Talk:Chiropractic/Archive 25

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Philosophy 2 rewrite

Although a wide diversity of belief exists among chiropractors,[1] they share the principle that the spine and health are related in an important and fundamental way, and this relationship is mediated through the nervous system.[2] Chiropractors pay careful attention to the biomechanics, structure and function of the spine, its effects on the nervous and musculoskeletal systems, and the role these systems play in preventing disease and restoring health.[3]

Chiropractic philosophy goes beyond simply manipulating the spine. Like naturopathy and several other forms of complementary and alternative medicine, chiropractic assumes that all aspects of a patient's health are interconnected, which leads to the following perspectives:[4]

  • Holism treats the patient as a whole, and appreciates the multifactorial nature of influences (structural, chemical, and psychological) on the nervous system, recognizing dynamics between lifestyle, environment, and health.
  • Conservativism carefully considers the risks of clinical interventions when balancing them against their benefits. It emphasizes noninvasive treatment to minimize risk, and avoids surgery and medication.[3]
  • Homeostasis emphasizes the body's inherent self-healing abilities. Chiropractic's early notion of innate intelligence can be thought of as a metaphor for homeostasis.[1]
  • A patient-centered approach focuses on the patient rather than the disease, preventing unnecessary barriers in the doctor-patient encounter. The patient is considered to be indispensable in, and ultimately responsible for, the maintenance of health.[1]

Chiropractic's early philosophy was rooted in spiritual inspiration and rationalism. A philosophy based on deduction from irrefutable doctrine helped distinguish chiropractic from medicine, provided it with legal and political defenses against claims of practicing medicine without a license, and allowed chiropractors to establish themselves as an autonomous profession. This "straight" philosophy, taught to generations of chiropractors, rejected the inferential reasoning of the scientific method,[1] and relied on deductions from vitalistic principles rather than on the materialism of science.[4]

As chiropractic has matured, most practitioners accept the value that the scientific method has to offer.[1] Balancing the dualism between the metaphysics of their predecessors and the materialistic reductionism of science, their belief systems blend experience, conviction, critical thinking, open-mindedness, and appreciation of the natural order. They emphasize the testable principle that structure affects function, and the untestable metaphor that life is self-sustaining. Their goal is to establish and maintain an organism-environment dynamic conducive to functional well-being of the whole person.[4]

Comments on Philosophy 2 rewrite

This version tells a story and is concise. It will capture the reader. The long and repetitive mainspace version is very boring to read. QuackGuru 18:18, 18 June 2008 (UTC)

The figure isn't needed and can be removed, so I removed it. That was the only change from the previous draft, so this draft is now equivalent to what is in the previous draft. I suppose it can be further edited now, but as I said before, this is low priority for me. Eubulides (talk) 22:20, 18 June 2008 (UTC)
For what it's worth, I like this draft much better than what's up now. I understand the point about priorities, though. --—CynRN (Talk) 23:47, 19 June 2008 (UTC)
Is there anything worth merging from the current vague mainspace version. QuackGuru 16:50, 30 June 2008 (UTC)
I don't see anything. Eubulides (talk) 00:39, 1 July 2008 (UTC)

ref

copied the references so there is no confusion on the rewrite. --AdultSwim (talk) 22:48, 3 July 2008 (UTC)

renaming scientific research

If we are going to rename the scientific research section I suggest we rename it with something that starts with Evidence such as Evidence basis. QuackGuru 16:20, 19 June 2008 (UTC)

Does a section on safety really belong under the heading of Evidence basis though? I am not sure I understand the problem with calling it Scientific Research. DigitalC (talk) 10:38, 5 July 2008 (UTC)

Archiving

As this page was over 600K (enormous, even by ANI standards), it was well past time to archive. There is an automated archive bot already set up on this page, but it had not triggered in several days. I took a look into the problem, and I am not 100% certain, but I believe that this was related to the levels of section headers that were being used. The bot tends to archive things at a "level 2" (==headername==) degree of granularity. There were a few sections on this page that started at level 2, and then had multiple level 3 and lower subheadings within them. As long as a single comment within those subheadings was within the last 10 days or so, it kept the entire thing from being archived.

To address this, I have manually archived several sections. Where I couldn't find a good place to "cut", I manually demoted some section headers, and added a {{sidebar}} which points to the related discussions in archive. If this caused confusion, I apologize... I was doing my best! If any thread was archived which must be back on this talkpage, feel free to pull it back into the discussion. However, I would prefer if people could instead use links and/or sideboxes to simply point to the archives. Also, in the future, please be cautious about making level-2 sections that are too wide in scope. When a single thread gets to be over 50K in size, then that's too large, and things need to be chopped down. Remember that some people's browsers start having trouble with anything over 32K, in total page size! One other suggestion, is that I noticed that some threads were quoting large amounts of article text here on the talkpage. A better way to handle this would be to make a subpage, and then link to the subpage. Some other places on Wikipedia might name this as "/Work" or "/Draft" or "/July 2008 draft subpage" or something like that.

I'll be unprotecting this page shortly after posting this message. Thank you for your patience, and let me know if you have any questions, --Elonka 21:29, 5 July 2008 (UTC)

This is being overly optimistic about how this talk page will operate. Discussions cover a lot of ground, and people are in a hurry; we can't expect every editor to follow a bunch of relatively-complicated procedures like sidebars and subpages. We can try to break up long level-2 sections, though; that's easy. As for people whose browsers can't handle more than 32K, well, sorry, but nowaays that's simply too small for reasonable web browsing; they'll just have to get a real browser. Eubulides (talk) 21:42, 5 July 2008 (UTC)
You are free to bring up that particular argument at WP:SIZE. --Elonka 21:59, 5 July 2008 (UTC)
WP:SIZE doesn't talk about a 32K limit for the whole talk page. It talks only about a 32K limit for individual subsections. And even there, it says that the limit is mostly obsolete. Until somebody actually complains about their browser messing up on this talk page, I wouldn't worry about it. Eubulides (talk) 22:18, 5 July 2008 (UTC)

Having a talk page of 650k is ridiculous. And saying if someone's browser can't handle it that they should get a new one/new computer is just plan condescending — Rlevse • Talk • 23:47, 5 July 2008 (UTC)

  • I agree that the talk page is large, but that's because there's a lot of talk on this subject.
  • Expiring the talk in a week has problems of its own, which are real problems: you can't expect every editor to visit here every week.
  • We don't really have time to worry about theoretical concerns. If there is a real Wikipedia editor who has a real problem with their browser that would be fixed by the proposed changes, we can worry about the problem. If not, let's move on to something more important.
Eubulides (talk) 10:32, 6 July 2008 (UTC)

Chiropracty vs. Chiropractic

After doing a quick scan through the archives, I didn't see an explanation of why the article is called Chiropractic. Isn't that an adjective? We don't call the article on Homeopathy homeopathic? Or Science scientific? They redirect to the noun version if you type in the adjective form. Shouldn't that be the case here too? Right now it's the other way around. ABlake (talk) 00:58, 7 July 2008 (UTC)

Chiropractic is a noun [4]. Compare a google search for "Chiropracty" to a google search for "Chiropractic". 1000x the results for Chiropractic. DigitalC (talk) 02:05, 7 July 2008 (UTC)
Here you will find chiropractors discussing this very matter. DigitalC is correct. -- Fyslee / talk 05:22, 11 July 2008 (UTC)

[Manually Archived] - DigitalC (talk) 06:00, 14 July 2008 (UTC)

History is hot topic

Edits to finished History 2

Relevant discussion at→ Talk:Chiropractic/Archive 24#History 2

I've made some edits to the article that were reverted by QuackGuru though I realize that I wasn't signed in and it looked like an anon IP, so I reverted back. -- Dēmatt (chat) 01:34, 2 July 2008 (UTC)


As discussed earlier, we have two different sources that consider the reasons that DD and BJ developed the innate intelligence; one was that they believed it and the other that it was to protect it from political medicine. Right now we have this sentence that states that "Early chiropractors believed". That gives the impression that all early chiropractors believed that innate was God's presence in man, but obviously this wasn't true. We know that John Howard didn't and he started the school right across the street from Palmer while DD was still there that later became National Chiropractic and now National University of Health Sciences. John Howard was very influential in making sure chiropractic did not become a religion.. as was Willard Carver who went up against BJ at every turn. These were both presidents of mixer schools. Anyway, ScienceApologist reverted my change to "DD professed", which might not have been a bad thing, because that, too was not totally accurate, but certainly an improvement. I am open to suggestions on how we can change this to make it more accurate and still follow the sources. -- Dēmatt (chat) 01:47, 2 July 2008 (UTC)

  • The source in question (Martin 1993, PMID 11623404) says (p. 812) "At the core of chiropractic's early appeal was its ability to reflect certain traditional values and beliefs in a way the new 'scientific' medicine did not. In contrast to the increasingly secular scientific medicine, chiropractic emphasized that disease resulted from a violation of God's natural laws. Chiropractors believed that all disease was caused by interruptions in the flow of a vital nervous energy that they called 'innate intelligence.'... At its inception chiropractic explicitly addressed considerably broader issues than etiology, diagnosis, and therapeutics. For chiropractors innate intelligence was more than a mysterious life force, it represented God's presence in man." Martin cites D.D. Palmer's 1910 textbook and B.J. Palmer's The Science of Chiropractic (3rd ed., 1917).
  • Again, it's reasonable for a historical article to say "Early Christians believed that Christ would return soon", even though this is not true of all early Christians, and even though the belief was motivated by more practical political considerations. Similarly, it's reasonable for Martin (and for Chiropractic) to talk about the beliefs of the majority of chiropractors in the important formative years in general terms, even if there were obviously some counterexamples, and even if there were political motivations behind the beliefs. The current text already talks about political motivations for the beliefs (legal protection) so I don't see important notions being omitted here.
Eubulides (talk) 05:15, 2 July 2008 (UTC)
  • I'm a little confused due to the archiving, but I believe that the draft that is currently being worked on is History 2? This sentence - "Although D.D. and B.J. were "straight" and disdained the use of instruments, some early chiropractors, whom B.J. scornfully called "mixers", advocated their use." is confusing and is not grammatically correct - it implies that mixers advocated the use of mixers. DigitalC (talk) 23:29, 7 July 2008 (UTC)
  • The next sentence is also a little confusing - "In 1910 B.J. changed course and endorsed the use of X-rays for diagnosis; this resulted in a significant exodus from Palmer of the more-conservative faculty and students.". Which Palmer was there an exodus from? PSC? DD Palmer? BJ Palmer? DigitalC (talk) 23:32, 7 July 2008 (UTC)
  • And one more - "By the mid-1990s there was a growing scholarly interest in chiropractic, which helped efforts to improve service quality and establish clinical guidelines that recommended spinal manipulation in some cases." Were the efforts really to establish guidelines recommeding SMT in some cases? Wouldn't the efforts be to establish clinical guidelines that recommend SMT? DigitalC (talk) 23:32, 7 July 2008 (UTC)
  • Thanks for pointing those out. I made this change to try to fix those problems. Eubulides (talk) 08:09, 8 July 2008 (UTC)

History 4 - section break

Relevant discussion at→ Talk:Chiropractic/Archive 24#History 4?
Oh, to clear up confusion. History 4 was started because I did not feel comfortable making changes to Eubulides History 2 without him getting a chance to see them. As we worked our way through our discussions, he updated History 2, but I never updated History 4, I just moved on to the next paragraph. So History 2 should be considered the working copy while History 4 is where I will try out my changes. I woud use my sandbox, but it works well because Eubulides seems to take a look and we can discuss things before we get in too deep. I believe I started that second paragraph and had to run without even finishing the sente...  ;-) I'll probably just be making changes to the article version from here anyway. Of course if you want a reference just let me know, sometimes what I think is obvious does need a source. -- Dēmatt (chat) 03:15, 29 June 2008 (UTC)
Re some recent edits: this edit adds "invented a new vocabulary"; this is what the source says, so this is following the source (Primer) better as stated in the edit summary.
This edit changed "mainstream medicine" to "political medicine". The source cited is Keating et al.'s "Primer". The sources uses the phrase "mainstream medicine" once, not, in my opinion, when discussing the topic of battles or competition, and uses the phrase "political medicine" multiple times and often in the context of active rivalry/conflict. Therefore this change brings the article closer to the source.
This edit changed "However, its future seemed uncertain: as the number of practitioners grew, evidence-based medicine insisted on treatments with demonstrated value, managed care restricted payment, and competition grew from massage therapists and other health professions. The profession responded by marketing natural products and devices more aggressively, and by reaching deeper..." to "However, as the number of practitioners grew, managed care restricted payment, and competition grew from other health professions its future seemed uncertain. The profession responded by reaching deeper...". The source given is Cooper & McKee 2003. The doi link is broken and I'm not sure whether I can easily obtain this source, so I can't comment. A quote from this source somewhere on this talk page says nothing about marketing natural products and devices; I don't know if that's somewhere else in the source.
I've run out of time, so I'll have to comment on "Early chiropractors believed" another time.
Eubulides, I apologize for some omissions on my part, which you've pointed out, and which were due to lack of time. ☺ Coppertwig (talk) 01:27, 3 July 2008 (UTC)

(outdent)

  • Invented a new vocabulary. It's true that if we include more words from the source, we are "following the source" better by some epsilon; but the source contains thousands of words, and we cannot include them all. The question is whether the information contained in the phrase "invented a new vocabulary" is worth the cost in space of adding it. I don't think it is. There is no grand theme, common to all or even most histories of chiropractic, that says that B.J. invented a new vocabulary; "invented a new vocabulary" is just one phrase out of Keating et al. 2005 and I don't see why we should highlight that particular turn of phrase. The important thing is that B.J. was using new words for the same things to avoid prosecution, and that point is made clearly in the text without using the phrase "invented a new vocabulary". I therefore suggest that we remove the phrase. This is not a big deal, as it is merely editing for brevity and is not fixing a POV problem; but these little phrases add up and it's better to be concise.
  • Political medicine. The phrase "political medicine" is different. The original use of the term "political medicine" was to mean what we would now call more "public health"; see, for example William Pulteney Alison. This use is still the most common one in mainstream literature; see, for example, Bergman 1995 (PMID 7478770). Using it instead to refer to organized medicine's attempt to squash chiropractic is a mildly pejorative Keatingism that has not been picked up in the mainstream literature. The phrase was part of the title of a paper by Keating & Mootz 1989 (PMID 2691602), and Keating clearly liked this use of the phrase, but hardly anyone else does, even within chiropractic (the common phrases are "mainstream medicine" or "organized medicine"), and we should not be introducing nonstandard terminology here. How about replacing "mainstream medicine" with "organized medicine" as a compromise? "Organized medicine" is also used by Keating et al. in the context of conflict, and has less of a pejorative connotation.
  • Natural products and devices. Cooper & McKee 2003 (PMID 12669653) write in their brief introductory summary (pp. 107–108) "At the same time, chiropractors are experiencing greater competition from acupuncturists and massage therapists, whose ranks also are growing. In response, the profession is expanding beyond its traditional forms of chiropractic treatment by reaching deeper into both alternative medicine and primary care, and practitioners are more aggressively marketing natural products and devices." They have an entire section (pp. 122–124) entitled "A broader role in alternative medicine", full of juicy quotes like "Surveys show that the ability of chiropractors to maintain their incomes increasingly depends on the sale of nutritional products and other ancillary items, such as orthotic supports, weight management products, and magnets."

Hope this helps. Eubulides (talk) 16:41, 3 July 2008 (UTC)

Thanks for your comments, Eubulides. Given your argument about "inventing a new vocabulary", I admit that those words are not needed. Re "organized medicine": that sounds like a good compromise. Re natural products: thank you for taking the time to provide a quote from Cooper & McGee; apparently that part of the article follows its source well. ☺ Coppertwig (talk) 01:20, 6 July 2008 (UTC)
OK, thanks, I made this change to replace "mainstream medicine" with "organized medicine". Eubulides (talk) 10:32, 6 July 2008 (UTC)

Please don't edit war

I think the edits by 98.24.93.125 are probably an improvement but will look at them more closely when I have time. ScienceApologist, please specify the source that says that early chiropractors (rather than just D.D.) believed ... . Everyone, regardless of whether the edits are good or bad, please discuss it on the talk page instead of repeatedly reverting. Let's not get the article protected again! ☺ Coppertwig (talk) 01:37, 2 July 2008 (UTC)

(Later comment:) I apologize. I was confused by the edit history when I wrote the above, and thought there were more reverts than there were. ☺ Coppertwig (talk) 00:33, 10 July 2008 (UTC)
I am very much in agreement with you here and would like to second your request for ScienceApologist (or some other editor) to produce such a source. -- Levine2112 discuss 01:47, 2 July 2008 (UTC)
There is a reliable source for early chiropractors. It's the cited source. For more details, please look above in the talk page and scan for the string "The source in question (Martin 1993, PMID 11623404) says (p. 812)". You can also search earlier in this talk page and catch the comparisons to early Christian beliefs (this was when talking about the terminology of what it means to say "Early chiropractors believed". Eubulides (talk) 05:15, 2 July 2008 (UTC)

People here seem to think that in order to write a Wikipedia article we are supposed to leave our brains at the door. We are not a computer program. There is no reason to particularly attribute a well-known belief. We have many "chiroskeptical sources", for example, which confirm the point. And, despite their continual disparagement here, they are unequivocally reliable since they were written by medical professionals. Using a primary source is fine, but trying to claim it is the ONLY source for something that everyone acknowledges is not a singular belief is really problematic. We are editors. We make editorial decisions. Read Quackwatch and Chirobase and realize that these are incredibly reliable sources and that they represent a real understanding of the state of chiropractic. ScienceApologist (talk) 02:03, 2 July 2008 (UTC)

It is your opinion that these are reliable sources. I believe ArbCom has declared them to be highly partisan and thus questionable sources - or rather sources to be used with caution. That said, please produce a source which supports the text you have reverted to. It would be appreciated. -- Levine2112 discuss 02:09, 2 July 2008 (UTC)
Arbcom was not making any claim in that decision as to a universal support or denial of any source. They were merely referencing ONE PARTICULAR INSTANCE. You can read all about it in the archives at WP:AE. For our purposes those "highly partisan" and "questionable" sources are better than a lot of the nonsense being pushed by self-promoting chiropractors on these talk pages. Why would QW be highly partisan? Is Barrett a member of an opposing political party from the chiropractors? No. Arbcom was talking about editor conduct in a very confined instance: So since I have provided the rationale, I call faker again. Two strikes, Levine. ScienceApologist (talk) 02:17, 2 July 2008 (UTC)
You seem to be ducking our request to produce a source which support your recent reversions. If you would like to discuss the merits of Quackwatch, perhaps it would be logical to first produce a source from Barrett's self-published site which actually supports your reverts. Thanks. -- Levine2112 discuss 02:25, 2 July 2008 (UTC)
I would think that if we want to know what chiropractors believed, a source written by chiropractors would be more reliable than a source written by medical doctors. In any case, at the moment in this thread no source has been mentioned supporting the claim. ☺ Coppertwig (talk) 02:31, 2 July 2008 (UTC)
Again, the source is Martin 1993 (PMID 11623404). Eubulides (talk) 05:15, 2 July 2008 (UTC)

Maybe you should stop disparaging reliable sources in general?

Here's the first couplalinks I found:

ScienceApologist (talk) 02:36, 2 July 2008 (UTC)

None of these sources appear to be remotely reliable save the last two. That said, can you located where in those sources your reverted text is supported? Thanks. -- Levine2112 discuss 02:40, 2 July 2008 (UTC)
All I have to do is show evidence that people other than DD believe in the idiocy. Done and done. Take it up at WP:RSN if you don't believe me. ScienceApologist (talk) 02:42, 2 July 2008 (UTC)
Yes, pretty much that's all you have to do. Specifically you should find a reliable source supporting that early chiropractors believed in this theory. Can you point to where in the reliable sources above (or some other reliable source) this is supported? -- Levine2112 discuss 02:52, 2 July 2008 (UTC)
  • Again, the source is Martin 1993 (PMID 11623404), which is the source currently being cited for the claim in question. I find it amusing, and a bit sad, that so many editors are assuming that the claim about early chiropractic beliefs isn't sourced. That sort of thing used to be common in Chiropractic, but we've come a long way in the past few months in getting things better sourced, and there should not be any such howlers now.
  • By the way, I don't know if anyone cares, but Martin is really good: he's a much better writer and thinker than Keating. Martin wrote the chiropractic chapter in The Cambridge World History of Human Disease (ISBN 0521332869).
Eubulides (talk) 05:15, 2 July 2008 (UTC)
There seems to be a bit of WP:IDIDNTHEARTHAT going on Eubulides :-) Shot info (talk) 06:50, 2 July 2008 (UTC)

(outdent) I figured I wouldn't be able to edit once History 2 was placed into mainspace without consensus. I am dissappointed that rational well thought out changes are summarily deleted without so much as conversation as to their validity and purpose. No matter what someone wants to call me, chiropractor, quack, true believer, or and editor with a COI, I have done the best I could to represent the sources and check my POV at the door, so much so that I doubt any of you know what I believe. I have represented every POV that exists, even ScienceApologist's so-called rational skepticism. I do not appreciate the lack of AGF, but I will continue to AGF. There were three small edits that were deleted by SA and QG essentially. Two were not supported by the source so were allowed to be deleted and I represented them that way on the edit summary, though I had not signed in, so perhaps QG did not realize that it was me. The other edit was about the "Early chiropractor's believed". I explained myself above by noting that first Martin states it as "Chiropractors believed", so I realize that Eubulidies had graciously added Early to soften the POV somewhat, however, it still does not go far enough to be accurate as it assumes that ALL Early chirorpactors believed... the fact is of course that this is not even remotely possible and Keating does a good job of tellin us what chiropractors believed (he is a psychologist by trade that worked in the chiropractic profession, Martin even uses him as a source) in his paper on the The Meanings of Innate. ScienceApologist was not terribly wrong in reverting the "DD Palmer believed" that I put in as well, but we need to find a way to express that "some" chiropractors believed.. BTW, I don't doubt that Medicine believed that ALL chiropractors believed that God was the source of all health. Maybe we can state it that way. Realistically, though, chiropractors had some really good thinkers back then, too, that were scientific in the way of practicing and evaluating responses, etc.. John Howard for one. Most were MDs before they were chiropractors in those early years. Just for the record, if chiropractors believed this heavenly stuff, and I were a chiropractor, don't you think I would be proud of it and be trying to fill wikipedia with it. Anyway, since I am not allowed to edit in mainspace. Could someone fix that for me? -- Dēmatt (chat) 12:44, 2 July 2008 (UTC)

Dematt, they manifestly ARE supported by the source. Using WP:FRINGE#Particular attribution to try to claim that only DD believed a certain way is ridiculous. We have wonderful sources which show that this is not the case. On the other hand, you seem to think that there existed some group of "early" chiropractors who didn't believe in vitalism mumbo-jumbo. You've got a source for this? You seem to think that Keating is saying that there were early chiropractors who didn't believe in DD's baloney. I don't see Keating saying that at all. I do see him trying to operate apologetics on his spiritual mentor and trying to rescue him from the derision we now heap upon magical claims such as DD were making, but you need a source that submits that there were contemporaries of Palmer that did not take him at his word. Not seen that one yet. ScienceApologist (talk) 15:53, 2 July 2008 (UTC)
Absolutely there were chirorpactors that didn't believe in DD's chiropractic into a religion. John Howard opened National College directly across the street and he was against turning chirorpactic into anything spiritual - though he was quoted as saying how DD needed to protect it with a "veil of secrecy" until science could prove some of it's tenets. However, that is not to say that vitalism was not part of many personal belief systems - including MDs of the time - Louis Pasteur was an avid vitalist. But that does not mean that the 'vital force' was "God's manifestation in man" - only that it was not a testable entity. Many still believe this.. and a lot of those are likely chiropractors, but I don't think you can claim to know either; if you do, let me see it. I don't think Keating had anything to apologize for, but you may be reading something into his writings that I am not seeing. Again, though, we not supposed to do that. -- Dēmatt (chat) 20:22, 10 July 2008 (UTC)
Martin 1993's comment about chiropractors' beliefs is in the context of his section on early chiropractic, e.g., "At the core of chiropractic's early appeal", so there is clear justification in the source for Chiropractic's saying "Early chiropractors believed". But changing this to "Some early chiropractors believed" would go well beyond what the source says. Again, by analogy, it is reasonable to say "Early Christians believed that Christ would soon return" even though obviously some early Christians did not believe that; the point is to document a belief that was widely held among early Christians. If we limited ourselves to describing only beliefs held by each and every early Christian, we would be describing almost the empty set of beliefs, and that would not be useful or encyclopedic. Chiropractic is similar in that respect. Eubulides (talk) 16:46, 2 July 2008 (UTC)
I commented in the History section. ☺ Coppertwig (talk) 01:27, 3 July 2008 (UTC)
Yes, thanks, I followed up there. Eubulides (talk) 16:41, 3 July 2008 (UTC)
Martin's piece was a nice piece on how technology of the time helped to push alternative medicine in general and chiropractic specifically into the realm of mainstream medicine. His point was the dichotomy that chiropractic had to breach as it tried to advance through science while at the same time appeal to the popular patinet base that had strong religious beliefs and disdain for anything big and powerful. It is not an end all piece on chiropractic and wasn't meant to be. He even said he was just trying to make his case for technology in the first paragraph. Our history needs to reflect the full spectrum of the times which includes the atmosphere of the times that produced this vitalistic approach out of the American midwest. -- Dēmatt (chat) 20:22, 10 July 2008 (UTC)

Forest of red links

This change, which I reverted, created more red links than I've ever seen in a Wikipedia article. Surely there's a better way to accomplish whatever that change is trying to accomplish. But before discussing improvements, first we need to know what the change was trying to accomplish. Eubulides (talk) 20:47, 5 July 2008 (UTC)

For one, it accomplished me starting a new article: Journal of Manipulative and Physiological Therapeutics. It's just a stub, so I'd love some more input there. Anyhow, I think Elonka's edit was a good one, in that it encourages more interlinking amongst articles and may also encourage a lot of new article creation. I would suggest keeping her edit. -- Levine2112 discuss 20:54, 5 July 2008 (UTC)
I have put the links back. Don't worry, they won't be redlinks for long. Many of them are just odd abbreviations, that just need to be set up as redirects to existing articles. In fact, in the infobox for journals, there's even an "abbreviation" line for this kind of stuff. For example, I just linked the (previously red) Am J Public Health to American Journal of Public Health,[13] and added the abbreviation to the infobox there.[14] In short, for all of those redlinks, these are generally major things such as publishing houses or academic journals, for which there should be articles or stubs on Wikipedia. If there truly isn't one, then it's usually a simple matter to make a quick stub, which both gets rid of the redlink on this article, and also adds an extremely useful stub to Wikipedia, which is probably already being linked to from other pages as well. Plus it makes your contrib list look really good, to show that you are adding needed stubs to the project.  :) --Elonka 21:38, 5 July 2008 (UTC)
  • OK, now that I see what's being proposed and why, I disagree with it strongly on stylistic grounds. Even if all the red links would turn into blue links, the result would violate the guidelines in MOS:LINK #Overlinking and underlinking, which talks about excessive links. For example, there are many links to J Manipulative Physiol Ther, whereas there should be at most one.
  • This idea of wikilinking every journal and source mentioned in an article is not common on Wikipedia. I've not seen it used elsewhere. I don't think it's a good idea in any article; but I especially don't think it's a good idea to "try it out" on a controversial article like this one. Please revert the change.
Eubulides (talk) 21:50, 5 July 2008 (UTC)
Ah, good point about J Manipulative Physiol Ther, I wasn't aware that I was multi-linking that one. Definitely remove all but the first link on that, or I'll go ahead and get it. Ditto with any others that I multi-linked. --Elonka 21:57, 5 July 2008 (UTC)
I still disagree that this is the way to go, but at minimum please review every change you made and verify that there is at most one link to a particular journal or other source, and that when you follow that link you get something useful. There should be no red links and no bogus links and no duplicate links. It's not reasonable to make a change like this and expect others to clean up the mess afterwards. Eubulides (talk) 22:27, 5 July 2008 (UTC)

Redlinks to articles that are likely to soon be created are fine. If someone is planning to create said article soon, the redlink should be left alone. — Rlevse • Talk • 23:46, 5 July 2008 (UTC)

All of the links that I added, were to sources, to link either the journal name, or the publishing house for a book. Redlinks are allowable if they are to articles which are likely to be created. If, however, we have a redlink to something that does not look like it's worth an article, then rather than simply removing the link, we should probably look at removing that entire source, since it probably does not meet WP:RS standards. --Elonka 01:59, 6 July 2008 (UTC)
  • I disagree that we should remove a source simply because the publishing house does not look like it's worth an article. Should we remove a citation to D.D. Palmer's 1910 book on chiropractic simply because its publisher was minor and went bankrupt long ago?
  • I spent a loooong time fixing up the obvious gotchas in the changes that were introduced. Some of these were duplicate wikilinks. Some were wikilinks to a bogus redirect (for example, Soc Sci Med is bogus: it merely points to a publishing house and says nothing about the journal in question).
  • It is aggravating that to spend so much time on this problem. I remain skeptical that the benefits of this exercise are worth the pain.
  • There are still 32 red links in the article. I'll wait for a day or so for someone to fill them in appropriately. However, we should not have longstanding red links on the off chance that someone will create an article someday. For your convenience, here is a list of the red links:
Eubulides (talk) 10:32, 6 July 2008 (UTC)
Eubulides, thank you for your work in removing duplicate links, and I apologize for any clumsiness on my part in duplicating a few here or there. Thank you also for making a comprehensive list here at the talkpage, it is very helpful. As for the comment about "a day or so", remember there is no deadline. We should not remove redlinks simply because they are, well, red. Indeed, having them in the article can encourage editors to create needed articles, and is a reminder the Wikipedia isn't "done" yet. See WP:REDLINK: "In general, red links should not be removed if they link to something that could plausibly sustain an article." So, if anyone doesn't like having a redlink, they are welcome to create a stub or a redirect, but please do not simply remove the links, thanks. --Elonka 17:10, 6 July 2008 (UTC)
  • Absolutely there is no deadline. Those other articles can be created whenever someone has the time to create them. But there is no reason to maintain this forest of red links here in the meantime. The red-linked items are not that notable for this subject. I'm not even convinced the blue wikilinks are useful.
  • The idea of having Wikipedia containing an article on every journal and publisher on the planet is a noble one, but that's a different goal, and Chiropractic should not be held hostage to it. If and when someone takes the time to write up good articles on these journals (most of the articles now being referred to are stubs, which is not that helpful), that would be a different matter. In the meantime the article-on-journals project is detracting from the main goal for this article, which is chiropractic. Writing about chiropractic is not easy, given the subject's controversy, and adding this extra project makes it harder.
  • I continue to reject the idea that the red links are a "flag" to the reader that the source may not be that reliable. That is a completely inappropriate way to write an article. The presence or absence of a Wikipedia article on a journal has zero bearing on whether the journal is a reliable source, and we should not encourage a new style that suggests otherwise.
  • I again suggest trying out the idea of wikilinking to all sources in a less-controversial article first. I suggest trying it out on Oxidative phosphorylation, the most recent featured article on a biomedical subject.
Eubulides (talk) 19:01, 6 July 2008 (UTC)
Three of the red links have been turned into blue ones, which is progress. However, adding these articles appears to be a low-priority task, so in the meantime I removed the 29 remaining red links. These wikilinks can be readded as blue links as the corresponding Wikipedia articles become available. Eubulides (talk) 16:26, 8 July 2008 (UTC)
  • I should mention that I still disagree with this editing style, which (as far as I know) is not used anywhere else in Wikipedia, and which should not be tried out first in such a controversial article.
  • I have not simply reverted the change; I've kept the links that are obviously useful. Levine2112 commented that it was useful for Journal of Manipulative and Physiological Therapeutics, and that link has been retained. Other links that point to Wikipedia articles have been retained as well. If any more articles get created, those links can be restored.
  • My biggest objection to this proposal is that it is based on the idea that the red links are a "flag" to the reader that the source may not be that reliable; that is a completely inappropriate use of red links and raises WP:NPOV issues. We already have too much trouble with NPOV in Chiropractic; let's not add some more trouble in this relatively unimportant area. If there is concern that a source is unreliable, it should be addressed with Template:Verify credibility or something like that; it should not be addressed in this backhanded way.
Eubulides (talk) 17:38, 8 July 2008 (UTC)
I have restored the links, per talkpage consensus. As for the questions about sources, I do have concerns about the reliability of several of the sources on this page, and I have brought up two in the below section. I will bring up more as well, as I go through them. The {{vc}} tag is also a reasonable option, which I have already used, and will probably use again. --Elonka 18:12, 8 July 2008 (UTC)
I disagree with the forest of red links. I have never seen so many red links in a reference section. This is very odd. QuackGuru 18:31, 8 July 2008 (UTC)
I am going to revert per WP:REDLINK: "In general, red links should not be removed if they link to something that could plausibly sustain an article". -- Levine2112 discuss 20:15, 8 July 2008 (UTC)
I tagged Best practice & research. Clinical rheumatology for several issues, but I guess that notability is not one of them. Bearian (talk) 20:56, 8 July 2008 (UTC)

