical academics who, in an attempt to protect health-care consumers from the dangers associated with unscientific clinical practices, have today written to the science deans at CQU urging them, as fellow academics, to reconsider this decision.

We want the deans to acknowledge the importance of our universities remaining champions of rigorous academic standards and remind them of the primacy of the evidence base for scientific conclusions and health-care practices.

We have no doubt that they will agree with this sentiment. So we can’t help but wonder if they’ve had a chance to look, in depth, at some of the nonsense claims many chiropractors make about the therapeutic benefits they can deliver.

More than just back pain

Some chiropractors limit their clinical activities to treat musculo-skeletal problems that cause back pain. There is evidence that shows these manipulations are marginally effective, though they’re unlikely to deliver lasting results, regardless of whether the practitioners are physiotherapists, osteopaths or chiropractors.

Few chiropractors stick to the evidence-based practice of treating musculo-skeletal back pain. Brother O Mara

But a practice limited to spinal area musculo-skeletal discomfort is not what modern chiropractic is all about. Most chiropractors believe and teach that spinal area “adjustment” can be used to treat the vast majority of medical problems.

This confidence is based on the theory generated by the founder of chiropractic who claimed that “innate intelligence”, which controls all normal bodily functions, is contained within the spinal column. He equated this phenomenon of “guiding energy” with metaphysical and physiological health. Interference with the flow of this energy, he said, resulted from spinal cord “subluxation” and thus manipulating the spine could restore the flow and correct “95% of all man’s ailments”.

The theory forms the basis for the chiropractors' peak association’s efforts to constantly broaden the role of chiropractic in primary health care. The Chiropractors Association of Australia’s (CAA) 2009 vision statement encompasses a major ambition: “To achieve a fundamental paradigm shift in healthcare direction where chiropractic is recognised as the most effective and cost efficient health regime of first choice that is readily accessible to all people”.

The 2011 Annual report of the CAA notes, “We are in a unique position to be in the forefront of primary care and the natural leaders in prevention and wellness for Australia. Our intellectual property over the power of subluxation and its impact on health is well understood by the CAA."

In 2010 the CAA reported, “after ten years of hard slog by the CAA every chiropractor in the country will be permitted under legislation to use the title doctor”. There’s no doubt this was a regrettable decision by the Federal government and confusing to the public. And it’s ironic that these “doctors” constitute the largest “professional” group within the Australian (anti-)Vaccination Network.

Child manipulation

The increasing involvement of chiropractors in establishing paediatric clinics that offer “adjustments” for a wide range of childhood problems is perhaps most disturbing. So it’s concerning that the new head of chiropractic studies at CQU endorsed the move to establish such clinics when he was at RMIT.

Some chiropractors claim their adjustments can alleviate a wide range of child health and development problems. Lorena

Chiropractic paediatric websites claim that “adjustment” can help many potentially serious childhood conditions including, fever, colic, croup, allergies, wheezing, poor posture, stomachache, hearing loss, headaches, asthma, bedwetting, bronchitis, learning disorders, arthritis and attention deficit hyperactivity disorder, among other things.

This five-minute video demonstrating adjustment techniques for adults and children shows just how risky the technique can be. And the literature contains details of more than 700 cases of serious complications following “adjustment”.

The broader problem

My fellow clinicians, academics and scientists and I conclude our letter to the deans of CQU by emphasising that, “[Y]our chiropractic students may well be exposed to excellent courses in anatomy and some basic sciences. However the inclusion of subluxation theory as evidence-based reality is unacceptable and will damage your reputation for academic leadership.”

It’s important to note that while CQU’s announcement prompted our latest response we are in no way singling out CQU for criticism; our comments apply to all tertiary institutions that are involved in legitimising anti-science. Currently three universities offer chiropractic studies while fourteen universities offer non-evidence based courses. RMIT’s “Energy Medicine” is just one.

Should university-based chiropractic education be restricted to evidence-based techniques? Have your say below

Join the conversation

165 Comments sorted by

  1. Marc Hendrickx

    Geologist

    Hear, Hear.

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  2. Tim Scanlon

    Author and Scientist

    But the university wants money.....

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    1. Graeme Hanigan

      logged in via Facebook

      In reply to Ken McLeod

      Nimrod Weiner is a prime example of some crack pot chiropractors, expounded ideas that are a threat to public health.

      But then when your not restricted by the boundaries of rigorous scientific evidence, any mumbo jumbo will do.

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  3. Wally Week

    Bicycle Engineer

    "In 2010 the CAA reported, “after ten years of hard slog by the CAA every chiropractor in the country will be permitted under legislation to use the title doctor”. "

    Most people using the Dr title these days should not. This includes physicians, surgeons, vets, dentists, etc. It is clear that everyone wants to use the Dr title these days. Why chiropractors would not want?

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  4. Russell Hamilton

    Librarian

    "Some chiropractors limit their clinical activities to treat musculo-skeletal problems that cause back pain."

    Yes, and they give (drugless) relief to people where doctors can't. So I hope your letter suggested a way where the usefulness of chiropractors in that area can be the basis of the course.

    "There is evidence that shows these manipulations are marginally effective, though they’re unlikely to deliver lasting results"

    My experience of chiropractors was 30 years ago. A doctor and physio couldn't help with back ache and eventually I went to a chiropractor who fixed the pain in 20 minutes - and who also told me the problem was weak muscles and I should take up swimming. Which I didn't, and a few months later was back at the chiropractor, who fixed it again, but told me very firmly that I needed to fix the problem myself and to start swimming! Which I did, and have done almost every day since and have never had the problem again.

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    1. Tim Scanlon

      Author and Scientist

      In reply to Russell Hamilton

      "Treating muscular-skeletal problems where doctors can't"
      As opposed to a physiotherapist...... Or perhaps one of a number of real practitioners.

      Your experience is the sort of experience I'd attribute to seeing a GP (who isn't the doctor you need to see about these problems) and a crap physio. Actually doing some exercise and deloading the spine (i.e. swimming) was what actually fixed the problem, not the chiropractor.

      I went through 5 physiotherapists before I found a decent one to help me rehabilitate my knee post-surgery. People seem to be thinking that seeing a GP equates with seeking medical treatment, it is only the referral to the medico you need to see.

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  5. ɹǝɯɐןq

    logged in via Twitter

    Institutions that are teaching misinformation are doing a public disservice.

    Their science departments contain experts in seperating medical information from misinformation. By neglecting their advice they're undermining their own academic credibility.

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  6. Paul Richards
    Paul Richards is a Friend of The Conversation.

    Most Australian's are grateful for our health care, the brilliance of vacines and all the medical expertise the professionals bring to our health system. Introducing another discipline is bound to cause friction, however our community has expressed the need for complementary approach and it does give the public choice.

    A more mature approach for medical professionals may be to look for a win win scenario and work with the Chiropractors to raise the disciplines awareness. It is easy to forget the medical system has a symbiotic relationship with pharmaceutical corporations, and looking from outside the system the challenge in the article looks like a 'union demarcation dispute'. After all the AMA is the second most powerful Association in the country.

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    1. Graeme Hanigan

      logged in via Facebook

      In reply to Paul Richards

      I reject your assertion of choice!
      To be lied to and ripped off by quacks offering false hope is not choice.

      In case your unfamiliar with the term, quackery is sham medical treatments and devices that are not grounded in science and which have no known evidence of efficacy.

      Chiropractic fits this definition. The notion of subluxation is no more than quaint folk lore and I refer you to the Cochrane Review for confirmation of the lack of compelling evidence of efficacy.

      There is better protection for the consumer buying a second hand car, than there is in the Wellness Industry.

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    2. Tim Scanlon

      Author and Scientist

      In reply to Paul Richards

      I have a great addition of choice for you Paul. I just came up with a brand new therapy, it is based upon the energy alignment of ore rocks. As you would know ore rocks are high in metal, metal aligns with the Earth's magnetic field, magnets can help with pain relief, thus by strategically placing rocks around your home and work I can cure most ailments.

      I have been fighting for recognition of this fantastic panacea by the evil medical establishment, but they are so far ignoring it. I think if I could get the alignment methods taught at university it could become more accepted as a practice, despite lack of actual scientific evidence, documented studies, efficacy protocols, etc.

      Who needs actual rigor to what is taught, especially in medicine? It's not as though proper treatment of our health is important enough to warrant actual evidence and scientific support.

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    3. Paul Richards
      Paul Richards is a Friend of The Conversation.

      In reply to Tim Scanlon

      Tim, I respect your right to promote the energy alignment of ore rocks.
      However, my level of awareness can see it may be appropriate for your stage of development, but isn't for mine. Something to consider might be who funds the research into the magnetic rocks and any vested interest.

      For me like a great deal of Australian's, I am happy with our medical professionals, the job they do and the care they give. May you keep evolving, wishing you well.

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    4. Paul Richards
      Paul Richards is a Friend of The Conversation.

      In reply to Graeme Hanigan

      Graeme, thanks for the comment. Personally I reject the Nanny state principle, but respect your right to believe and take responsibility for everyone. In my personal medical journey, I find this site a favourite to consult; http://www.quackwatch.com/
      It generally is a good starting point as it sorts out the facts concisely.

      It is good to remember current medical understanding allows for the placebo affect. Many of these CAM techniques actually function on this level and as you know thousands of pharmaceutical trials accept it as well. Good health professionals understand faith or belief has real world benefits and actually has an affect on human wellness.

      We both might not agree with peoples beliefs but our culture of tolerance differentiates us from those that enforce theirs on others. As a believer in "Caveat Emptor", I try to apply it to more than health regardless of assurances from experts.

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    5. Tim Scanlon

      Author and Scientist

      In reply to Paul Richards

      The point being that chiropractors are not real medical professionals. Medicine is a science based degree. Therefore the universities shouldn't be incorporating it..

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    6. Graeme Hanigan

      logged in via Facebook

      In reply to Paul Richards

      Paul,

      I hope your not suggesting that we don't require any standards for anything, no road rules, no aircraft safety standards, let forget about educational standards and descend into primitive superstitious hocus pocus. Go live in a country where this exists and see how you like it.

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    7. Paul Richards
      Paul Richards is a Friend of The Conversation.

      In reply to Tim Scanlon

      Tim, the point being this is like "a demarcation dispute", or competitive conflict. Your comment only raises the question. Why compete if it is pseudo science?
      After all, the universal truth is anything unreal is no threat.

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    8. Tim Scanlon

      Author and Scientist

      In reply to Paul Richards

      Actually it does pose a threat, despite being a pseudoscience. I was using satire to highlight the stupidity of supporting or acknowledging any pseudoscientific "health" practices, whether that be my made up magnetic rocks or your chiropractic care. This rubbish does pose a threat because allowing it at a university offers an air of legitimacy that it doesn't have. Anyone being treated by it or anyone promoting it is perpetuating a myth. This means people are, at best, not getting proper treatment for real ailments, or at worst, could end up worse off as a result of treatment.
      E.g. http://www.quackwatch.com/01QuackeryRelatedTopics/chirostroke.html

      So allowing these myths/quacks to continue and gain higher recognition just exacerbates the likelihood of further people receiving poor treatment and possible injury.

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    9. Paul Richards
      Paul Richards is a Friend of The Conversation.

      In reply to Tim Scanlon

      Tim thanks for your reply, you made your points clear.
      Like you I held the same views, they were appropriate for me once, just as they are for you now.

      For the record, today I look at both disciplines warily; caveat emptor.
      Wishing you well.

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    10. Jeff Bain

      Naturopath

      In reply to Tim Scanlon

      Look this is an interesting but somewhat meaningless discussion. What should matter to everyone involved is patient outcomes. Yes clinical evidence is important but let us not ignore the importance of anecdotal evidence. Someone who has spent days in bed and in pain with a lower back problem and gets relief after visiting a chiropractor really isn’t going to be persuaded by an intellectual argument over its validly.
      In an environment where individuals are free to choose whatever therapy they want…

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  7. Graeme Hanigan

    logged in via Facebook

    Offering degrees in Chiropractic Pseudo-Science is the Central Queensland Universities equivalent of pharmacies selling ear candles, for no other reason the easy money and a willingness to overlook slack jawed academia.

    Chiros do a vague sham diagnosis, such as your spine is out of balance and then proceed to treat it over an arbitrary number of visits depending on the practitioners estimation of your wealth.

    Heard the joke how many chiros does it take to change a light bulb?
    Just the one but it takes 100 visits.

    As a health consumer I am fed up with the $B Wellness Industry offering nothing more than sham medicine.

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  8. Doug Cotton

    IT Manager

    If you have a problem such as uneven weight distribution on your legs, who but a chiropractor is likely to even test for such, let alone fix it?

    My own (yes, anecdotal) experience is that such problems can be rectified by chiropractors, and subsequent test results showed improvement in my case. Also, the number of adjustments needed each visit has decreased significantly in time, so I assume there has been some permanent improvement. And of course the back pain I used to suffer in my forties has…

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    1. Tim Scanlon

      Author and Scientist

      In reply to Doug Cotton

      I can think of a dozen medical professions that test and treat what your describe Doug. Unlike chiropractors, these medical professionals actually treat the patient, rather than some magical shakra lines.

      Also, the old bent over people are from a number of reasons. Most is from tendon/ligament shortening or calcification. Chiro will not fix this.

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    2. Graeme Hanigan

      logged in via Facebook

      In reply to Doug Cotton

      Doug the old uneven weight distribution is a sham diagnosis which the chiro will then charge you to fix. Everyone even animals have uneven weight distribution.

      Also your own personal anecdote is not evidence.

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    3. Cris Kerr

      Volunteer Community Health Researcher, Advocate for the value of Patient Testimony

      In reply to Graeme Hanigan

      This is interesting and has brought back an old memory.

      When I was 17 I was told by a Brisbane city GP that my lower back pain and occasional shooting nerve pains down my leg was caused by one leg being shorter than the other.

      He said I needed an orthotic support in one shoe to level me out, and that I'd have to use the orthotic for the rest of my life.

      He said that if I didn't start using the orthotic I'd be crippled by the time I was 30.

      I remember the words vividly because the prediction was so dire... he scared the living daylights out of me.

      I heard about chiropractors. Went to one. The problem was fixed.

      That event was some 35 years ago now.

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    4. Andy Gilbey

      logged in via Facebook

      In reply to Cris Kerr

      Chris,

      Great that your GP was wrong--it is the nature of their job that on occasion they will be--but that doesn't logically mean the chiropractic treatment worked. (Although I'm sure that fans of chiropracty will be more than happy to claim that it did.) Maybe it's just a coincidence?

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    5. Cris Kerr

      Volunteer Community Health Researcher, Advocate for the value of Patient Testimony

      In reply to Andy Gilbey

      Yes Andy, I was pretty well pleased about that too :-)

      I would agree with you that it could have been co-incidence if not for other occasions when the same 'co-incidence' relieved mobility issues and pain.

      Yes, subjectivity is a variable factor, but numbers aren't.

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    6. Andy Gilbey

      logged in via Facebook

      In reply to Cris Kerr

      I disagree: The plural of anecdote is not data ;-)

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    7. Cris Kerr

      Volunteer Community Health Researcher, Advocate for the value of Patient Testimony

      In reply to Andy Gilbey

      Hi Andy,

      I believe a single anecdote does indeed contain much data. I had a look at wiki and it says 'Data are qualitative or quantitative attributes of a variable or set of variables', which makes sense.

      The problem is that the data contained in a single anecdote can be subjective, is typically not structured, and occurs on a single occasion only... which means it's very difficult to obtain any measures from the data.

      So the real reason an anecdote is afforded little to no value is not…

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  9. Phillip Ebrall

    Professor of Chiropractic at Central Queensland University

    It would be helpful to the discussion if Prof Dwyer, as the author of the original piece above, did two things: (a) actually sought evidence from me or the University that what he thinks is contained within an evidence-based chiropractic program actually matches his unfounded fears, and (b) ceased perpetuating lies. This paragraph is a complete fabrication containing untruth: "The increasing involvement of chiropractors in establishing paediatric clinics that offer “adjustments” for a wide range…

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    1. Graeme Hanigan

      logged in via Facebook

      In reply to Phillip Ebrall

      The good Professor Dumdledore should note that the quickest way to shut up a skeptic is to present some credible evidence.

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    2. Eran Segev

      logged in via Facebook

      In reply to Phillip Ebrall

      Dr Ebrall, was it not you who said that "Subluxation theory will be taught because it is an emerging theory that's developing an amazing amount of evidence at new levels in support of some of its underlying principles"? Do you have any good evidence that this 200 year-old discredited notion is "an emerging theory", or do you just like to call it that? Note: 'good evidence' means at least a few papers published in mainstream high-impact journals that are NOT dedicated to chiropractic and reviewed…

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    3. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Phillip Ebrall

      There are no ad-hominem attacks that I have seen. It is the lack of evidence that is being called into question and this is precisely how academic discussion takes place. Prof Ebrall might want to check his terminology before making further accusations.

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    4. Paul Richards
      Paul Richards is a Friend of The Conversation.

      In reply to Rachael Dunlop

      Rachael - I fail to see, for example how calling someone "The good Professor Dumdledore" doesn't qualify as an attack that is insulting or belittling an opponent.
      argumentum ad hominem "to the man" or "to the person"
      In this forum we often see clear evidence of cognitive bias, this subjet is no exception.

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    5. Eran Segev

      logged in via Facebook

      In reply to Paul Richards

      Paul,

      You are correct in pointing out that statement, and it would be better if it hadn't been said, but Ebrall wasn't referring to that comment when he mentioned ad-hominem attacks on him, so it's irrelevant to Rachael's point, and Ebrall was wrong to invoke this logical fallacy.

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    6. Paul Richards
      Paul Richards is a Friend of The Conversation.

      In reply to Eran Segev

      Eran - thanks for the comment, I appreciated both your points. But none of us aware of the extent of the comments made to Phillip and furthermore the comment he made was rhetorical. There is no precedent for vitriolic ad hominen attacks, they are unprofessional, ergo; will go unpublished.