The links are all blue now, as I have added articles for each one (with one exception noted above; a non-notable topic for which no sources are likely to be found). I still disagree with this sort of style: the make-work provides little utility for the readers and editors' time would be far better spent elsewhere. Also, for the record, two editors were opposed and two in favor of this change, and hardly any responses were given to the arguments against the change, which is disappointing. I still don't understand why this dubious experiment was tried out on this article. Eubulides (talk) 20:48, 9 July 2008 (UTC)

Eubulides, I am finding your tone somewhat uncivil, could you please try to do better? The whole "make work" concept is bizarre. This is Wikipedia, a volunteer project with thousands of new articles coming in every day. Just having some redlinks in the references section of one article, did not "require" anyone to jump to work. We do things because we want to, no one's required to take on a "make work" task because the boss says so.  ;) Also, I am perplexed by the term "dubious experiment" as though this was the first article on Wikipedia where the sources were ever linked. This is definitely not the case.  :) However, thank you for creating stubs. I am also working on expanding some of them, as I am sure you have seen. I would also appreciate more eyes on Social Science & Medicine (Soc sci med), since it has a fairly complex publishing history. There are also differing descriptions at various websites. Pubmed says it ran 1967-1977, then was split into sub publications, which were re-merged in 1982. However, the Elsevier website says simply that publication started in 1978. So I'm not sure how to reflect this in the Wikipedia article, and would appreciate other opinions. Thanks, Elonka 21:54, 9 July 2008 (UTC)
  • It is not uncivil to point out that editorial work is unnecessary. And it is make-work from the point of view of Chiropractic to make this article the guinea pig for an unrelated project that progresses slowly, making Chiropractic look bad. (It is obviously not make-work if one's goal is that unrelated project; but this article is about chiropractic, not about particular journals or publishers.)
  • It is uncivil to revert with little or no comment here, to claim "consensus" when there were two editors vs. two, and to ignore these and other important points raised here. The important NPOV issues raised here were not addressed. These NPOV issues are moot now only because of the make-work I did.
  • There has been no mention here of any other Wikipedia article where this sort of citation style is routinely used.
  • I copied the comment about Soc Sci Med to Talk:Social Science & Medicine, a more appropriate location for it.
Eubulides (talk) 22:28, 9 July 2008 (UTC)

Speedy deletion of former red link

I have been adding articles for the red links. It's a lot of makework but I see no better way around the problem. One of them, Jones and Bartlett Publishers, has been tagged for speedy deletion. If it is deleted, we should remove the wikilink, for obvious reasons; there is no point redlinking to an article on a non-notable topic. Eubulides (talk) 23:49, 8 July 2008 (UTC)

Stub has been expanded. --Elonka 18:50, 9 July 2008 (UTC)
Eubulides, I see now that you did the absolute minimum (actually less than minimum), creating one-line stubs for many of the links. The stubs have little more than a title and an ISSN number. I see this as a violation of Don't disrupt Wikipedia to make a point. As a result of your actions, many of the stubs have now been nominated for AfD deletion, which is further wasting community time, requiring a discussion on each one. In the future, when creating a stub, please include at least a few sentences and a couple sources. Otherwise, just leave the link as red, thanks. --Elonka 21:52, 10 July 2008 (UTC)
Creating those stubs was not the absolute minimum, since the stubs exceeded what was already there (namely, dozens of red links in Chiropractic). The disruption of Wikipedia to make a point, and the wasting of community time, began when those dozens of red links were inserted into Chiropractic, for reasons that still have not been well explained or justified; as far as I can tell, they have something to do with questioning the sources used in Chiropractic, which is an inappropriate use of red links. In the future, please consider gaining real consensus (not two-versus-two "consensus") over changes like that, particularly when making such changes to an already-controversial article like Chiropractic. This will help us all save time in the future. Eubulides (talk) 22:10, 10 July 2008 (UTC)
Eubulides, I am sorry, but I feel that there is a violation of WP:OWN here. I have seen you oppose every single change since I arrived at this article. When even attempts to add a link are reverted, and the archiving of a 650K talkpage is met with opposition, it is clear that the atmosphere has become very toxic. In the future, I strongly recommend that you try harder to assume good faith, rather than arguing about every single action. If not, you may be asked to completely avoid this article and its talkpage. --Elonka 22:40, 10 July 2008 (UTC)
Elonka, I think you should probably read a bit more of the history of this page rather than just basing your opinion on what has happened since you got here. Could you do that for me? Eubulides is one of the best editors at this page we've got and he's fighting some rather nasty ownership problems on the part of others that have been at place at this article for some time. ScienceApologist (talk) 22:44, 10 July 2008 (UTC)
  • It might be asking Elonka a bit much to read the megabytes of talk-page commentary, and the hundreds of edits to the article, generated in the past few months.
  • That being said, Elonka's summary of recent events is misleading. Elonka writes "I have you seen oppose every single change since I arrived at the article." But only one change, the change proposed by Elonka, has been made to the article since Elonka arrived. Two editors (including Elonka) initially supported that change and two (including me) initially opposed. I eventually accepted the change despite real problems with it, which were mentioned here but not addressed by the proposers of the change. Similarly, I did not like the botched job of archiving the talk page, and I still disagree with archiving comments after only 7 days of inactivity, but Elonka's change stuck there as well. And now I'm being accused of WP:OWNERSHIP? Even if we judge only by recent events, the ownership of the article clearly does not lie with me.
  • Elonka's most recent three posts to this talk page all contain accusations against my actions:
  1. The abovementioned accusation of WP:OWNERSHIP[15].
  2. An accusation of disruption to prove a point[16].
  3. A vague accusation that I was uncivil[17].
  • This most-recent accusation needs to be read in context of the longer string of accusations. Eubulides (talk) 15:55, 11 July 2008 (UTC)
In general there is divided opinion about whether every mention of a peer=reviewed journal should be linked--Personally, I think it unnecessary--Basic information about finding journals is rather easy to find in OCLC WorldCat and elsewhere, not to mention the publishers web pages. The links do not not really help the article, and I think if anything confuse the reader. But some of the other science people I respect feel quite the opposite--that they help the reader evaluate the reference quality--but of course this only works if the journal articles are informative. See my comment below--I am trying to fill in the stub articles to prevent deletion, and it would have been much better to have done this a few at a time. Eubulides, you are correct that things like this done in large batches always attract unfavorable attention and unnecessary drama. DGG (talk) 02:32, 11 July 2008 (UTC)

Emphasis on the spine

I just added this most fundamental fact about the profession, yet something is missing.

Many could get the impression that the chiropractic emphasis on the spine is solely because of concern for the health of the spine alone, when that is not the case at all. The spine is considered the key to the health of the entire body, IOW, by treating the spine alone (if a straight), a chiropractor believes (s)he can treat dis-ease [tm] in other parts of the body, as well as prevent dis-ease in other parts of the body. The spine is not the aim, but the means to an end. How do we get this included? There are plenty of RS discussing this, mostly from the straight perspective, although this thinking is also basic to mixers, and is a fundamental characteristic of the whole profession, with very few exceptions. The only difference is that mixers add other treatments than spinal adjustments to their mix of methods. They will be inclined to consider treatment of the affected area as also of worth, not considering treatment of the spine alone as sufficient. -- Fyslee / talk 05:55, 12 July 2008 (UTC)

We should use a ref from the body of the article and not add a new ref to the lead. QuackGuru 06:39, 12 July 2008 (UTC)
Quite true. -- Fyslee / talk 14:53, 12 July 2008 (UTC)

Spine emphasis is poorly sourced and is not in body

  • This change is poorly sourced. The cited source[18] does not say that chiropractic has a special emphasis on the spine. It says only that the physical examination during the initial visit has a special emphasis on the spine.
  • Special emphasis is a reasonable point to make, but it must have a better source than this.
  • For now, I have added a "Failed verification" tag to this new citation. Can you please find a better source? Preferably one published in a peer reviewed journal, or something like that?
  • As per WP:LEAD the lead should summarize the body, but this new text in the lead does not summarize anything in the body. This should be fixed by adding a discussion of the special emphasis in the body. Can you please write that as well?
  • I agree with QuackGuru that a good rule of thumb is that the lead should never cite any source that is not also cited in the body. This is a corollary of WP:LEAD. Let's use that rule here. This can be done by citing the better source in the new text in the body.
Eubulides (talk) 09:16, 12 July 2008 (UTC)
All very true. Let's all work on this, because anyone who knows anything about chiropractic knows this to be a fact. We just need some better refs and inclusion in the body of the article. -- Fyslee / talk 14:53, 12 July 2008 (UTC)
I made this change to work around the immediate problem. Eubulides (talk) 18:37, 12 July 2008 (UTC)
Just to clarify: this change was just a quick fix to work around the immediate problem of failed verification. I have some qualms about citing Nelson et al. 2005 (PMID 16000175) so prominently, as it is a prescriptive paper (it proposes a model of the profession) rather than a descriptive paper. It's clearly an improvement over the previous citation, but it would be nice if we could do better. Eubulides (talk) 19:08, 12 July 2008 (UTC)
Your concerns are very legitimate. That source could still be used in some manner, notable and reliable source that it is, but it should be introduced and attributed properly. Let's keep it as a source for possible use. I hope you understand and agree with my wish to get this matter included as a valuable bit of information in the article. -- Fyslee / talk 21:39, 12 July 2008 (UTC)
That sentence that we have sourced to Nelson now is so common that we shouldn't even have to source it. I am sure that almost all chiropractic literature says it, including the ACC;
"Chiropractic is a health care discipline that emphasizes the inherent recuperative power of the body to heal itself without the use of drugs or surgery.
"The practice of chiropractic focuses on the relationship between structure (primarily the spine) and function (as coordinated by the nervous system) and how that relationship affects the preservation and restoration of health. In addition, Doctors of Chiropractic recognize the value and responsibility of working in cooperation with other health care practitioners when in the best interest of the patient."
More important about the Nelson source is that it represents current chiropractic thought as suggested by CorticoSpinal and DigitalC's reform minded education. It suggests that chiropractors restrict their practices to the musculoskeletal issues related to the spine. I'm not sure that it supports the issue that Fyslee is talking about, where chiropractors might adjust spines in an effort to affect general health issues.
-- Dēmatt (chat) 22:29, 12 July 2008 (UTC)
The Nelson source is a proposal for future practice. It is currently a model employed by some chiropractors, and officially by all reform DCs. Other sources, most notably straight - but many mixers as well - support the traditional use of spinal adjustments to affect and effect general and specific health issues, including those totally unrelated to the spine or nervous system. We should be able to find a number of such sources. The official guidelines of the International Chiropractic Association and the World Chiropractic Alliance probably include such wordings. -- Fyslee / talk 16:10, 13 July 2008 (UTC)
I think that at present, Chiropractic does have an emphasis on the spine. I think this is due partly to public perception, partyly to professional branding, and partly to Chiropractic's philosophical origins. On the other hand, saying that there is an emphasis on the spine in an effort to treat non-spinal conditions would be a POV statement, rather than a NPOV statement. DigitalC (talk) 05:02, 14 July 2008 (UTC)
The whole section deals with various POV regarding the spinal emphasis, and there is a segment of chiropractic that still advocates adjustments of the spine to treat non-spinal conditions. They're called "straights". There are myriad sources that bear this out. It's not my POV, and of course should never be included without appropriate sourcing. This isn't a final version. -- Fyslee / talk 06:02, 14 July 2008 (UTC)


  • IE - I think that these quotes from Fyslee are POV. They may be verifiable, but are not the truth, and do NOT represent the profession as a whole.
  • "treating the spine..." "a chiropractor believes (s)he can treat dis-ease [tm] in other parts of the body, as well as prevent dis-ease in other parts of the body"
  • "this thinking is also basic to mixers, and is a fundamental characteristic of the whole profession, with very few exceptions."[citation needed]
I basically agree with you. Not all those statements (well, not "those" statements, as they are my own rough ideas, not even close to any final wording, which is being attempted elsewhere here at Wikipedia) should be attributed to the whole profession. I hope I haven't given that impression. The different POV regarding spinal emphasis should be attributed properly to the correct segments of the profession. -- Fyslee / talk 06:09, 14 July 2008 (UTC)
It keeps coming down to attribution. Like I said before, I think the problem with the first version of Chiropractic is that we understated the reform POV and overstated the straight POV. That triggered CS (not understanding how WP worked) to write something that was totally reform minded, which in turn caused concern with Eubulides' medical understanding so he jumped in. The problem with trying to write one article about something that covers the entire gamot of healthcare is that, unless you attribute the specifics, it comes across as being one sided and by definitiion is POV. We either have to restrict this article to the things that all POVs have in common (such as the Medicine article and link to articles that are specific to the groups (ie Straight chiropractic, etc..), or attribute statements appropriately. Just thinking out loud. -- Dēmatt (chat) 13:09, 14 July 2008 (UTC)

POV tag on evidence basis

Chiropractic #Evidence basis has a {{POV-section}} tag, but I don't recall discussion about that here. There's been a lot of discussion about that section's {{Synthesis}} tag (see Talk:Chiropractic/Archive 24 #Syn and implicit conclusions above for the latest installment) but that's a different subject. With all the recent archiving I suppose I could have missed the discussion. I'm creating this section to be a repository for discussion of this topic, with the goal of resolving that issue. Eubulides (talk) 20:29, 6 July 2008 (UTC)

There's been no comment on this topic for several days. Any further thoughts? If not, I'm inclined to remove the {{POV-section}} tag. Obviously this would not affect the {{Synthesis}} tag. Eubulides (talk) 21:15, 11 July 2008 (UTC)
The section needs lots of work, some SYN and some POV. If we fix the SYN, it's likely that the POV will disappear with it, but let's leave it for now. We'll get it all worked out soon enough. -- Dēmatt (chat) 03:00, 12 July 2008 (UTC)
I don't see any Syn or POV. Vague comments of some POV is unhelpful. Please provide your evidence of POV. QuackGuru 06:48, 12 July 2008 (UTC)
I agree with QuackGuru about vagueness being unhelpful here. A POV tag should be accompanied by a specific allegation of POV. Eubulides (talk) 09:16, 12 July 2008 (UTC)
I don't remember a specific allegation about the History section that was rapidly replaced due to POV problems. Regardless, as a result of the SYN violations that equate chiropractic care with spinal manipulation, it gives that impression that the limitations of spinal manipulation are the same for chiropractic care. This becomes a problem of Neutrality and verifiability where we have sources that are combined in a dubious manner, marginalizing positive sources and emphasizing negative sources. Combine this with the lack of discussion for all the other treatment techniques results in WP:Weight issues that are also part of WP:NPOV. The section further breaks down into subsections that repeat these same problems, because the only information we have is about spinal manipulation not chiropractic care. All of this can be solved by moving discussions related to particular therapies to their respective articles and reserving any discussion of scientific research for general discussions of chiropractic care. Dematt 14:53, July 12, 2008
Thanks, but that's still too vague for us to cure any defects in the section. Which positive sources are being unduly marginalized, and which negative sources are being unduly emphasized? Which other treatment techniques are not being discussed? It is certainly not the case that "the only information we have is about spinal manipulation"; other treatment techniques are discussed. And I remain mystified as to how NPOV problems here, assuming there are any, can be cured by moving the POV discussion to some other article. If it's POV here, it'll be POV there too. Eubulides (talk) 09:00, 13 July 2008 (UTC)
No specific evidence of POV has been presented. QuackGuru 18:35, 13 July 2008 (UTC)
Again, no specific evidence of POV has been presented. QuackGuru 01:57, 15 July 2008 (UTC)
Please see Talk:Chiropractic#Antiscientific_reasoning - DigitalC (talk) 04:06, 15 July 2008 (UTC)
The Talk:Chiropractic #Antiscientific reasoning thread contains complaints about the use of the word "antiscientific", but that word is supported by multiple reliable sources and is not opposed by any reliable source. I'll follow up further in that thread. Eubulides (talk) 06:16, 15 July 2008 (UTC)

Commented-out reference

ImperfectlyInformed asked, "why was this reference commented out?" When two or more consecutive sentences are supported by the same reference, as in this case, the footnote only needs to go after the last one. The reference was left there, commented-out, to assist with editing, for example if the sentence gets moved; or to discourage people from adding fact tags, as you were going to do: it worked, didn't it? ☺ Coppertwig (talk) 20:56, 20 July 2008 (UTC)

Would have worked much better with a brief explaining note... but soon after I looked at it, I saw that a similar statement was cited near the lead. So it doesn't matter so much for close readers, a group of which I am not always a part. :p II | (t - c) 01:14, 21 July 2008 (UTC)
Well, after your edit, I went to add such explaining notes in all the places where I'd done that in the article, but decided not to, because they would take up too much space. If someone else wants to add such notes that's fine with me, though. ☺ Coppertwig (talk) 01:44, 21 July 2008 (UTC)

Reliable sources

While working my way through the sources on this article, I see several are articles published in Dyn Chiropr (Dynamic Chiropractic). This does not appear to be a peer-reviewed journal, but instead is more of a tabloid-format periodical, which is heavy on the ads.[19] Has there been a discussion about whether or not this meets WP:RS standards? Please note that I have no strong opinion at this point as to whether it is a reliable source, I'm just acting here as a source-checker, and asking to see if this has been discussed or not? --Elonka 12:04, 7 July 2008 (UTC)

Your characterization of Dynamic Chiropractic is correct: it's not peer-reviewed and contains a high percentage of biased and unreliable junk. Not every article in Dyn Chiropr is unreliable, though. Do you have concerns about a particular citation? Eubulides (talk) 16:53, 7 July 2008 (UTC)
What criteria are you using to determine which articles in Dynamic Chiropractic are or are not reliable? --Elonka 18:13, 8 July 2008 (UTC)
DC is the most widely read of all chiropractic publications. It is very notable, probably the most notable and representative of all chiropractic publications. It is an accurate window into the soul of the profession at any given time. I receive it, and I know chiropractors who line their bird cages with it.
It is indeed an advertising rag, including having (to this day) hardly a single page (that's not hyperbole!) without advertisements for some form of quackery or get-rich-quick "practice building" scheme/scam. This is par for the course in chiropractic and many chiropractors don't consider it problematic, since they believe this stuff. There are historical reasons for this situation. The problem is old and chiropractic's leading historian has scolded the profession for it a long time ago:
  • But the kernels of quackery (i.e., unsubstantiated and untested health remedies offered as "proven") are ubiquitous in this profession.3,4 I dare say that health misinformation (if not quackery) can be found in just about any issue of any chiropractic trade publication (and some of our research journals) and much of the promotional materials chiropractors disseminate to patients. the recent unsubstantiated claims of the ACA are exemplary. "Quackery in Chiropractic" - Keating (1991)
Unfortunately for the profession the editor (Petersen, who is not a DC) owns the magazine and its advertising company and he does nothing to curb the nonsense that detracts from the profession's image (among non-DCs). Little has changed since 1991, at least for DC magazine.
In spite of that, it also includes some excellent articles that are good sources for the opinions of leaders and other notable chiropractors. All chiropractic leaders write in it, all subjects of interest are discussed there, all controversies usually get mentioned, and the letters to the editor are very interesting reading ;-) As a source of such opinion it is useful here. Attribution might solve any problems. -- Fyslee / talk 05:20, 11 July 2008 (UTC)

Similar question with Chiropractic Diplomatic Corps, specifically this pdf.[20] Has this been discussed as to whether or not it meets the standard of "Reliable Source"? Thanks, Elonka 13:35, 7 July 2008 (UTC)

The question hasn't come up. As far as I can tell the Chiropractic Diplomatic Corps is a one-man operation and the source in question should be considered to be self-published. The only news item I found on that source with a quick search is here. Eubulides (talk) 16:53, 7 July 2008 (UTC)
CDC is not a "one-man operation". It is a non-profit, non-governmental organization based in Canada. Other executive members of the CDC are listed here. DigitalC (talk) 23:07, 7 July 2008 (UTC)
Sure, but having multiple executive members is not inconsistent with their being a one-man operation. Lots of one-man operations have a large board (that's how you raise money :-). By the way, it may be difficult to find out more about them, as it's not clear that they still exist. Their last newsletter is dated 1Q2006. Their current activities page is dated 2005. The 2007 story I mentioned above, the only item I found for them in the popular press, is the last record I can find for them. Of course their lack of existence now doesn't mean they weren't a reliable source back then. Still, that source very much has the feeling of a self-published paper. Eubulides (talk) 23:32, 7 July 2008 (UTC)
The newsletter may be a one man operation, but CDC is not. For instance, (from the site under current activities, then India) In March of 2004, Dr. Gary Auerbach, past and founding President of the World Federation of Chiropractic (WFC), began a dialogue at the invitation of Dr. Roberta Ritson, External Relations officer of the World Health Organization. He was queried as to the ability of the chiropractic profession to provide spinal health promotion to the urban poor in a “Healthy City Initiative” being implemented in Bangalore, India. In addition, it also mentions activity in 2007 - "February 2007 was the inaugural presentation of the Straighten Up! India activities when Dr. Kirk was the keynote speaker at a Bangalore and Karnataka conference on Workers' Health and Occupational Safety. Chiropractic continues to be invited to contribute its special healthcare focus in the state of Karnataka, India." - None of this negates that the source does appear to be self published. DigitalC (talk) 01:30, 8 July 2008 (UTC)

I would encourage everyone to look at WP:REDFLAG with respect to these two sources. Surely we can do better than those. ScienceApologist (talk) 00:43, 11 July 2008 (UTC)

If they were making scientific claims, then that would apply. As sources of opinion, and when properly attributed, REDFLAG might not apply. -- Fyslee / talk 05:27, 11 July 2008 (UTC)
WP:REDFLAG deals with redflag claims, not with sources. What claims are you objecting to SA? DigitalC (talk) 05:36, 11 July 2008 (UTC)
  • The CDC document is used to reference this claim - "Chiropractic is well established in the U.S., Canada and Australia". This doesn't seem like a suprising claim, it doesn't report a statement that seems out of character, and I don't see this claim being contradicted by the prevailing view within the relevant community. Do you feel that this claim alters medical or scientific assumptions, even though it is not a scientific claim? For the record, The US, Canada, and Australia have the highest number of practicing chiropractors. They each have a CCE. They all have multiple Chiropractic schools. DigitalC (talk) 05:42, 11 July 2008 (UTC)
Again, what claims are you objecting to ScienceApologist? DigitalC (talk) 04:04, 15 July 2008 (UTC)

If I may make a few comments. From Sackett, writing in the BMJ [21] "The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. .... Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming tyrannised by evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. Without current best evidence, practice risks becoming rapidly out of date, to the detriment of patients." Is the claim that a significant number of chiropractors would dissent from this verifiable? It is sourced first to an opinion expressed in Skeptical Inquirer.

Skeptical Inquirer perhaps should in all fairness be looked at in the same context as Dynamic Chiropractic; both are frank non-peer reviewed vehicles of opinion, the latter differs in being a vehicle for both skeptical and supportive opinions.

The second source states, in its summary "In summary, the present study found overall positive perceptions of research in a sample of chiropractors and massage therapists practicing in Alberta with most of them acknowledging the importance of research to validate their practice. In contrast, self-reported research use was low, and differed significantly between the 2 professional groups. Based on the data and evidence in the literature, it appears that the more frequent research use reported by chiropractors may be related to the chiropractic profession's relatively research-oriented culture, their more intense research education, and exposure to research during their professional training. As a result of their training, chiropractors may be more confident in their research skills and ability to apply evidence-based findings in their practice."

Does this really support the statement in the article?

On history, I have commented on ahistorical presentation on Dematt's talk page.Gleng (talk) 11:46, 11 July 2008 (UTC)

Hi Gleng. I see that you are speaking in reference to this first section on Chiropractic#Evindence base.
  • "The principles of evidence-based medicine have been used to review research studies and generate practice guidelines outlining professional standards that specify which chiropractic treatments are legitimate and perhaps reimbursable under managed care.[5] Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims.[6] A 2007 survey of Alberta chiropractors found that they do not consistently apply research in practice which may have resulted from a lack of research education and skills.[7] Evidence-based chiropractors possess the ability to apply research in practice. Continued education enhances the scientific knowledge of the practitioner.[8]"
  • Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims.[6]
Is the claim that a significant number of chiropractors would dissent from this verifiable?
I doubt we can find anything that says that any group of chiropractors would dissent from Sackett [22]. -- Dēmatt (chat) 02:51, 12 July 2008 (UTC)
  • A 2007 survey of Alberta chiropractors found that they do not consistently apply research in practice which may have resulted from a lack of research education and skills.[7]
Does this really support the statement in the article?
No.
This is the kind of thing that I see that I consider WP:SYN. When we pick pieces of the source and juxtaposition them to infer things that the author did not express. I would appreciate any help in cleaning some of these up!
Thanks for clarifying Gleng's remarks. They seem to be a continuation of a discussion elsewhere, and I couldn't make heads or tails of them without your clarification. Let me follow up, now that I understand them:
  • The claim "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims." is sourced to Keating 1997. Keating is widely considered to be a reliable source in the matter of history and philosophy of chiropractic. For example, he wrote the History and Philosopy chapters of Principles and Practice of Chiropractic, the leading chiropractic textbook. I see no reason to doubt this source simply because Keating published it in Skeptical Inquirer.
  • Like Dematt, I doubt that we can find anything that says that any group of chiropractors dissent from Sackett. But I don't see why that's relevant. After all, I doubt that we can find anything that says that any group of chiropractors agrees with Sackett either. I don't think chiropractors have been asked about Sackett, by any reliable source.
  • Suter et al. (PMID 17320731), the cited source, does support Chiropractic's claim "A 2007 survey of Alberta chiropractors found that they do not consistently apply research in practice which may have resulted from a lack of research education and skills." Suter et al. wrote in their abstract "It appears that in Canada neither chiropractors nor massage therapists consistently apply research in practice, which may result from a lack of research education and research skills."
Eubulides (talk) 09:16, 12 July 2008 (UTC)
I have been thinking about the ahistorical aspects that you mentioned on my talk page and think maybe we might be able to manage it by bringing over that first paragraph from Chiropractic history that mentions Louis Pasteur and putting it on top of the history that we have. Then if we move the history section to the top, that would allow us to address the historical aspects of vitalism early and grow the article into the present.. that way the lead would work out the same way. Whatcha think? -- Dēmatt (chat) 02:54, 12 July 2008 (UTC)

Well I'm just an observer here. It seems obvious to me that the three sentences beginning "Evidence based guidelines ..."should just be ditched; they don't say much at all, they just sound as though they're trying to say something important, but what they do say is probably wrong and probably unverifiable even if true. You know the problems with ahistoricism, you know what to avoid; DD Palmer was a man of his times, and what he believed was pretty much the same kind of thing as most scientists and physicians of the time believed. They were mostly vitalists, and mostly believers in God, and in intelligent design as we would describe it now. Gleng (talk) 08:05, 12 July 2008 (UTC)

Please take a look at #History to see what I was thinking for addressing your concern about Chiropractic taking an ahistorical path. -- Dēmatt (chat) 01:19, 13 July 2008 (UTC)
I've been trying to play catch-up on this topic thread and I have to say that Gleng's suggestion that 'the three sentences beginning "Evidence based guidelines ..." should just be ditched' seems to be the most logical and painless way to proceed. I fully support this suggestion. -- Levine2112 discuss 02:18, 15 July 2008 (UTC)
The first sentence is supported by multiple reliable sources, and no reliable sources have been proffered in disagreement. It is not "logical" to remove sourced text merely because one disagrees with it. No reliable sources have been proffered in disagreement. Eubulides (talk) 06:16, 15 July 2008 (UTC)
All three sentences are supported by reliable sources. The point they're trying to make is that evidence-based medicine is controversial within chiropractic, and that a significant number of chiropractors don't use it or believe in it. This is a significant point for the Evidence basis section of Chiropractic, and the point should not be removed completely. However, I agree that the sentences could be trimmed. The essential point in the four (not three) sentences beginning with "Evidence-based guidelines ..." could be made by keeping the first sentence and omitting the last three. Eubulides (talk) 09:16, 12 July 2008 (UTC)
I agree with Eubulides. The point needs to be made, but it could be done in a more concise manner. -- Fyslee / talk 14:48, 12 July 2008 (UTC)
Evidence-based medicine is controversial in all aspects of health care, including medicine and physical therapy. Are you suggesting that medical doctors and physical therapists are pseudoscientists as well? Just because we have a source that says something doesn't mean we have to use it. Besides, the Keating source was 10 years old. In EBM years, that is about 70 :-) Things have changed a lot in health care since then - including chiropractic. See if you can find a more current source for something like that and then maybe we'd have something to go with. -- Dēmatt (chat) 20:58, 12 July 2008 (UTC)
I'm not exactly sure what you mean. EBM isn't controversial in mainstream medicine. It is the desire of mainstream medicine to weed out the chaff and improve practice. Now if professions resisted clear evidence and continued to practice in antiquated ways, then there'd be a problem. It wouldn't exactly be pseudoscientific, but other unfavorable terms might apply. That's where the "ahistorical" matter may lead us off track. Yes, it's unfair to judge current matters by historical facts, but when those historical foibles are continued by significant parts of the profession in spite of clear evidence to the contrary, and leaders make fun of that EBM evidence because it comes from the side of the "enemy" and those who have persecuted the profession (AMA, et al), well, then we need to recognize that criticism of that type of opposition and lagging behind the times is proper. I've read so much of that in chiropracic literature, Dynamic Chiropractic, and chiropractic websites that nothing surprises me anymore. While the EBM movement is a relatively recent development in medical history, chiropractic has been loath to adopt it, and certain factions of the profession still oppose its findings, while giving lipservice to EBM. Just take the "Journal of Subluxation Research", for example. Its very existence says loads about a dilemma the profession isn't willing to deal with effectively. We're dealing with ancient historical POV and practices being preserved and guarded, not just ahistoricism. It isn't history. It's current reality for too many DCs. -- Fyslee / talk 03:12, 13 July 2008 (UTC)
It depends what you understand by EBM. The broad definition as given by Sackett is uncontroversial in medicine, and I'd be surprised if it was controversial in chiropractic; the cited Alberta study indicated that most chiropractors supported the principles of EBM even if some were unsure how to apply them in practice. EBM is however frequently misunderstood as sole reliance on RPCTs, and this emphasis is also controversial in medicine (as expressed by Sackett). Fyslee may well be right in everything he says, and Eubolides below. But the peer reviewed source quoted says that chiropractors generally support the principles of EBM, while the Keating source is an opinion, not explictly about EBM, in an opinion source. Keating is a good source of opinion, whether he writes in Skeptical Inquirer or Dynamic Chiropractor, I am not suggesting deleting it. I am suggesting that thought be given to distinguishing clearly between evidence of fact and evidence of opinion.Gleng (talk) 09:35, 13 July 2008 (UTC)
Maybe we should consider the "peer reviewed" source as optimistic opinion too... Fortunately we only have to provide RS for both "facts" (what some at times might consider "opinions") and opinions. We use both here at Wikipedia because we document everything about a subject. If they are unusually controversial, we attribute them. Keating's opinion carries alot of weight and we're fortunate that he was able to retain the status he had in the profession his whole life. No one else comes even close to understanding the inner workings and history of the profession like he did. Quoting from above:
  • The claim "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims." is sourced to Keating 1997.
That's about as accurate as it gets, even today. -- Fyslee / talk
I agree with Fyslee that EBM sees far more opposition from chiropractic practitioners than it does from mainstream medical practitioners. Some chiropractors favor EBM, but many don't. They view EBM as makework prescribed by government beancounters, they think that the evidence doesn't really matter, and they think that decisions on whether chiropractic will be used are, at bottom, political decisions that have little to do with the evidence. There is certainly some cynicism like this on the mainstream medical side too, but it's less. I don't have a reliable source that will justify everything I've said in this paragraph, though. Eubulides (talk) 09:00, 13 July 2008 (UTC)
Sounds like you've been reading Keating! He wasn't afraid to criticize precisely those trends and attitudes, which are still common. -- Fyslee / talk 15:57, 13 July 2008 (UTC)

Antiscientific reasoning

Re this wording: "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims." This is not NPOV wording. Just because one reliable source (of opinion) uses similar wording doesn't mean the Wikipedia article has to present it in that way as fact. I don't think anyone would say that they themselves are making unsubstantiated claims. The same idea can be expressed in neutral language: they "rely on intuition rather than proof" or they "consider proof unnecessary". Does anyone consider themself to be "antiscientific"? I doubt it. There's probably a neutral term for that, too: maybe "ascientific"? "nonscientific"? "intuitive"? Another option is to use prose attribution: "the other end employs what chiropractic historian Keating calls 'antiscientific ... reasoning' and 'unsubstantiated claims'." The Wikipedia article should be written in such a way that everyone would agree that it's true, and so that the reader doesn't get the feeling that the writer of the article had a particular, identifiable POV. ☺ Coppertwig (talk) 19:08, 13 July 2008 (UTC)