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    7. Eran Segev

      logged in via Facebook

      In reply to Paul Richards

      I think I am well aware of the extent of the comments made to Phillip and about Phillip, certainly the ones made by the people he mentioned: Dwyer, Harvey and Marron. I have seen the reports, letter and articles, and not one of them contains anything that an objective observer would construe as an ad-hominem attack.

      Where I think Ebrall gets it wrong is that he thinks one must only attack views, not people; but attacking a person for promoting certain views is legitimate, if you attack the views too. What would be illegitimate would be to say that Ebrall is ugly and therefore he is wrong (or something equivalent). Nothing like that had happened here.

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    8. Paul Richards
      Paul Richards is a Friend of The Conversation.

      In reply to Eran Segev

      Eran - Once again thanks for the comment. However none of us knows what has been said to Phillip by all skeptics, particularly the ones named, only he has that truth.
      So I can't stand on either side of this argument. I just know there is always room for a win win and it takes highly evolved individuals to see this, and not lower their value system. As I have said before, it looks very much like "a demarcation dispute".

      As for your reference to the latin, "to the man" or "to the person", here is a rhetorical question for you.

      How personally do you take an attack on your career and value system?

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    9. Eran Segev

      logged in via Facebook

      In reply to Paul Richards

      Paul, I'm afraid you are wrong on this one (or perhaps engaging in a bit of a straw man argument, to spice things up). I know for a fact (i.e. I'm not guessing) that I have seen everything written to Ebrall by the people he mentioned, and they did not attack him in a fallacious way. In fact, they hardly attacked him at all - they focused on the CQU decision to have the course he leads. I was not suggesting that I know everything said by all skeptics, and if Ebrall has any exmaples of people attacking him this way I'd be the first to denounce such attacks - as I have in a previous comment.

      As to your other question, I fail to see the relevance. That he takes it personally does not make it an ad-hominem argument. It's only an ad-hominem argument if he is attacked based on who is rather than on what he says or does. Which he wasn't. So it isn't.

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    10. Paul Richards
      Paul Richards is a Friend of The Conversation.

      In reply to Eran Segev

      Eran - Once again thank you for your comment.
      My awareness of your position is clear and distinct.
      Wishing you well.

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    11. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Paul Richards

      Paul, I presume that question is directed at me? I can tell you with regards to my career, given that my value system is not relevant here.

      I respond with evidence refuting the claims, if I have it. Or I redress my position accordingly. This is how science works. We do it all the time - it's called the peer review process. It's not new and you can't take it personally even though sometimes it's difficult to deal with.

      It's not nice to be told by an anonymous reviewer that your work is badly written…

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    12. Paul Richards
      Paul Richards is a Friend of The Conversation.

      In reply to Rachael Dunlop

      Rachael - You have made you points well. It is clear how you feel about your profession and that of your opposition to this discipline. I am sad that the only arguments left to you are about the honesty of the Chiropractic disciplines intention to defraud and deceive.
      Which is when it is directed at an individual, is personal - "ad hominen".

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    13. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Paul Richards

      Paul, with all due respect, I think you are still misinterpreting what constitutes an ad-hom. Also I did not say anywhere that the chiro profession "intentionally defrauds and deceives". I haven't used these terms (and I wouldn't because it's wrong to make this claim and highly libelous).

      I confess, I am having difficultly following your argument.

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    14. Paul Richards
      Paul Richards is a Friend of The Conversation.

      In reply to Rachael Dunlop

      Rachael, I understand you perfectly and I am glad you have not actually come out and said profession "intentionally defrauds and deceives".

      But failing to see others have by using the phrase "pseudo", raises the question of cognitive bias. Against that there is no reply. So again, the context of all my replies are from your initial comment;

      "There are no ad-hominem attacks that I have seen"

      For the record I look at both disciplines warily ; Caveat emptor.

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    15. Graeme Hanigan

      logged in via Facebook

      In reply to Paul Richards

      Sorry Paul but Prof. Ebrall made reference to 'the vitriolic ad hominen attacks that are currently the tool-of-choice of the sceptics' prior to my referring to Professor Dumbledore. It is you that made that link to Prof. Ebrall not me.

      Just as I ask Prof. Ebrall for credible evidence to support the claims made for chiropractic, I also ask him to provide credible evidence of the vitriolic ad hominen attacks.

      Thanks to the proliferation of quacks in the Wellness Industry, Dwyer, Harvey and Marron…

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    16. Paul Richards
      Paul Richards is a Friend of The Conversation.

      In reply to Rachael Dunlop

      Rachael, again your points are clear. I must point out that in defending the writers view point, you are endorsing it's headline, direct discussion with any Chiropractor or about the discipline carries it's weight.
      I understand you feel this is appropriate, but neutral observers feel differently.
      If you need to research my meaning further look here; http://goo.gl/hkJG

      "There are no ad-hominem attacks that I have seen" - Rachael Dunlop

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  10. (Dr. T.) William M. Thomas, Chiropractor

    logged in via LinkedIn

    Most chiropractors have abandoned the traditional view of subluxation and do follow a scientific paradigm. I have a degree in biochemistry and became a chiropractor after a profoundly helpful experience with chiropractic. Although some chiropractors are "alternative", mainstream chiropractic utilizes a scientific approach to neuromusculoskeletal problems. I have more information on my website http:///www.DrTChiro.com if you would like to understand another perspective on chiropractic. Chiropractic admittedly has an "interesting" history, however, modern chiropractic has evolved and what is being taught in the schools is essentially what is being taught in medical schools along with chiropractic technique. Diagnosis and diagnostic procedures as well as orthopedic and neurological testing are similar to what MD's do. Many of my professors in chiropractic school were MD's and PhD' in their respective scientific specialties.

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    1. Matt M

      Chiropractic Student

      In reply to Graeme Hanigan

      Physiotherapy entails a more comprehensive rehab pathway with passive treatment using basic chiropractic techniques, whereas chiropractic uses a plethora of adjustments on all joints of the body to restore or improve joint mobility (amongst other benefits) (proven) and thus well-being. Chriopractors use a wholistic approach when treating a patient but using not only adjustments but the modern practitioners approach of improving lifestyle inclusing of rehab exercises etc. Chiropractic simply holds more tools in its pockets and is shown by a longer course time than physiotherapy.

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  11. Cris Kerr

    Volunteer Community Health Researcher, Advocate for the value of Patient Testimony

    I have had back problems with severe pain in the past.

    I have been sent for x-rays and prescribed pain medication.

    The x-rays showed nothing. The pain continued unabated.

    One trip to a good chiropractor... relief.... and no return of the problem.

    The evidence-based science argument is a furphy because no-one conducts very expensive clinical trials for anything they can't patent and profit from.

    So there will never be any evidence of patient benefit whilst that system continues, and those who…

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    1. Graeme Hanigan

      logged in via Facebook

      In reply to Cris Kerr

      Chris just because it worked for you, does not mean it works.

      I attended a chiropractor, 40 odd visits for lower back pain and achieved zero results. I obviously hadn't found a 'good' chiropractor. I then went to an osteopath with the same result.

      Your anecdote is not evidence and when tested scientifically the results reveal that chiropractic is no better than placebo with the exception perhaps the treatment of lower back pain. Sadly not in my case though.

      It's a properly performed trial that sorts the wheat from the chaff and chiropractic has been found to be mostly chaff.

      It is irresponsible to perpetuate the myth that it has wider efficacy in an educational facility such as a university.

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    2. Cris Kerr

      Volunteer Community Health Researcher, Advocate for the value of Patient Testimony

      In reply to Graeme Hanigan

      Hi Graeme,

      Sorry I missed your comment till now.

      Chiropractic has worked for me on several different occasions over the years... and no doubt the many others that have visited a chiropractor on more than one occasion.

      If it didn't help, people wouldn't return... so we need many more good practitioners... and that points to university courses.

      You said earlier that "the quickest way to shut up a skeptic is to present some credible evidence", and I agree.

      Gravity existed for millions of years…

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  12. Marcello Costa

    Professor of Neurophysiology, Department of Physiology at Flinders University

    As one of the signatures of the letter that gave rise to the article I would like to add that the very use of the term complementary when applied to Chiropractic is flawed. There is nothing complementary in a "profession" that tries to replace scientific medicine with unscientific practices. Chiropractic is alternative and thus goes against the advancing human health by evidence based knowledge. Those Chiropractic who claim to use scientific principles in their practices are simply no longer "Chiropractors…

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    1. jerry sprom

      logged in via email @gmail.com

      In reply to Marcello Costa

      Marcello,
      I am interested to know your thoughts on the teaching of subluxations at RMIT. Which part of the model that is taught at RMIT is particularly "unscientific". Can you explain how this model of subluxation "goes against the advancing human health by evidence based knowledge".

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    2. Tony Croke

      logged in via Facebook

      In reply to Marcello Costa

      Having read the letter to CQU, I'm surprised and disappointed by the lack of academic rigour it demonstrates. Selectively drawing quotes from an early 20th century chiropractic pamphlet to characterise contemporary chiropractic practise is no more reflective of current chiropractic thinking a testimonial about smoking in a 1950's cigarette ad would be reflective of today's understanding of medical practise.