  • Obviously the fringe element of chiropractors themselves would not agree their claims are unsubstantiated (they would say things like "It worked for Lillard"); but that is true for believers in any fringe topic. It's inappropriate to reword language from a reliable source in an attempt to avoid offending straight practitioners, who are firmly on the scientific fringe, and this article should not bowdlerize Keating.
  • It is unrealistic to insist that Chiropractic be written "in such a way that everyone would agree that it's true". Chiropractic is a controversial topic. Writing so that everyone (or even every Wikipedia editor) would agree that it's true is a recipe for removing important mainstream material from this article. That is not how Wikipedia ought to work. If this article is written properly according to Wikipedia standards, fringe chiropractors (and they are significant minority of chiropractors) should disagree with large chunks of the article.
  • "Antiscientific" is the proper philosophical term here. It was used by the source, and we shouldn't water it down.
  • I get the feeling that there's some concern here that Keating, no matter how good his reputation on chiropractic history and philosophy is, may have erred on this particular point, or perhaps his opinion is dated. That would be a reasonable concern if Keating's views in this area were seriously disputed in reliable sources. But they're not. On the contrary, his views in this area are mainstream. You can see an example of this in the following quotation from a 2005 reliable source not coauthored by Keating, a source that is talking about D.D. Palmer's postulates:
'Despite the critical threats to the validity of this paradigm, a sizable proportion of the profession still holds these postulates to be valid. The segment of the profession that continues to hold firmly to Palmer's Postulates do so only through a suspension of disbelief. Given that one of the philosophical pillars of science is skepticism, a suspension of disbelief or a lack of skepticism, is evidence of antiscientific thinking. These stratagems to avoid the truth that Palmer's Postulates are unproven might be beneficial to the chiropractor, but are ethically suspect when they allow the practitioner to maintain a "faith, confidence and belief" in that paradigm to the patient's ultimate detriment.'[9]
  • This newer source makes the additional point that strategems by some chiropractors to avoid evidence-based review raise serious ethical issues. Perhaps that point should be added to Chiropractic #Evidence basis? It's an important point, no?
Eubulides (talk) 21:55, 13 July 2008 (UTC)
We should place the same value on the Nelson et al. 2005 source that was quoted above by Eubulides as we would for anything from Dynamic Chiropractic and Skeptical Inquirer. Think about it; is there a verifiable source that shows that anything but a tiny minority "maintain a "faith, confidence and belief" in that paradigm to the patient's ultimate detriment"? I would assume (and could likely be wrong) that there would be a lot of patient's that had ultimate detriment occurring to them. I don't see that the research (even their own) is backing that up. This is an opinion piece of course and makes a good argument for the mainstreaming of chiropractic into the spinal care model. It is also the SPOV view which is just one view. We are certainly obligated to fully explain their POV, but we don't have to use their descriptive term for their antithesis - at least not without attribution and "quotes" as Coppertwig suggests. We also have to be careful what we call mainstream view because we don't really know what that means. Is it a matter of majority? majority of what? experts? chiropractors? lay people? MDs? scientists? chiropractic scientists? PhDs? -- Dēmatt (chat) 00:08, 14 July 2008 (UTC)
  • I gave Nelson et al. 2005 as one example of a recent source agreeing with what's currently cited in Chiropractic. There are others. Here's another: Hughes 2007 (PMID 17996344) places chiropractic in the context of CAM, focuses more on the philosophy of users of CAM rather than practitioners of CAM, has a section called "Antiscientific perspectives on CAM", and explains the popularity of chiropractic and other CAM treatments by saying (for example), "the increase in the seriousness with which people regard CAM might reflect the decreasing seriousness accorded to mainstream science".
  • This makes for three reliable sources agreeing that antiscientific attitudes are a notable issue in chiropractic. I don't know of any reliable source claiming they are not a real issue.
  • "is there a verifiable source that shows anything but a tiny minority"; Keating's point is that there is a significant minority of chiropractors that use antiscientific and pseudoscientific reasoning. I don't agree that it's a "tiny" minority. The exact size of this minority, of course, is not something that one can nail down to the nearest percentage point, but it's certainly substantial enough to be mentioned here, as part of a spectrum of beliefs, which is what Chiropractic currently says.
  • "we don't have to use their descriptive term" What other descriptive term is supported by a reliable source?
  • For this particular point, "mainstream" includes both mainstream medicine and mainstream chiropractic.
Eubulides (talk) 01:52, 14 July 2008 (UTC)
Are you asking us to consider Hughes 2007 as a source for this article? That would be scraping the bottom of the barrel for sure. I suppose we could say that "clinical psychologists consider that chiropractic is not a valid treatment for anything psychological." But that would be a good example of SYN because it would be misplaced in this article as I don't know that chiropractors are making those claims. Maybe I'm misunderstanding you though. -- Dēmatt (chat) 12:57, 14 July 2008 (UTC)
  • I wasn't suggesting adding Hughes 2007 (PMID 17996344) to Chiropractic; I was simply noting it as another reliable source that makes the point about antiscientific attitudes and chiropractic.
  • Some chiropractors are making claims like that, I'm afraid. Hughes 2007 says "Although the majority of chiropractic consultations are for back pain, practitioners recommend chiropractic for a range of other conditions including depression and anxiety." Hughes cites Brockman 2007 (doi:10.1016/j.clch.2006.08.004) as an example.
  • Although I wasn't suggesting adding Hughes, I did suggest adding some text about ethical concerns. That suggestion wasn't specific; I'll make a concrete proposal in #Evidence basis rewording proposal below.
Eubulides (talk) 18:23, 14 July 2008 (UTC)

Evidence basis rewording proposal

Following up on the discussion in #Reliable sources, which discussed shortening some of the text and adding a new topic, namely ethical concerns, I propose to replace this text in Chiropractic #Evidence basis:

Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims.[6] A 2007 survey of Alberta chiropractors found that they do not consistently apply research in practice which may have resulted from a lack of research education and skills.[7] Evidence-based chiropractors possess the ability to apply research in practice. Continued education enhances the scientific knowledge of the practitioner.[10]

with this text:

Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims,[6] stratagems that are ethically suspect when they let practitioners maintain their beliefs to patients' detriment.[9]

Eubulides (talk) 18:23, 14 July 2008 (UTC)

Well, it is one POV. We can use it but we would have to figure out who to attribute it to and who it is talking about. Probably we can consider it from the far right (reform) and about the far left (straight). Here is the course syllabus for the Evidence-Based Chiropractic from Palmer West for the summer of 2008. This is a supposedly straight school. The class looks pretty thorough... it even uses Glengs Sacket textbook as a recommended reading. That's the part II syllabus, too. Notice it's three hours a week... times 15 weeks... times 2 for part I... thats 90 hours for EBM. We might have to consider Keating 1997 is out of date, no? -- Dēmatt (chat) 22:03, 14 July 2008 (UTC)
Wow, check this one out, even Sherman Chiropractic College of Straight Chiropractic is doing research. This is the most straight you can get. It is so straight that its graduates can't even practice in most states in the US. I mean, we are talking minority straight POV (maybe even objective straight) and they even have a science research program. Of course we have no idea about the quality of this research, but we can't say ascientific, or antiscientific is coming from the schools. I'm still thinking that if there is anything out there that is negative, it's not so much antiscience as much as anti-competition. Maybe they just don't like their competition. Either way, I would think the word antiscience is used pejoratively in this case.. and we need more to verify that we aren't talking about a small minority that have "detrimented their patients" :-) -- Dēmatt (chat) 22:41, 14 July 2008 (UTC)
Apparently CCE has requirements for Clinical competencies so I would suppose that all CCE accredited schools have to follow these. This was at the bottom of that Palmer West Syllabus from above.
Required CCE Clinical competencies addressed:
  1. Professional Issues Attitudes: Acknowledge the societal obligation of the profession to produce research, and appreciate the importance of research in education, clinical practice and to the growth of the profession.
  2. Professional Issues Attitudes: Demonstrate a desire and an ability to critically evaluate new and current knowledge.
  3. Professional Issues Knowledge: Understand the need to maintain a breadth and depth of knowledge and skills necessary for the practice of chiropractic through continuing education.
  4. Professional Issues Skills: Demonstrate an ability to use personal computers and other business and communication technologies.
  5. Professional Issues Skills: Demonstrate the ability to critically review clinical research literature.
  6. Diagnostic Studies Knowledge: Demonstrate an understanding of the clinical indications for and the relative value of diagnostic studies.
  7. Diagnosis / Clinical Impression Attitudes: Understand the importance of collecting sufficient clinical information in order to avoid reaching a premature diagnosis or clinical impression.
  8. Diagnosis / Clinical Impression Knowledge: Demonstrate reasoning and understanding in using sources (such as the available literature and clinical experience) to support the diagnostic impression.
  9. Diagnosis / Clinical Impression Knowledge: Demonstrate an ability to develop the clinical impression by recognizing and correlating significant information.
  10. Diagnostic Studies Attitudes: Recognize the importance of considering benefits, costs and risks
I really don't see that we can ask for more? -- Dēmatt (chat) 22:55, 14 July 2008 (UTC)
I don't see anything in the CCE statement, or the Haneline's course listing at Palmer West, or the list of papers at Sherman, that would undermine the proposed text. The CCE has been favoring mixers since at least the 1950s and represents the mainstream chiropractic position, and its statement doesn't mention evidence-based anything. Sherman's list of papers doesn't talk about evidence-based medicine. Haneline's course at Palmer West is just one course; it no more shows that straights favor EBM than (say) a course on Islam at the University of Texas would show that Texans are Islamic. Let's please see some reliable sources, ideally published in peer-reviewed journals, that address the general topic, rather than scouring the net for isolated dribs and drabs that we would have to make inferences from. Eubulides (talk) 23:15, 14 July 2008 (UTC)
Hehe, I like that, dribs and drabs :-). But the point, of course was that they aren't antiscientific, and straights do use EBM. I think those sources are as good as any opinion piece citing one primary source. When we write edits that we know not to be true, that's POV editing. -- Dēmatt (chat) 01:21, 15 July 2008 (UTC)
  • None of those three sources are on point. None of them say anything about "antiscientific" one way or another. And none of the sources say that straights use EBM. Only one of the sources even mentions EBM, and that source doesn't say anything about straights.
  • Furthermore, even if this evidence were on point (which it's not), it is extremely weak: none of it appears in a peer-reviewed journal, or any journal at all. It's just random webpages pulled off the net.
  • In contrast, we have multiple reliable sources published in peer reviewed journals, including the leading chiropractic historian of the past two decades, agreeing about the "antiscientific".
  • This isn't a close call; there are good sources agreeing with the "antiscientific", and no sources disagreeing.
Eubulides (talk) 06:16, 15 July 2008 (UTC)
I'll go one further and say that the CCE, Haneline and Sherman sources are better than any opinion piece - especially one citing just one primary source. Calling straights "anti-scientific" should not be given any weight except perhaps in the context of an attributed opinion. Frankly though, I don't think this opinion merits any mention as it has been summarily refuted by the reliable sources at hand. -- Levine2112 discuss 02:21, 15 July 2008 (UTC)
It has not been refuted; it's not even disputed by these sources. The CCE, Haneline and Sherman sources do not disagree with the "antiscientific". And they do not appear in peer-reviewed journals. Two of them are merely course listings. The CCE is more authoritative, but it doesn't address the issue. Eubulides (talk) 06:16, 15 July 2008 (UTC)
Levine2112 claims "it has been summarily refuted by the reliable sources". Levine2112, please provide your specific evidence. QuackGuru 18:00, 15 July 2008 (UTC)
Just read (or re-read) the sources which Dematt has provided here. Eubulides interpretation here is way off. The CCE, Haneline and Sherman sources establish scientific practices and education. -- Levine2112 discuss 17:39, 16 July 2008 (UTC)
The Sherman source doesn't say anything about evidence-based medicine, or about antiscience. Neither does the CCE source. The Haneline source mentions evidence-based medicine, but it says nothing about antiscience; and it's merely a course-catalog listing. None of these sources are nearly as authoritative as the peer-reviewed journal articles that are talking about the antiscientific philosophy of a minority of chiropractors. And, although these sources do supply evidence that research methods are used in chiropractic, they do not address the question whether a minority of chiropractors have an antiscientific philosophy. For many years straights were notorious for doing "research" that wasn't scientific, but was merely designed to confirm the straights' philosophy; nothing in these new sources says that this practice has changed. Eubulides (talk) 18:10, 16 July 2008 (UTC)
"For many years straights were notorious for doing "research" that wasn't scientific, but was merely designed to confirm the straights' philosophy;" I bet that's harder to do that than to design real tests. You would have to give them credit for that :-)
Seriously, though, we can probably work with some of this stuff, we just need to explain it better, I think.
-- Dēmatt (chat) 01:07, 17 July 2008 (UTC)

Vincent reference etc.

The Vincent reference clearly states that "There is no evidence of a flight from science characterising all complementary patients, but rather...a pluralism and pragmatism on the part of patients" Other relevant quotes include "The fact that there were relatively few consistent group difference suggested that there are few clear cut differences between complementary and general practice patients." "The most powerful overall predictor, clearly associated with a relative preference for complementary medicine, related to a belief in the importance of psychological factors in illness" "Complementary medicine patients may therefore be better health-educated than those using exclusively the orthodox medicine sector." "all four groups were clear that orthodox medicine was necessary for severe, life threatening illnesses. Complementary medicine is seen as relatively more effective for minor and chronic conditions by the GP group, and as being generally superior to orthodox medicine for these conditions by the acupuncture and homeopathy groups." Nothing in this reference indicates that "anti-scientific thinking" is a major issue among CAM patients is generally; these words are not used nor anything equivalent to them, indeed the whole tone of the article is consistent with patient attitudes being a rational judgement based on selective judgements about perceived efficacy of different forms of treatment, informed by experience of both orthodox and CAM treatments, and judgements that tend to be similar for GP patients as well as CAM patients. The inference that more skeptical views about the effectiveness of orthodox treatment for problems with a psychological component is indicative of an antiscientific attitude seems just wrong to me. It does seem to me that the view that skepticism about the effectiveness of orthodox medicine is equivalent to antiscientific attitudes is just false. Attitudes of patients may be ill informed, but this does not make them antiscientific in general, quite the contrary, patients are making pragmatic choices based on experience and knowledge, however imperfect that knowledge and subjective that experience may be.

Multiplying direct or indirect quotes from Keating or attributions to Keating does not alter the fact that this is an opinion, expressed in these terms by one person, notable and noteworthy as he is. If "antiscience" had objective factual content my view would be different, but it does not.

The Reed B. Phillips quote above is interesting "this antiintellectual position persists in a small percentage of chiropractors in this twenty-first century". Is it right to give prominence in this article to views held only by a small percentage of chiropractorsGleng (talk) 12:53, 23 July 2008 (UTC)

This is a three-ringed circus, medicine, science and chiropractic, and it would be a mistake to think that views of scientists about medicine are uncritical; they wouldn't be scientists if they were. As Steve Jones writes in The Language of the Genes, "Scientists, in general, despise doctors." That's an opinion, not a fact, and I wouldn't want it to be confused as such however notable the author is. Perhaps they despise some CAM practitioners more. Perhaps many medics despise chiropractors, and perhaps many chiropractors despise organised medicine. But the claim here is that a significant number of chiropractors despise science. This, of all these possibilities, is the only one I really doubt.Gleng (talk) 13:28, 23 July 2008 (UTC)

I agree, then, that the statement should be attributed as opinion by Keating. I think we also need to make sure we address why some of these chiropractors don't agree with evidience based guidelines, particularly that they are concerned that it will pigeonhole them into treating all patients the same way, will be used by insurance companies to deny coverage (i.e. the same reasons MDs are concerned), etc.. There are plenty of sources for these objections I am sure. -- Dēmatt (chat) 15:48, 23 July 2008 (UTC)
There is no need to attribute anything. We should not attribute it to the source just because some editors disagree with the leading historian on chiropractic. The fact is not controversial and is verified. QuackGuru 17:05, 23 July 2008 (UTC)
It is not verified to be fact, it is verified as an opinion, and is indeed controversial. - DigitalC (talk) 05:42, 25 July 2008 (UTC)

(outdent)

  • None of the above comments addressed the point that the three sources in question are not about chiropractic. Vincent et al. 1995 (PMID 10159673), Furnham & Forey 1994 (PMID 8071452), and Jonas 1998 (PMID 9496994) do not mention chiropractic at all, and they are not derived from any chiropractic data. Their relevance to this discussion is dubious.
  • Not that it's relevant, but I continue to disagree with the characterization of Vincent et al., which clearly shows a negative correlation between attitude toward science and use of complementary medicine. This does not contradict Vincent's comments about "There is no evidence of a flight from science characterising all complementary patients..." (emphasis mine), as we are talking about some, not all, patients. And the evidence of Vincent et al. is entirely consistent with the claim in Chiropractic about there being an ideological continuum, one end of which employs antiscientific reasoning.
  • The cited sources are not all "direct or indirect quotes from Keating". Tanvetyanon 2005 (PMID 15956016), for example, is an independent source: it is not an indirect quote from Keating, and does not cite Keating. And even when reliable sources are citing Keating, that's still strong evidence that this is mainstream opinion. For example, when Nelson et al. 2005 (PMID 16000175) cite Keating and agree with him, we have the case of eight respected researchers in chiropractic, from five different chiropractic institutions, agreeing with Keating on this point.
  • In contrast, so far we've seen zero reliable sources disagreeing with Keating on this point.
  • It is right to mention the opinion of the straights in Chiropractic. Their opinion is that of a significant minority, and Chiropractic should give it due weight. By my count Chiropractic #Evidence basis currently devotes only 10 out of 1450 words to the antiscientific attitudes of the straights. This is not at all overkill considering the significance of the straights within chiropractic; if anything, it's underkill.
Well, I've hunted through accounts of chiropractic on NHS websites (its available on the NHS and 25% of GPs refer patients to them), on Select committee reports, BMJ clinical reviews, NIH information pages - none seem to think that antiscientific attitudes are worth mentioning at all. But I wasn't suggesting losing any words, only clarifying their status.Gleng (talk) 00:57, 24 July 2008 (UTC)
I wouldn't expect clinical reviews or government websites to talk about the attitudes about the practitioners one way or the other. Eubulides (talk) 05:06, 24 July 2008 (UTC)
  • Chiropractic does not say that a significant number of chiropractors "despise science"; it merely says that one end of a continuum among chiropractors "employs antiscientific reasoning and makes unsubstantiated claims", which is not at all the same as despising science.
  • Like QuackGuru, I disagree that this mainstream opinion should be attributed to Keating in the text. It's not just Keating's opinion; it's the opinion of every recent reliable source that we've found on the topic. It would be incorrect to imply that this opinion is just Keating's, or that it's controversial among reliable sources.

Eubulides (talk) 18:55, 23 July 2008 (UTC)

Quackguru's comment is worth noting; he confuses what you rightly call opinion with fact. That's exactly my point. It can be easily be confused unless you declare it as opinion.Gleng (talk) 00:57, 24 July 2008 (UTC)
To state an opinion as if it is a fact is worse than to use weasel words. If it's an opinion that X is true, then it's worse to just have a Wikipedia article state "X is true." than for the article to state "Several [unnamed] commentators have stated that X is true." In this case, I didn't quite catch whether there was more than one reliable source making the "antiscientific" claim about chiropractic specifically, but if so, we might say something like "what commentators such as chiropractic historian Keating have called "antiscientific"..."; or just say "commentators" and use footnotes to specify who they are.☺ Coppertwig (talk) 01:46, 24 July 2008 (UTC)
The style you are proposing is not used in Chiropractic, nor is it common in Wikipedia. The vast majority of claims in Wikipedia are opinions, but we rarely see phrases like "So-and-so said" in front of them. Phrases like "So-and-so said" are needed only in special circumstances, and this isn't one of them.
Let's take one example of where the proposed style would take us. The very first claim in Chiropractic is an opinion, not a fact. Here it is:
"Chiropractic (...) is a complementary and alternative medicine health care profession...."
As this opinion is sourced to Nelson et al. 2005 (PMID 16000175), I suppose the proposed style would mean the first sentence would have to be rewritten to be something like this:
"According to commentators like Craig F. Nelson, Dana J. Lawrence, John J. Triano, Gert Bronfort, Stephen M. Perle, R. Douglas Metz, Kurt Hegetschweiler, and Thomas LaBrot, chiropractic (...) is a complementary and alternative medicine health care profession...."?
Obviously this would be a bad idea. If we were to adopt this strategy when editing, the length of the text of Chiropractic would double, and it would become much harder to read, for no good reason. A reader who wants to know the source for the opinion that chiropractic is a CAM profession can simply follow the citation to Nelson et al.; there's no need to mention the source explicitly in the text. The case of "antiscientific" is similar.
Eubulides (talk) 05:06, 24 July 2008 (UTC)
I agree that we can work something using Coppertwig's suggestions along the lines of NPOV#Attributing and substantiating biased statements that will be NPOV. -- Dēmatt (chat) 03:27, 24 July 2008 (UTC)
No evidence has been presented that the statement about "antiscientific" is biased. We've found multiple reliable sources, independently published in peer-reviewed journals, agreeing with the statement. We've found zero reliable sources disagreeing with it. Eubulides (talk) 05:06, 24 July 2008 (UTC)
The evidence that "antiscientific" is biassed is that chiropractors do not, apparently, refer to themselves as "antiscientific"; also it simply sounds pejorative. Also you yourself, Eubulides, referred to it as "opinion". Note that we don't need reliable sources to verify these arguments since we're not proposing to insert the statement "'antiscientific' is biassed" into the article. Not everything needs to be prose-attributed, but this statement sounds jarring and non-NPOV if baldly stated as if Wikipedia is asserting it as fact. Wikipedia asserts facts, or things that seem to be facts based on reliable sources; not opinions. Several editors including myself consider it important to attribute it and have explained why. No reason has been presented not to attribute it, other than that it's stated by more than one source: but I think maybe the other sources were not mentioning chiropractic specifically? and if they were, then a more complex attribution can be made, as I suggested above. ☺ Coppertwig (talk) 13:31, 24 July 2008 (UTC)
Please see Talk:Chiropractic #Inserting "Keating says" below. Eubulides (talk) 16:25, 24 July 2008 (UTC)

History

History comments

  • I take it that this section is intended as a working draft to replace Chiropractic #History.
  • This draft is too long. Chiropractic #History is already overlong as a summary of a subarticle; it should not be made significantly longer.
  • The first paragraph of this draft is almost entirely unnecessary in a brief summary. There is no need to talk about details such as when and where Andrew Taylor Still opened the ASO. The ASO is about osteopathy, not chiropractic.
  • The phrase "After nine successful years," is not explained. I assume it means that Palmer was successful financially as a magnetic healer for nine years before developing chiropractic? I doubt whether this detail is important at this level, but if so it needs to be explained.
  • The sentence "He gave the first chiropractic adjustment to a deaf janitor, Harvey Lillard, on September 18, 1895." is not supported by any reliable source and is almost certainly false.
  • The sentence "By this time medicine had organized into a major political force creating state laws that limited the practice of medicine." is not supported by a reliable source and is unnecessary.

Eubulides (talk) 09:16, 12 July 2008 (UTC)

I think I handled all of these. -- Dēmatt (chat) 19:11, 27 July 2008 (UTC)
Thanks, but there are still several problems; please see #History comments again. Eubulides (talk) 15:00, 28 July 2008 (UTC)
  • "I take it that this section is intended as a working draft to replace Chiropractic #History." As we agreed that your version was just a start, there is still room for improvement. Unfortunately, the previous version got archived!
  • "This draft is too long. Chiropractic #History is already overlong as a summary of a subarticle; it should not be made significantly longer." I'm thinking we can tweak everything quite a bit once I get it all in.
  • "The first paragraph of this draft is almost entirely unnecessary in a brief summary. There is no need to talk about details such as when and where Andrew Taylor Still opened the ASO. The ASO is about osteopathy, not chiropractic." See Gleng's concerns below as well as on my talk page. There are many osteopaths that think the timing of the ASO is very important. This is why most DCs went to jail after all. It is also why DD was forced to come up with a date of that first adjustment. All very important as it set the tone for the entire century.
  • "The sentence "He gave the first chiropractic adjustment to a deaf janitor, Harvey Lillard, on September 18, 1895." is not supported by any reliable source and is almost certainly false." I agree. We can deal with that.
  • "The sentence "By this time medicine had organized into a major political force creating state laws that limited the practice of medicine." is not supported by a reliable source and is unnecessary." this is a good one pages 109 - 112. Are you thinking that political organized medicine had nothing to do with shaping chiropractic?
-- Dēmatt (chat) 01:47, 13 July 2008 (UTC)
  • Obviously osteopaths think that Still and the ASO are important for osteopathic history, but that is osteopathy, not chiropractic. That sort of detail about some other profession is completely unnecessary in a brief summary of chiropractic history.
  • I agree that organized medicine fought chiropractic for many years. But Chiropractic #History already says that. There is no need to lengthen the discussion of that battle here. The details can be put in Chiropractic #History.
  • The goal of the proposed new paragraph is to say that chiropractic was not scientific initially, but neither was mainstream medicine. That point can be made quite briefly and sourced. There is no need to write a long paragraph, full of details that have nothing to do with chiropractic, to make that point. This paragraph is supposed to be a brief summary of Chiropractic #History; it is not supposed to grab one large section of Chiropractic #History and emphasize it here.
  • The current rewrite of the Lillard incident is still not right. We don't have reliable sources saying that Palmer's encounter with Lillard led Palmer to hypothesize about manipulation.
  • The rewrite claims that Palmer had "nine successful years" as a magnetic healer, but this is not sourced.
  • The rewrite has removed the information that B.J. scornfully called mixers "mixers".
  • No sources have been given for the claim "Tension soon developed between the two groups as mixers continued to develop new methods and open new schools to teach their proprietory techniques."
  • The draft says the AMA excluded chiropractors and osteopaths, but the cited source about the AMA says they excluded osteopaths, chiropractors, Christian Scientists and other faith healers, midwives, and chiropodists. It would be better to say "osteopaths, chiropractors, faith healers, midwives, and chiropodists" if we're going to list who the AMA excluded.
  • The phrase "With no laws to protect them" is redundant and can be removed.
  • The phrase "Until 1983" has been removed; it needs to be retained.
  • The phrase "essentially locking chiropractic out of the mainstream of health care" is not supported by a source.
  • The phrase "and was hampered by antiscientific and pseudoscientific ideas that sustained the profession in its long battle with organized medicine" has been removed, but it is supported by a reliable source and is an important point.
  • The sentences "However, its future seemed uncertain: as the number of practitioners grew, evidence-based medicine insisted on treatments with demonstrated value, managed care restricted payment, and competition grew from massage therapists and other health professions. The profession responded by marketing natural products and devices more aggressively, and by reaching deeper into alternative medicine and primary care." have been removed, but they are supported by a reliable source and are an important point. The removed text is much more important and relevant to chiropractic today than the long paragraph about osteopathy in the 19th century etc.
Eubulides (talk) 09:00, 13 July 2008 (UTC)
I second Eubulides comments, especially the concerns about the removed text. That really surprised me. -- Fyslee / talk 15:39, 13 July 2008 (UTC)
See below. Nothing new here and still a work in progress. -- Dēmatt (chat) 18:21, 13 July 2008 (UTC)
Thanks for your help. This is still a work in progress and any comments help. Keep in mind that I am trying to write something that includes all pertanent information without overdoing it. Sometimes that means I have to add a bunch before taking some out. Also, remember, this is not only about medicine and chiropractic. It is illustrating the historical context to the state of health care at the time - this has to include all the things that affected the profession, science, medicine, a young country, bad treatments, quackery, monopolies, politics, legal issues, etc.. All these things are essential to understanding what chiropractic is, because it is more than just spinal manipulation :-).
  • Obviously osteopaths think that Still and the ASO are important for osteopathic history, but that is osteopathy, not chiropractic. That sort of detail about some other profession is completely unnecessary in a brief summary of chiropractic history.
If you were here two years ago, you'd know that we had osteopaths adding all kinds of tidbits about how DD Palmer was not the first... this is my attempt to include their POV. I might be able to make it more succinct.
  • I agree that organized medicine fought chiropractic for many years. But Chiropractic #History already says that. There is no need to lengthen the discussion of that battle here. The details can be put in Chiropractic #History.
I suspect you mean Chiropractic history. Chiropractic history should be a more inclusive description of a proper analysis made here. I am not purposely adding anything here, it just seems that any explanation seems to come back to that. I think it is important to make it as NPOV as possible so that the reader can't tell if we are advocating fro any particular side.
  • The goal of the proposed new paragraph is to say that chiropractic was not scientific initially, but neither was mainstream medicine. That point can be made quite briefly and sourced. There is no need to write a long paragraph, full of details that have nothing to do with chiropractic, to make that point. This paragraph is supposed to be a brief summary of Chiropractic #History; it is not supposed to grab one large section of Chiropractic #History and emphasize it here.
No, the point was to bring context to the thought of the time. Medicine was only a small part of that then.. BTW, as Gleng noted, these vitalists were the ultimate scientists, so apparently I didn't make the point. I'll keep working on it.
  • The current rewrite of the Lillard incident is still not right. We don't have reliable sources saying that Palmer's encounter with Lillard led Palmer to hypothesize about manipulation.
I'm open to suggestions here, but I think that a mention of Harvey Lillard is necessary because it is basic chiropractic history. How can we be considered and encyclopedia without including Lillard. It would be like considering discovery of the cause of yellow fever without mentioning the legend of Jesse William Lazear dying from a self inflicted mosquito bite. Though, it does need to be accurate.. if possible. -- Dēmatt (chat) 18:21, 13 July 2008 (UTC)
  • The rewrite claims that Palmer had "nine successful years" as a magnetic healer, but this is not sourced.
It's in there.
  • The rewrite has removed the information that B.J. scornfully called mixers "mixers".
So. It was removed in an attempt to NPOV. NPOV does not mean that we use verifiable sources to pass POV statements.
  • No sources have been given for the claim "Tension soon developed between the two groups as mixers continued to develop new methods and open new schools to teach their proprietory techniques."
Yeah, you're right here... do you disagree with this statement?
Kaptchuk was where I saw it. [11]
  • The draft says the AMA excluded chiropractors and osteopaths, but the cited source about the AMA says they excluded osteopaths, chiropractors, Christian Scientists and other faith healers, midwives, and chiropodists. It would be better to say "osteopaths, chiropractors, faith healers, midwives, and chiropodists" if we're going to list who the AMA excluded.
Hmmm, I'll look at that.
  • The phrase "With no laws to protect them" is redundant and can be removed.
I'll work on that.
  • The phrase "Until 1983" has been removed; it needs to be retained.
I took that out because it was unclear. The years were from 1963 to 1983 I think and wasn't sure, so 'Until 1983' seemed to assume from the beginning (which I am not sure was the case). So I took it out.
  • The phrase "essentially locking chiropractic out of the mainstream of health care" is not supported by a source.
I agree.
  • The phrase "and was hampered by antiscientific and pseudoscientific ideas that sustained the profession in its long battle with organized medicine" has been removed, but it is supported by a reliable source and is an important point.
Again, reliable sources don't have to be used when they make NPOV violations, especially when taken from opinion pieces without attribution.
  • The sentences "However, its future seemed uncertain: as the number of practitioners grew, evidence-based medicine insisted on treatments with demonstrated value, managed care restricted payment, and competition grew from massage therapists and other health professions. The profession responded by marketing natural products and devices more aggressively, and by reaching deeper into alternative medicine and primary care." have been removed, but they are supported by a reliable source and are an important point. The removed text is much more important and relevant to chiropractic today than the long paragraph about osteopathy in the 19th century etc.
When I read the source it occurred to me that this is in the wrong section because it is current, not history. I din't mean to take it out of the article, just the history... though it probably needs work because it changed all the verbs to past tense.
I'll work on some of those here soon. Thanks for the input. -- Dēmatt (chat) 18:21, 13 July 2008 (UTC)

(outdent) Dematt, you write above:

  • "NPOV does not mean that we use verifiable sources to pass POV statements."

If you really think about the consequences of that, then we can't include any POV here, no matter how well sourced. Maybe you didn't mean it quite the way it sounds to me. Actually all we do here is to include well-sourced POV. We don't even officially care whether it's totally "truth" or not, as long as it's well-sourced, since one person's absolute "facts" and "truth" are another person's "POV" and "opinion". NPOV does mean "that we use verifiable sources to pass POV statements." It's just a matter of attribution. It shouldn't appear to be editorial opinion and POV. To avoiid that we also use direct quotes. Coppertwig has made a comment that closely parallels yours, but ends with a good solution. -- Fyslee / talk 21:18, 13 July 2008 (UTC)

This is the part of NPOV that both Coppertwig and I seem to be simultaneously talking about[23]. IOWs, our responsibility is to choose sources that explain those separate POVs without taking sides. Just because the source is verifiable doesn't mean we have to use it. If it is that relevant, that same word should be found in several verifiable sources. Words like "scornfully" are good for a secondary source, but we shouldn't import it here. Like you say, though, this does not mean that a POV gets left out, just that we explain it dispassionately and without taking sides. The sentence says the same thing, just as Coppertwig's suggestion says the same thing without using the POV wording. BTW, if I were writing a history of chiropractic, I would surely include these words along with the words mixers used for straights, and everybody called everybody else! (Steth comes to mind :-) (Though you have some good ones, too:-) There is a lot of drama there that would definitely sell books. -- Dēmatt (chat) 22:03, 13 July 2008 (UTC)
I agree with Eubulides that the first paragraph, mostly about what health care in general was like back then, is much longer than necessary. ☺ Coppertwig (talk) 01:39, 14 July 2008 (UTC)
Okay, I'll work on it. Thanks for all the comments. -- Dēmatt (chat) 13:01, 14 July 2008 (UTC)
I welcome Dematt's attempts to further improve Chiropractic #History. The goal of the first paragraph is an important goal, and is very important, in that it helps bring the section towards a NPOV. I also agree that we do not need to use a POV source's POV wording to explain something. - DigitalC (talk) 01:04, 15 July 2008 (UTC)
I don't see why adding so much detail about pre-chiropractic history adds NPOV. If the neutrality point is to say that mainstream medicine was just as unscientific as chiropractic was in the beginning, that point can be made briefly. Giving an entire paragraph to this theme, in what is supposed to be a brief history of chiropractic, smacks of apologetics and is a strong POV. This sort of weight is not given in standard histories of chiropractic; why give so much weight to it here? Eubulides (talk) 06:16, 15 July 2008 (UTC)
You keep saying that "medicine was just as unscientific as chiropractic". That's interesting. Do you think these vitalists were not scientific? Pasteur? Driesch? They were scientists. I disagree that other histories don't include context. I disagree that adding context adds POV.
Sorry, you're right, I should have said "as vitalistic", not "as unscientific". But the rest of my point remains. Yes, other histories include context, but they don't devote such a large fraction of their contents to the pre-chiropractic context. One sentence should be enough here; a paragraph is way overkill. Eubulides (talk) 17:28, 15 July 2008 (UTC)
(ec)I'm editing your history draft, Dematt. If I wasn't supposed to, or if you don't like my edits, feel free to revert or to ask me to revert. (and then we can discuss it ...) ☺ Coppertwig (talk) 01:21, 15 July 2008 (UTC)
Hey, that's the heart of collaboration. Nobody's perfect! I think your edits are an improvement. -- Dēmatt (chat) 16:55, 15 July 2008 (UTC)
This version is way too long and has a lot of unnecessary details. There is a lot of unnecessary context. It would be better to get to the point. I recommend starting over using the current History version and adding what you think is most nececessary. At this point, this rewrite is not it. QuackGuru 17:21, 15 July 2008 (UTC)
I suggest that the following sentences could perhaps be deleted: "Fueled by vitalist Louis Pasteur's ... take hold."; "Meanwhile, renowned scientists such as Wilhelm Roux and ... some sort of "spiritual entity".[1]"; "Chiropractic leaders often invoked religious imagery and moral traditions."; "Early chiropractors also tapped into the Populist movement, ... Association (AMA).": "The longstanding feud between chiropractors and medical doctors continued for decades. " This last sentence is unnecessary, as the information can be deduced from the other sentences. In the version in the current article: "and was hampered by antiscientific and pseudoscientific ideas that sustained the profession in its long battle with organized medicine." can be deleted; I looked in Keating's primer and didn't see it, and it seems unnecessary anyway.
Here's another draft. I based it on both the current article version (576 words) and Dematt's draft above (796 words); this one has 595 words. Feel free to comment and to edit it.☺ Coppertwig (talk) 20:27, 19 July 2008 (UTC)
Thanks for the new draft. I agree with many but not all of the proposed deletions. I'll comment further below the draft. Eubulides (talk) 21:11, 21 July 2008 (UTC)

List of hot topics

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Discussion

It's been 3 weeks. Shall we arbitrarily move the "hot topic" link to the next topic? We can still continue to work on History, too. ☺ Coppertwig (talk) 23:02, 19 July 2008 (UTC) Signature for bot: 18:19, 25 July 2008 (UTC)

Reliable sources

Evidence basis rewording proposal

Re "to patients' detriment": if I understand correctly, the source is subtitled "Debate": it's an expression of opinion. As Dematt says, it would have to be attributed. We might be able to cite something to provide another perspective. Suggested wording: "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims";[6] the ethics of the maintenance of such beliefs by practitioners when they may be to patients' detriment have been called into question by the authors of a debate article[9], but a chiropractic panel emphasizes the importance of a holistic, patient-centered approach.[12]" ☺ Coppertwig (talk) 23:02, 19 July 2008 (UTC)
  • The source is clearly an opinion piece, but it is not subtitled "Debate"; it is one of two articles (the other being Wyatt et al. 2005, PMID 16001976) that were put into a "debate" section by the editors of the journal.
  • We have already run into a similar situation in Chiropractic's citation of DeVocht 2006 (PMID 16523145), an opinion piece that was part of a debate (the opposing side being Homola 2006, PMID 16446588). In that case, there was no need to weaken the text by noting explicitly that DeVocht is a "debate" article; and there is no need to weaken the text here either. In both cases the points being sourced are not disputed by the other side.
  • I don't see how the the proposed addition of "but a chiropractic panel emphasizes the importance of a holistic, patient-centered approach" is relevant here. Holism and patient-centered approaches are entirely compatible with evidence-based medicine. The topic of holism and patient-centered approaches are relevant for Chiropractic #Philosophy, but the source you give is pretty old (1995) and is not that strong; Chiropractic #Philosophy already makes that point and cite better sources.
Eubulides (talk) 21:11, 21 July 2008 (UTC)
This seems a very sensible suggestion to me. I suspect that Keating's use of "antiscientific" was simply rhetoric for the sake of effect, and certainly not really a statement of a philosophical position somewhere between Hobbes and Feyerebend (as suggested by a fairly incoherent article on Wikipedia). Nothing wrong with a robust rhetorical statement, it conveys the spirit of a skeptical opinion, and should be attributed as coming from someone whose opinion is worth noting (which it does), but it should not be mistakable as a statement of fact. "Unscientific" I would have less trouble with, but anti-scientific... well ... if these chiropractors were campaigning to stop research into chiropractic I'd feel there was some grounds for the claim.Gleng (talk) 16:41, 21 July 2008 (UTC)
Keating's use of "antiscientific" is not simply rhetoric. He repeated the wording in many sources that were published in peer-reviewed journals and standard textbooks in chiropractic. The same wording has appeared in other sources, as mentioned above. As Antiscientific makes clear, one does not need to campaign to stop research into a subject to have antiscientific ideas. Eubulides (talk) 21:11, 21 July 2008 (UTC)

That it is published in peer reviewed journals, however often, doesn't make it any less an opinion, and it is certainly a noteworthy opinion. The Hughes article that you quote, as you rightly point out does not suggest that chiropractic is antiscientific, it only speculates that CAM is popular amongst those who are skeptical of science. That is speculation, plausible, but speculation, it also is plausible speculation that many turn to CAM because of medical conditions which have not been resolved by conventional treatment, as suggested by the House of Lords select committee report into CAMs. In any case, the Hughes paper seems irrelevant to the issues here. The term "antiscience" may indeed be ill defined and changing constantly, but has generally been applied to those who have attacked scientific research and science teaching: in the 70s it was a charge levelled at those on the left concerned about the dehumanizing effects of technology, in the 90s mainly against creationism and intelligent design, now also against Greenpeace, animal rights protestors, and those who oppose GM crops. Gleng (talk) 21:48, 21 July 2008 (UTC)

Gleng (talk) 21:48, 21 July 2008 (UTC)

  • Again, I wasn't suggesting using Hughes as a source in Chiropractic.
  • I disagree that the term "antiscience" is reserved for people who attack scientific research and teaching. As Antiscience says, "Antiscientific views generally claim that science is non-objective method generating non-universal knowledge, and that scientific reductionism is flawed. Antiscience criticises the perceived power and influence of science, and objects to what proponents perceive as an arrogant or closed-minded attitude amongst scientists." This is pretty much how many chiropractors view mainstream medicine in general and evidence-based medicine in particular.
and these are quite common criticisms of science and medicine from other scientists. Skepticism and self criticism are hallmarks of scientific attitudes, it would be absurd to characterise these views as intrinsically antiscientific. They may be characteristics of antiscience views, but cannot be defining characteristics.Gleng (talk) 11:16, 22 July 2008 (UTC)
What can I say? It sounds like now you're disagreeing with Antiscience, and would prefer "antiscience" to mean something different from what it usually does. Eubulides (talk) 23:19, 22 July 2008 (UTC)
Well I certainly question whether Antiscience is a reliable source; my point is that these may be features of antiscience but cannot be distinguishing features if they are shared by scientists. Four legs are features of a dog but everything with four legs is not a dog.Gleng (talk) 00:22, 24 July 2008 (UTC)
You are correct that Antiscience is not a reliable source for Wikipedia purposes (Wikipedia is not supposed to cite itself as an authority). However, it is a reasonable summary of antiscience. And of course we are not relying on Antiscience to support the claim that antiscientific attitudes are at one end of the chiropractic spectrum; we are relying on reliable sources outside Wikipedia. The claim in question is about "antiscientific reasoning", not antiscience in general; perhaps this addresses some of your concern about the use of the term "antiscientific". Eubulides (talk) 05:06, 24 July 2008 (UTC)
  • Antiscience also says "antiscience first arose as a reaction against scientific materialism", which neatly captures the connection between antiscience and the vitalism behind straight chiropractic.
Indeed. This though is a reference to 18th century origins, when virtually all science was vitalistic, in other words antiscience then was in opposition to contempoarry (vitalistic) science. If it captures the connection, it does so by an ahistorical synthesisGleng (talk) 11:16, 22 July 2008 (UTC)
Antiscience does not say that antiscience first arose in opposition to vitalism. It says antiscience arose as a reaction to scientific materialism. This places antiscience firmly on the vitalistic side of the vitalism/materialism schism that is already well-documented in Chiropractic #Philosophy, and it helps to explain why Keating and others say that the vitalistic tradition of the straights has antiscientific components. Eubulides (talk) 23:19, 22 July 2008 (UTC)
Well, Antiscience counts Hobbes as the archetypal antiscientist of the 18th century. Something seems seriously adrift here because Hobbes is generally regarded as an arch reductionist: his "rejection of matter-spirit dualism and his emphatic affirmation of the one-world realism that lies at the heart of modern science..."[24] Just shows the problems of ahistorical syntheses (or possibly of a pretty dreadful blunder in Antiscience). Of any scientist of the 18th century Hobbes is probably the one who was not a vitalist. In his argument with Boyle, his position was anti-empiricist - he argued (putting it oversimply) that, in this case, facts were shaky, reason was sound. He had a point at least, in that he revealed an error in Boyle's theory which Boyle duly put right Gleng (talk) 00:48, 24 July 2008 (UTC)
  • In this discussion about "antiscientific", one side has cited multiple reliable sources (Keating, and others, in peer-reviewed journals) supporting the use of the term "antiscientific" to describe one end of the chiropractic spectrum, and the other side has cited no reliable sources disputing the use of the term. If there's no dispute among reliable sources, that should end the discussion as far as Wikipedia is concerned, no?
Eubulides (talk) 05:45, 22 July 2008 (UTC)
The one peer reviewed source quoted above (Hughes) is contradicted here in JAMA "Patients who use CAM do not harbor antiscientific or anticonventional medicine sentiments, nor do they represent a disproportionate number of the uneducated, poor, seriously ill, or neurotic." [25]. The Nelson source simply cites Keating for the statement, published in Skeptical Inquirer, a non peer-reviewed, frank skeptical opinion source. But in 2001, in J Can Chiropr Assoc, Keating writes “… despite all of these genuinely progressive steps, the chiropractic profession here in North America may be slipping backwards. I perceive that we are at risk of returning to the antiscientific and dogmatic traditions that we have worked so hard to shake off during the past several decades. " Now to me at least, this form of expression "at risk of returning..." etc does suggest that Keating believed that Chiropractic as a profession has reformed itself, even though some chiropractors still adhered to outdated modes of thinking. Now, dogmatic adherence to theories is a problem, but a problem issue in medicine and indeed in science itself, as recognised since Thomas Kuhn's dissection of the scientific method. Kuhn indeed regarded dogmatic adherence to theories as an almost universal feature of science in practice, and a feature integral to scientific progress. In summary, again, I think it is right to note critical opinions of chiropractic, with attribution and possibly a date stamp, but it would be unscientific to foster confusion between what is fact and what is opinion.Gleng (talk) 11:16, 22 July 2008 (UTC)
Well said, Gleng. I agree with your comments above. Eubulides, just because a sources doesn't specifically say that "antiscience" doesn't apply doesn't mean it supports the use of that term: otherwise we would have to state that there are purple aliens from another planet in Joe Smith's backyard if a source states that there are and no source can be found stating that there aren't, etc. Repetition of the word many times by an author does nothing to transform it from opinion to fact. ☺ Coppertwig (talk) 12:35, 22 July 2008 (UTC)
When the source specifically states antiscience that means it is sourced. Why are we judging the source when we are following the source. More than one sources says antiscience anyhow. Something simple like this should not be so complicated. QuackGuru 14:51, 22 July 2008 (UTC)
  • There is not just "one peer reviewed source quoted above". There is also Nelson et al. 2005.[9] Nelson et al. clearly agree with Keating's assessment and they are a reliable source as well. Other sources can also be supplied. For example:
  • "Finally, alternative care often seems to shelter an antiscience attitude. For instance, women with breast cancer who believe that cancer spreads by air and that chiropractic care is an effective anticancer therapy often present at a late stage, which is associated with great suffering, short survival, and staggering cost of care." -- Tanvetyanon 2005 (PMID 15956016)
  • "This protective shield apparently prompted a segment of the profession to extend its comfort zone by adopting not only an antimedicine but an antiscientific stand.... Although this antiintellectual position persists in a small percentage of chiropractors in this twenty-first century, the profession never developed a broad-based consensus around Stephenson's 33 principles." -- Reed B. Phillips, page 72 of the latest edition of Principles and Practice of Chiropractic, the leading textbook on chiropractic
  • "Lastly, the ACC claims that chiropractors use the 'best available rational and empirical evidence' to detect and correct subluxations. This strikes us as pseudoscience, since the ACC does not offer any evidence for the assertions they make, and since the sum of all the evidence that we are aware of does not permit a conclusion about the clinical meaningfulness of subluxation." -- Keating et al. 2005 (PMID 16092955)
  • The claim "Patients who use CAM do not harbor antiscientific or anticonventional medicine sentiments" (Jonas 1998, PMID 9496994) is an entertaining one. Jonas supports this claim solely by two citations, both of which disagree with the claim.
  • The first citation, Furnham & Forey 1994 (PMID 8071452), is a survey of alternative practitioners in London that mentions dozens of alternative medicine styles but (as far as I can tell) nowhere mentions chiropractic, which means it's not that relevant here. Furthermore, Furnham & Forey write (page 468) that their results could be explained by patients who "have embraced the underlying philosophies and, thus, become more critical" of conventional medicine. They go on to write, "Or, it could be that their underlying beliefs about the causes of illness and treatment have meant a conflict between their ideas and the principles of modern medicine that led them to use an AP." ("AP" means "alternative practitioner".) In other words, Furnham & Fory 1994 do not at all support the claim about alternative medicine in general; on the contrary, they suggest the opposite of the claim.
  • The second citation, Vincent et al. 1995 (PMID 10159673), does not address chiropractic at all: it covered only acupuncture, homeopathy, and osteopathy. Again, its conclusions are diametrically opposite to the claim about antiscientific attitudes. Its Table V (page 402) shows a significant (P < 0.01) negative correlation between attitude toward science and use of complementary medicine.
Hence this claim of Jonas 1998 is extremely dubious; I can only surmise that it was an error in the source. In any event, the evidence supporting the claim refers solely to non-chiropractic data, so it's not that relevant here.
  • So now we have five reliable sources, including Keating himself in a 2005 peer-reviewed journal article, supporting the claim that antiscientific and/or pseudoscientific attitudes are notable and relevant to how chiropractors practice. In contrast, no reliable sources have been supplied asserting the contrary. Eubulides (talk) 23:19, 22 July 2008 (UTC)

It's not complicated, Coppertwig made an eminently reasonable proposal to word it "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims";[17]"; that preserves the message, states it as an opinion and attributes it. The one peer reviewed source mentioned above (Hughes) uses antiscientific to characterise patient beliefs and is contradicted by a peer reviewed source (in JAMA) that is at least as strong (it's a peer reviewed secondary source citing two peer reviewed primary sources for the explicit statement of contradiction)Gleng (talk) 16:07, 22 July 2008 (UTC)

There is no need to attribute this to Keating in the text, just as there is no need to attribute (say) the existence of an efficacy controversy to DeVocht in the text. It suffices to attribute this to Keating in the citation. I suppose that we could add several more citations to support the point; but this shouldn't be necessary, as the point is not controversial among reliable sources. Eubulides (talk) 23:19, 22 July 2008 (UTC)

Inserting "Keating says"

Related discussion: Reliable sources

It appears that my comments about this "Keating says" insertion have not been clear enough.

  • "is a CAM profession" is also pejorative to the straights, and I expect to many mixers. They do not concede that chiropractic is "complementary" or "alternative" to anything: they view it as a primary or mainstream health care approach. I expect that to a straight, calling chiropractic "complementary" is far more pejorative than calling it "antiscientific".
  • We have multiple reliable sources, not just Keating, who all agree on the "antiscientific" point. It is not reasonable to attribute this opinion only to Keating in the text, as that makes it appear to the reader that it's just the opinion of one guy. If attribution is to occur in the text, it should be to all the sources, to make it clear to the reader that this is the consensus opinion.
The reliable sources you suggest are Hughes[26] who uses the word antiscientific once in the heading of a section (" Antiscientific perspectives on CAM" that does not refer directly to chiropractic at all, but to discussion of postmodernist attitudes amongst CAM users. It certainly does not support the claim in the text about chiropractors. Tanvetyanon 2005 is in a peer reviewed journal, but is a letter - these are opinion pieces and not peer reviewed. Be careful what doors you open. If you accept letters attacking papers as reliable sources that opens a floodgate of published letters from chiropractors and others expressing often ludicrous viewpoints. We're left with Keating I think, I think in one peer reviewed opinion piece.Gleng (talk) 09:05, 25 July 2008 (UTC)
I suggested several reliable sources other than Hughes and Tanvetyanon, and I have just added these sources (all in peer-reviewed journals or in the leading textbook on chiropractic) in Chiropractic here. Eubulides (talk) 18:06, 25 July 2008 (UTC)
  • Inserting the "Keating says" here makes the article less balanced. Before this change, Chiropractic used a consistent style for attributing opinions about chiropractic: it simply supplied a citation. And yet here, for one opinion that is critical of chiropractic, we are using a different style that casts doubt on the opinion, by making it appear to be the opinion of just one guy. This raises serious NPOV issues. It is not right to insert phrases like "Keating says" in front of statements critical of chiropractic, casting doubt on them, while leaving all supporting opinions unqualified; that obviously leads to an unbalanced presentation.
This is a misunderstanding of intent. The object here is not to dilute the criticism itself but to not apparently endorse the way it is expressed. If the criticism embodies legitimate concerns, let those be expressed without using terms which are offensive and (my concern) intellectually untenable. The criticism is that some chiropractors adhere dogmatically to untested theories that invoke unneccessary assumptions.Why not put it that way? That's exactly what Keating says he means.Gleng (talk) 09:25, 25 July 2008 (UTC)
Regardless of the intent of the change, its actual effect is to dilute mainstream opinion. The terms are certainly not offensive in the usual sense; they are nothing like four-letter words or anything like that. And the reliable sources using the terms evidently do not think they are intellectually untenable or offensive. The mainstream characterization of straight chiropractic includes not only dogmatism, but go well beyond that: they include the use of antiscientific and pseudoscientific thinking. Eubulides (talk) 18:06, 25 July 2008 (UTC)
  • Unlike the "antiscientific" point, which is not controversial among reliable sources, the "chiropractic is CAM" point is controversial. And yet with this change, Chiropractic goes out of its way to imply a controversy in "antiscientific", while ignoring the controversy in "chiropractic is CAM". This is a serious NPOV problem.
Well even Keating argues that the theory of VSC is a perfectly valid scientific construct for example, so his criticism is not about all contentious straight views but specifically about dogmatism and unneccessary assumptions. These I wouldn't dispute at all; I'd merely note that these are endemic in science and medicine, so antiscientific is overblown rhetoric. Gleng (talk) 09:25, 25 July 2008 (UTC)
Yes, obviously VSC is a valid scientific construct, but the point of Keating, and many other reliable sources, that part of the chiropractic spectrum employs antiscientific and pseudoscientific reasoning in order to defend their dogma on that subject. This is a well-known problem in chiropractic, it's not contentious among reliable sources, and Chiropractic should not attempt to downplay it. Eubulides (talk) 18:06, 25 July 2008 (UTC)
And can't we state the problem while avoiding value-laden pejoratives? Their choice expresses the authors subjective distaste. That's the POV issue, if its not attributedGleng (talk) 21:35, 25 July 2008 (UTC)
The current version of Chiropractic says "antiscientific" just once, and attributes it in the text as well as citing it in a footnote; there seems to be some consensus that this sort of thing is appropriate. Eubulides (talk) 23:48, 25 July 2008 (UTC)
  • The "chiropractic is CAM" opinion is just one example: I chose it purely because it's the first claim in the article. There are dozens of other examples like this scattered throughout the article. Many of these opinions are supportive of chiropractic and pejorative of medicine. If it is necessary to put "Simon says" in front of each opinion that might offend somebody, we have a lot of work to do; and we certainly should not be focusing solely on the critical opinions.

Eubulides (talk) 16:25, 24 July 2008 (UTC)

Again, the objection is to inserting a gratuitously insulting term as though it carried clear factual content without even attributing it to what is really a source that is extremely unusual in using it in a peer reviewed paper in this way. It's not an objection to criticism, indeed for me it devalues the integrity of any message it intends to convey.Gleng (talk) 09:25, 25 July 2008 (UTC)
It's not "extremely unusual" for reliable sources to use terms like "antiscientific" and "pseudoscientific" to talk about the reasoning used by the straights. Terms like these are used by many sources, and no reliable source disagrees with them. Obviously you find them "gratuitously insulting", but reliable sources in refereed journals are publishing them, so evidently mainstream authors and editors don't find them gratuitously insulting, and there doesn't seem to be a controversy about this among reliable sources. Eubulides (talk) 18:06, 25 July 2008 (UTC)
Yes, we have slowly removed all attributed phrases, haven't we. I was going to point out the Janse phrase, but I see we lost that one, too. I have no problem attributing chiropractic as a CAM according to the NIH. Fyslee and I had this conversation a long time ago and only found that the US categorizes things this way anyway. Keep in mind that while reforms would consider it complementary, straights consider it alternative. I think that is the only reason it sticks. If you tried to change it to one or the other, that would be a problem. -- Dēmatt (chat) 18:26, 24 July 2008 (UTC)
  • I am disappointed that a revert war is now brewing, with almost none of the above bulleted points being addressed by the other side. It would be more helpful to address these points, instead of merely pressing the revert button.
  • To address the single bullet you did respond to: It wouldn't be correct to attribute "chiropractic is CAM" to the NIH, as the NIH didn't make that decision, Congress did. I'm sure we could find reliable sources on both sides of that controversy, though. For starters, there's Redwood et al. 2008 (PMID 18435599), which says that by a wide margin, chiropractors themselves reject the claim that they are CAM practitioners. So it's quite clear that the "chiropractic is CAM" opinion is controversial among reliable sources. In contrast, we've found zero reliable sources disputing the claim that some chiropractors use antiscientific reasoning.
Eubulides (talk) 20:44, 24 July 2008 (UTC)
Nor would I expect you to, for the reasons given below that you have not addressed - that "antiscientific" is not a coherent term but a pejorative. It is generally avoided in serious journals. Search on PubMed reveals only a handful of references, generally talking about frankly antagonistic sectors (GM protest, stem cells etc) - a joint search with chiropractic throws up none; perhaps these searches miss some, but I've tried. Nothing as I've said on NHS sites, NIH sites, AMA sites, select committee sites - nothing anywhere, no mention. And its not surprising, if Hobbes is antiscientific what modern scientist isn't? Apart from Keating, there's one paper that talks of antiscientific attitudes in patients - I havent accessed that yet, and one letter (these aren't peer reviewed by the way) in opposition to a supportive article on chiropractic. It seems to me that you are confusing critical comments with pejorative comments. I don't see any objection to objective criticism, only to subjective expressions of distaste.Gleng (talk) 21:22, 24 July 2008 (UTC)
"Antiscientific" is pejorative to people who think that science is a good thing and that viewpoints opposed to science are a bad thing. It is not a pejorative in the wider scheme of things, a wider scheme that includes straight chiropractic. Again, you've done extensive searches and have found zero reliable sources disputing the use of the word "antiscientific" in this context. I have done similar searches and have found several reliable sources supporting the use of the term. We should not let our personal prejudices and reactions to terminology override the mainstream consensus on this point, a consensus expressed by several independent reliable sources. Eubulides (talk) 21:38, 24 July 2008 (UTC)
As I understand it, straight chiropractic was conceived from the outset as a scientific alternative to then current medical practice (have I got this wrong Dematt?) - the idea that straight chiropractic is antagonistic to science seems wholly contrary to the philosophy behind it, as seen by them. We may not think much of their science, but they're not anti-science. You are right that people who are antagonistic to science would not see it as a pejorative. But only if they read into it something not intended by Keating, or understood by most readers. In effect, you're using the isolated use of antiscientific in a single chiropractic publication as evidence of mainstream consensus use, and seeking peer reviewed articles rebutting this rare use. Gleng (talk) 10:39, 25 July 2008 (UTC)
"As I understand it, straight chiropractic was conceived from the outset as a scientific alternative to then current medical practice" This is exactly right. The issues have never been about science. Chiropractic was born out of a perceived need to pull away from the drugging and surgeries that were in practice at the time. Choosing the vitalistic approach does not make it unscientific, antiscientific, or pseudoscientific. It just makes it difficult to prove. In days of old, invoking religious answers was common to explain the things that we did not understand, or could not prove. Vitalism does not in itself require a spiritual being, if it did - 95% of chiropractors would shun it. No, the "vitalism" that chiropractors look to just supposes that life cannot be explained totally through reduction of the material - it is more than the sum of it's parts. This is not unique to chiropractic, it is a philosophy of science issue that chiropractors don't claim to know the answers to, but as those who study this understand, reductionism has not been able to answer all the questions of how life interacts to create health. Be aware, though (and Gleng make sure I've got this right), that Emergent behavior appears to be the keyword now, and thanks to new breakthroughs in Computational Biology, it looks like scientists may be making headway here. If nothing else, I hope that we as wikipedians realize that taking sides with any of these approaches will do a disservice to all of us. To pretend that we know any of it would be erroneous. At this point, while each side (straight, reform, medicine) may have an opinion, that is all that it is. Changing behavior based on opinion would be a political choice, not one based on science, antiscience, antiintellectualism, or pseudoscience. -- Dēmatt (chat) 00:01, 26 July 2008 (UTC)
That's right. Complex systems can display behaviour that is not predictable from the behaviour of lower level parts; this is emergent behaviour. Many higher level concepts (e.g. intelligence, cognition, motivational states - hunger, fear etc) are thought to be emergent properties of complex systems. Such concepts are essentially "vitalistic" but without the mystical mumbo jumbo. Gleng (talk) 12:08, 26 July 2008 (UTC)
Sources indicate antiscience and it is not necessary to apply attribute. The bulleted text at the top of this section should not be ignored again. If this continues it may have to go to ANI. QuackGuru 02:11, 25 July 2008 (UTC)
Straight chiropractors themselves probably do say they're "scientific", even today, but reliable mainstream chiropractic and science sources say the straights use antiscientific reasoning. We should not let a fringe within chiropractic dictate our summary of what the mainstream says. The use of terms like "antiscientific", "pseudoscientific", and "antiintellectual" is not isolated to a single chiropractic publication; it's in common use in many reliable sources, and we have found no reliable source that disagrees with these descriptions. I have taken the liberty of adding some more reliable sources here, since there seems to be some confusion on this subject: because the older version of Chirorpactic cited only Keating, many people seemed to think that only Keating holds the opinion in question, which is obviously not the case. Eubulides (talk) 18:06, 25 July 2008 (UTC)
[1][24][73][74] This is highly referenced. QuackGuru 17:04, 25 July 2008 (UTC)

Keating also says

"Chiropractors have long abided by the principle of restoring health through restoring life balance. In the US, 50% of all deaths are due to poor lifestyle choices. Health problems due to poor lifestyle produce the most chronic, debilitating, and medically untreatable diseases of our day. The 21st century chiropractor will be vigilant for the manifestations of a stressful and often unhealthy lifestyle. The chiropractor of the future will address subluxations beyond the spine – to nutrition, sleep, stress, family, and community. Recognizing that alcohol and drug abuse, depression, and suicide may be symptoms of deeper “diseases of meaning,” chiropractors may play a greater role in community health, health education and disease prevention. By encouraging healthy behaviors, the 21st century chiropractor could play a role in decreasing over-reliance on expensive and risky technological medicine."(Chiropractic History: A Primer)

This is the paradigm that reform chiropractic (of which Keating, Triano, Perle, -and the 11 other chiropractors mentioned above) is suggesting for the future of chiropractic. As you can see, it is not much different from the straight "vision". This needs to be incorporated into the article at some point. -- Dēmatt (chat) 23:00, 25 July 2008 (UTC)

  • Just to clarify, this is not just Keating on the author list, and I suspect by looking at the style that one of his coauthors actually composed most of those words, although Keating as a coauthor obviously stood by them.
  • I agree that Chiropractic should do a much better choice of discussing lifestyle, nutrition, etc. This subject has come up several times on the talk page. The logical place to improve the discussion is Chiropractic #Treatment procedures, which currently only briefly alludes to these topics in the table.
Eubulides (talk) 23:48, 25 July 2008 (UTC)

Antiscientific three times

Do we realize that we state Keating's opinion about "antiscientific reasoning" three-times in this article?! Talk about a WP:WEIGHT violation. We should attribute and mention it maybe once and then be done with it. -- Levine2112 discuss 17:22, 25 July 2008 (UTC)

It is an important point and is well worth summarizing in the lead, as well as in the body. The two places where it is mentioned in the body are both important: one is with respect to the evidence basis (or scientific research). The other is in discussing the history of chiropractic and why serious research did not begin until the 1970s and was hampered by antiscientific and pseudoscientific attitudes. Eubulides (talk) 18:06, 25 July 2008 (UTC)
[13] Is this one of the sources to verify the antiscience text? See ref 74. We should not attribute source after source. I see no reason for that. QuackGuru 17:27, 25 July 2008 (UTC)
Those sources source Keating's opinion in that regard. It's actually page 64 (not 74) of Principles and Practice of Chiropractic where the word "antiscience" appears in a chapter of the book written by Keating and it is merely in a footnote reference back to the source of Keating's opinion already cited here. -- Levine2112 discuss 17:29, 25 July 2008 (UTC)
Where the word "antiscience" appears is merely in a footnote reference back to the source of Keating. That's WP:V.
No reason has been given to attribute every source. Do you have any references that differ from the current sources. QuackGuru 17:40, 25 July 2008 (UTC)
But it is still Keating's opinion. He is merely citing himself in a chapter of a book which he wrote. He doesn't even support the claim we are stating in this article. It is just a reference which happens to have the word "antiscience" in it. That's all. Several references have been supplies which differ from Keating opinion. And at the very least, we should not be restating Keating's opinion three times in our article! -- Levine2112 discuss 17:46, 25 July 2008 (UTC)
There seems to be some confusion here. The citation in Chiropractic #Evidence basis to Principles and Practice of Chiropractic is not to Keating. It is to Phillips, which is a different chapter. This is not the case of Keating merely citing himself. Eubulides (talk) 18:06, 25 July 2008 (UTC)

The bullet points still haven't been addressed by the above comments. I took the initiative to start working on the most urgent bullet point, namely that the current edit mischaracterizes "antiscientific" by implying that only Keating makes this claim. I did this by adding three citations to other mainstream sources that make similar claims on this topic. These sources are Nelson, Lawrence, Triano, Bronfort, Perle, Metz, Hegetschweiler & LaBrot 2005 (PMID 16000175), Keating, Charlton, Grod, Perle, Sikorski & Winterstein (PMID 16092955), and Phillips 2005 (in Principles and Practice of Chiropractic, 3rd ed.). The first two of these sources are peer-reviewed; the last one is a chapter in the leading current textbook on chiropractic. I hope this lays to rest any concerns that editors have that the opinion in question is merely that of the leading chiropractic historian of the last 15 years.