      There are a growing number of published case studies, case series, outcomes studies and…

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  13. Rachael Dunlop

    Post-doctoral fellow at University of Technology, Sydney

    "Dr Tassell said although some chiropractors supported the anti-vaccination network, this had nothing to do with the teachings of chiropractic theory or treatment and he said the association neither supported nor discouraged it".

    Read more: http://bit.ly/sPKbmR

    This is why chiros deserve all the criticism they get. So it's okay if discouraging vaccination leads to a loss of herd immunity and kids suffering from vaccine preventable diseases? How the devil you can expect to contribute to public health if this is the nonsense you disseminate? It’s completely irresponsible to have “no position” on a serious public health issue. This is exactly why chiros belongs back in the dark ages. With spokespeople like this you should be embarrassed and we should be entitled to point and laugh.

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  14. Clive A Marks

    logged in via email @attglobal.net

    A really interesting debate and example of how easy it is to get lost without evidence based claims.

    I don't have a big problem with having two standards of medicine; those that are based on science and those that are not. The problem comes down to disclosure and the willingness of some to accept the label of 'second class'. A bitter pill for some.

    I've always been amused at how practices that are effectively dismissive of science want the respect the label gives; ie. the chiropractic industry…

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    1. Graeme Hanigan

      logged in via Facebook

      In reply to Clive A Marks

      Hi Clive I totally agree that the bulk of the Wellness Industry relies on the placebo effect. The placebo effect is undergoing vast amounts of scientific enquiry and I suspect that it will soon be delivered under the umbrella of medicine rather than by quack providers.

      For this very reason it is important reign in the proliferation of pseudo-science because it ultimately adds nothing to our understanding of human physiology.

      I would like to say that I am not an academic. I have no qualifications in either science or medicine however I am a health consumer that has had adverse experiences at the hands of quack practitioners, including chiropractors. It is that experience that has turned me into an advocate for better regulation of the health industry and at all times I welcome criticism of my position.

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  15. Andy Gilbey

    logged in via Facebook

    Good that this tie-up is being challenged. Hopefully it will go the same way as the one suggested for Florida State University. No where!

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    1. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to Andy Gilbey

      For those who may be puzzled by the references to Florida State University, an account can be found at http://www.dcscience.net/?p=241

      Briefly, FSU decided to turn down a large donation to fund a school of chiropractic after an enterprising Chemistry professor published a map of what the campus might look like in future if chiropractic mumbo jumbo was endorsed by the university. There would be a School of UFO Abduction Studies, a College of Dowsing, A Creationism foundation, a Department of Tarot Studies, and so on. These subjects are no dafter than chiropractic in their foundations.

      It's worth remembering that chiropractic was invented by a 19th century grocer and fairground salesman who found he couldn't make enough money from magnetic mumbo jumbo, so claimed he could cure just about anything by manipulating the spine. He became rich by that deception.

      The vice-chancellor, Professor Scott Bowman. should have done his homework better before endorsing this nonsense.

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  16. Phillip Ebrall

    Professor of Chiropractic at Central Queensland University

    Eran says "It's only an ad-hominem argument if he is attacked based on who he is rather than on what he says or does." One can only conclude the current criticism is based on the fact I am involved in its establishment (ie who I am) as there has been no effort by external parties to seek evidence to support their claims about their perception of what is being done.

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  17. Phillip Ebrall

    Professor of Chiropractic at Central Queensland University

    Given Andy's reference to FSU one could appreciate he has done his research and understands the political nature of that campaign. It is also interesting to now have evidence that links that disgraceful behaviour with current activity.

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  18. Phillip Ebrall

    Professor of Chiropractic at Central Queensland University

    As a health-oriented researcher Rachel would appreciate the meaning of 'scope of practice'. Quite simply, vaccination is not part of the chiropractic scope of practice and it is perfectly understandable why a 'position' is difficult to identify. As with all health disciplines a small number of practitioners will push the envelope and operate outside their training. Rachel makes a good point that responsible public healthcare workers would have a view on vaccination. Not all views have to be the same, however as a patient is involved it is appropriate to for practitioners to do exactly what the sceptics are preaching, that is, become an informed consumer. The public has a right to be informed on all sides of all public health issues.

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    1. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Phillip Ebrall

      Hi Prof Ebrall,

      I agree with you that vaccination is outside the scope of practice of Chiros, and Dr Tassell also agrees on this issue (see my comment below). For this reason, I wonder why so many chiros registered with the CAA take an anti-vaccine stance? As a scientist, you would be aware that there are not always two sides to the story when it comes to science - and with respect to vaccination this has been clearly demonstrated over many years and with many studies. Vaccination works, the benefits…

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    1. Eran Segev

      logged in via Facebook

      In reply to Phillip Ebrall

      Phillip, how about you provide evidence that we are wrong? Can you state that the concept of Vertebral Subluxation Complex will not be taught at the program? If you can't state that, and considering the state of the evidence on the existence of this phenomeno, then you will be providing the evidence you are seeking of Rachael.

      Alternatively, you can provide evidence that VSC is a sound from a scientific perspective, but you'll have to stick to proper evidence (see my comment at http://theconversation.edu.au/theres-no-place-for-pseudo-scientific-chiropractic-in-australian-universities-4576#comment_15794) not a couple of papers in some low-impact journal.

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  19. Phillip Ebrall

    Professor of Chiropractic at Central Queensland University

    Graeme

    Is it placebo when a patient changes their lifestyle, drops 20 kg or more and improves their blood sugars and blood pressure readings? Are you really calling the Government's aim to enhance lifestyle to reduce disease, a placebo effect?

    Come on, please be serious and please, read the literature.

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    1. Graeme Hanigan

      logged in via Facebook

      In reply to Phillip Ebrall

      Firstly it is possible that a greater number of chiropractors dissuade parents from vaccination than are members of the AVN.

      Secondly a great number of chiropractors actively promoted the bogus Power Balance Band, including being paid for endorsing advertisements. I will acknowledge that it was a group of chiropractors that eventually tested the Power Balance Band and found its claims to be baseless, but only after pressure from skeptics.

      Again I assert that if chiropractic is not bound by scientific rigour then any mumbo jumbo will do and often does.

      In these very pages Prof Ebrall backed the "fries and coke" deal between the Pharmacy Guild and Blackmores which in my opinion demonstrates that he has a greater interest in promoting the economic benefits to the provider than the health benefits to the patient.

      In my opinion Chiropractic does not have a reputation for adequate ethical or scientific standards to be providing a credible health service.

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    2. Tim Scanlon

      Author and Scientist

      In reply to Phillip Ebrall

      [Is it placebo when a patient changes their lifestyle, drops 20 kg or more and improves their blood sugars and blood pressure readings? Are you really calling the Government's aim to enhance lifestyle to reduce disease, a placebo effect?]

      Phillip, what has any of that got to do with Chrio? And I don't think you understand what the placebo effect is.

      Anyone can change their lifestyle, drop weight, etc, and they don't need a pseudo treatment to do it. My physio took me from not walking to squatting 180kg, fixing muscle imbalances, joint ROM, etc, all using scientific principles. I know that there is no way I chiro could achieve this, because it didn't rely on just doing something (classic placebo response to any treatment), it required nuanced understanding and treatment.

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  20. Phillip Ebrall

    Professor of Chiropractic at Central Queensland University

    Rachel

    Thank you for your fresh and honest questioning. It is appreciated. My first comment is that I probably accept your suggestion that 128 chiropractors are part of the AVN; I would have guessed around 100, but even so, we are still talking less than 3% of registered chiropractors in Australia. This is, I think, a small number.

    You suggest vaccination works. Clearly the press disagree with you, as does the AMA who have urged medical practitioners to more closely monitor the negative effects…

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    1. Travis Roy

      Sr. Systems Engineer.

      In reply to Phillip Ebrall

      "Clearly the press disagree with you, as does the AMA who have urged medical practitioners to more closely monitor the negative effects"

      Where does the AMA say this? I just went to their website and all over the site they urge people to get their vaccinations.

      In fact on the site there's stuff like:

      "We hope that physicians and other health care professionals will use this new information to increase influenza immunization rates across the United States."

      "Without vaccines, epidemics of vaccine-preventable…

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  21. David Colquhoun

    Professor of Pharmacology, UCL at University College London

    It is very sad to see an Australian university peddling degrees in pseudo science. In the UK such courses are closing as revelation of what’s taught on them embarrasses vice-chancellors into shutting them down,

    In the UK we have been through all this. When Simon Singh (author of some great books, Fermat's Last Theorem, Trick or Treatment) described chiropractic treatments as "bogus", the British Chiropractic Association (BCA) sued him for defamation. We were assured that there was a "plethora…

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  22. Clive A Marks

    logged in via email @attglobal.net

    Hi Graeme - many thanks for the reply.

    I feel that my points are quite trivial compared to the barrage being laid down by the waring sides. So, I reply with my tin helmet on.

    I'm a scientist, but my recipients of placebo have always been animals without informed consent! What I have always wondered was that if you disclose your treatment as a placebo to a human, a placebo won't work! No placebo trial in humans reveals who is getting the placebo. So there is an issue with informing the patient…

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  23. Colin Jenkins

    Software

    The international face of chiropractic is so confusing. The UK GCC say that subluxation is a historical concept while Phillip Erball says it's an emerging theory! Some UK HVLA chiropractors say McTimoney adjustments are worthless, yet both sets of waiting rooms are populated, which has interesting possible implications. Some chiropractors embrace the innate and organ-ic wellness while others dismiss it as voodoo and attempt to stick to M/S issues; which then begs the question: what is the difference…

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    1. Graeme Hanigan

      logged in via Facebook

      In reply to Colin Jenkins

      Well made point Colin. Its the same internal arguments that go on between all the quack modalities, especially homeopathy.

      If chiropractic wasn't pseudo-science there would be no obscurity.

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  24. Phillip Ebrall

    Professor of Chiropractic at Central Queensland University

    Graeme

    Two things:

    You say "I will acknowledge that it was a group of chiropractors that eventually tested the Power Balance Band and found its claims to be baseless, but only after pressure from skeptics" - this is not correct. The research team who investigated the Power Band commenced their journey outside any influence from others. Being one who actively supported this investigation puts me in the unique position of actually knowing the discussions that lead to the hypothesis that was tested; and

    You say "In these very pages Prof Ebrall backed the "fries and coke" deal between the Pharmacy Guild and Blackmores" - if your recollection was correct you would appreciate I actually seriously question the ethics of such an arrangement.

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    1. Graeme Hanigan

      logged in via Facebook

      In reply to Phillip Ebrall

      Prof. Ebrall,

      I acknowledge that my statement incorrectly implied that skeptics directly pressured the RMIT chiropractic team into investigating the Power Balance Band, which was not the case as far as I am aware. The Power Balance Band fraud was exposed by Dr Ken Harvey and I suspect the investigation was as a result of the ensuing publicity and I thank the RMIT team for that clarification. Your further clarification would be appreciated.

      Regarding the Guild/Blackmores agreement you wrote "There are two distinct illness-care paradigms at play and perhaps there should be a celebration that the Pharmacy Guild is taking an initial step in trying to bring them together." which sends quite a clear, positive message to me.

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    2. Phillip Ebrall

      Professor of Chiropractic at Central Queensland University

      In reply to Graeme Hanigan

      Dear Graeme

      I'm not interested in claiming 'we did it first' or such as we both know that ideas are often memes and emerge concurrently in many places. I'm pleased Ken questioned a product that was proven to be sham. This is a good thing. It is also good we have some evidence supporting this view, regardless of the origin of the evidence.

      My views on the Guild/Blackmores agreement are illustrative of what I see as a significant challenge in understanding sceptics. What I thought I clearly proposed…

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  25. Phillip Ebrall

    Professor of Chiropractic at Central Queensland University

    Rachel:

    You ask of me "If you can provide evidence that vaccination doesn't work, I will take a look" - have you not heard the point that vaccination is NOT within chiropractic's scope of practice? It is not for me to provide you with evidence of effectiveness either way. As a health researcher you would surely have some level professional awareness that should satisfy you.

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    1. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Phillip Ebrall

      I see. So you concede that vaccination is outside the scope of practice for chiros, but you are happy to let them spread anti-vaccination nonsense ala the CAA? For that reason alone, this course should not go ahead. Have you heard of herd immunity? If not, now would be a good time to look it up. I'm gobsmacked that you don't think this is an issue.

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    2. Phillip Ebrall

      Professor of Chiropractic at Central Queensland University

      In reply to Rachael Dunlop

      Vaccination is only an issue for chiropractic educators in that it is a matter of public health and indeed our program will address that very question. Further, the topics of pharmacology and vaccination will be taught by experts in those fields, and not chiropractors.

      And please appreciate that while I am an academic and an educator I do play a role in other areas, such as being a Director of the CAA National, and Chair of the Human Research Ethics Committee of a significant public health network…

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    3. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Phillip Ebrall

      I have called the CAA, the NSW branch, when I was researching an article and they told me "they have no position". Yesterday, the President of the CAA said this: "...although some chiropractors supported the anti-vaccination network, this had nothing to do with the teachings of chiropractic theory or treatment and he said the association neither supported nor discouraged it".

      Have they changed their mind today? Are you serious?

      I can give you an example of one member, Nimrod Weiner, who was spreading…

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    4. Phillip Ebrall

      Professor of Chiropractic at Central Queensland University

      In reply to Rachael Dunlop

      Hello Rachael

      I apologise for mis-spelling your name in an earlier post.

      The way the CAA works is that education policy is a national brief, which means CAA National (coincidentally located in NSW) is the appropriate body to approach, especially regarding what may be a position common to all states and territories and not just NSW. I hope this clarification is helpful to you.

      As an educator I have little interest in and no influence over what a practitioner says and does. There is a line that…

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    5. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Phillip Ebrall

      I'm not really concerned with how many chiros have graduated and where they have gone. It's irrelevant. When a complaint is made about a chiro, or a doctor for that matter, the regulatory body needs to address the complaint accordingly and act. The CAA or CCNSW did not do this in this case. When they were asked why they decided not to act they refused to answer any questions. As such, the CAA becomes complicit in the anti-vaccine messages disseminated by their members.

      What is the point of a regulatory body if it does not exercise transparency? It is useless, as the CAA has effectively demonstrated.

      I'm interested to know which part of my last par shows "bias and ignorance". To answer your question, no deaths were linked to the Fluvax adverse reactions. One child was permanently injured in WA.

      Careful, your anti-vax colours are beginning to show.

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    6. Phillip Ebrall

      Professor of Chiropractic at Central Queensland University

      In reply to Rachael Dunlop

      Rachael

      Please be careful with your throw-away lines. It adds nothing to your reputation as a researcher to make an accusation, in the absence of evidence, that I have anti-vax colours. For the record I have worked over a period of 7 or so years in one of Australia's busiest emergency departments. I also travel frequently to developing countries. I maintain relevant vaccination.

      Also it is somewhat embarrassing for me to need to correct a person in your position by telling you the CAA, state or national is NOT a regulatory body as you falsely claim.

      The regulatory body is the Chiropractic Board of Australia and should you have any concerns with the behaviours of any chiropractic registrant you have not only the right but also the responsibility to follow it through using the appropriate channel.

      I would appreciate your explanation of the report at this link: http://www.medicalobserver.com.au/news/the-flu-vax-falloutmaking-sure-youre-covered

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    7. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Phillip Ebrall

      The letter my colleague received regarding the complaint about Nimrod Weiner came from the Chiropractic Council of NSW. I mentioned this earlier in my comment - I got my acronyms mixed up. But thanks for the lecture. Perhaps you missed my point that we did make a complaint through the appropriate channels and in my opinion, and that of others, the response we received was inadequate.

      So, I make a comment that kids die from vaccine preventable diseases and that chiros are contributing to a reduction…

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  26. Phillip Ebrall

    Professor of Chiropractic at Central Queensland University

    For David Colquhoun:

    The point you make about the 'creative campus map' developed for FSU simply demonstrates how the grossly uninformed resort to fear to change human thinking. Sounds a little like religion to me.

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  27. Phillip Ebrall

    Professor of Chiropractic at Central Queensland University

    Eran has requested me to provide evidence that your fears about chiropractic education are wrong. Hang on, should it not be that it is the person making the accusations who provides evidence to support their argument?

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    1. Eran Segev

      logged in via Facebook

      In reply to Phillip Ebrall

      Yes it is, but you claim we are wrong and it would be very easy for you to show we are, so why don't you? I suggest it is becasue you cannot for two reasons:
      1. Your program will teach VSC as being at the core of chiropractic; and
      2. There is no good evidence that you can provide to show that VSC is anyhting but a mythical concept.

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    2. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to Phillip Ebrall

      Phillip Ebrall

      You make a big mistake if you think your opponents are grossly uninformed. Since the Simon Singh affair we have been through the evidence in detail. One of my contributions is at http://www.dcscience.net/?p=1775

      The evidence for the "principles" of chiropractic is very similar to the evidence for the principles of dowsing, i.e. zero. The evidence for the effectiveness of chiropractic isn't much better.

      As you must know, the Bronfort report found no reason to think that chiropractic was any more effective than physiotherapy. But physiotherapy comes with the absurd 19th century mumbo jumbo about "subluxations", or the mediaeval vitalism of "innate energy".

      The idea that this constitutes science, worthy of a Bachelor of Science degree, shames the university, and in particular shames the vice-chancellor, Professor Scott Bowman, who allowed it to happen. It degrades Australia's reputation for good science.

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    3. Phillip Ebrall

      Professor of Chiropractic at Central Queensland University

      In reply to Eran Segev

      Thank you Eran.

      I don't think I am really concerned that you are wrong, but I do feel it is somewhat unscientific for you to express a view (your point 1) in the absence of you actually having any evidence, meaning your view is based on hearsay and innuendo. Of course you are entitled to this view but perhaps not in an academic forum.

      As for your point 2, I do not know your field of speciality and therefore at this time I do not understand your expertise in reading, understanding and interpreting the clinical and neurophysiological evidence that does exist.