This doesn't fix that bullet point, though, as the text still says this:

'the other end employs what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims"'

This text no longer accurately summarizes what the cited sources say, since the cited sources now include 15 mainstream chiropractic researchers who agree on this topic. It's no longer appropriate to use Keating's name (unless we also use 14 other names, which is unrealistically awkward). Nor is it appropriate to use quote marks, since the various sources uses different words (e.g., "antiintellectual", "pseudoscientific") to make similar points. So I suggest that we replace the text with this:

'the other end employs what chiropractic researchers call antiintellectual, antiscientific or pseudoscientific reasoning'

Eubulides (talk) 18:06, 25 July 2008 (UTC)

In response to Eubulides' points: (Edit conflict. This was in response to the bulleted points at the top of the "Inserting "Keating says"" section, and to a comment by QuackGuru. I had originally intended to say here but forgot: Thank you, Eubulides, for clearly organizing and restating your points, and I'm sorry if I hadn't read the previous discussion thoroughly enough.) (13:20, 26 July 2008 (UTC))
  • If "is a CAM profession" is pejorative, then it violates WP:NPOV, which states "The tone of Wikipedia articles should be impartial, neither endorsing nor rejecting a particular point of view." The existence of one part of the article which violates NPOV is not an excuse for another article to also violate NPOV in order to match it.
  • "multiple reliable sources, not just Keating": Others have stated in the discussion above that all of the other sources are either citing Keating, or are not talking about chiropractic.
  • Balance: if there are any statements from another viewpoint which are also mere opinions, are also ultimately traceable to one relevant reliable source, and are stated in the article as if they are fact, then please point them out; probably they need to have prose attributions attached, too. Or, undue weight could be addressed in some other way. Again, the existence of some NPOV violations doesn't justify other NPOV violations.
  • Re "antiscientific" not being controversial: as I pointed out earlier, it's fallacious reasoning to assert that we must take something as universally agreed merely because no one has negated it using precisely that word. (see my comment re purple aliens.)
  • Re "Simon says": I think it would be good to go through the article and make sure all opinions have prose attributions attached. Only uncontroversial, verifiable facts should be stated as if they are facts.
QuackGuru said, "Sources indicate antiscience and it is not necessary to apply attribute." Actually, those sources are expressing an opinion, not a fact. The word "antiscience" is a pejorative label with more than one possible meaning; applying it to a group is not asserting a fact. If we find out what Keating meant, perhaps a verifiable statement in other words could be based on it and asserted as fact, if it really is verifiable as fact from reliable sources. If it's a fact, it's something about the real world which can be expressed in different words so as to avoid a non-NPOV pejorative tone.\
I agree with Levine2112's edit which re-instated the prose attribution of "antiscientific" to Keating and caught two more uses of this word. Please don't repeatedly delete this prose attribution which is supported by many editors of this page and required by the NPOV policy. I agree with Levine2112 that per WP:UNDUE, the use of this word should be reduced to once in the article. Coppertwig (talk) 18:19, 25 July 2008 (UTC)
  • In some circles "is a chiropractor" "chiropractic" is pejorative: does this mean that Chiropractor Chiropractic must quote every use of the term "chiropractic", and attribute the quote in the text? Surely not.
  • I don't recall the claim "all of the other sources are either citing Keating, or are not talking about chiropractic". In any event, the claim is incorrect. The Phillips source (which Levine2112 deleted without discussion!) is about chiropractic, and does not cite Keating. Here's the citation: [13]
  • So this opinion is not "ultimately traceable to one relevant reliable source", and it should not be treated specially in Chiropractic.
  • Furthermore, it is misleading for the text to imply that only Keating holds this opinion, or that the opinion is controversial among reliable sources. It is not controversial among reliable sources. Many sources agree with it. Despite considerable search, zero reliable sources have been found that disagree with it.
  • I don't understand the significance of the "purple aliens" remark. No reliable sources have been been proffered that dispute the claim of antiscientific reasoning using any terminology. If you look for "pseudoscience" or "antiintellectual" or any roughly-equivalent term, reliable sources all use words like these to describe the sort of ideas or thinking used in straight chiropractic. No reliable sources disagree on this point.
  • This antiscientific reasoning is a significant problem in chiropractic. It is a primary reason that chiropractic has not been accepted within mainstream medicine. Downplaying this significant problem is an important WP:WEIGHT problem of its own.
Eubulides (talk) 19:36, 25 July 2008 (UTC)
and here we're getting to the root of the issue; antiscientific is not being used for any philosophical or objectively coherent meaning, but as a surrogate for "pseudoscientific" that somehow sounds more serious, somehow worse that unscientific and much worse than mistaken. Antiscience or antiscientific is virtually absent from the entire PubMed literature base, and pseudoscience and pseudoscientific are rare, in both cases almost vanishingly rare in connection with chiropractic. This is not a sign of endorsement of chiropractic, it is a sign of objective treatment of controversial issues avoiding offensive terms that have no coherent meaning. If something is wrong, it's enough to say its wrong, and if chiropractic's theories are not accepted more widely maybe its because they are unconvincing or unneccessary. Hyperbole or rhetoric makes the objectivity of the case look suspect. Avoidable pejoratives simply antagonise the neutral reader. Gleng (talk) 20:30, 25 July 2008 (UTC)
These terms are used in the standard primer on chiropractic history, and in the most-popular textbook on chiropractic. They are used by chiropractic researchers, not by mainstream medical researchers (which may help to explain why they're so rarely mentioned in Pubmed), but that doesn't mean that they are not notable terms within the context of Chiropractic. Again, zero reliable sources disagree with the point that antiintellectural/antiscientific/pseudoscientific/whatever-you-want-to-call-it is a significant and continuing problem within chiropractic. It would be a violation of WP:WEIGHT not to mention this significant problem.
Well that explains why a joint search for chiropractic and antiscience produses no hits at all, though PubMed carries some chiropractic journals. But I'm not sure here of the logic - mainstream medicine and science doesn't use it, but one end of the chiropractic continuuum does occasionally uses it about the other, so it would be right to use it here?Gleng (talk) 21:21, 25 July 2008 (UTC)
"in some circles "is a chiropractor" is pejorative: does this mean that Chiropractor must quote every use of the term "chiropractic", and attribute the quote in the text? Surely not." Whether or not someone is a chiropractor is a fact, not an opinion. This fact can be verified by determining if the person has a license to practice chiropractic. DigitalC (talk) 23:30, 25 July 2008 (UTC)
Ouch, my comment was not coherent; it mixed "chiropractic" and "chiropractor". I have corrected it. Sorry about the confusion. The point about "chiropractic" being pejorative to some people remains. In controversial areas, lots of words can become pejoratives, I'm afraid. Eubulides (talk) 23:48, 25 July 2008 (UTC)
I'm sorry, I don't see how "chiropractic" can be used in a perjorative sense. DigitalC (talk) 22:53, 27 July 2008 (UTC)

Education etc

Since UK chiropractors are mentioned in this section, may be appropriate to cite The GCC[27], the statutory body analagous to the General Medical Council in the UK.Gleng (talk) 14:52, 26 July 2008 (UTC)

I put it in, make sure I got it right! -- Dēmatt (chat) 04:52, 27 July 2008 (UTC)

References

  1. ^ a b c d e Keating JC Jr (2005). "Philosophy in chiropractic". In Haldeman S, Dagenais S, Budgell B et al. (eds.) (ed.). Principles and Practice of Chiropractic (3rd ed. ed.). McGraw-Hill. pp. 77–98. ISBN 0-07-137534-1. {{cite book}}: |edition= has extra text (help); |editor= has generic name (help)CS1 maint: multiple names: editors list (link)
  2. ^ Gay RE, Nelson CF (2003). "Chiropractic philosophy". In Wainapel SF, Fast A (eds.) (ed.). Alternative Medicine and Rehabilitation: a Guide for Practitioners. New York: Demos Medical Publishing. ISBN 1-888799-66-8. {{cite book}}: |editor= has generic name (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)
  3. ^ a b American Chiropractic Association. "History of chiropractic care". Retrieved 2008-02-21.
  4. ^ a b c Mootz RD, Phillips RB (1997). "Chiropractic belief systems". In Cherkin DC, Mootz RD (eds.) (ed.). Chiropractic in the United States: Training, Practice, and Research. AHCPR Pub No. 98-N002. Rockville, MD: Agency for Health Care Policy and Research. pp. 9–16. OCLC 39856366. {{cite book}}: |access-date= requires |url= (help); |editor= has generic name (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)
  5. ^ Villanueva-Russell Y (2005). "Evidence-based medicine and its implications for the profession of chiropractic". Soc Sci Med. 60 (3): 545–61. doi:10.1016/j.socscimed.2004.05.017. PMID 15550303.
  6. ^ a b c d e Keating JC Jr (1997). "Chiropractic: science and antiscience and pseudoscience side by side". Skept Inq. 21 (4): 37–43. Retrieved 2008-05-10.
  7. ^ a b c Suter E, Vanderheyden LC, Trojan LS, Verhoef MJ, Armitage GD (2007). "How important is research-based practice to chiropractors and massage therapists?". J Manipulative Physiol Ther. 30 (2): 109–15. doi:10.1016/j.jmpt.2006.12.013. PMID 17320731.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  8. ^ Feise RJ, Grod JP, Taylor-Vaisey A (2006). "Effectiveness of an evidence-based chiropractic continuing education workshop on participant knowledge of evidence-based health care". Chiropr Osteopat. 14: 18. doi:10.1186/1746-1340-14-18. PMID 16930482.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link)
  9. ^ a b c d Nelson CF, Lawrence DJ, Triano JJ; et al. (2005). "Chiropractic as spine care: a model for the profession". Chiropr Osteopat. 13: 9. doi:10.1186/1746-1340-13-9. PMID 16000175. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link)
  10. ^ Feise RJ, Grod JP, Taylor-Vaisey A (2006). "Effectiveness of an evidence-based chiropractic continuing education workshop on participant knowledge of evidence-based health care". Chiropr Osteopat. 14: 18. doi:10.1186/1746-1340-14-18. PMID 16930482.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link)
  11. ^ Cite error: The named reference Kaptchuk-Eisenberg was invoked but never defined (see the help page).
  12. ^ [1] Meridel I Gatterman. The Journal of Alternative and Complementary Medicine. December 1, 1995, 1(4): 371-386. doi:10.1089/acm.1995.1.371.
  13. ^ a b Phillips RB (2005). "The evolution of vitalism and materialism and its impact on philosophy". In Haldeman S, Dagenais S, Budgell B et al. (eds.) (ed.). Principles and Practice of Chiropractic (3rd ed. ed.). McGraw-Hill. pp. 65–76. ISBN 0-07-137534-1. {{cite book}}: |edition= has extra text (help); |editor= has generic name (help)CS1 maint: multiple names: editors list (link)

Antiscience and ahistorical syntheses

From the outset I objected that "antiscientific" was a pejorative masquerading as objective; that it had rhetorical force, that it expressed distaste, but was an opinion and because its nature might be confused should be flagged as that. It is a catch-all descriptor of diverse groups antagonistic to science, lacking a coherent operational definition. Eubolides countered by saying that antiscience had a philosophical pedigree, and its origins in the 18th century attack on scientific materialism by Thomas Hobbes captured the essence of the vitalistic theories held by straight chiropractors. This is a comprehensive misunderstanding. Thomas Hobbes was vehemently opposed to vitalism, and was an arch reductionist; his views read as almost a manifesto of modern scientific method "Everything is best understood by its constitutive causes. For, as in a watch or some such small engine, the matter, figure and motion of the wheels cannot be well known except it be taken asunder and viewed in parts." Hobbes was attacking the materialism of the empiricists, who believed that understanding could be gained by speculative theory and experiment; he argued for close observation and rigorous reason. "Antiscientific" as used by Keating is not congruent with this position. It may be possible to trace some connection; indeed it may be possible to change "husband" to "cuckold" in ten moves, but not I think without cheating.

What is left is evidence of misunderstanding of what "antiscientific" might mean, and evidence that the opinions it gives voice to are confusable with fact. Now is its use controversial? Must we annotate every opinion? Well chiropractic as a CAM is not controversial as it is a view held by chiropractors themselves. If straight chiropractors describe their position as antiscientific then I will happily accept it is not controversial, but I don't think that they do. Perhaps they are so small a minority that they can be disregarded, the 3% of Reed Phillips: but if this is true then are their views worthy even of mention?

Thus it seems that the philosophical attribution of a meaning to antiscientific is unfounded here; what remains is its opinionated nature, that expression of perhaps merited distaste. Let it be said, but let it not be confusable with fact; in kind it is no different from other pejorative expressions, and that it is used by a few authors repeatedly does not make it more objective. Hitler is almost universally regarded as evil, but it is still a subjective judgement. Hitler wisely refrains from using it or any equivalent judgemental statement.Gleng (talk) 09:43, 24 July 2008 (UTC)

WP:TL;DR and Godwin's law. Rewordings or attribution could probably help in this case. Do you have a proposed rewording to correct what you see as the PoV nature of current references to "antiscience" in the article? Jefffire (talk) 10:21, 24 July 2008 (UTC)

Coppertwig's suggestion above was to rephrase the disputed text as "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims"[17]". Seemed fine to me.Gleng (talk) 10:51, 24 July 2008 (UTC)

Sound as a pound to my eyes. Jefffire (talk) 10:55, 24 July 2008 (UTC)
Sorry, I had to look that up! Apparently "Sound as a pound" indicates agreement. I haven't been paying attention to exchange rates, so I have no idea whether the pound is sounder than other currencies at the moment. ☺ Coppertwig (talk) 14:16, 24 July 2008 (UTC)
Thanks. OK, I put in the wording attributing "antiscientific" to Keating. I count four editors supporting this edit (Jefffire, Gleng, Coppertwig and Dematt) versus two opposing (Eubulides and QuackGuru). Also, I don't see positive reasons given for opposing the edit: only that it's "unnecessary". (Unless, as I said, there are other sources specifically mentioning chiropractic, in which case the attribution can be modified.) Eubulides may not see a distinction between attributing "antiscientific" and attributing statements like "is a complementary and alternative medicine health care profession". but don't worry: I do see a distinction, so the article won't turn into a pincushion of prose-attributions. As Gleng pointed out, chiropractors themselves consider themselves to be in "complementary and alternative medicine"; but (18:19, 25 July 2008 (UTC)) I think it would be difficult to find chiropractors referring to themselves as "antiscientific". ☺ Coppertwig (talk) 14:30, 24 July 2008 (UTC)
The only objection I have heard to CAM is that it is an oxymoron. How can something be complementary (used with) as well as alternative (used instead of) - its like new & improved. I see no problem with attribution here, and perhaps we will need to attribute more in the article (Eubulides suggested we would need to attribute DeVocht). However, I disagree that statements of fact need to be attributed. - DigitalC (talk) 23:59, 24 July 2008 (UTC)
Perhaps you missed the discussion in #Inserting "Keating says" on this subject? Coppertwig (who cited Gleng, but I don't see Gleng making this claim) was incorrect to claim that "chiropractors themselves consider themselves to be in 'complementary and alternative medicine'". Redwood et al. 2008 (PMID 18435599) says that by a wide margin, chiropractors themselves reject the claim that they are CAM practitioners. Eubulides (talk) 18:06, 25 July 2008 (UTC)
An interesting point Eubulides. If the majority of Chiropractors consider Chiropractic to be a part of integrated medicine, why isn't THAT in the article? DigitalC (talk) 23:43, 28 July 2008 (UTC)
No, the study said only 27% of surveyed chiropractors considered chiropractic to be part of integrated medicine. Eubulides (talk) 00:15, 29 July 2008 (UTC)

Evidence basis rewrite

The practice of evidence based medicine involves integrating the doctor's clinical judgement, based on his experience and expertise, with the best available external clinical evidence. Such evidence includes evidence from randomized trials and meta-analyses, and evidence from more specific studies relevant to particular cases.[1] Chiropractors have access to several databases of information to foster good patient care practice[2] including DCConsult and the Index of Chiropractic Literature. Chiropractors also use consensus guidelines developed by experts in the field.

Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors while the other end tends to use consensus guidelines that rely on postulates that are not part of mainstream science and medicine, and which, according to critics within the chiropractic profession, reveal dogmatic attitudes and uncritical thinking.[3]

EBM alternative

"The practice of evidence based medicine involves integrating the doctor's clinical judgement, based on his experience and expertise, with the best available external clinical evidence. Such evidence includes evidence from randomized trials and meta-analyses, and evidence from more specific studies relevant to particular cases.[1] Chiropractors have access to several databases of information to foster good patient care practice[2] including DCConsult and the Index of Chiropractic Literature. Chiropractors also use consensus guidelines developed by experts in the field."Gleng (talk) 12:12, 27 July 2008 (UTC)

Excellent, I used that! I think we can use this as the intro for this section and now start building on what we want next. What do we want next? -- Dēmatt (chat) 14:30, 27 July 2008 (UTC)
  • This new discussion of evidence-based medicine is misleading. It promotes the notion that evidence-based medicine is individual chiropractors using whatever clinical trial results they want to, in order to justify their own preconceptions about the best treatment. That is not what EBM is about.
  • This new discussion is derived from a source that is quoted in Evidence-based medicine #Criticism of evidence-based medicine, a source that is covering only one part of EBM. The discussion does not adequately cover the point that EBM, although obviously not the last word in every medical decision, "seeks to clarify those parts of medical practice that are in principle subject to scientific methods and to apply these methods to ensure the best prediction of outcomes in medical treatment" (quoting Evidence-based medicine lead).
  • This article does not need a lengthy summary of evidence-based medicine that (in effect) argues against applying evidence-based guidelines. We can just use the phrase in context, wikilink to Evidence-based medicine, and be done with it. Which is what Chiropractic already does.
Eubulides (talk) 16:32, 27 July 2008 (UTC)

Evidence basis rewrite comments

I have started by taking some of the sentences that concerned evidence based guidelines from different subsections of Chiropractic#Evidence basis and brought them into the initial paragraph where they help to explain the reasons that physicians are concerned about the abuse of evidence based guidelines. I believe it is NPOV and accurate. I have not thoroughly checked the references yet. -- Dēmatt (chat) 02:00, 25 July 2008 (UTC)

Suggestion: drop "anyway" from "validity of these guidelines anyway." and instead use "validity of these practice guidelines." -- Fyslee / talk 05:03, 25 July 2008 (UTC)
Done. -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)
Overall, this version seems extremely solid. Nice work! -- Levine2112 discuss 17:12, 25 July 2008 (UTC)
Thanks! Still more work to do though! -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)
This version has problems. For example, the part that says Those that are opposed are concerned is not NPOV. The current version without attribution is best. QuackGuru 17:17, 25 July 2008 (UTC)
Please describe why you feel that sentence is not NPOV? Please refer to the source when possible. -- Levine2112 discuss 17:43, 25 July 2008 (UTC)
Yep, hard to fix something that doesn't look broken. Any suggestions? -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)
I suggest that you can just say "some are concerned..." it may also be a concern amogst supporters of EBM that the research base is not always specifically about chiropractic. But generally think you've done a good job. I think it is helpful to start by explaining what EBM is as it is so often misunderstoodGleng (talk) 11:11, 26 July 2008 (UTC)
  • If the idea is to take text away from some other section and put it here, then we also need to see what the other section will look after the text is removed from there. Can you please show the entire proposed change, rather than just this part of it? (I did take the opportunity of migrating the recent change to Chiropractic into this part of the proposal]].)
No preconceived intentions other than to follow the sources and fix synthesis problems so that we can remove the tag. So far just some re-arranging. Not sure I see where you've migrated anything? -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)
  • I haven't migrated the text in question. As I understand it, this draft proposes migrating text (like "Many controlled clinical studies of SM are available, but their results disagree") from other paragraphs into the first paragraph of Chiropractic #Evidence basis. If so, then we need to see what the other changed paragraphs will look like as well, in order to see what the entire proposal is. Eubulides (talk) 02:40, 26 July 2008 (UTC)
  • The new phrase "Those that are opposed are concerned that" is not supported by a reliable source. QuackGuru also objected to this phrase on NPOV grounds, but the lack of a source is even more worrisome to me.
You really think it needs one? -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)
Yes; that phrase is a claim that the chiropractors who employ antiscientific reasoning etc. are are concerned that research has focused on SM in general. But we don't have a reliable source saying that. And in fact, I expect that the actual concern is also shared by many chiropractors who stick to scientific reasoning, so I am concerned that the phrase may in fact be misleading. Finding and citing reliable sources on this topic will help to dispel this concern. Eubulides (talk) 02:40, 26 July 2008 (UTC)
There is a continuum; I assume that includes those that object for reasons that are not antiscientific. But I did make some changes try and clarify this. -- Dēmatt (chat) 05:30, 26 July 2008 (UTC)
  • The "These" in the new phrase "These chiropractors" is not supported by a reliable source.
You really think it needs one?-- Dēmatt (chat) 01:54, 26 July 2008 (UTC)
Yes, for the same reason as before. We don't have a reliable source equating the set of chiropractors who employ antiscientific reasoning etc. with the chiropractors who voice concerns about stealing SM procedures, and in fact I am concerned that these sets of chiropractors are substantially different. Eubulides (talk) 02:40, 26 July 2008 (UTC)
  • The phrase "and they are typically of low quality" (referring to clinical studies on SM), which was present in the source, is absent here. It seems important; why omit it?
It seemed POV and unnecessary as everyone knows that clinical studies are not as good quality as RCTs. I think that is the point that was made by the source as well. -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)
I doubt that the typical Wikipedia reader will know this. For one thing, the text doesn't even say that the studies are typically clinical studies rather than RCTs. The low quality of studies is an important point, and should be summarized in this section, rather than expecting the reader to follow the citation in order to see the point. Perhaps you meant to leave the low-quality sentence in the source paragraph? This is why we need to see the edited source paragraphs as well as the edited destination paragraph. Eubulides (talk) 02:40, 26 July 2008 (UTC)
Just a query. If the source criticises the low technical quality of the clinical trials then I'd support Eubolides here, if the source is referring to low quality in the EBM context (i.e. possibly well conducted but of low weight as far as systematic assessment is concerned because of small numbers/single centre etc) then a different wording might be better. Gleng (talk) 11:11, 26 July 2008 (UTC)
  • The phrase "leaving questions about the validity of these guidelines anyway" which Coppertwig spotted as a grammar problem, is not supported by the source. The source talks only about guidelines for low back pain, not about guidelines for chiropractic care in general.
Good point. It doesn't belong in the effectiveness for low back pain section either then. -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)
Sure it does. It's about low back pain. Eubulides (talk) 02:40, 26 July 2008 (UTC)
  • As mentioned above, I suggest replacing this:
the other end employs what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims".[4][5][3][6]
with this:
the other end employs what chiropractic researchers call antiintellectual, antiscientific or pseudoscientific reasoning,[4][5][3][6] stratagems that are ethically suspect when they let practitioners maintain their beliefs to patients' detriment.[4]
Eubulides (talk) 18:06, 25 July 2008 (UTC)
Still an ongoing discussion on that one. See below. -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)
I certainly agree that its right to mention ethical issues somewhere. All professions have theirs - academic medicine with conflict of interest, medical practice with overprescribing, science with fraud etc.; I'd have thought that the major ethical concern with chiropractic has been over advertising. Obviously it must be a concern if patients are deflected from effective care, but is there evidence of much actual harm arising from straight chiropractic, or is this mainly fear that it might? Gleng (talk) 22:43, 25 July 2008 (UTC)
I don't know of any scientific evidence about actual harm arising from chiropractic (either straight or mixer) due to deflection. Certainly there is anecdotal evidence of deflection, as well as a few (quite rare) documented cases of harm due to treatment, but that is not scientific evidence. Eubulides (talk) 23:48, 25 July 2008 (UTC)
I agree that we should mention ethical issues NPOV. Of course, these get complicated too ;-) Do appreciate all the help we can get! -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

I see that further edits have been made but it seems to be a work-in-progress; some lengthy quotes about EBM have been added, which aren't that relevant here, and there's still material (e.g., "'steal' SM procedures) taken from other paragraphs but it's not clear how the other paragraphs will be altered. So I'll hold off further comments for now. Eubulides (talk) 08:31, 26 July 2008 (UTC)

Yes, still a work in progress and I simply had to get some sleep :-) Re: EBM stuff added; I am waiting to see how the SM decision works out. After Coppertwig seemed to think that we can use good information even if it is not specific to one article, I think it is perfectly reasonable to explain EBHC so that the reader can understand the various POVs concerning it. BTW, I just quoted straight from Sackett for now, but will paraphrase soon (though I think Coppertwig and Gleng are good at this, too). Notice that Sackett explains that EBM is not restricted to RCTs. I was considering that we can include other types of research that help a doctor evaluate patients. Ie., in the absense of RCTs, we might be able to find sources that make some EBM choices based on the latest expert consensus type guidelines. Of course, we would have to explain that as well. -- Dēmatt (chat) 15:28, 26 July 2008 (UTC)
I've rewritten my rewrite in a totally different direction. It seemed that the information that I had was going nowhere so I followed what I thought the reader would want to know. It's just a start again, and needs some balance, so feel free to give some advice. -- Dēmatt (chat) 04:07, 27 July 2008 (UTC)
Please see #EBM alternative above. Eubulides (talk) 16:32, 27 July 2008 (UTC)
Thanks Eubulides. I hear what you are saying. I added the second paragraph which adds our infamous sentence. I'll let us digest that one for awhile. Any input? -- Dēmatt (chat) 18:15, 27 July 2008 (UTC)

"the other end tends to use consensus guidelines that rely on postulates that are not part of mainstream science and medicine, and which, according to critics within the chiropractic profession, reveal dogmatic attitudes and uncritical thinking" As far as I can see the source doesn't say "the other end" (i.e., straights) uses "consensus guidelines". Also, this is watering down what the source says: it says that "the other end" uses antiscientific and pseudoscientific reasoning, a much stronger charge than mere dogmatic attitudes and uncritical thinking. Eubulides (talk) 15:00, 28 July 2008 (UTC)

Complementary and alternative

I take back the pincushion remark. Eubulides has stated that [28] "The very first claim in Chiropractic is an opinion, not a fact." I now realize that Eubulides is right about this. However, NPOV requires that Wikipedia articles not present opinions as if they are facts, so we need to change this. I suggest deleting "complementary and alternative" from the first sentence, making it "Chiropractic is a health care profession..." Later in the article, the phrase "complementary and alternative" can be used with appropriate prose attribution.
If the article becomes peppered with prose attributions, so be it. It must conform to the WP:NPOV policy, which states "Assert facts, including facts about opinions—but do not assert the opinions themselves." (emphasis in the original.) We can take as a model the Circumcision article, which has many prose attributions, largely due to the careful, precise work of Jakew who worked hard to ensure that the article conforms to NPOV. It's hard to find any statement in the Circumcision article about which anyone is likely to say "But that's not true!" This article needs to be elevated to that standard. ☺ Coppertwig (talk) 18:19, 25 July 2008 (UTC)

This sounds to be entirely reasonable. I would support such an edit. -- Levine2112 discuss 18:22, 25 July 2008 (UTC)
  • The Circumcision article is not a model of text attribution for every opinion. Let's take the very first claim in the body of Circumcision:
"For infant circumcision, clamps, such as the Gomco clamp, Plastibell, and Mogen are often used."
This is an opinion, not a fact, because the word "often" is a judgment call made by the cited source (Holman et al. 1995, PMID 7625325). Were the "Simon says" style actually used, this sentence would have to be worded like this:
"According to the physicians John R. Holman, Evelyn L. Lewis, and Robert L. Ringler, for infant circumcision, clamps, such as the Gomco clamp, Plastibell, and Mogen are often used."
(As it happens, this wording is also incorrect, because "often used" is not what the cited source actually says; but that is a problem for Circumcision, not for Chiropractic.)
  • This is just one example, the first thing I looked at in Circumcision; I'm sure there are many others.
  • What this illustrates, is that WP:NPOV does not require the proposed style, even in controversial articles such as Chiropractic or Circumcision. It is common and entirely appropriate to state and source mainstream opinions, where no reliable sources disagree with the opinions, without putting "Simon says" in front of each sentence.
  • For this reason, I disagree with adding "Simon says" to "complementary and alternative". It suffices to cite reliable sources on the topic; we shouldn't add "Simon says" all over the place.
Eubulides (talk) 19:36, 25 July 2008 (UTC)
One more point. The proposed replacement '"Chiropractic is a health care profession..."' also fails the proposed "Simon says" rule, since it is merely an opinion (not a fact) that chiropractic is health care. See, for example, Chiropractic and its Role in the Health-Care Profession, which says "I would suggest that chiropractic is not health care, but neither is it more than health care. It is something different altogether, so different that it defies description and comparison to health care." This source is not a reliable mainstream source (it is the FACE, a straight-chiropractic website), but if the rule is that we have to put "Simon says" in front of every opinion expressed in Chiropractic, then we cannot simply say "Chiropractic is a health care profession" in the lead. Eubulides (talk) 21:24, 25 July 2008 (UTC)

I think that you are over-reacting. I and others objected to expressing judgemental opinion in a way that seemed to allow those opinions to be understood as fact. We also objected because the word antiscientific has no consistent objective meaning, and didn't endorse its use in this way in a serious encyclopedia. You might say, with postmodernists, that all language is value laden and everything is opinion - that is indeed a philosophically anti-science position. That's not our position. Scientists don't generally see a real problem is distinguishing facts from interpretion, and interpretation from opinion. Who objected to the lead sentence? Is it a real objection, or was it just to make a point?

"Chiopratctic is a health care profession is a factual statement. It may be wrong, in which case put it right, but "health care profession" is an objective descriptor with an operational definition. "X is antiscientific reasoning" is a judgemental opinion, unless it is used in a contect where there is a relevant operational definition of "antiscientific reasoning". You pointed to Antiscience for this, which, as I detailed above, led to Hobbes ....[User:Gleng|Gleng]] (talk) 18:19, 26 July 2008 (UTC)

  • My comments have nothing to do with postmodernist theory; they use terms like "antiscientific", "pseudoscientfic", "antiintellectual", "health care", "profession", etc., in their usual senses, the sense used by chiropractic researchers. These researchers are published in peer-reviewed journals, which are more-serious sources than Wikipedia itself. No reliable sources are disagreeing with them, and it is not our place to second-guess reliable sources.
  • My objection to the lead sentence is a real objection. The lead sentence is directly contradicted by a reliable source that says that, by a landslide, chiropractors reject the CAM label. This is a far more serious problem than the "antiscientific" one. First, because it's the lead sentence. Second, because (unlike "antiscientific") we have reliable sources directly disagreeing with the opinion expressed in Chiropractic. Eubulides (talk) 15:00, 28 July 2008 (UTC)
  • This is not the only such opinion in the lead, or in Chiropractic. Chirorpactic #Philosophy, for example, is almost 100% opinion, from beginning to end. And yet the "Simon says" style is not used in that section, which is entirely supportive of chiropractic. It is a clear violation of NPOV to insist on the "Simon says" style for critical opinions, while using ordinary style for supportive opinions.
  • "Chiropractic is a health care profession" (which is not the lead sentence, but has been proposed as the lead) is clearly an opinion. Some people don't think chiropractic contributes to health care; others think that it is a way of life and is not health care. Some people don't think chiropractic is a profession. Their opinions, even if we disagree with them, are opinions that reasonable people can hold, just as the opinion that "chiropractic is a health care profession" is an opinion that reasonable people can hold. "Chiropractic is a health care profession" is just as much an opinion as "X is antiscientific reasoning" is, and if our style rules are such that we must use "Simon says" and quotation marks for the latter, then for consistency and fairness we must do something similar for the former.
Eubulides (talk) 15:00, 28 July 2008 (UTC)

Archiving

This talkpage has again ballooned to a size which limits participation: Over 220K (and some editors have browsers that cannot easily handle anything over 32K). I don't think we need to pare back to a 32K size, but getting back to under 100K would be good. There is an archive bot trying to manage this page, but it is being blocked because of the way that section headers are being used. In other words, it archives sections that start with level 2 headers (==title==). However, if there is a single message within any of the level 3 headers (===subtitle===) of that section that is recent, the bot assumes that the entire level 2 section is recent, and won't archive any of it.