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    4. Phillip Ebrall

      Professor of Chiropractic at Central Queensland University

      In reply to David Colquhoun

      Dear David

      In your par 3 I think you meant to say 'chiropractic comes with...' instead of 'physiotherapy comes with ...'

      One thing that is interesting to ponder is whether manipulative physiotherapists treat the same clinical findings as chiropractors. And if so, why are there no vigorous call for that discipline to 'cease and desist'? After all, you are familiar with the Meade paper, aren't you? I appreciate it is outside your field of expertise (pharmacology) but in the sense of you wanting to have evidence for your criticism I am sure you would have read it, along with my own work published in the early 1990s.

      Perhaps the answer lies in questions of philosophical intent and if this is true, then your arguments are demonstrated as lacking substance in terms of 'fear of harm', 'quality of training', 'clinical indicators' and indeed, 'patient outcomes'.

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    5. jerry sprom

      logged in via email @gmail.com

      In reply to Phillip Ebrall

      Professor Ebrall,
      Perhaps Eran and others are thinking the 'vertebral subluxation complex' is still being taught as the 'bone out of place' model. It is a common misconception I have seen among many skeptics.

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    6. Eran Segev

      logged in via Facebook

      In reply to Phillip Ebrall

      Yet more evasion.

      This is not a scientific discussion, it's a matter of policy. You have shown through your past work that you promote unscientific (indeed, anti-scientific) concepts, and it is a fair assumtpion that when put in charge of a program you'd bring this attitude to bear. You can easily show that that's not the case, yet you refuse to. I think we know why.

      And what do my credentials have to do with it? let's assume I'm an ignorant
      moron - why don't you put the evidence out there for all to see? This is a public forum and there are many people here who are perfectly capable of judging the quality of evidence you might present. BTW - you don't need to be a specialist to tell the difference between a good study and a bad one, you just ned to understand how and why good studies are conducted. See David Colquhoun analysis of the BCA "evidene" for a great example.

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    7. Phillip Ebrall

      Professor of Chiropractic at Central Queensland University

      In reply to jerry sprom

      Hello Jerry

      Thank you so much, sincerely, for the best laugh of the day! I love it when patients tell me 'they've put their back out' - my usual response is 'along with the cat?'

      The 'bone-out'of place' myth is seriously so last century and had no place at all in chiropractic education as I have known it for 25 years. Remember, in the days this concept was developed we had no way of imaging the disc. As fibrocartilagenous material it remains unseen on plain radiography.

      I think it was not until…

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    8. Phillip Ebrall

      Professor of Chiropractic at Central Queensland University

      In reply to Eran Segev

      Hang on Dear Eran,

      I don't think you can play a switcheroo from science to policy when we are this deep into a reasonable discussion that seems to demand I provide the scientific evidence for what I am teaching in the absence of my critics having any evidence of what is taught.

      You assumption that I'd bring past attitudes to bear is exactly the critical point I made earlier; this whole discussion is driven on fear and innuendo, not fact. And this suggests this current round of criticism is indeed…

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    9. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to Phillip Ebrall

      Phillip Ebrall

      Yes you are right, I meant to say

      "But physiotherapy comes withOUT the absurd 19th century mumbo jumbo about "subluxations", or the mediaeval vitalism of "innate energy"."

      I notice that you evade my question about the Bronfort report, but since you ask, yes I am familiar with Meade et al, 1990 and 1995. I am also familiar with the extensive criticism of these papers. There is a convenient summary of these at http://www.ebm-first.com/chiropractic/the-meade-report-criticism.html

      For anyone interested in the evidence, I can recommend the comprehensive coverage at http://www.ebm-first.com/chiropractic.html

      It really will not do for you to pick out a few papers that favour your cause and ignore the rest. That is what all quacks (and some pharmaceutical companies too) do. It is why can't be taken seriously as part of the scientific world.

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    10. Eran Segev

      logged in via Facebook

      In reply to Phillip Ebrall

      For a start, you promote chiropractic, and that alone could be the answer (unless you are willing to provide evidence to the contrary), but if you want me to be a bit more specific, how about the following:

      Quoted on http://www.abc.net.au/pm/content/2011/s3384081.htm: Subluxation theory will be taught because it is an emerging theory that's developing an amazing amount of evidence at new levels in support of some of its underlying principles.
      By having the body operate at its optimum an individual…

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    11. Phillip Ebrall

      Professor of Chiropractic at Central Queensland University

      In reply to Eran Segev

      Good Grief Eran

      Where on earth did this come from? "How about you telling a journalist you could cure bi-polar without medication?" I have never, ever said that and for you to state otherwise is defamatory.

      You also ask "Speaking of which: what would it take to convince you that chiropractic cannot treat colic, or asthma, or bipolar?" It is not my position that chiropractors treat these diagnostic labels so you are playing with a redundant point.

      You are correct in quoting me from the ABC site…

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    12. jerry sprom

      logged in via email @gmail.com

      In reply to Eran Segev

      Eran,
      Here a couple of my thoughts on this.
      I think it is important to remember that when we are talking about evidence, rather than thinking that their either is or isn’t, it is probably more appropriate to think about evidence in terms of levels. To suggest that anything other than lower back pain is “against scientific evidence”, I believe is incorrect. I have provided a link that you may care to read http://chiropracticreport.com/portal/images/back_issues/201007.pdf

      My next thought is…what…

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    13. Eran Segev

      logged in via Facebook

      In reply to Phillip Ebrall

      I'm not a scientist, but you claim to be one so how come you so shabilly confuse theory with hypothesis? Your view of theories and evidence is very odd, to say the least. I'd like to hear what philosophers of science would have to say about your framing. I'm not sure they'd be impressed.

      The condemnation of the program is that it lacks an evidence base. How can you claim with a straight face that the condemnation is based on rumour and inuendo when you (and the BCA, and other chiropractic organsiations…

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    14. Eran Segev

      logged in via Facebook

      In reply to Eran Segev

      Phillip,

      I have now been told that I cannot publically identify the person who told me the story about the journalist and I apologise for raising it. I should have checked before making a public statement.

      Eran

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    15. Ian Flynn

      High School Teacher

      In reply to Phillip Ebrall

      Phillip,

      Obviously you have the right to defend your viewpoint, but the fact you need to call into questions peoples' knowledge of the subject to give your own viewpoint a higher standing smacks of you knowing your argument lacks facts (not that I'm saying your facts actually are right or wrong either way, but surely you should be able to win an argument on your facts alone- scientifically?).

      Saying "I appreciate it is outside your field of expertise" to David is rather condescending.

      As for…

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    16. Ian Flynn

      High School Teacher

      In reply to Ian Flynn

      Just to clarify, I just read above that Eran stated he is not a scientist. However I'd still like my above comment to stand based on the fact that Eran seems to have a very good understanding of scientific process, anyway.

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    17. Eran Segev

      logged in via Facebook

      In reply to Ian Flynn

      Ian, with fairness to Phillip he didn't call me that name. I gave it to myself as a hypothetical, and he was only too happy to endorse it - though he said he was one too...

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    18. Phillip Ebrall

      Professor of Chiropractic at Central Queensland University

      In reply to Ian Flynn

      Ian, I am sorry that my position challenges your current thinking. My view is based on the new expectations of TEQSA that academics will engage, but they will engage in their area of expertise. I fully understand that this 'decision of government' is going to create both elitism and escapism and will watch to see where it goes.

      But in the meantime, it does seem quite sensible to suggest chiropractic educators like me refrain from being critical of, for example, astrophysicists. Similarly, and with meaning no disrespect at all to an experienced and respected pharmacologist, one must ask, what really is their understanding of chiropractic?

      I personally think we are entering a new minefield under TEQSA, but remain mindful of what started this discussion: people made accusations without evidence, and then tried to swing the argument to force me to provide evidence that would defuse their unfounded position.

      And that remains the elephant in the room.

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    19. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to Phillip Ebrall

      I find it odd that Phillip Ebrall should mention chiropractic and astrophysics in the same sentence. The whole point that we are trying to make is that chiropractic "principles" are entirely outside science. They are pure myth, or rather the invention of a 19th century charlatan, out to make money. They have nothing to do with science at all.

      This was well known at the time. To quote from Rose Shapiro's excellent book, Suckers.

      “By the 1890s Palmer had established a magnetic healing practice…

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    20. Eran Segev

      logged in via Facebook

      In reply to Phillip Ebrall

      What you are saying here, Phillip, is simply untrue. As a minimum, we know you will be teaching VSC as "an emerghing science", and that would be enough for all the heat you and CQU are taking. In addition, you have shown that you believe that chiropractic can treat a lot more than lower back pain, which is contrary to the evidence. You refuse to state that these unsupported treatments will not be taught at the course, and there is every reason to believe that that will be the case.

      So for you to…

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    21. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to Eran Segev

      According to PubMed, Phillip Ebrall has a total of eight publications since 1992 (plus two in chiropractic journals).
      http://www.ncbi.nlm.nih.gov/pubmed?term=Ebrall%20P

      I'm the last person to think you can judge people by counting papers. Nonetheless that would be nothing like enough to gain the title of "professor" in most subject areas.

      I should imagine that the professors of real science at CQU might well feel pretty miffed about this.

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    22. jerry sprom

      logged in via email @gmail.com

      In reply to David Colquhoun

      David,

      I think it is fair to say that you have strong opinions about chiropractic. I am interested to know which part of the subluxation model, as currently proposed to be taught in CQU (or any of the institutions in Australia) is particularly unscientific and 'outside science'.

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    23. Eran Segev

      logged in via Facebook

      In reply to jerry sprom

      Jerry, I don't think you've been following the story line: ANY part of subluxation theory is unsupported by evidence (this has been confirmed by many chiropractic organisations) and therefore teaching it as anything other than a historical remnant (similar to blood letting for medical students) is outside science. If you have evidence to the contrary, please present it.

      Having said that, I don't expect much as you obviously think that the special pleading you have provided in a previous post, showing…

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    24. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to Eran Segev

      Exactly, the whole "subluxation" business is pure fairground hokum. it's no more than a marketing trick. Even the general Chiropractic council has been forced into admitting that at last. What took them so long?

      And when will Australian universities catch up?

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    25. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to Eran Segev

      Perhaps Phillip Ebrall would like to give us his opinion on a recent Cochrane review
      http://summaries.cochrane.org/CD005427/combined-chiropractic-interventions-for-low-back-pain

      It says

      "The review shows that while combined chiropractic interventions slightly improved pain and disability in the short term and pain in the medium term for acute and subacute low-back pain, there is currently no evidence to support or refute that combined chiropractic interventions provide a clinically meaningful advantage over other treatments for pain or disability in people with low-back pain. Any demonstrated differences were small and were only seen in studies with a high risk of bias."

      So even for its core claim, to help back pain, the evidence is very weak.

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    26. jerry sprom

      logged in via email @gmail.com

      In reply to Eran Segev

      Eran,
      Perhaps you are correct that I am not following. What I am getting so far is that yourself, Prof David, and others have suggested that subluxation is not supported by 'any scientific evidence', that it is 'fairground honkum' and various other unhelpful descriptors. What I am asking specifically is.....how is the subluxation model currently being taught in CQU (or in Australia) and what is so unscientific about it?

      I think you are critising the subluxation but don't actually know what students are being taught (or have been in recent times), or what model of subluxation is being used. I stand to be corrected, but I haven't had a response to my question..

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    27. Phillip Ebrall

      Professor of Chiropractic at Central Queensland University

      In reply to Eran Segev

      Eran

      You say "Jerry, I don't think you've been following the story line: ANY part of subluxation theory is unsupported by evidence".

      This is a completely untrue and unfounded statement. One of the five elements within the concept of subluxation relates to kinematic change for which there is ample published evidence from sound studies, notably performed by physiotherapists such as Gewn Jull.

      To debunk these is to debunk manipulative physiotherapy, manipulation by medical practitioners (albeit it with low-grade skills training) and osteopaths.

      Perhaps you should do as you preach, namely, identify, understand and provide the evidence for your outrageous claims.

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    28. Eran Segev

      logged in via Facebook

      In reply to Phillip Ebrall

      I did a quick search and couldn't find where Professor Jull mentions subluxations. Could you point that out? If you claim that any evidence for spinal manipulation supports chiropractic then what's special about chiropractic? In any case, what about the other four elements? What about treating non-musculoskeletal problems?

      As to "evidence for [my] outrageous claims": You've got this wrong way around. I'm not the one making the scientific claims here; you are claiming that there is evidence for subluxations…

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    29. Phillip Ebrall

      Professor of Chiropractic at Central Queensland University

      In reply to Eran Segev

      The evidence I am asking you to provide is the evidence that you actually know what is in the curriculum at CQUniversity about which you are being so critical. The fact is you have no knowledge of this, and thus no evidence to support your continued wailing about the program.

      You also have difficulty in understanding simple statements. I did not state Jull talks about subluxation. I stated her evidence relates to kinematic change. End of her involvement. Kinematic change is an element within the…

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    30. Eran Segev

      logged in via Facebook

      In reply to Phillip Ebrall

      Apart from the fact that the entire profession is lacking in evidential basis, you have provided the evidence by stating that VSC theory will be taught as more than the founding myth that it is. I fail to see what more evidence is needed to discredit your program. I wouldn't need to know the precise technique used to draw star charts to discredit a degree in astrology.

      Once again, you fail to do the simplest thing, which is provide a list of references showing that the above statement is wrong…

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  28. Marcello Costa

    Professor of Neurophysiology, Department of Physiology at Flinders University

    As one of the authors of the documents described in the article, I feel elated that it has triggered some very good and robust discussion.
    The comments have raised indeed many relevant issues. I would like to try to summarise my views on some of the main points. I am pleased that there is a good consensus that the articles and letters were not intended to attack personally any individuals, but certainly the actions and ideas behind the proposed Chiropractic course at the UCQ.
    On the core issue…

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    1. jerry sprom

      logged in via email @gmail.com

      In reply to Marcello Costa

      "If not then as Graeme Hanigan says “why not just stick with physiotherapy?” "

      I've got a better idea. Why don't we upskill and improve the education of physio who wish to focus their practice on the function of peoples spines and improving peoples overall health and wellbeing and call them chiropractors. :-)

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  29. Doug Cotton

    IT Manager

    Yes, well come on over to the new thread written by a chiropractor all ye who criticise.

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  30. Phillip Ebrall

    Professor of Chiropractic at Central Queensland University

    I found this link interesting as regards to things we accept in the absence of what some contributors to this discussion would demand as 'evidence'.

    http://www.newscientist.com/article/mg21228402.300-banishing-consciousness-the-mystery-of-anaesthesia.html?page=1

    I'm also waiting for the first randomised, controlled trial on the use of parachutes when existing an aircraft at 8,000 feet or so. Can anyone point me to such a study, or in the absence of evidence, would you jump without a 'chute?

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    1. Eran Segev

      logged in via Facebook

      In reply to Phillip Ebrall

      I'm astounded that you should make such statements. First, with regard to DBRCT not always being pursued, it has to be recognised that it is not always practical to do these, but there is no place in medicine where it is not only practical but very easy to do, yet regularly avoided. However, this happens all the time in quackery - it's the number one distinguishing factor and it's called "special pleading". It's why chiropractic is so identified.

      There is also no doubt that in some cases we know…

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    2. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to Phillip Ebrall

      Oh dear, oh dear. Phillip Ebrell must be getting desperate to roll out the corny parachute analogy. There is so little analogy that I won't patronise your readers by spelling it out.

      The interesting aspect of it is that Ebrell is, by citing this rather silly example. Essentially Ebrell is saying that we don't need proper evidence because it's obvious. Well it isn't obvious at all. In fact the evidence mostly says that it doesn't work.

      I suppose that the allusion to the article about general…

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    3. Phillip Ebrall

      Professor of Chiropractic at Central Queensland University

      In reply to David Colquhoun

      David,

      It is interesting that you retreat to the realm of 'common knowledge' and accept it as a valid way of knowing, albeit amongst an elite group, pharmacologists, while continuing to deny the 'common knowledge' that exists within another discipline.

      It is also interesting that you state the mode of action for many drugs is not more or less unknown, and take a position that it 'doesn't matter a damn if they do their job'.

      Your hypocrisy is stunning in its clarity. Why can't you accept there is a common knowledge amongst trained and educated chiropractors and why can't you accept the evidence, in all three forms as established by the father of EBM, Sackett, that there is a positive outcome for much of what chiropractors do, with far less harm than that associated with the prescription of many medications?

      Please, hold the mirror, and apply the same standards of evidence across more disciplines than your own.

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    4. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to Phillip Ebrall

      I'm going to have to state the obvious again,

      What I said is that it's common knowledge that "it doesn't matter how it works as long as it does work".

      What I did not say was that it's common knowledge that something actually works. To find out whether a treatment works or not turns out to be really hard work, in most cases. Chiropractors have, by and large, preferred to rely on anecdotes and testimonials rather than do the hard work.

      I am, of course, doing precisely what you urge "apply the same standards of evidence across more disciplines than your own" It's you who is refusing to do that. It's because of that refusal that chiropractic has no place in a university (or indeed anywhere else).

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    5. Graeme Hanigan

      logged in via Facebook

      In reply to Phillip Ebrall

      Phillip,

      I really don't know what point you are trying to make as your overall message is becoming increasingly obscure.

      Are you suggesting that we have no understanding of how or why a parachute works and that somebody randomly decided to jump from a great height with one and it worked?

      At least there is no room for the obfuscation, which you apparently delight in because you spend so much time doing it, over chiropractic.

      Either a parachute works or it doesn't!

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    1. Joyaa Antares

      Prospective Researcher, Osteopath (Australia), UCL Alumni (Stats)

      In reply to Andy Gilbey

      Fabulous reference Andy!

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  31. Colin Jenkins

    Software

    @Phillip Ebrall,

    How do you explain the fact that UK colleges only teach VSC (by any name) as a historical concept while you believe it to be an emerging theory?