To address this problem, I recommend more frequent use of level 2 headers, or perhaps "downgrading" a subsection when it appears that it has gone inactive. For example, if there is a section "==Stuff==", and there is a level 3 subsection within it, "===Painting===", and the subsection is no longer active, but other subsections within "Stuff" are active, then we could change the subsection's header to "==Stuff: Painting==", and then the bot would recognize and archive it. Or, at that point the subsection could simply be archived manually. Another option is to move lengthy subsection discussions off to a subpage. Whichever way it is handled, I recommend that something be done, otherwise this page is going to continue to grow to even more unmanageable levels. --Elonka 17:54, 24 July 2008 (UTC)

Would collapsing templates address this problem? I came across a talk page the other day (unfortunately I can't recall which one), which had sections that were collapsed. So, given that something in a level 3 subsection is quite related to the other subsections under that level 2 heading, we might not want them sent to the archive yet. However, if we could collapse the previous level 3 subsections until we are ready to archive the whole section, that might be an improvement? Another example would be the proposed History section. The proposed text could be collapsed, with the comments about it uncollapsed. - DigitalC (talk) 00:46, 25 July 2008 (UTC)
(page currently at 300K and growing). Collapsed sections help with the scroll, but unfortunately not with the download. The entire (uncollapsed) page is still downloaded by the browser, it's just displayed as though it's smaller than it actually is. My recommendation at this point is to do partial archives of "inactive" sections of certain large threads, and just link to the archives via a {{sidebar}}. --Elonka 04:08, 27 July 2008 (UTC)
(317K) Another reason that the page seems to grow so large, is the practice of incorporating large quantities of page content here. A better practice might be maintaining a "mirror" page, such as at Talk:Chiropractic/draft. Then discussions and consensus-building could proceed on that page, with constructive changes periodically moved over to the live article. --Elonka 03:54, 28 July 2008 (UTC)
(362K) Okay, unless anyone has another idea, I'm going to start with archiving, per above suggestions. --Elonka 21:45, 29 July 2008 (UTC)
Archiving seems like a good idea to me. -- Levine2112 discuss 21:47, 29 July 2008 (UTC)
The idea of archiving is fine, but it has to be done with care. Currently we have Wikipedia:No original research/noticeboard #Chiropractic section on evidence basis with several wikilinks into this talk page; I don't want those links to stop working, nor do I want them to point into a newly created archive, as the SYN discussion is still very much active. Eubulides (talk) 22:08, 29 July 2008 (UTC)
Good point, and if someone who is familiar with that situation wants to handle the archiving, that's fine. But the situation is currently at a critical level, as this page is over triple the "maximum" size, and is continuing to grow at a rapid rate. --Elonka 22:19, 29 July 2008 (UTC)

I archived the page with this edit to the talk page and this edit to the archive, but my edit to the talk page got reverted by Dematt. For now I have reverted the edit to the archive to avoid duplicate archiving in the future. I guess I'll retire from the archiving business for now (to be honest, my heart wasn't in it). Eubulides (talk) 01:56, 30 July 2008 (UTC)

It looks as though you tried to archive the very much active "History" section toward the top of this page. That conversation is still going so it would be inappropriate to archive it just yet. -- Levine2112 discuss 02:01, 30 July 2008 (UTC)
If you, Levine2112, think it is inappropriate to archive when a conversation is still going then wait for the discussion to finish.[29]
I think the archive is appropriate as along as links to the archives are given. Maybe an admin needs to do the archiving. This page is way too long. QuackGuru 02:12, 30 July 2008 (UTC)
Sorry for the confusion! I just did not want to lose that history again. The last time it wouldn't let me copy and paste from the archive and I didn't want to lose too many subsequent edits so I tried to act fast. The effect was lots of edit conflicts! Sorry. The next archive, please leave the history part, we can archives the comments though. -- Dēmatt (chat) 02:22, 30 July 2008 (UTC)

History

Main article: Chiropractic history

In the early 19th century, chemists and physicians alike shared a common vitalistic belief that, unlike inanimate objects, living objects had a substantial entity (or spirit) controlling their organic processes.[7] Homeopaths and Eclectics had become the majority health care practitioners. Drugs, medicines and patent medicines were becoming more prevalent and were mostly unregulated and laced with compounds such as mercury, alcohol and cocaine.[8] Somewhere around 1895, Davenport, Iowa magnetic healer Daniel David Palmer (D.D. Palmer) developed a theory that manual manipulation, especially of the spine, could cure disease. [9] Although initially keeping the theory a family secret, in 1898 at his new Palmer School of Chiropractic he began teaching it to a few students, one of whom, his son Bartlett Joshua (B.J.) Palmer, became committed to promoting chiropractic, took over the Palmer School in 1906, and rapidly expanded its enrollment.[10] By this time medicine had created the American Medical Association (AMA), absorbed the homeopaths and eclectics and organized into a major political force creating state laws that limited the practice of medicine, but the small chiropractic faction was not included.[8]

Prosecutions and incarcerations of chiropractors for practicing medicine without a license grew common. To defend against medical statutes B.J. argued that chiropractic was separate and distinct from medicine, asserting that chiropractors "analyzed" rather than "diagnosed", and "adjusted" subluxation rather than "treated" disease.[11] The Palmers continued to develop D.D.'s theory along vitalistic lines: all disease was caused by interruptions in the flow of innate intelligence, a vital nervous energy or life force that represented God's presence in man. Chiropractic leaders often invoked religious imagery and moral traditions. D.D. and B.J. both seriously considered declaring chiropractic a religion, which might have provided legal protection under the U.S. constitution, but decided against it partly to avoid confusion with Christian Science.[10][12] Early chiropractors also tapped into the Populist movement, emphasizing craft, hard work, competition, and advertisement, aligning themselves with the common man against intellectuals and trusts, among which they included the American Medical Association (AMA).[10]

D.D. and B.J. defined chiropractic as "practice by hand" or "straight" and did not use instruments or "mix" chiropractic with other remedies or cures. Chiropractors that did were coined "mixers". Tension soon developed between the two groups as mixers continued to develop new methods and open new schools to teach their proprietory techniques.[13] In 1910 B.J. changed course and endorsed X-rays as necessary for diagnosis; this resulted in a significant exodus from the Palmer School of the more conservative faculty and students. The mixer camp grew until by 1924 B.J. estimated that only 3,000 of the U.S.'s 25,000 chiropractors remained straight. That year, B.J.'s promotion of the neurocalometer, a new temperature-sensing device, was another sign of chiropractic's gradual acceptance of medical technology, although it was highly controversial among B.J.'s fellow straights[10] and ultimately sealed the fragmentation of chiropractic with the development of two professional associations; the mixer American Chiropractic Association(ACA) and straight International Chiropractors Association(ICA).

Despite heavy opposition by organized medicine, by the 1930s chiropractic was the largest alternative healing profession in the U.S.[10] The longstanding feud between chiropractors and medical doctors continued for decades. The AMA labeled chiropractic "an unscientific cult" and held that it was unethical for medical doctors to associate with an "unscientific practitioner".[14] This culminated in a landmark 1987 anti-trust lawsuit, Wilk v. AMA, in which the court found that the the AMA had engaged in unreasonable restraint of trade and conspiracy, and which ended the AMA's de facto boycott of chiropractic.[15]

Serious research to test chiropractic theories did not begin until the 1970s. By the mid 1990s there was a growing scholarly interest in chiropractic, which helped efforts to improve service quality and establish clinical guidelines that recommended manual therapies for acute low back pain.[11] In recent decades chiropractic gained legitimacy and greater acceptance by physicians and health plans, and enjoyed a strong political base and sustained demand for services; like other forms of complementary and alternative medicine, chiropractic became more integrated into mainstream medicine.[15]


History comments

Relevant discussion at→ Talk:Chiropractic/Archive 25#History

(outdent) I see that further changes have been made to this draft. However, it still has real problems with balanced coverage. Far too much time is spent on topics that are not important for chiropractic (cocaine, for example). And material highly relevant to recent history is still absent (recent competition from other health care professions). Although early chiropractic history is obviously important, the history since 1930 should consume at least a third, and preferably closer to a half of the space. Also, the total length of this section should be cut down so that it's no longer than what's in Chiropractic #History now (which is already too long). Eubulides (talk) 18:06, 25 July 2008 (UTC)

Chiropractic was born and grew as a result of it's non-drug, non-surgery perspective. Are you thinking that cocaine was not used then? I had heroin (from the Still source), but our new source says cocaine. If we aren't specific, people will think we are talking about things like penicillin or antibiotics which of course were not around at the time. Everyone knows that cocaine is not used like it was then. As far as recent competition from other health care professions; is this different? Are you thinking that there was not competition before? Are you aware that chiropractors employ massage therapists? The source that you had was about the present, not the past? How is that history? Those are just a few of the thoughts that went through my head when I read it. I do think that they are appropriate in some section, but not history. -- Dēmatt (chat) 19:11, 27 July 2008 (UTC)
  • Sure, cocaine was used back then. It was even part of Coca-Cola. But cocaine is not important enough to mention in a brief summary of chiropractic history. There is no need to mention specific surgical or pharmaceutical techniques used by non-chiropractors back then. This is supposed to be a very brief history of chiropractic, not a long-winded treatment of chiropractic's competition.
  • Yes, there has always been competition. But the changes in the past few decades are highly relevant to Chiropractic #History. Certainly the "branching out" of chiropractic into alt-med, natural products is quite relevant. This stuff is sourced to a paper on issues and trends, and the trends compare chiropractic of a few decades back to chiropractic today; this is clearly part of recent history. This stuff is far more important for chiropractic history than mercury in circa-1890s non-chiropractic pharmaceuticals.
Eubulides (talk) 15:00, 28 July 2008 (UTC)

History comments again

This draft is still way too long, and still focuses too much on early history and not enough on more recent history. Some more-detailed comments follow. Eubulides (talk) 15:00, 28 July 2008 (UTC)

There is still waaay too much about the history of chemistry and medicine before chiropractic. It's all vaguely relevant, but it's not nearly important enough to be worth mentioning at this level. There is no need to go back to the early 19th century, or to repeat a discussion and explanation of vitalism (which is already discussed in Chiropractic #Philosophy), or to mention homeopaths or eclectics, or to mention patent medicines, or to mention mercury, alcohol, and cocaine. This stuff should be in History of chiropractic, perhaps. The following text should be trimmed down to one brief sentence or phrase, which talks about vitalism in a historical context: "In the early 19th century, chemists and physicians alike shared a common vitalistic belief that, unlike inanimate objects, living objects had a substantial entity (or spirit) controlling their organic processes.[7] Homeopaths and Eclectics had become the majority health care practitioners. Drugs, medicines and patent medicines were becoming more prevalent and were mostly unregulated and laced with compounds such as mercury, alcohol and cocaine.[8]" Eubulides (talk) 15:00, 28 July 2008 (UTC)

Similarly, the following sentence should be eliminated. There is no need to go into the pre-chiropractic history of the AMA. "By this time medicine had created the American Medical Association (AMA), absorbed the homeopaths and eclectics and organized into a major political force creating state laws that limited the practice of medicine, but the small chiropractic faction was not included." Eubulides (talk) 15:00, 28 July 2008 (UTC)

The phrase "Somewhere around 1895" is confusing ("where"?) and should be simplified. Eubulides (talk) 15:00, 28 July 2008 (UTC)

The phrase "magnetic healer" should be wikilinked to Magnetic healing. Most readers won't know what it is. Eubulides (talk) 15:00, 28 July 2008 (UTC)

The wikilink to Populist isn't right, as that is a disambiguation phrase. It should point directly to Populism. Eubulides (talk) 15:00, 28 July 2008 (UTC)

"1987 anti-trust lawsuit" That's not correct. 1987 is the date of the decision, not the date of the lawsuit. It should be "1987 decision". Eubulides (talk) 15:00, 28 July 2008 (UTC)

"the the". Eubulides (talk) 15:00, 28 July 2008 (UTC)

The phrase "and was hampered by the chiropractic philosophy that sustained the profession in its long battle with organized medicine", present in Chiropractic #History is important and should be kept.

The following material on recent history is also important and should be kept (certainly far more important than homeopaths, or the neurocalometer, or vitalism and chemistry, or a bunch of other things like that): "However, its future seemed uncertain: as the number of practitioners grew, evidence-based medicine insisted on treatments with demonstrated value, managed care restricted payment, and competition grew from massage therapists and other health professions. The profession responded by marketing natural products and devices more aggressively, and by reaching deeper into alternative medicine and primary care." Eubulides (talk) 15:00, 28 July 2008 (UTC)

History (another draft)

Chiropractic was founded in the 1890s in Davenport, Iowa by Daniel David (D.D.) Palmer, who had turned from teacher and grocer to the magnetic healing developed by MD Andrew Taylor Still[16] as an alternative to what he saw as the abusive nature of the drugs of that time. After nine successful years as a magnetic healer, Palmer had developed a theory about the cause of all disease, and an encounter with deaf janitor, Harvey Lillard, who reported that after two treatments he could hear quite well, convinced him that manual manipulation to reposition body parts could cure disease. [9] Although initially keeping the theory a family secret, in 1898 at his new Palmer School of Chiropractic he began teaching it to a few students, one of whom, his son Bartlett Joshua (B.J.) Palmer, became committed to promoting chiropractic, took over the Palmer School in 1906, and rapidly expanded its enrollment.[10]

Prosecutions and incarcerations of chiropractors for practicing medicine without a license grew common. To defend against medical statutes B.J. argued that chiropractic was separate and distinct from medicine, asserting that chiropractors "analyzed" rather than "diagnosed", and "adjusted" subluxation rather than "treated" disease.[11] In the early 19th century, chemists and physicians alike shared a common vitalistic belief that, unlike inanimate objects, living objects had a substantial entity (or spirit) controlling their organic processes.[7] The Palmers continued to develop D.D.'s theory along vitalistic lines; all disease was caused by interruptions in the flow of innate intelligence, a vital nervous energy or life force that represented God's presence in man. Chiropractic leaders often invoked religious imagery and moral traditions. D.D. and B.J. both seriously considered declaring chiropractic a religion, which might have provided legal protection under the U.S. constitution, but decided against it partly to avoid confusion with Christian Science.[10][17]

Tensions developed between "straight" chiropractors such as D.D. and B.J. who disdained the use of instruments, and those, scornfully called "mixers" by B.J., who advocated their use; some opened new schools to teach their proprietary techniques. In 1910 B.J. changed course and endorsed X-rays as necessary for diagnosis; this resulted in a significant exodus from the Palmer School of the more conservative faculty and students. The mixer camp grew until by 1924 B.J. estimated that only 3,000 of the U.S.'s 25,000 chiropractors remained straight. That year, B.J.'s promotion of the neurocalometer, a new temperature-sensing device, was another sign of chiropractic's gradual acceptance of medical technology, although it was highly controversial among B.J.'s fellow straights and ultimately sealed the fragmentation of chiropractic with the development of two professional associations; the mixer ACA and straight ICA.

By the 1930s chiropractic was the largest alternative healing profession in the U.S., but faced heavy opposition by organized medicine.[10] The AMA labeled chiropractic "an unscientific cult" and held that it was unethical for medical doctors to associate with an "unscientific practitioner".[18] This culminated in a landmark 1987 decision, Wilk v. AMA, in which the court found that the the AMA had engaged in unreasonable restraint of trade and conspiracy, and which ended the AMA's de facto boycott of chiropractic.[15]

Serious research to test chiropractic theories did not begin until the 1970s. By the mid 1990s there was a growing scholarly interest in chiropractic, which helped efforts to improve service quality and establish clinical guidelines that recommended manual therapies for acute low back pain.[11] In recent decades chiropractic gained legitimacy and greater acceptance by physicians and health plans, and enjoyed a strong political base and sustained demand for services; like other forms of complementary and alternative medicine, chiropractic became more integrated into mainstream medicine.[15]

Comments on history (another draft)

"Chiropractic was founded in the 1890s in Davenport, Iowa by Daniel David (D.D.) Palmer, who had turned from teacher and grocer to the magnetic healing developed by MD Andrew Taylor Still". The cited source here is the autobiography of Andrew Still, which obviously does not support most of the claims in this part of the sentence. This sentence needs an appropriate source. Furthermore, I don't think Still's autobiography should need to be sourced at all; surely every detail in this sentence can be sourced by a reliable history of chiropractic, and if we really have go to that ancient primary source that is an indication that we are delving into a non-notable area. Also, there's certainly no need to mention that Still was an MD here. I am skeptical that Still needs to be mentioned at all. Eubulides (talk) 21:11, 21 July 2008 (UTC)

"After nine successful years as a magnetic healer" This isn't important enough to appear here. It's enough to say Palmer was a magnetic healer, which has already been said. Eubulides (talk) 21:11, 21 July 2008 (UTC)

"an encounter with deaf janitor, Harvey Lillard, who reported that after two treatments he could hear quite well" There is substantial doubt that this episode ever occurred as recounted by the Palmers. It should not be repeated here without giving the skeptical side. Eubulides (talk) 21:11, 21 July 2008 (UTC)

The citation to DD' Palmer's Lifeline is inappropriate here. These are Keating's notes, which never appeared in a peer-reviewed paper (and he published plenty of papers on this subject). We should not refer to Keating's notes directly; we should refer to his published papers or to other more-reliable sources. Eubulides (talk) 21:11, 21 July 2008 (UTC)

"In the early 19th century, chemists and physicians alike shared a common vitalistic belief that, unlike inanimate objects, living objects had a substantial entity (or spirit) controlling their organic processes.[7]" This neglects the important fact that orthodox medicine rejected vitalism even though chiropractic embraced it. Furthemore, it omits several other important ways in which chiropractic departed from mainstream medicine. Also, that source is not that reliable; we should be using a peer-reviewed journal for anything this basic. I suggest basing the discussion of vitalism etc. on far more-reliable and more-relevant sources, e.g., by paraphrasing ideas from the following quote:

"Emphasizing observation rather than experimentation, the ability of the commoner as well as the expert to be a scientist, a vitalist rather than a mechanist philosophy, and a mutually supportive rather than antagonistic relationship between science and religion, chiropractors had created an alternative science. This science justified their approach to healing, attacted supporters, furnished expertise for practitioners, and provided chiropractic at least some of the social and cultural authority derived from the aura surrounding science."[19]

Eubulides (talk) 21:11, 21 July 2008 (UTC)

Of course, our initial sentence is pertinent as it illustrates how some scientists were vitalists at the time. The new quote could be used as well. Some might have to be attributed, like the "alternative science" part. What does that mean? -- Dēmatt (chat) 18:57, 27 July 2008 (UTC)
Vitalism was dying among respectable scientists by then; it is quite misleading to cast chiropractic as state-of-the-art science circa 1895. Eubulides (talk) 15:00, 28 July 2008 (UTC)

The draft removes the following text, which is important, relevant, and well-sourced: "Early chiropractors also tapped into the Populist movement, emphasizing craft, hard work, competition, and advertisement, aligning themselves with the common man against intellectuals and trusts, among which they included the American Medical Association (AMA)." Eubulides (talk) 21:11, 21 July 2008 (UTC)

"some opened new schools to teach their proprietary techniques" This is undoubtedly true, but it needs to be supported by a citation. Eubulides (talk) 21:11, 21 July 2008 (UTC)

"The Palmers continued to develop D.D.'s theory along vitalistic lines" This is not supported by a reliable source, and it's pretty misleading: I don't think "the Palmers" collaborated on the time of day, much less on the development of D.D.'s theory. Eubulides (talk) 21:11, 21 July 2008 (UTC)

The draft replaces "Despite heavy opposition by organized medicine, by the 1930s chiropractic was the largest alternative healing profession in the U.S. The longstanding feud between chiropractors and medical doctors continued for decades." with "By the 1930s chiropractic was the largest alternative healing profession in the U.S., but faced heavy opposition by organized medicine." This misses the important point that the pre-1930s growth was despite opposition, and that the opposition continued for decades more. Eubulides (talk) 21:11, 21 July 2008 (UTC)

The draft removes the important point that evidence-based research "was hampered by antiscientific and pseudoscientific ideas that sustained the profession in its long battle with organized medicine." Eubulides (talk) 21:11, 21 July 2008 (UTC)

The draft removes the even-more important point that "However, its future seemed uncertain: as the number of practitioners grew, evidence-based medicine insisted on treatments with demonstrated value, managed care restricted payment, and competition grew from massage therapists and other health professions. The profession responded by marketing natural products and devices more aggressively, and by reaching deeper into alternative medicine and primary care." These are key issues in the recent history of chiropractic. Eubulides (talk) 21:11, 21 July 2008 (UTC)

OK, you caught me, Eubulides. ☺ I didn't look at the sources much but just rearranged the material from the current article version and the other draft. I may have ended up with footnotes in the wrong place etc. Thanks for agreeing with some of the proposed deletions. I may or may not find time to work on this more. Coppertwig (talk) 12:35, 22 July 2008 (UTC)
I took several of the more constructive criticisms and cut out or cleaned up a lot of the pre-chiropractic info from the first paragraph the first history above just to see what it would look like. -- Dēmatt (chat) 03:19, 25 July 2008 (UTC)
This "another draft" thread (and the subsection immediately above) appear to have gone inactive in favor of the history draft/discussion further up in the thread. Would anyone object if I archived these lower two subsections, #History (another draft) and #Comments on history (another draft)? Thanks, --Elonka 15:51, 1 August 2008 (UTC)
Hi Elonka, sorry we're being such a pain, but thanks for working with us through this! I don't feel comfortable deleting that part without input from Coppertwig as he wrote that. I think some of the older comments were handled, or likely need to be restated anyway so I feel safe in removing them. Just leave the first History as I am slowly working through that when not distracted by other hot topics... Thanks again! -- Dēmatt (chat) 21:03, 1 August 2008 (UTC)

Removing vague tag

This change, which removed the {{vague}} tag with changes not previously discussed, had some problems:

  • It created a sentence with confusing mixed tense "has gained"/"enjoyed"/"is gradually becoming".
  • The newly-introduced "gradually" is not supported by the source.
  • The introduction of "certain" and "methods" is not supported by the source. That wording was the result of a long discussion in Talk:Chiropractic/Archive 22 #"Rigorously proven"; you might want to read that discussion before proposing further changes.
  • The newly-inserted quote marks are not clearly connected to any source, and are confusing to boot. I was at a loss to understand why "subluxation" was quoted, just by itself. The quote marks are not necessary and can be removed.

I attempted to fix these problems with this change. It's better to discuss changes like these first, I expect. Eubulides (talk) 07:16, 30 July 2008 (UTC)

Maybe the tenses did get mixed, but I attempted to correct misleading language. "[B]ecame more integrated into mainstream medicine" is misleading as it can lead readers to think that chiropractic has become integrated, but it is still far from integrated. Only in certain areas is that the case, but it is gradually becoming so. Does the added qualifier violate the source, or do we just need another source for what should be an uncontroversial qualifier? (see below about the lack of need for sourcing of uncontroversial wordings)
Adding "certain" and "methods" doesn't violate the source, does it? It's at least closer to the truth, because the previous wording is misleading. It is only certain methods that are questioned, not chiropractic as a whole. The existing wording was very vague and misleading. If the addition of qualifiers doesn't violate the source, and is closer to the truth, then we should just provide a better source, IF that is really needed, which I don't think is necessary in the lead. We deal with the topic later. Uncontroversial true statements don't usually need special sourcing, so I didn't consider it an issue to introduce such modifying terms.
The quotation marks in this phrase "sustained by "anti-scientific and pseudo-scientific ideas" like "subluxation" that are significant barriers to scientific progress within chiropractic."[11] are precise quotes from the source. I followed it very closely, so I don't understand your objection. If you don't want quote marks, fine, but those words are exact and supported by the source. -- Fyslee / talk 14:44, 30 July 2008 (UTC)
  • As far as I can see, the cited source (Cooper & McKee 2003, PMID 12669653) does not say or imply that the integration is "gradual". It does uses the phrase "increasingly integrated", which Chiropractic summarizes (accurately, I think) as "more integrated". Here's the sentence containing that phrase; the context is a discussion of chiropractic: "Moreover, it is at the vanguard of complementary and alternative medicine (CAM), which receives ever greater proportions of health expenditures and which is being increasingly integrated into conventional medicine."
  • As for "certain" and "methods", the cited source (DeVocht 2006, PMID 16523145) does not have these qualifiers. It says "Nevertheless, there are different views concerning the efficacy of chiropractic treatment, which is not surprising." Inserting these qualifiers weakens what the source says. The claim "It is only certain methods that are questioned, not chiropractic as a whole." is not correct: a significant number of critics question chiropractic as a whole.
  • It is not necessary or desirable to quote every word that is shared by Chiropractic and a source. If that were done, more than half of Chiropractic would be surrounded by quote marks, and the article would be weird and harder to read. Quote marks should be used only on special occasions, e.g., when the quotes are long or are opinions that are controversial among reliable sources.
  • For an example of the use of quote marks in a high-quality article, please see the most-recent Featured Article on a biomedical topic, namely Genetics. Genetics uses quote marks when defining terms like "Mendel's second law", but it never uses quote marks in the proposed "Simon-says" style, despite the fact that genetics is even more controversial than chiropractic is. Here's the very first claim in the body of Genetics:
'Although the science of genetics began with the applied and theoretical work of Gregor Mendel in the mid-1800s, other theories of inheritance preceded Mendel.'
If the "Simon says" style were used, I suppose that would have to be something like this:
'According to historian of science James P. Dooley, Jr., although the "science of genetics" began with the "applied and theoretical" work of Gregor Mendel in the mid-1800s, other "theories" of inheritance preceded Mendel.'
(I am inventing Dooley's name, if that's not clear. :-) After all, it is only an opinion that genetics was a science in Mendel's time, and it is only an opinion that the speculation about inheritance that preceded Mendel amounted to "theories".
Eubulides (talk)
I am okay with most of those changes other than the antiscience and pseudoscience one only because it is being discussed above now and consensus has not been reached. I agree they seem to reflect an accurate assessment (as much as one can be made) and are reasonable tweaks that as long as they are still supported by the references, why not? The issue with anti and ps is attribution and your fix was certainly according to the source, though I see that Keating has more to say about it in Keating 2005, so I guess we still have some work to do. -- Dēmatt (chat) 17:43, 30 July 2008 (UTC)
As discussed in my previous comment above, the changes are nto supported by the sources. I agree we have more work to do. Eubulides (talk) 18:50, 30 July 2008 (UTC)
Eubulides, I don't know what you mean by "the proposed "Simon-says" style": I thought you had been the one to introduce the term "Simon-says". The existence of another article which never quotes short phrases is not a reason that we can't do so here. Quotes need to be used when the word or phrase has a significantly non-NPOV tone (if the phrase is appropriate to include in the article at all) or when a word has multiple meanings so it isn't sufficiently clear what is meant, or when the statement is opposed by more than a tiny minority of reliable sources. See WP:NPOV. The examples you gave for the purpose of reductio ad absurdum do not seem to me to fall into any of these categories. ☺ Coppertwig (talk) 02:28, 31 July 2008 (UTC)
For a reply, please see #Simon-says in 1st paragraph below. Eubulides (talk) 14:22, 31 July 2008 (UTC)

(outdent) Eubulides, from the cited source -- (Cooper & McKee 2003, PMID 12669653): "Moreover, it is at the vanguard of complementary and alternative medicine (CAM), which receives ever greater proportions of health expenditures and which is being increasingly integrated into conventional medicine." -- you have chosen a phrase. The part of that source you have chosen to use doesn't seem to even refer to chiropractic, but to alternative medicine in general. That sentence needs to be parsed very carefully. I have underlined and bolded the key words. "It" refers to chiropractic, while both "which" seem to refer to alternative medicine in general, not specifically to chiropractic. This source provides context. The article has some positive words, but it actually paints a dismal picture for the future of the profession, it's current lack of growth, the much faster growth of other competing professions, its poor evidence base for spinal manipulation, its lack of worth for viscerosomatic disorders, and other concerns that are commented on in this chiropractic article:

The PubMed synopsis also raises concerns:

Out of curiosity, I would like to read your source, as it obviously contains more than I have found, but the context of your quote indicates that it is "complementary and alternative medicine (CAM)" that "is being increasingly integrated into conventional medicine," not specifically chiropractic.

This leaves us without any backing for our wording at all! Even the profession's growth has stagnated and other competing professions are growing much faster.

You make this comment about my talk page quote above:

  • The claim "It is only certain methods that are questioned, not chiropractic as a whole." is not correct: a significant number of critics question chiropractic as a whole.

I fully agree that many critics question chiropractic as a whole, which proves that integration into the mainstream is far from complete, but that wasn't my point. I was referring specifically to methods, and it is certain methods that are criticized more than others. I think we actually agree about the realities of the situation, but may need to tweak the edit in order to cover all the bases and see eye to eye.

As to my use of quote marks, I understand your concerns about overuse of the Simon says format, but I agree with Coppertwig. We are sometimes required to use it in our attempts to provide proper attribution and maintain NPOV. By doing that we avoid anyone getting confused about whether a source says it, or Wikipedia says it. I'm not saying my edit was perfect, but it was at least true to the source. I'm certain it can be improved, but the objection about it not being sourced isn't correct. FA articles can and do contain specific quotes. That is no hindrance to becoming an FA. It just shouldn't be overdone. -- Fyslee / talk 03:57, 31 July 2008 (UTC)

  • I don't recall an objection about your edit not being sourced. My objection was more about the "Simon-says" style.
  • Of course featured articles sometimes contain specific quotes, but I don't know of any featured article that contains nearly as many quotes as what is being proposed here. Can you cite some examples?
  • I remain skeptical that the "Simon-says" style is advisable here. Certainly it is not required.
  • I agree that Cooper & McKee 2003 (PMID 12669653) talks about integration of CAM in general (in which it includes chiropractic), not about chiropractic in particular. As a quick fix to this problem I removed the claim.
Eubulides (talk) 14:22, 31 July 2008 (UTC)
  • I agree that Cooper & McKee 2003 (PMID 12669653) talks about integration of CAM in general (in which it includes chiropractic), not about chiropractic in particular. As a quick fix to this problem I removed the claim. Am I missing something. Are you saying you are looking at something that is not in the abstract? I don't see anything but chiropractic - and it is saying chiropractic "... has entered the mainstream of health care, gaining both legitimacy and access to third-party payers." -- Dēmatt (chat) 01:50, 2 August 2008 (UTC)
Oh, I see it in Fyslee's source of the first page of the actual paper. I agree he was talking about CAM. -- Dēmatt (chat) 02:10, 2 August 2008 (UTC)
Your "source" objection is found at the start of this section: "The newly-inserted quote marks are not clearly connected to any source, and are confusing to boot. I was at a loss to understand why "subluxation" was quoted, just by itself. The quote marks are not necessary and can be removed."
I then documented that I had followed the source very closely, and by using quote marks I made sure that readers would be clear it was a quoted source, and not editorial opinion. Subluxation was quoted by itself because it was the only example named in the quote. -- Fyslee / talk 14:45, 31 July 2008 (UTC)
  • Thanks for clarifying about the "source" objection. Sorry I wasn't clear earlier: that objection was primarily about the style being used (in that the connection between the quotes and the source wasn't entirely clear), not that the statements were not sourced at all. Eubulides (talk) 22:20, 31 July 2008 (UTC)
I think you're right Fyslee. I don't think that you can make an article NPOV by somehow balancing POV statements that are favorable with POV statements that are critical. To make all statements NPOV, you must be clear about which statements are statements of fact, and which report an opinion; there is a middle ground of interpretation, but the first step is to be clear about the extremes. Of course you report opinions, without dilution, but as opinions. You might try to strip the text of editorial value judgements. Some phrasings could be made more objective include:
  • has enjoyed a strong political base: received considerable political support
  • related in an important and fundamental way, drop ""important and"
  • Chiropractors pay careful attention, drop "careful"
  • beyond simply manipulating the spine, drop "simply"
  • Conservativism carefully considers, drop "carefully"
  • accept the value that the scientific method has to offer, change to "accept the importance of scientific research into chiropractic"
  • primary underlying risk factor, drop primary
  • lack rigorous proof of effectiveness, drop rigorous.
  • unreasonable restraint of trade and conspiracy, needs quote marks. This is the converse to the "antiscientific" dispute above; the word unreasonable is a value judgement, in this case it's a legal judgement, but it's still a judgement of value not of fact. I'd quote it as the actual words of the Judge.Gleng (talk) 09:27, 31 July 2008 (UTC)
Wow, those are some good choices, Gleng. I don't know about anyone else, but I am willing to let Gleng go through and make those changes and any other ones that he sees. He has proven himself a valuable NPOV editor on wikipedia in the past and am sure that we will all be satisfied with his work. I know that it is his style to make several screening passes through an article and clean up things like that. I would really appreciate his skill in that regard. -- Dēmatt (chat) 13:17, 31 July 2008 (UTC)
It's worth a try. Just do a few at a time, save, and then go on. Go for it. -- Fyslee / talk 14:10, 31 July 2008 (UTC)
I agree with many of Gleng's proposed changes. Here are the ones I have qualms about:
  • "received considerable political support". The source says "Chiropractic's political base is strong", and Gleng's rewording is much weaker than this. How about if we instead use "has had a strong political base".
Fine by meGleng (talk) 18:31, 31 July 2008 (UTC)
  • "primary underyling risk factor". Why drop "primary"? Saying just "a risk factor" is too weak, surely.
Primary has a technical meaning. Fine if that is true, not fine if it's just a reinfocing adjectiveGleng (talk) 18:11, 31 July 2008 (UTC)
I just now checked the source,[11] and it doesn't talk about risk factors at all. I propose that we fix this problem by replacing 'an "Innate Intelligence" within the human nervous system and is a primary underlying risk factor for almost any disease' with 'an "Innate Intelligence" which directs all the functions of the body via the human nervous system', as the "directs all the functions of the body" is supported by the cited source. Eubulides (talk) 22:20, 31 July 2008 (UTC)
  • "lack rigorous proof of effectiveness". Let's keep the "rigorous". The source says "rigorous" and this is an important part of the qualification of that statement. Here's the quote from the source. "Unfortunately, it is difficult to establish definitive, unarguable, and conclusive findings regarding much in the healing arts despite the millions of papers that have been written about presumably scientifically sound studies. Because of this difficulty, numerous medical procedures have not been rigorously proven to be effective either." (DeVocht 2006, PMID 16523145)
proof is a technical statement; something is either proved or not. A proof that isn't rigorous is not a proof. Just because a source uses a word redundantly or imprecisely, we don't have to follow it.Gleng (talk) 18:11, 31 July 2008 (UTC)
DeVocht is not talking about mathematical proof; he's talking about empirical tests; the kind of proof one sees at automobile proving grounds. This sort of proof can be more or less rigorous. Eubulides (talk) 22:20, 31 July 2008 (UTC)
Then don't use the word proven; it has no scientific meaning except as conclusive demonstration. Use shown instead.79.68.13.143 (talk) 08:40, 1 August 2008 (UTC)
As Coppertwig notes below, this isn't math. If you look at biomedical uses of the word "proven" (e.g., here) you'll see that we are using the commonplace meaning here. "Shown" is considerably weaker than "proven" and to some extent "rigorously shown" is self-contradictory: merely "showing" something is less-rigorous than "proving" it. Eubulides (talk) 14:30, 1 August 2008 (UTC)
I din't mention math. Proof is "

The evidence or argument that compels the mind to accept an assertion as true."[30]. Rigorously is a redundant reinforcer, a rhetorical device. If the evidence isn't compelling, it's not proof. If it's not rigorous, it can hardly be compelling.Gleng (talk) 20:51, 2 August 2008 (UTC)