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  32. Andy Gilbey

    logged in via Facebook

    I found a few more articles (33) authored by Prof Ebrall on the data base, EBSCOhost. Almost all are published in the Chiropratic Journal of Australia. Can't say any more as I have been the subject of a defamation claim by the NZ chiropractors.

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  33. David Colquhoun

    Professor of Pharmacology, UCL at University College London

    I've been away from this argument for a few days, at a meeting in Cambridge on "Reason and Unreason in 21st Century Science", sponsored by the Academia Europaea (where my account of what's happening at CQU gave rise to some hilarity).

    I must respond to Phillip Ebrall's comment

    "The evidence I am asking you to provide is the evidence that you actually know what is in the curriculum at CQUniversity about which you are being so critical. The fact is you have no knowledge of this, and thus no…

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    1. Phillip Ebrall

      Professor of Chiropractic at Central Queensland University

      In reply to David Colquhoun

      Thank you David.

      By asking for lecture notes and presentations you admit you do not have the evidence to support your previous statements.

      It hardly seems reasonable to me for you to have made extensive critical comment on the basis of your own belief, in the absence of evidence, as to what may be in the curriculum.

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    2. Eran Segev

      logged in via Facebook

      In reply to Phillip Ebrall

      Phillip, you can't respond to David's message the way you did while ignoring my message at https://theconversation.edu.au/theres-no-place-for-pseudo-scientific-chiropractic-in-australian-universities-4576#comment_16844 (well, you can, but it's disingenuous).

      We don't need to know the precise details of the course to know that what you teach is not science; first, becasue chiropractic isn't science; and second, because you have provided plenty of evidence in this debate and in past statements. David is simply saying that you can prove us wrong very easily, but as I've said in the past and will say again as many times as necessary: we don't expect you will, because obfuscation and nit-picking are the only way to go when you have no evidence to support your profession.

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    3. jerry sprom

      logged in via email @gmail.com

      In reply to Eran Segev

      Eran,
      "We don't need to know the precise details of the course to know that what you teach is not science; first, becasue chiropractic isn't science"

      As s prominent figure within the Aust. Skeptics, I am very surprised by this comment. I, like you don't know what is to make up the course content of CQU, but to suggest that you don't need to know in order to make an informed decision is, in my opinion, not a skeptical approach. I believe you are doing a disservice to your membership and your…

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    4. Eran Segev

      logged in via Facebook

      In reply to jerry sprom

      I have seen this before, and you are missing the point: If a course in astrology taught atrophysics, it would still not be a science course. And in any case, this course teaches that subluxations are "the main paradigm of chiropractic", which is contrary to the declarations by many chiropractic organisations and puts chiropractic squarely in the quackery basket. We don't need the links, because Phillip said this will be taught at CQU.

      You also use a straw man argument - I said I don't need to…

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    5. jerry sprom

      logged in via email @gmail.com

      In reply to Eran Segev

      Eran,
      In my opinion, your analogy is a cop out. It provides an excuse to remain in the dark regarding the education chiropractors receive. I was not expecting you to know the precise details of the course, but I would have expected you to know how the vertebral subluxation complex ihas been taught.

      'the evidence is insufficient, despite it being clear to anyone who looks at it without a vested interest."
      You appear to be suggesting that the 4 intergovernmental reports done in the last 40 years…

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  34. David Colquhoun

    Professor of Pharmacology, UCL at University College London

    The great pleasure of this conversation is that every time I ask Phillip Ebrall a question, he digs a deeper hole for himself.

    I take his response to mean that he refuses to disclose to the public the details of what he teaches. That sort of secrecy is something that has been ruled to be against the public interest by the Information Commissioner and by and Information Tribunal. You can read the judgement at http://www.dcscience.net/?p=2485

    In one sense it doesn't matter since Ebrall has already admitted publicly to teaching ideas that are discredited. even in the eye of the (UK) General Chiropractic Council, never mind in the eyes of scientists.

    Nevertheless I hope that some Australian scientists will use the Australian Freedom iof Information legislation to obtain the material that Ebrall has refused to disclose.

    Of course if Ebrall had any confidence in what's taught he would simply show us

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  35. Raj Sitharthan

    Prof

    I recently picked up a brochure from a shopping centre and the chiropractors had advertised that they can cure virtually evrything under the sun. Hence, this is a timely article. Besides, why do chiropractors refer to themselves as Doctor when they don't hold a medical degree or a PhD? This is misleading the public.

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  36. Roger Fuller

    Medical Practitioner

    This is another arrogant and unprovoked statement by the Medical Profession. To question the quality of Chiropractic Degrees supplied by some of the top universities in Australia with out investigating the individuals behind the Departments is ludicrous. John Dwyer should know a lot better than making negative statements about quality of science departments just because his bias against a profession outweighs his logic.
    The Macquarie University Chiropractic Department includes 5 Medical Practitioners, 1 Neurologists and 1 Orthopaedic Surgeon, whom are all members of AMA. Therefore by claiming the teaching of Chiropractic as pseudo-science is to question the quality of our own profession. Are Medical Practitioners incapable of teaching science?
    Just to make it clear I am not a Chiropractor. I am an MD.

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    1. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to Roger Fuller

      This seems a good moment to point out a really good source.

      The Institute for Science in Medicine has published a scholarly white paper on chiropractic written by attorney Jann J. Bellamy and edited by Dr Stephen Barrett. http://scienceinmedicine.org/policy/papers/Chiropractic.pdf

      The report stresses that (a) chiropractic is based on faulty premises and (b) that although spinal manipulation has some value for treating back pain, "many chiropractors employ methods that are unsubstantiated, implausible, and not based upon the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community." The paper provides most comprehensive and insightful analysis of the chiropractic marketplace written in the past 20 years.

      In the words of Simon Singh, chiropractors happily promote bogus treatments. Any university that condones this is a bogus university, run by a bogus vice-chancellor.

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    2. Roger Fuller

      Medical Practitioner

      In reply to David Colquhoun

      David,

      This is a good paper. Thank you. Besides the bias of the authors (Barret operating a quackwatch website) and the opinion piece nature of the arguments supported by irrelevant references, it does point out the lack of evidence behind the "subluxation" theory and "applied kinesiology" aspects of that (only some) Chiropractors practice today. Other than this the paper doesn't achieve too much. It summarizes the information at the end by their own opinion which does nothing for no one and the 'Dangers of Chiropractic' section is laughable with its clear cherry picking of references clearly being outdated by the work of Cassidy et al. 2008 showing that there is just as likely association of VBS after a visiting a GP.
      It terms of Chiropractic and EBP i think it should be better summarized by the Australian Health Goverment policies and the implications for SMT- can be easily looked up.

      Cheers.

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    3. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to Roger Fuller

      Yes there is a great deal of interesting information about chiropractic on the quackwatch web site (http://www.quackwatch.com/ ), and particularly in the chirobase section http://www.chirobase.org/.

      At least as informative is "What alternative health practitioners might not tell you" which has a very up-to date summaries of relevant work.
      http://www.ebm-first.com/chiropractic.html

      One obvious aspect that hasn't been much aired hear is the chiropractic was invented by a late Victorian grocer, DD Palmer, who, finding he couldn't make enough money out of "magnetic healing", hit on a different mystical money making gimmick and called it chiropractic.

      By all means believe a cranky grocers, with a flair for making money if that's what you want. Personally I prefer science.

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  37. Matt M

    Chiropractic Student

    As a chiropractic student a macquarie university and having previously worked in the industry with other chiropractors, physiotherapists, podiatrists and others, I can safely say that my experience and interactions in the modern day of conservative healthcare has shown me this mythical belief about pseudoscience is completely false. To the author and all other ignorant keyboard warriors that continually blast the chiropractic profession, can you please take a breath, stretch your fingers and learn…

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  38. Mitchell Beer

    Student

    As a current student of chiropractic at Macquarie university I can inform you that much of what you have said or inferred here is incorrect. While some older chiropractors have neglected their responsibility to incorporate the best available evidence into their practice, the tertiary institutions in Australia that teach chiropractic make it abundantly clear to its students that evidence based practice is a foundation for any health profession. The very notion that we are taught about innate intelligence…

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    1. Colin Jenkins

      logged in via Twitter

      In reply to Mitchell Beer

      Hi Mitchell.

      Do you have any idea why so many members of the CAA and chiropractors in general in fact, are anti-vaccination (an ex member of the UK BCA estimated about 50% in the UK). Posting pseudo-scientific nonsense on their business websites and facebook pages for example?

      Do you think this anti-vaccination tendency will gradually drop off as more recent chiropractic graduates enter the field...? Do you think graduates will be under pressure to adopt a more traditional position when they get jobs in practices run by older chiros?

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    2. Andy Gilbey

      logged in via Facebook

      In reply to Mitchell Beer

      Hello Mitchell,

      I wonder if, as a student embarking on a new career, you may just be a little biased towards chiropracty. Or perhaps you are not yet at a stage of your education where you have been taught to critically appraise the evidence.

      My guess is that the evidence to which you refer, may be biased towards positive findings. I suspect this because, as far as I am aware, higher level evidence (systematic reviews, meta analyses, etc), does not provide much in the way of evidence of effectiveness for chiropracty for, well, anything.

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