  • There is no need to quote "unreasonable". The "unreasonable" is in the context of the phrase "the court found that", so it's already quite clear to the reader that "unreasonable" is the opinion of the court, not the opinion of Wikipedia.
Eubulides (talk) 14:22, 31 July 2008 (UTC)
Wouldn't wish that a reader might be mistakenly think that this word is editorial POV.Gleng (talk) 18:11, 31 July 2008 (UTC)
I like Gleng's changes because they excise a lot of the flowery and loaded descriptors which are inherently POV and unnecessary. Go for it, Gleng. -- Levine2112 discuss 17:00, 31 July 2008 (UTC)
I'm going to leave it to you good people, I really don't have the time these days to get into a line by line fight. Sorry, but you have my best wishes.Gleng (talk) 18:11, 31 July 2008 (UTC)
"Can't says that I blames ya." -- Dēmatt (chat) 18:33, 31 July 2008 (UTC)
I went for it, for the changes that were not controversial in the above discussion. We can discuss other changes as needed. Thanks, Gleng, for coming up with that helpful list. Alas, as discussed in #Simon-says in 1st paragraph below, I fear that the list is only a partial one. Eubulides (talk) 22:20, 31 July 2008 (UTC)
I also agree with most of Gleng's proposed changes. Re underlying risk factor: I suggest just dropping "primary" for now. The source (the primer) doesn't talk about primary underlying risk factor, but it also doesn't say (from what I was able to find) that straight chiropractors currently believe that an innate intelligence directs all functions of the body.
re "rigourous": I agree with Eubulides that it's better to keep this word. There may be proof of a sort, enough to convince some people, even if there isn't rigorous proof. This isn't math.
If we can verify that "unreasonable restraint" is the actual words of the court decision, I think it's useful to put it in quotes so the reader knows it isn't a Wikipedian paraphrase. ☺ Coppertwig (talk) 02:03, 1 August 2008 (UTC)
  • The source doesn't talk about risk factors at all, whether "primary" or not; so it cannot be used to justify any claim about risk factors. If you don't agree with that paraphrase of the source and innate intelligence, I suggest that we rely instead on Kaptchuk & Eisenberg 1998 (PMID 9818801), a more-reliable source anyway, which talks about straights and innate intelligence. Shall I draft something along those lines?
  • "Unreasonable restraint" is a generic term of antitrust law, and is not a specific or unusual conclusion made by this particular judge. It would be misleading to quote it, as it would suggest to the inexpert reader that the word "unreasonable" was a notable, particular opinion of that judge. Suppose we altered Timothy McVeigh to read 'McVeigh was found "guilty"'; such a quote would be literally repeating the words in the court's decision, but it would mislead the reader into thinking that there was something unusual about that decision. We shouldn't change Timothy McVeigh in that way; nor should we change Chiropractic in a similar way.
Eubulides (talk) 08:08, 1 August 2008 (UTC)
LOL! OK, "guilty" is usually not put in quotes, and although "unreasonable restraint" is not as frequently-used a term and in my opinion therefore needs quotes more than "guilty" does, and I still prefer it quoted, you've convinced me that it's OK to leave it unquoted. This article puts "not guilty", and some other short phrases, in quotes, and it doesn't look at all odd to me: it's giving the information that those are the exact words of the source. ☺ Coppertwig (talk) 12:54, 1 August 2008 (UTC)
LOL!! Yep, the important one is that they put "Yale Sluts" in quotes! How would you like to be the poor sweet girls being called antiscientific Yale sluts. :-D -- Dēmatt (chat) 22:17, 2 August 2008 (UTC)

Simon-says in 1st paragraph

  • By "'Simon-says' style" I meant the style used in changes like this. I coined the term in #Inaccurate insertion of "Simon says" phrases.
  • The existence of featured articles on controversial subjects like Evolution, articles that do not use the "Simon-says" style, shows that we need not use the "Simon-says" style here. The "Simon-says" style is certainly not required for NPOV. It is merely a style; other, better styles are available.
  • The proposed style guideline, which is to insert quotes "when the word or phrase has a significantly non-NPOV tone", raises the question of how one determines whether a word or phrase has a significantly non-NPOV tone. Some editors think "antiscientific" doesn't have such a tone; others do. How can this be resolved?
It's not about tone of words at all, it's about wording things in a way that the editorial opinion doesn't intrude, one way or the other. It's about reporting facts, coolly and objectivelyGleng (talk) 09:17, 1 August 2008 (UTC)
  • The best and most-reliable way to resolve it is to see whether reliable sources use the term in high-quality publications, without quote marks, and without any significant disagreement within reliable sources.
This opens terrible doors. Can I see someone stating that 'generally scientists despise doctors', on the authority of Steve Jones (see above) and challenging others to find any dissension in the peer reviewed literature? Pfff. The original source if it is any good, will have a whole context to qualify and explain the exact meaning and as importantly the status of words used. As we have seen here, a common problem is that different sources use the same words in very different ways to mean different things. Here you must think of the reader and of internal coherence of the article. So don't get hung up on the exact words; understand the factual content, and express that so that it can be understood.Gleng (talk) 09:39, 1 August 2008 (UTC)
I'm not familiar with the claim "scientists despise doctors"; I couldn't find it with a Google search. However, assuming Jones actually said that, it is easy to dispute such a claim with reliable sources saying that more physicians should be scientists and so forth, e.g., see Rosenberg 1999 (PMID 9925491). I suppose there might be some obscure topic where a reliable source makes an controversial claim and nobody else bothers to counter it, but the antiscience claim is hardly obscure: we have several sources, including the leading chiropractic textbook, making the claim. If this well-established claim were really controversial (which it's not), I would expect to see some dispute about it among reliable sources. Eubulides (talk) 14:30, 1 August 2008 (UTC)
It's in his most fanous book. But I see you are happy to counter this with references that rebut this indirectly, so you'd be happy to accept references asserting that straight chiropractic endorses the value of scientific research, as a rebuttal of the "antiscientific" opinion, right? I really think we must avoid double standards at all costs.Gleng (talk) 16:46, 2 August 2008 (UTC)
Either way, I'm game. -- Dēmatt (chat) 17:18, 2 August 2008 (UTC)
To quote Gleng from above "This opens terrible doors." When any wording is controversial, it needs to be clear it's a citation. It is the sources that say it, not Wikipedia. That's why any specific wording, no matter how controversial, opinionated, offensive, or whatever, is legitimate content in any article, as long as it is from a RS and complies with other editorial guidelines and policies. If we don't do this, we will constantly be getting edit wars over the phrasing from newbie editors who come along and discover it, as well as risking that readers think it is Wikipedia's "opinion", when it's not supposed to have an opinion. I can think of situations where attribution is so clear that such quote marks won't be necessary, but it must be very clear to all readers and newbie editors. -- Fyslee / talk 18:04, 2 August 2008 (UTC)
  • Another way to determine whether a word or phrase has "a significantly non-NPOV tone" is to let Wikipedia editors decide, as a matter of their own personal preference, regardless of what reliable sources say. That is what has been done here. But it should be obvious that this is a recipe for Wikipedia editors, no matter how well-meaning, to introduce their own biases into the article.
  • I disagree with Coppertwig's characterization of the "James P. Dooley" example in #Removing vague tag; that example is not just reductio ad absurdum. But rather than waste time talking about some other article, let's talk about Chiropractic, as that's more useful here.
  • Let's start with the very first paragraph of Chiropractic's body.
  • This paragraph has several non-POV terms, including (obviously) "important" and "fundamental", but also including more-subtle opinions in phrases like "a wide diversity of belief" (why not just "many opinions"?), "share the principle that" (why not just "agree"?), "pay careful attention to" (why not just "study"?), and "preventing and restoring health" (why not just "disease prevention and treatment"?). Obviously this paragraph is reeking with puff-piece phrases, all supported by a reliable source; if the Simon-says style must be use whenever a POV phrase is used, then this paragraph has at least a dozen words that need quoting and text attribution.
Agree with these examples. Prefer "believe" to "agree". "Fundamental" though is harder to remove, I read it as not really a reinforcing term but a qualifying term.Gleng (talk) 09:17, 1 August 2008 (UTC)
  • But the POV in this 1st paragraph is much deeper and more fundamental than its puff-piece words. This paragraph passes off as undisputed the chiropractic dogma that the structure and function of the spine play an important fundamental role in preventing disease and restoring health, a dogma that is at the heart of chiropractic and that lacks good scientific evidence and is disputed by many in the scientific and medical mainstream.
This paragraph is about the Philosophy of chiropractic, i.e. stating the mere facts of what they believe. It's not stating either the basis for those beliefs or the reasons why others don't hold them. If it is clear that this paragraph is simply summarising what chiropractors believe, without endorsing or denigrating those beliefs, then it will be NPOVGleng (talk) 09:17, 1 August 2008 (UTC)
The problem is that the current wording doesn't make it clear that the paragraph is simply summarizing what chiropractors believe. It appears to be endorsing the chiropractor's opinion that the spine is central to overall health. Eubulides (talk) 14:30, 1 August 2008 (UTC)
  • It doesn't matter whether one counts single words, or looks more deeply at what is being said. Either way, the 1st paragraph of the body of Chiropractic has much more POV than the "antiscientific" sentence. And this is not an isolated example: I chose it merely because it happened to be the 1st paragraph in the body.
  • I haven't objected to the 1st paragraph before now, because my understanding was that opinions that are sufficiently supported by reliable sources can be written down and cited, and that's enough. If we are changing the rules, it's obviously completely POV to change the rules only for critical comments of chiropractic, which is what's been done so far. We need to be consistent for the whole article.
  • With that in mind, here is a proposed rewrite for the first paragraph of Chiropractic #Philosophy, which uses what I understand to be the Simon-says style. If my understanding of the style is incorrect, please let me know
Although chiropractors disagree about many things,[20] they agree that the spine "occupies a unique and privileged position" in affecting health via the nervous system.[21] Chiropractors study what the American Chiropractic Association says are "the biomechanics, structure and function of the spine, its effects on the musculoskeletal and neurological systems, and the role played by the proper function of these systems in the preservation and restoration of health".[22]
Eubulides (talk) 14:22, 31 July 2008 (UTC)
I would say that the quotes here are neccessary in the first use if you use those exact words, and the second half could be rephrased as a factual statement.Chiropractors study the biomechanics, structure and function of the spine, its effects on the musculoskeletal and neurological systems, and its role in health and disease. It's a factual statement. Is it true? if so fine, if not, put it right Gleng (talk) 09:17, 1 August 2008 (UTC)
That second-half rewording still appears to endorse chiropractors' opinion that the spine is central to overall health. How about the following rewording instead? It omits quote marks but adds a qualifier to avoid the appearance of endorsement: "Chiropractors study the biomechanics, structure and function of the spine, along with what they say are its effects on the musculoskeletal and neurological systems and its role in health and disease." Eubulides (talk) 14:30, 1 August 2008 (UTC)

I see how you might think this could be a problem, though to scientists, when you study the effects of something, say when you study the effects of a treatment on a health outcome, you are not implying that the treatment is effective merely by the fact of studying it. Your alternative is I think wrong; chiropractors do not study "what they say" are its effects and its role, they study its effects and its role - even if others may disagree that these are in fact its effects and its role. I am not sure if it can disputed that the biomechanics, structure and function of the spine have an impact on muscoskeletal and neurological systems, nor that this has some role in health and disease. The legitimate dispute is only about the extent of that impact. This study is the particular focus of chiropractic. Others might feel that chiropractors attach more importance to spinal malfunction than it merits; but I suspect that every speciality ever conceived attaches much much importance to its own areas of interest than others do.Gleng (talk) 20:18, 1 August 2008 (UTC)

Why not just change "agree" to "the beliefs"
Although a wide diversity of ideologies exist among chiropractors,[20] they share the belief that the spine and health are related in a fundamental way, and this relationship is mediated through the nervous system.[23] Chiropractors pay attention to the biomechanics, structure and function of the spine, its effects on the nervous and musculoskeletal systems, and the role these systems play in preventing disease and restoring health.[22]
But this is different than the "antiscience" situation. More like a strawman. -- Dēmatt (chat) 03:31, 2 August 2008 (UTC)

Think your text is a good suggestion Dematt; you've proposed a way of declaring what chiropractors assert without implying that what they assert is generally accepted. I agree with you that here we are simply discussing the most accurate expression of a factual statement (about what chiropractors believe), the statement expresses facts not opinions (though there may be different opinions about whether the facts about their beliefs are true; whether their beliefs are true is not relevant here)Gleng (talk) 16:35, 2 August 2008 (UTC)

  • It is different from the "antiscience" situation, but only because it is worse than the "antiscience" situation. With the "antiscience" situation we had multiple reliable sources agreeing, with none disagreeing, that antiscience is an issue in a segment of chiropractic. In contrast, the first paragraph in Chiropractic #Philosophy contains multiple opinions for which it is easy to find reliable sources that disagree. And yet the Wikipedia article presents these controversial, pro-chiropractic opinions as its own.
  • I don't understand the 'Why not just change "agree" to "the beliefs"' comment, nor the duplication of a paragraph from Chiropractic immediately after that comment. That stuff looks like stray discussion text to me; I can't make heads or tails of it.
Eubulides (talk) 06:14, 2 August 2008 (UTC)
  • Which POV word are you objecting to. I don't have any problem with creating a prose attribution for whatever it might be.
  • Take another look, it was subtle, but accurate and succinct.
-- Dēmatt (chat) 17:18, 2 August 2008 (UTC)

Proposed wording for NOR/N

Following up on Talk:Chiropractic/Archive 24 #Draft questions would not resolve disagreement above, I have drafted below proposed wording for an WP:NOR/N request. Here's how I came up with it. Looking at similar requests already on that page, I don't think generic questions like "Is it possible for an idea which is expressed implicitly but not explicitly in an article to be a SYN violation?" would be that helpful. Once things get too generic, the answer will come back "it depends", which means that a generic question that begins "Is it possible..." will always be answered "Yes, depending on the circumstances" which won't give us much help on this particular question. So we need to be somewhat more specific.

The draft wording is in #SYN and chiropractic's evidence basis below. Eubulides (talk) 21:11, 21 July 2008 (UTC)

SYN and chiropractic's evidence basis

Does Chiropractic #Evidence basis have a significant synthesis problem?

In the opinion of the section's critics, the section is a WP:SYN violation when it presents specific research on spinal manipulation (SM) as evidence of effectiveness of chiropractic care as opposed to the whole range of treatments performed by chiropractors (not just SM), because the reader may confuse the assertions about spinal manipulation specifically as being assertions about chiropractic treatment in general.

In the opinion of the section's proponents, the section clearly distinguishes SM research from other research, every claim in the section is directly supported by a reliable source, standard practice in evidence-based chiropractic relies on SM research, and excluding highly-relevant mainstream research would raise serious WP:WEIGHT problems.

See also Syn tag and SYN and implicit conclusions.

(end of draft wording) Eubulides (talk) 21:11, 21 July 2008 (UTC)

Comments on proposed wording for NOR/N

(Please put comments on draft wording here.) Eubulides (talk) 21:11, 21 July 2008 (UTC)

  • When we state, "standard practice in evidence-based chiropractic relies on general-SM studies", we should probably qualify this with a source or suggest that there are sources out there that support this opinion. This is key because this is where the critic's claim of SYN lies. Sources which state that conclusions from general SM research can be applied to make conclusions about chiropractic SM are the "Source B" component of the the critic's claim of SYN. (Whereas, the general SM studies are the "Source A".) Considering that this is a SYN question, I actually think it would be a good idea to clearly illustrate the alleged "A + B and therefore C" scenario. I really think that's all we have to do. Then the respondents on the noticeboard can just examine the formula and determine if it equates to SYN. Sound reasonable? -- Levine2112 nondiscuss 21:32, 21 July 2008 (UTC)
  • I'd rather keep the question short; it's already overlong as it is, compared to the questions already asked at WP:NOR/N. The longer the question is, the less likely it'll get answered.
  • I suggest that any lengthy argument about "Source A" and "Clause B" and so forth be put in the talk page, and that the question itself merely contain a wikilink to the lengthy argument.
  • I'd rather not have the "Proponents of this section" sentence edited in favor of the critics. That sentence should argue the proponents' side, not the critics' side.
  • Do you have any specific wording-change proposals? They could include wikilinks to the talk page or the talk page archives.
Eubulides (talk) 05:45, 22 July 2008 (UTC)
I am not suggesting that we put in "any lengthy argument"; however, this is a question for the NOR/N specifically about SYN. Therefore, we must illustrate what the critic's perceive as "A + B so therefore C". If you think the question is overlong now, then I would suggest cutting something out. But clearly the perceived "A + B so therefore C" formula must be illustrated for the NOR/N as this formula is at the heart of any SYN discussion. Let's make it extremely clear what Source A states, what Source B states and what the perceived Conclusion C is, because this is core to the SYN charge and we must provide any noticeboard respondents with complete clarity. Once we get that wording in there, then we can talk about including "wikilinks to the talk page" or "any specific word-change proposals". Please take a crack at inserting the perceived "A + B so therefore C" formula into the question as I think it would be a good-faith exercise in "writing for the enemy", so to speak. Thanks for your efforts to resolve this dispute in good faith, Eubulides! -- Levine2112 discuss 06:22, 22 July 2008 (UTC)
I don't think this would be a good idea, as I think it will make the question way too long. Obviously you disagree, though. I doubt whether I can do full justice for text I disagree with, so can you please propose a specific wording change? Thanks. Eubulides (talk) 06:33, 22 July 2008 (UTC)
Sure, here it goes:

::::Critics of the section say the section employs SYN when it cites sources on SM in general (as opposed to studies specifically on chiropractic SM), because these citations imply to the reader that general-SM studies are relevant to chiropractic, a conclusion that these studies themselves do not make. Whereas there exists some Source A which applies conclusions from some non-chiropractic SM research to make conclusions about chiropractic SM, and whereas there exists some Research B which studies non-chiropractic SM as performed by non-chiropractic practitioners and makes no conclusions about chiropractic SM specifically whatsoever. Thus, there is a rationale that since there exists some Source A which applies non-chiropractic research to make conclusions about chiropractic, therefore it is okay for our article to use non-chiropractic Research B to make or imply some Conclusion C about chiropractic SM. Hence, "A and B, so therefore C."

I think that is pretty clear. It's pretty much my position here in this dispute, though I don't know how well it represents the positions of Dematt, DigitalC, TheDoctorIsIn, GlenG, and several other editors on the critical side here. I'd love input from them here, as well as from the supporting side (just Eubulides and QuackGuru, I believe). -- Levine2112 discuss 07:02, 22 July 2008 (UTC)
OK, I agree with the general idea being discussed here of the question to be asked focussing directly on the reason for this particular SYN tag, noting though that the more general question I suggested will probably not be answered and may need to be addressed later when some other issue arises. Here's an attempt at a short version of the question:

::::::Does the evidence basis section of Chiropractic contain a SYN violation because it discusses the effectiveness of spinal manipulation (SM) baseed on studies of SM performed by various professionals, not just chiropractors, studies which made no conclusions about the effectiveness of chiropractic? Does this mislead the reader about the effectiveness of chiropractic? Another study[citation needed] states that research on SM in general is relevant to studies of chiropractic effectiveness (make sure this wording agrees with the source); does citing this study fix the SYH violation or make it worse?

If this is too long, perhaps only the first sentence could be used. ☺ Coppertwig (talk) 12:35, 22 July 2008 (UTC)
I think this is really good, Coppertwig, as it really implies the A, B, C without spelling it out. Here is a slightly revised version:

::::::Does the evidence basis section of Chiropractic contain a SYN violation because it discusses the effectiveness of spinal manipulation (SM) based on studies of SM in general (SM as performed by various professionals, not just chiropractors) studies which made no conclusions about the effectiveness of chiropractic SM specifically? Does this mislead the reader about the effectiveness of chiropractic SM? Another study[citation needed] states that research on SM in general is relevant to studies of chiropractic SM effectiveness (make sure this wording agrees with the source); does citing this study fix the SYN violation or make it worse? Essentially, if one source says that it is okay to apply general SM research to make conclusions about chiropractic SM, does that give us license to draw the same conclusions about other sources?

I feel that my last question/sentence above really distills this to the core issue. Thoughts? -- Levine2112 discuss 20:05, 22 July 2008 (UTC)
A few statistics. The wording in #SYN and chiropractic's evidence basis devotes (by my count) 48 words to critics of the section and 39 words to supporters. Levine2112 originally proposed adding 143 words to the critical side. Coppertwig proposes adding (by my count) 64 words to the critical side and 17 words to the supportive. Levine2112 responded by proposing (by my count) 103 critical and 17 supportive words. Adding any of these three changes hardly sounds fair, as more weight was already being given to the critical side. What to do? Eubulides (talk) 23:19, 22 July 2008 (UTC)
Let's not get bogged down in word count stats just yet. Let's first seek writing for clarity of the issue at hand. That said, I don't think that Coppertwig nor my responding version is intended to be wording for the supporters or the critics. The intent (at least my intent) was to combine rather than divide the points of view here. After all, doesn't my last question alone summarize the core of the dispute without being worded for the supporters nor the critics?

::::::::If one source says that it is okay to apply general SM research to make conclusions about chiropractic SM, does that give us license to draw the same conclusions about other sources?

If you feel that this isn't a neutral question, perhaps you could suggest a revision and/or explain why you feel it isn't neutral. -- Levine2112 discuss 00:18, 23 July 2008 (UTC)
Levine2112 listed me as being on the "critical" side, but I thought I was neutral/undecided on this SYN issue. Also, I thought we were going to try to straighten it out by clarifying the various definitions of SM and SMT in various contexts; some work was done on that but I'm still confused about it.
Suggestion: Use Eubulides' draft wording, but if it's desired to shorten it, then delete the "Here's the background" paragraph (and spell out SM the first time it appears). Also reduce the number of words when giving the additional links at the end, by saying simply "See also (link) and (link)."
Re Levine2112's last suggested wording: I would append "about other sources".☺ Coppertwig (talk) 02:14, 23 July 2008 (UTC)
Thanks for the suggestions. I deleted the "Here's some background" paragraph, spelled out SM, and reduced the words at the end, as you suggested. Eubulides (talk) 05:17, 23 July 2008 (UTC)
I would be reluctant to use Eubulides version. Let's examine the sentences in his/her proponents section:

::::::::::: Proponents of the section say that every claim in the section is directly supported by a reliable source, that standard practice in evidence-based chiropractic relies on general-SM studies, and that excluding highly-relevant mainstream research would raise serious WP:WEIGHT problems.

First, "standard practice in evidence-based chiropractic relies on general-SM studies". This should be clarified. Eubulides says that this is standard practice and bases his opinion off of a couple of sources. However, I and others have shown him/her sources where this is refuted; where either chiropractors or non-chiropractors have stated that general SM studies should not be used to draw conclusions about chiropractic SM.
Second, "excluding highly-relevant mainstream research" is an opinion. Especially the "highly relevant" portion. It is Eubulides' contention that this research is "highly-relevant". Also, no one is talking about excluding mainstream research in general, yet this is what is insinuated here. I welcome mainstream research. What's more I welcome highly-relevant mainstream research. And by highly-relevant, I mean mainstream research which is specifically about chiropractic. If it isn't about chiropractic, it isn't highly-relevant. -- Levine2112 discuss 02:34, 23 July 2008 (UTC)
Suggestion: re-write the "critics say" section the way you like it, but in the same number of words. Insert "what they consider to be" before "highly-relevant mainstream research". ☺ Coppertwig (talk) 03:03, 23 July 2008 (UTC)
  • I like that suggestion as well; we should let the critics write the section describing the critical viewpoint. I disagree with Levine2112's criticism of the proponents' section, naturally; the proponents should be allowed to make their case as well.
  • As for the proponent viewpoint, I don't think "what they consider to be" is necessary there. It's quite clear from the context that the text in question is being written from the proponents' viewpoint.
  • Similarly, it isn't necessary to insert a "what they consider to be"-like qualifier before the phrase "these citations imply to the reader" in the critical section. Obviously, it's the critics who are asserting that these citations imply something to the reader, and we don't have to repeat that here.
Eubulides (talk) 05:17, 23 July 2008 (UTC)
If we are each going to be making our cases, we should at least be doing that honestly and clearly. If something is an opinion, it should be made clear as Coppertwig suggests (i.e. "what they consider to be"-like qualifier). I don't want to move forward on this until we all can at least agree to this basic principle in fairness. -- Levine2112 discuss 22:49, 23 July 2008 (UTC)
It shouldn't be necessary to add "proponents of the section say" in front of every clause in that sentence. That will make the sentence longer and harder to read. If its leading "Proponents of the section say that" isn't clear enough, how about replacing the phrase with "In the opinion of the section's proponents," and making the obvious grammatical changes to the rest of the sentence? Similarly for the critical section, of course. Eubulides (talk) 23:04, 23 July 2008 (UTC)
Give it a whirl and I will try and base the critic's section on your lead. Let's not worry about word count yet. Let's focus on making this clear. Perhaps we should start off with an agreed statement of fact. Thoughts? -- Levine2112 discuss 23:08, 23 July 2008 (UTC)
OK, I reworded it as I suggested above. Originally I drafted what I assumed was an agreed statement of fact, but removed that "Here's some background" paragraph after Coppertwig suggested removing it. We could resurrect it, I suppose; but all other things being equal, shorter is better. Eubulides (talk) 23:49, 23 July 2008 (UTC)
  • "Chiropractic #Evidence basis discusses the evidence basis for chiropractic treatment" - This is part of the problem. Chiropractic #Evidence basis doesn't discuss the evidence basis for chiropractic treatment, it discusses the evidence basis of various conservative treatment procedures, that may be employed by Chiropractors or other health care practitioners. The implication that this is disussing effectiveness of chiropractic treatment IS the SYN violation. - DigitalC (talk) 23:22, 21 July 2008 (UTC)
  • Please see the above comments about keeping the question itself short, the above suggestion for doing this by wilinking into the talk page, and the above request for specific wording-change proposals. Eubulides (talk) 05:45, 22 July 2008 (UTC)
  • I would suggest changing "Chiropractic #Evidence basis discusses the evidence basis for chiropractic treatment" to "Chiropractic #Evidence basis discusses the evidence basis for various treatment methods, focusing on spinal manipulation (SM)..." - DigitalC (talk) 05:54, 22 July 2008 (UTC)
  • OK, thanks, done, except "various" sounded a bit discursive; I used "several" instead. Eubulides (talk) 06:33, 22 July 2008 (UTC)
I agree with DigitalC here; that the SYN violation is that we are placing evaluations of specific conservative treatments (like spinal manipulation) and passing them off as evaluations of chiropractic care. I don't even think we should be discussing evaluations of spinal adjustments in this article because there are so many different types they shoud be handled in their own articles. But, I don't see where this is reflected in anything that has been changed or written so far. I admit though that I may be missing something. -- Dēmatt (chat) 03:07, 24 July 2008 (UTC)
Nothing is being passed off. Every statement in Chiropractic #Evidence basis accurately describes its source. If the source talks about SM, the statement talks about SM. Eubulides (talk) 05:06, 24 July 2008 (UTC)
Dematt, could you suggest a specific change in wording of the question? How about this: "In the opinion of the section's critics, the section is a WP:SYN violation when it cites sources on spinal manipulation (SM) in general (as opposed to SM performed by chiropractors specifically or, more to the point, the full range of chiropractic treatment, not just SM), because the reader may think the assertions apply to chiropractic treatment."
There was nothing wrong with the "here's some background" part; it's just that the suggestion had been made to make the question shorter; I agree that shorter tends to be better.☺ Coppertwig (talk) 13:31, 24 July 2008 (UTC)
Well, my contention has been that discussing the good information in the wrong article is a form of synthesis because it implies to the reader that conclusions about one leads to conclusions about the other. So mine would look something like this:
  • In the opinion of the section's critics, the section is a WP:SYN violation when it presents specific research on spinal manipulation as evidence of effectiveness of chiropractic care as opposed to the whole range of treatments performed by chiropractors (not just SM), because the reader may confuse the assertions about spinal manipulation specifically as being assertions about chiropractic treatment in general.
I might be missing part of other's issues as well, so it probably still needs tweaking. -- Dēmatt (chat) 03:06, 26 July 2008 (UTC)
OK, thanks, I switched to that wording, and to balance added "the section clearly distinguishes SM research from other research" to the wording on the other side. Can anybody suggest further tweaking? Eubulides (talk) 08:31, 26 July 2008 (UTC)
I'm OK with the current wording, but here's an attempt to insert the concern that some of the SM research involved SM by some non-chiropractors; I don't know if this lengthens it too much and makes it too confusing:
"In the opinion of the section's critics, the section is a WP:SYN violation when it presents research on spinal manipulation (SM), some of which was performed by non-chiropractors, as evidence of effectiveness of chiropractic care as opposed to the whole range of treatments performed by chiropractors (not just SM), because the reader may confuse the assertions about spinal manipulation specifically as being assertions about chiropractic treatment in general." —Preceding unsigned comment added by Coppertwig (talk • contribs) 00:31 28 July 2008
Sorry, I don't know who made the above unsigned comment, but if it's all the same to you I'd rather just keep the question shorter. It's already too long, I think. It's been a week now doing ever more minor and minor edits; I'm inclined to ask the question at the appropriate administrator's noticeboard, unless there's some objection. Eubulides (talk) 15:00, 28 July 2008 (UTC)
No further comment so I put up the NOR/N question at Wikipedia:No original research/noticeboard #Chiropractic section on evidence basis. Eubulides (talk) 19:04, 29 July 2008 (UTC)
I am a little disappointed that Eubulides posted this to NOR/N without gaining a consensus. I thought discussions may have stalled but I don't think they were over. We have two options, I think: take down the post or edit the post. I chose the latter for now and expanding it to better represent the situation, I feel. -- Levine2112 discuss 19:22, 29 July 2008 (UTC)
  • Sorry, I did not realize that consensus was lacking. All specific objections to the wording were accepted. As far as I know the last comment you made was 23:08, 23 July 2008 (UTC), and you did not object to any of the proposals or changes in wording after that. The last objection was by Dematt at 03:06, 26 July 2008 (UTC), with a relatively minor wording change which was accepted as-is. The previous change was also a minor wording change. That sounded like consensus (even boredom) to me.
  • We have a third option, which I prefer: just go ahead with the query as written. You are of course free to open a new query of your own, or to append your own commentary to the query. I disagreed with the rewrite you made; it's obviously unfair to give one side significantly more discussion than the other. I took the liberty of undoing the rewrite at WP:NOR/N #Chiropractic section on evidence basis and moving the easily-separable addition in that rewrite to a later paragraph, signed by you.
Eubulides (talk) 21:31, 29 July 2008 (UTC)
Okay, well I understand your mistake in thinking that there was a consensus. I guess it would have been better to ask us first before posting. Anyhow, what's done is done and I have taken your advice and appended my own commentary to the query. I don't think it is unfair to give more discussion because the discussion your version made was insufficient and incorrect in its coverage of the opinions of the section's critics. I hope my attempts have rectified that. -- Levine2112 discuss 21:37, 29 July 2008 (UTC)

(<<outdent) A request was made for a shorter question. [31] How about "Short version: Is it a SYN violation to present results about effectiveness of spinal manipulation in a section on effectiveness of chiropractic treatment?" (I.e. this could be added at the bottom as a shorter version of the question.) ☺ Coppertwig (talk) 00:25, 5 August 2008 (UTC)

Suggest moving Treatment procedures

I suggest we move "Treatment procedures" to right below "Scope of practice", maybe even making it a subheading of that section. They belong together so much that we are even duplicating some subject content. -- Fyslee / talk 14:39, 4 August 2008 (UTC)

Sounds like a reasonable and rational thing to do. -- Dēmatt (chat) 14:56, 4 August 2008 (UTC)
OK. ☺ Coppertwig (talk) 21:49, 4 August 2008 (UTC)
Done. Now we need to eliminate the duplication of subject matter, BUT I suggest we wait until we have decided on whether to use the suggested replacement for the Treatment techniques section, otherwise we will be wasting our time. -- Fyslee / talk 01:12, 5 August 2008 (UTC)

Suggest renaming "Treatment procedures" to "Treatment techniques"

I suggest we rename "Treatment procedures" to "Treatment techniques", in keeping with the title of the main article on that subject (here we leave out "Chiropractic", since subheadings aren't supposed to unnecessarily repeat the article title. -- Fyslee / talk 14:39, 4 August 2008 (UTC)

OK. ☺ Coppertwig (talk) 21:49, 4 August 2008 (UTC)
Done. -- Fyslee / talk 01:13, 5 August 2008 (UTC)

Inaccurate insertion of "Simon says" phrases

I see now that what I predicted earlier would happen, is indeed starting to happen: this edit inserted two more "Simon says" remarks, and inserted quotation marks, in order to weaken the discussion. In these cases, the "Simon says" remarks were not accurate, as the source in question is by Keating and two other authors, not by Keating alone. Also, the newly-inserted quotation marks are not strictly accurate. Furthemore, the edit made the controversial change of removing "pseudoscientific" (a point that is made by the source). It also unnecessarily removed wikilinks. I'll sew what I can do to fix all this now, but I wish controversial changes like this were discussed first, before being made. Eubulides (talk) 18:06, 25 July 2008 (UTC)

Actually, my edits were discussed above first. My issue is that we are stating Keating's "antiscience" opinion three times in this article. That is most certainly a WP:WEIGHT violation. I have reduced it to one time. -- Levine2112 discuss 18:14, 25 July 2008 (UTC)
  • No, all that was said above was "we should not be restating Keating's opinion three times in our article". That is not a discussion of specific edits; it is a statement of a problem.
  • The changes introduced errors, as discussed above, and I will try to repair them on short notice. It would have been more helpful to discuss the specific edits first.
  • It is not a WP:WEIGHT violation to mention an important topic once in the body and to summarize it in the lead. The straights's dogma/pseudoscience/antiscience/antiintellectual/whatever-you-want-to-call-it is an important reason chiropractic continues to have problems with mainstream medicine, and this problem needs to appear in the lead. In an attempt to reach a compromise I will attempt to reword it without the word "antiscience", which appears to be a hot-button among sveral editors.
  • I continue to disagree with the idea of making controversial changes like this without specific discussion of the edits first. This is not a good way to move forward in this controversial article.
Eubulides (talk) 19:36, 25 July 2008 (UTC)

I have attempted a quick workaround of the problem with this edit, which does the following:

  • Restore the discussion of the issue to the lead, without using the hot-button word "antiscientific". This discussion uses terminology that comes from "Chiropractic History: a Primer", while avoiding the hot-button word.
  • Move the single use of the word "antiscientific" from Chiropractic #History to Chiropractic #Evidence basis. The problem of antiscientific/pseudoscientific/antiintellectual/whatever-you-want-to-call-it is a continuing one, so if it's going to be mentioned in one place, it's better not to imply that the problem has gone away by putting it into the History section.
  • Restore the point that evidence-based guidelines are supported by some chiropractors. Removing this point was not discussed, and I assume it was inadvertent.
  • Restore the citations to Phillips in PPC; this is an independent source (which does not cite Keating) about the issue.
  • Restore the citation to the "subluxation or dogma" paper, as it is a relevant source here (as elsewhere in the article).
  • Add a phrase talking about ethical issues; this was suggested in Talk:Chiropractic/Archive 25 #Antiscientific reasoning above, and nobody has objected to this particular phrase.

Eubulides (talk) 21:09, 25 July 2008 (UTC)

  • "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs what chiropractic researchers call antiintellectual, antiscientific or pseudoscientific reasoning,[5][3][6] stratagems that are ethically suspect when they let practitioners maintain their beliefs to patients' detriment.[4]"
This sentence gives the impression that all chiropractic researchers call some undescribed set of chiropractors antiintellectuals, antiscientific or pseudoscientific. I think what other editors are suggesting is that, rather than using the words antiscience, ps.... that we use the reasons that these particular researchers call them that instead. That way we avoid the pejorative sensations that the words themselves present without explanation.
BTW, is it okay if I make changes to the article without first getting consensus here, too. I'm okay with that if you are. -- Dēmatt (chat) 00:26, 26 July 2008 (UTC)
  • It doesn't call the undescribed set antiscientific; it merely says that they employ antiscientific reasoning, which is a different thing.
  • I don't think the other editors were saying that the word "antiscientific" be removed; only that it not be mentioned more than once and that it be attributed in the text; the current version does that.
  • I'd rather that we stick to the advice "Please read this page and discuss substantial changes here before making them." which has long been at the top of this talk page. I wish we had followed that advice in this instance.
Eubulides (talk) 00:41, 26 July 2008 (UTC)
  • The references that we have sourced do not say anything about a continuum that I can see. They all do seem to be opinion pieces; in fact as Coppertwig enlightened us, they are part of a debate within chiropractic. Why don't we consider phrasing it in the context of a chiropractic debate such as, "The debate within chiropractic circles is whether resistance to evidence based guidelines is justifed or is based on anti-scientific reasoning and unquestioning adherence to dogmatic beliefs." This way, we as wikipedians avoid taking sides. I'm not sure that it fits in the evidence based section though, unless we lost a link somehwere.
  • I'm not sure what you mean by "opinion pieces"; by the "Simon says" standard being proposed, I'd guess that all the sources currently cited by Chiropractic are opinion pieces, so in that sense, yes, they are opinion pieces. But this particular point is not controversial among reliable sources, and it's not being debated as far as I can see. The paraphrase you suggest is about evidenced-based guidelines and would clearly fall within the subject of Chiropractic #Evidence basis; however, I don't know of any reliable source that would support that paraphrase. Eubulides (talk) 02:40, 26 July 2008 (UTC)
  • I wish we had followed that advice in this instance. I think Coppertwig did. I wish we had followed it in every instance. That is the only fair way and it actually encourages collaboration, rather than destroys trust. -- Dēmatt (chat) 01:15, 26 July 2008 (UTC)
Eubulides (talk) 02:40, 26 July 2008 (UTC)
Oh, I returned it to the consensus version that Coppertwig made. I still don't see the continuum part. I really thought we had something that said that. -- Dēmatt (chat) 04:46, 26 July 2008 (UTC)
I see, but this version still has a problem. The text says:
'what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims"'
but the citations are not just to Keating 1997; they are also to Phillips 2005 (an independent source: he doesn't cite Keating) and to Keating, Charlton, Grod, Perle, Sikorksi, and Winterstein 2005. We need to fix the text to match the sources, which are not just Keating. The quote-marks are no longer appropriate, since we're citing some non-Keating sources, and they don't all use those exact words. To fix this I propose changing the abovementioned text to look like the following instead:
'what chiropractic researchers call antiscientific reasoning and unsubstantiated claims'
Eubulides (talk) 08:31, 26 July 2008 (UTC)
Thank you, Eubulides, for your effort in working towards a consensus version. The reference Keating, Charlton, Grod, etc. 2005 apparently does not contain the word "antiscientific". I'm not sure if I can access Phillips 2005: does it use that word?
Re "the other end employs what chiropractic researchers call antiintellectual, antiscientific or pseudoscientific reasoning": The phrase "chiropractic researchers" could easily be misinterpreted to mean researchers who are chiropractors, leading to an erroneous impression that we're saying that chiropractors are calling themselves antiscientific etc. A list of several pejorative terms seems unnecessary and leads to a non-neutral tone even if it's in a quote or indirect quote.
Re "'what chiropractic researchers call antiscientific reasoning and unsubstantiated claims'" OK except for my concerns about the phrase "chiropractic researchers". How about "commentators" or "commentators about chiropractic" or "researchers about chiropractic" or "commentators such as chiropractic historian Keating" or possibly just "researchers"?
You said that the prose attributions had been added for the purpose of weakening the phrase. That isn't my purpose. The purpose is to satisfy NPOV. The statement can be very clear and strong, as long as it's neutrally worded. How about something like "...the other end relies on postulates which are not scientifically established"? Does that express the concept sufficiently? If not, can you find a way to explain it in a phrase like that, rather than relying on individual words such as "antiscientific" which may mean different things to different people? Such a phrase may not need prose attribution, if we can agree that it's a verifiable fact expressed in neutral terms. ☺ Coppertwig (talk) 18:37, 26 July 2008 (UTC)
  • I realize it wasn't your purpose to make the text NPOV POV. But that is the effect of these changes. And it is this effect that we must deal with and fix.
I think you meant POV here. In which case I disagree.Gleng (talk) 17:53, 27 July 2008 (UTC)
I did mean "POV". Sorry about that. I corrected it. Eubulides (talk) 15:00, 28 July 2008 (UTC)
  • Keating, Charlton, Grod, etc. 2005 don't use the specific word "antiscientific", but they do make the point, and they do use the word "unsubstantiated" several times. Here's a brief sample: they say that the "preeminent theoretical construct" of "many chiropractors" (i.e., straights) "remains unsubstantiated". They also say that the ACC's subluxation claims are "exemplary of scientifically unjustified assertions" and that they "can only bring scorn and continued alienation from the wider health care community and the public"; this point is summarized in the abstract, using the word "ridicule" rather than "scorn". Their summary says "The dogma of subluxation is perhaps the greatest single barrier to professional development for chiropractors.... Commitment to this dogma undermines the motivation for scientific investigation of subluxation as hypothesis, and so perpetuates the cycle."
No dispute. Why not give as a quote that last sentence as you've put it, which makes their point admirably?Gleng (talk) 17:53, 27 July 2008 (UTC)
The last quote wouldn't make sense by itself. ("the cycle"? what cycle). Also, it's too long. The main point here is that straights make unsubstantiated claims, and that this sort of behavior brings ridicule/scorn from the mainstream. Eubulides (talk) 15:00, 28 July 2008 (UTC)
I meant the whole of your last sentece beginning "the dogma...", but better ended after "hypothesis". 79.68.13.143 (talk) 20:38, 28 July 2008 (UTC)
Ah, I see, but there's two problems with that. First, that's about subluxation, not evidence basis, so it would belong in Chiropractic #Vertebral subluxation, not in Chiropractic #Evidence basis. Second, that's really long: "The dogma of subluxation is perhaps the greatest single barrier to professional development for chiropractors; commitment to this dogma undermines the motivation for scientific investigation of subluxation as hypothesis." is much longer than "the other end employs antiscientific reasoning and makes unsubstantiated claims". Eubulides (talk) 22:05, 28 July 2008 (UTC)
That's about dogma and unsubstantiated claims.. Let's use those words. -- Dēmatt (chat) 16:13, 29 July 2008 (UTC)
I don't object to mentioning dogma and unsubstantiated claims in addition to antiscience, pseudoscience, and antiintellectualism. I do object to watering down the stronger terms and substituting the weaker ones, when no reliable source opposes the stronger terms. Eubulides (talk) 19:04, 29 July 2008 (UTC)
  • Phillips 2005 uses "antiscientific" (along with "antimedicine" and "antiintellectual"). I've already quoted this above. Look for "antimedicine" in Evidence basis rewording proposal. Phillips makes the explicit point that this antiscientific/antimedicine/antiintellectual persists today.
again, these are words that express an opinionated judgement but which have in themselves no clear objective meaning. Alone, they are the sauce without the beef.Gleng (talk) 17:53, 27 July 2008 (UTC)
These are the words that the source uses. This is a reliable source published in a refereed journal. No reliable source has been found that disagrees with this point. It is not our place to water down the points that reliable sources are making because, in our opinion, the words have "no clear objective meaning". That is simply arguing against reliable sources, something we are not supposed to do. Eubulides (talk) 15:00, 28 July 2008 (UTC)
Not arguing against sources, that this is their opinion is not in dispute. Representing their expression of distaste (which Fyslee clearly argues that it is) as though its an editorial judgement of fact is POV, to my mind at least. I don't think you'll find such expressions used much (if at all) in serious encyclopedias, or serious reviews in mainstream scientific/medical journals (though occasionally in opinion pieces maybe), or on NHS sites, NIH sites, AMA sites, etc etc. But we're going round in circles; it's an honest disagreement; I wouldn't give the word houseroom myself except in a context where it had an operational definition, I think it's just a small step up from playground insults. It's fine in forums for expressing gut feelings, should be absent from reasoned, objective discourse. But that'll be my last word on it and here.79.68.13.143 (talk) 20:38, 28 July 2008 (UTC)
I agree that words like "pseudoscientific" and "antiscience" are not commonly used in serious reviews, because most serious reviews don't waste their time on pseudoscientific and antiscientific views. But they are used on occasion, when fringe theories gain enough popularity to be a significant issue. For example, Weiss et al. 2008, a source on autism treatments (an area where many parents desperately choose treatments that have no scientific support), have a section entitled "Science, pseudoscience, and antiscience", which goes on for multiple pages, as this is a serious problem in autism treatments. See: Weise MJ, Fiske K, Ferraioli S (2008). "Evidence-based practice for autism spectrum disorders". In Matson JL (ed.) (ed.). Clinical Assessment and Intervention for Autism Spectrum Disorders. Academic Press. pp. 33–64. ISBN 0123736064. {{cite book}}: |editor= has generic name (help)CS1 maint: multiple names: authors list (link) Eubulides (talk) 22:05, 28 July 2008 (UTC)
  • I disagree that the supposed "list of pejorative terms" is unnecessary. It's important to make the point that the mainstream, and this includes the chiropractic mainstream, strongly repudiates the antiscientific attitude of the straights. We should not be bowdlerizing what reliable sources say on this matter. The terms being used may be strong but they are important.
  • I suggest just plain "researchers"; there's little point giving more details about their identities in the text.
  • No further comment on this, so I changed it to use the wording you suggested, choosing "researchers" among the alternatives you listed. Eubulides (talk) 15:00, 28 July 2008 (UTC)
  • I see now that Levine2112 reverted the change with the log entry "no consensus to change this yet". I don't see any disagreement about this on the talk page: Coppertwig proposed the change and I agreed. If there is some disagreement, please discuss it here, rather than reverting without comment here. Thanks Eubulides (talk) 15:19, 29 July 2008 (UTC)
I don't see where Coppertwig agrees and I don't agree that all chiropractic researchers think straights are antiscientific. Ceratinly some researchers think they are totally scientific. You've gone too far the other way. -- Dēmatt (chat) 16:13, 29 July 2008 (UTC)
  • Coppertwig actually proposed the wording in question, in his comment 'Re "what chiropractic researchers call antiscientific reasoning and unsubstantiated claims" OK except for my concerns about the phrase "chiropractic researchers". How about "commentators" or "commentators about chiropractic" or "researchers about chiropractic" or "commentators such as chiropractic historian Keating" or possibly just "researchers"?'. I took the last alternative, "researchers".
  • The proposed text does not say "all researchers", it just says "researchers". Of all the reliable sources we've found, all agree on this subject; there's no reason to water it down by giving the implication that it's just Keating's opinion.
Eubulides (talk) 19:04, 29 July 2008 (UTC)

(outdent) From edits like this one it appears that QuackGuru as well would prefer the wording that Coppertwig proposed to the wording that's in Chiropractic now. Do any other editors have an opinion on this topic? Eubulides (talk) 02:08, 30 July 2008 (UTC)

I prefer what's in there now. It's not misleading. Or perhaps we should just remove the phrase for the time being until we can agree on something. Further, I think Keating was referring to a group now all but expired. This would be better suited for the history section. -- Levine2112 discuss 02:14, 30 July 2008 (UTC)
I prefer we just remove the Keating phrase for now and perhaps we can replace it with researchers. Dematt agrees the current text is misleading. QuackGuru 02:28, 30 July 2008 (UTC)
I prefer to leave the text attributed to Keating until we find a different configuration. Changing it to researchers goes too far the other way. I will not argue with its temporary removal if others are not happy with it as is. -- Dēmatt (chat) 02:33, 30 July 2008 (UTC)
So far we have three editors (Coppertwig, QuackGuru, and myself) preferring the Coppertwig-suggested wording with "researchers", Dematt preferring the existing text until we think of something better, and Levine2112 preferring either the existing text or nothing. The existing text is highly misleading, though, so we really do have to improve it it one way or another. Removing it is not a reasonable alternative, as antiscience is a significant problem in any profession that uses evidence-based principles. This is not as good a consensus as I'd like, but so far the "researchers" variant seems to be ahead of the known alternatives. Any other suggestions? Dematt? Eubulides (talk) 07:16, 30 July 2008 (UTC)

(<<outdent) I did suggest the individual word "researchers". But we have to make sure the article accurately reflects the sources. In this version, as Dematt points out, it seems to imply that all researchers use the phrase "antiscientific", yet the first footnote goes to a source that doesn't use that word. (How many sources actually say "antiscientific"?) Inserting "some" before "researchers" would go too far the other way, though, if Eubulides is right that there are no dissenting views. How about this wording, based partly on Gleng's: "...the other end rely on postulates that are not part of mainstream science and medicine, and which have been called "antiscientific" and "unsubstantiated claims" by critics within the chiropractic profession." (and putting the footnotes in order: those containing "antiscientific" first if that word is quoted first in the sentence.) Coppertwig (talk) 13:29, 30 July 2008 (UTC)

Oops, I made a mistake; but – wait a minute! This source does contain the word "anti-scientific" after all; I had searched using control-F in my browser for "antiscientific" without the hyphen only. Sorry about that. However, it appears to be saying more-or-less that chiropractic is not anti-scientific, so it's the source Eubulides was asking for that refutes the "anti-scientific" claim. It says "There is nothing inherently dogmatic or anti-scientific in the notion that an articular lesion may have health consequences, or that correction of joint dysfunction may relieve symptoms and/or improve health." (I suggest reading this whole paragraph in the source: Keating Charlton Grod etc.). ☺ Coppertwig (talk) 16:29, 30 July 2008 (UTC)

  • I was not asking for a source refuting the claim that chiropractic is antiscientific. Nobody has made that claim, and Chiropractic did not make that claim. I was asking for a source that refutes the claim that a segment within chiropractic use antiscientific reasoning, which is the claim that Chiropractic actually makes, and which the source you mention confirms. The rest of the paragraph you quote goes on to warn us against "the unreasonable extrapolation of current knowledge into speculation and presentation of theory as fact", which is exactly what this segment of chiropractic does, and which corresponds to the "unsubstantiated claims" and "pseudoscience" that several reliable sources attest to.
  • I have several times read the sources in question. Before this current editing ruckus started, Chiropractic summarized them accurately, and gave the accurate impression that there is an antiscientific component of the chiropractic community that uses antiscientific and pseudoscientific reasoning which is a barrier to evidence-based medicine. There is no controversy about this among reliable sources.
Eubulides (talk) 18:50, 30 July 2008 (UTC)
Regardless if that is what you were asking for, you got it. Keating is saying that there is nothing inherently antiscientific about dogma or subluxation, just the dogmatic reliance on unsubstantiated claims. Also, that makes the group that he is referencing a much smaller group - super straight or objective straight is his target, but even they don't make claims that they cure any disease... in fact, they have a healthy respect for science, they just don't "waste their time" making a diagnosis. (Notice the judicious use of the quotes so as to show it is their opinion). That leaves us with one source of Keating using the word to slap the other side. So we should either attribute it with quotes because of its questionable definition or describe the opinion NPOV with less POV wording. Either way, we probably need to give the other side.. -- Dēmatt (chat) 13:54, 31 July 2008 (UTC)
Obviously Keating is not saying that all chiropractic is antiscientific. But Chiropractic is not saying that either. It is merely saying that one end of a continuum is antiscientific. There is not "one source" using the word: we have several sources, including Principles and Practice of Chiropractic (in a chapter that Keating did not write, and which does not cite Keating). Eubulides (talk) 14:22, 31 July 2008 (UTC)
One editor claims or is implying the text may not be verfied.[32] QuackGuru 01:20, 1 August 2008 (UTC)
The diff in question is fairly cryptic; I can see several ways to interpret it. I wouldn't worry about it too much (it's just a user talk page comment) unless the topic is brought up on this page. Eubulides (talk) 08:08, 1 August 2008 (UTC)
That was me. I was not claiming or implying that the text may not be verified. I was simply expressing an intention to examine the sources before proposing another suggested version of the text. I see no need to bring that comment into this discussion. ☺ Coppertwig (talk) 12:40, 1 August 2008 (UTC)

It's been a day and a half since I noted the impasse in the discussion, with the current wording clearly having a problem (it misleadingly suggests that only Keating holds the opinion), and with a proposal on the table that seems to be favored by three editors, disliked by one, and keep-until-we-think-of-something-better by a fifth. If nobody can think of something better, we should switch to the Coppertwig-suggested wording with "researchers", as it's clearly an improvement over the misleading text currently in use. We can substitute the something-better later, once we think of it. Eubulides (talk) 14:30, 1 August 2008 (UTC)

I don't think we should have to keep commenting in order to "keep" a consensus version. Which three editors? -- Dēmatt (chat) 03:09, 2 August 2008 (UTC)
Coppertwig (who proposed the wording in question), QuackGuru, and myself. The version in Chiropractic is not really a consensus version; on the contrary, there is considerable sentiment that it is misleading in its current form (as it talks only about Keating saying "antiscientific", when "antiscientific" is actually the consensus among several reliable sources). Eubulides (talk) 06:14, 2 August 2008 (UTC)
Read the last part of the edit summary:[33] Don't assert non-NPOV statements without quotes.
It is misleading to claim it was only Keating. If it was non-POV then quotes would not help. Based on the edit summary the editor thinks it is not NPOV. I thought we have been through this before. The text is verified by more than one reseacher. If this continues then the neutrality noticeboard is one of the options we can choose. QuackGuru 17:15, 1 August 2008 (UTC)
  • I take the last part of that edit summary to be referring to "pseudoscientific", which is not the wording being discussed here.
  • I think there's consensus that it's misleading to give the impression that it's only Keating. Where there's less agreement is how to fix the problem. The Coppertwig-suggested wording with "researchers" has the most consensus of any proposed replacement. I hope the neutrality noticeboard isn't needed for this relatively-minor issue.
Eubulides (talk) 17:50, 1 August 2008 (UTC)
"researchers" goes too far the other way. I'm also thinking the use of "antiscientific" can be used in the history with both Keating and Phillips 2005 and "unsubstantiated claims" in Evidence base. -- Dēmatt (chat) 03:09, 2 August 2008 (UTC)
"Antiscientific" belongs better under Evidence basis (formerly Scientific investigation) because it is about an obstacle to evidence-based medicine. The antiscientific component of chiropractic is not merely a historical issue; it doesn't belong only, or even primarily, under History, although I suppose it could be mentioned there as well. Do you have any specific wording to propose other than the wording Coppertwig proposed, with "researchers"? Eubulides (talk) 06:14, 2 August 2008 (UTC)

Speaking as a historian

He's speaking as a historian, talking about how history has forged contemporary attitudes. He's notable as a historian, almost uniquely well qualified to talk about this. He's not a scientist, which is maybe why he uses terms scientists generally avoid (in public, in private hey use them all the time - about each other).Gleng (talk) 17:53, 27 July 2008 (UTC)
Again, this is not just Keating; lots of other chiropractic researchers agree with him and so far we've found no reliable sources disagreeing. The chiropractic researchers have D.C.s and are publishing in peer-reviewed journals or in popular chiropractic textbooks. This is all in public. Eubulides (talk) 15:00, 28 July 2008 (UTC)
  • "the other end relies on postulates which are not scientifically established" isn't right, as it waters down what the mainstream chiropractors are saying. They are not saying merely that straights are speculating. They are saying straights are antiscientific and pseudoscientific. Real scientists speculate; but they don't continue to speculate, indefinitely, when evidence can be found, and is found.
No, afraid that's not true. Scientists hang on to theories long after they've been superceded - see "The Structure of Scientific Revolutions" by Thomas Kuhn (actually I don't recommend the WP articles unless you want a headache). They are dogmatic too; conservatism is I'm afraid a neccessary part of science. The point at which such adherence becomes unreasonable is hard to judge, at some point it does - but it's a judgement call, not black and white.Gleng (talk) 17:53, 27 July 2008 (UTC)
Kuhn's thesis does not affect the point that real scientists do not continue to speculate, indefinitely, when evidence can be found, and is found. Eubulides (talk) 15:00, 28 July 2008 (UTC)
Merely on a point of accuracy, Kuhn said very clearly that older, more experienced scientists did usually adhere dogmatically to older theories indefinately. He quote Max Planck:"A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grow up that is familiar with it."Gleng (talk) 09:04, 29 July 2008 (UTC).
Even if Planck's quip were largely true, which it is not, that would still not explain the straights' dogmatic and antiscientific position, which has held sway for a century. B.J. died long ago, no? And Planck is a counterexample to his own quip (and to Kuhn's thesis as well, of course): his own doctoral thesis of 1879 specifically opposed Boltzmann's constant and Boltzmann's statistical interpretation of the 2nd law of thermodynamics, but obviously he changed his mind in his quantum theory. For more, please see: Blackmore JT (1978). "Is Planck's 'principle' true?". Br J Phil Sci. 29 (4): 347–9. doi:10.1093/bjps/29.4.347. I realize that postmodernists love Kuhn because it allows them to say science is all relative, but encyclopedia articles should stick with the common interpretation of words like "science" and "antiscience". Eubulides (talk) 15:19, 29 July 2008 (UTC)
Well, what Kuhn actually said was "every individual choice between competing theories depends on a mixture of objective and subjective factors." While both he and Popper are postmodernists, they certainly did not say that science was all relative - and Kuhn regarded science as the "most rational" of all human activities. But defining science is the job of Philosophy of Science, and his book is the most cited book in the category of Philosophy and History of Science (and indeed one of the most cited academic books of all time, with more than a million copies sold).</ref>
I agree that what Kuhn said differs from what other postmodernists say about science and relativism. But we are straying from the discussion's point. The popularity of Kuhn's book, and even Kuhn's book itself (assuming one agrees with it), do not affect the point that some chiropractors are antiscientific. Eubulides (talk) 19:04, 29 July 2008 (UTC)
So what does Kuhn think is antiscientific. Let's compare it to Keating's and Eubulide's. Maybe we are talking about two different things. -- Dēmatt (chat) 20:45, 29 July 2008 (UTC)
Quite possibly we are. The "antiscientific" I'm talking about is the "antiscientfic" of chiropractic historians and researchers like Keating, Phillips, etc. Eubulides (talk) 21:31, 29 July 2008 (UTC)
Kuhn's approach was empirical: you can define scientists by their communities, professional affiliations journals etc, and then science is what scientists do. Unscientific things are things they don't allow, and different communities allow different things, so it's not a universal. Antiscientific I think he reserved for things in clear opposition to science (with the primary meaning of anti as hostile to) - he certainly used it to describe the book burning by the Church in the 16th century.Gleng (talk) 09:00, 30 July 2008 (UTC)
Ah, so what we are talking about here are two distinct groups of chiropractors that have their own ideas of science; one that uses vitalistic constructs like Innate Intelligence and Universal Intelligence as metaphors to explain what they think happens and the other side uses evidence based best practice procedures based on results no matter what the cause. It seems that Kuhn would think that each had their own science then. In that case, using the word antiscience from Keating and his friends is just an attack on the other side's science. Is that your impression? -- Dēmatt (chat) 15:50, 30 July 2008 (UTC)
I disagree completely with this speculation about what "Kuhn would think". But it doesn't matter what I, or any other Wikipedia editor, speculates in this area. What matters is what reliable sources say, and on this point there is no disagreement among reliable sources. Eubulides (talk) 18:50, 30 July 2008 (UTC)
  • Asking me to "find a way to explain it in a phrase like that", without using the word "antiscientific", sounds an awfully lot like a request to depart from what reliable sources say, in order to spare the sensibilities of... who? Wikipedia readers? They won't care. There are no four-letter words here. Of chiropractors? But the sources were edited by mainstream chiropractors: they won't care either. Of fringe chiropractors? No, they won't care either, they're used to words like that. Or are we sparing the sensibilities of some Wikipedia editors? But that shouldn't matter: what should matter here is what reliable sources say. On this subject there is zero disagreement among reliable sources. We should not be searching for toned-down language to weaken what reliable sources say, in order to avoid upsetting some editors. We should be summarizing what sources say, as best we can.
Well not really; I have a lot of respect for Keating because he goes on to say exactly what he means, and he did not mean "antiscience" in the sense of being anatagonistic to science, which is the most common contemporary understanding, and certainly not "antiscience" in the philosophical postmodernist sense, but dogmatic attitudes about unneccessary postulates. So why not say that? If you want to express not merely his argument but also his emotional distaste, by all means use the words he used in quotes and attributed specifically. Gleng (talk) 17:20, 27 July 2008 (UTC)
Actually we would be doing OR by not accepting his word "antiscience", although I certainly understand that we should follow the author's obviously real meaning, rather than the exact text if it is obviously misleading. Why do I say that? Because I think Keating actually meant the true revulsion and distrust of science, of the scientific method, and of scientists, when he wrote "antiscience". You see, the people he wrote about had/have their own "science", the "science of chiropractic", which is pseudoscience at best, and antiscience at worst. I've read a number of statements from very notable chiros like Sid Williams (Life College founder) and Fred Barge that express such sentiments. I think the reason is just what you have expressed - their defenses of and "dogmatic attitudes about unneccessary postulates." Keating wrote this about Barge: "... by this time we had already established some degree of mutual understanding of our frequently opposing views about chiropractic, about science, about vitalism, and about health care in general. We are opponents, not enemies." Keating understood science better than Barge did, but they were both gentlemen and friends. As to Williams, he was a football player turned practice builder, who started the largest chiropratic school. The depth of his intellectual understanding of the true workings of science are about as thick as a byte on cyberpaper, but his influence was huge. As to the Palmers themselves, their antiscientific and antiintellectual attitudes are legendary. Keating really did mean "antiscience", because he was likely referring to such prominent chiros who often spewed very antiscientific sentiments, and those sentiments were picked up by their followers. -- Fyslee / talk 14:13, 28 July 2008 (UTC)
Barge is dead. And so are the rest of them. Sid Williams was basically kicked out of Life College for causing them to lose their accreditation. I suppose that is what Kuhn meant. IOWs, that's history now, lest we want to continue to talk about leeching in the medical articles. -- Dēmatt (chat) 13:30, 29 July 2008 (UTC)
Is this an assertion that straight chiropractic is dead? If so, I disagree: it's still very much alive. Keating is dead too, alas, but that doesn't mean his opinions are dead; others still share them. Eubulides (talk) 15:19, 29 July 2008 (UTC)
What are you calling straight chiropractic, the one that doesn't mix with other things; the one that holds that the body i smore than the sum of its parts; or the one that believes that scientists are idiots. I think the one that thinks scientists are idiots is dead, though there is still a significant group of straights and mixers that think that medicine is pseudoscience and makes unsubstantiated claims, but that's not using antiscientific reasoning. -- Dēmatt (chat) 16:13, 29 July 2008 (UTC)
If you can come up with reliable sources saying that the antiscientific component is dead, then fine, let's cite and use them. However, we have multiple reliable sources, three dated 2005, that agree that the antiscientific component is signficant; and we have no reliable sources disagreeing. We can't go against reliable sources just on our say-so, or by conducting our own original research. Eubulides (talk) 19:04, 29 July 2008 (UTC)
I agree with Fyslee here. The criticism of Keating (and others) is not strictly limited to dogmatic attitudes; it also refers to the antiintellectual/antiscience attitudes of the straights, and to the pseudoscience that they use. Making it sound like dogmatism is the only criticism, waters down that criticism greatly. Eubulides (talk) 15:00, 28 July 2008 (UTC)
This may well be what he thought - although to be fair, that needs reading into his words, because these are not things he goes on to say in the articles concerned. In those articles he talks about dogmatic attitudes and untested assumptions at great and careful length. So I think it is probably OR (if correct OR) to say that he also meant these other things; whereas its not OR to say he meant to say the things he went on to specify. Again, I don't object to using his words, if it's made clear that they are his words and not necessarily the words that would have been chosen by Wikipedia editors. As for the Palmers' attitudes to science I am much less sure; that is a tricky historical call; William Cullen wrote -the major medical textbook of the late 18th/early 19th century, and he held that almost all diseases had a major nervous system component, and proposed the vague concept of "sympathy" to explain nervous influences on disease processes. Sounds so like innate intelligence that I wonder if Palmer didn't simply lift it and re-express it.Gleng (talk) 17:33, 28 July 2008 (UTC)
  • The current situation, in which the ideas have been watered down and then surrounded with quote marks and then (incorrectly) attributed in the text only to Keating, is the worst of both worlds. If we're going to use quote marks, we should let these reliable sources have their say, without removing words like "antiscientific" and "pseudoscientific" that some editors think are pejorative. Both antiscience and pseudoscience are real problems in a segment of chiropractic, a problem that reliable sources agree on, and Chiropractic should not attempt to sweep this issue under the rug.
Eubulides (talk) 16:32, 27 July 2008 (UTC)
I think that criticisms are stronger when they are expressed rigorously and objectively. Again, using these words risks alienating the neutral reader, and risks making the sophisticated reader contemptuous of the lack of rigor and clarity. It seems that you're trying to make the conclusion for the reader, rather than explaining the arguments and letting him or her draw a conclusion themselves. Gleng (talk) 17:20, 27 July 2008 (UTC)
These sorts of words are used by reliable mainstream chiropractic sources published in refereed journals. It is not our place to second-guess and water them down out of fearing of "alienating the neutral reader". If we water them down, then it is we who are trying to make the conclusion; that's not our job. It's our the job of our sources' to make the conclusions, and it is our job to summarize these conclusions as accurately and concisely as we can. Eubulides (talk) 15:00, 28 July 2008 (UTC)?
Thanks for thoroughly stating the arguments here. I still don't see enough reason to think that we have enough not to attribute the statement to Keating and am thinking that the word should be used in the scope of practice section under the straights - properly attributed and defended. Now that Eubulides points out the fact that subluxation vs evidence based medicine objection, I am wondering if Keating was talking about evidence based medicine when he wrote that. We might consider just deleting it as being in the wrong section. -- Dēmatt (chat) 13:30, 29 July 2008 (UTC)
It's not a question of attribution. Of course we must attribute the claim to Keating, as well as to Bronfort, Charlton, Grod, Hegetschweiler, LaBrot, Lawrence, Metz, Nelson, Perle, Phillips, Sikorski, Triano, and Winterstein. It's a question of whether the attribution must give the reader the incorrect impression that Keating is the only person to share this opinion, which is obviously not the case. The point about antiscience is crucial to evidence basis, as the antiscientific attitudes of some chiropractors have hampered the job of coming up with practice guidelines. It's not so clearly relevant to scope of practice: after all, it's not as if legislators are putting the word "antiscience" in the laws regulating chiropractic! Eubulides (talk) 15:19, 29 July 2008 (UTC)
You said Pillips 2005 didn't use antiscience. It's not antiscience that is hampering the guidelines, it is genuine concern that guidelines will limit what they can do for their patients.. that is not disbelief in science; they believe science will validate what they do. It is distrust of the insurance system that they see as dominated by medicine. -- Dēmatt (chat) 16:13, 29 July 2008 (UTC)
  • I didn't say that Phillips 2005 didn't use antiscience. On the contrary, I quoted Phillips 2005 as using words like "antimedicine", "antiscientific", and "antiintellectual".
  • Genuine concern hampering the guidelines does not contradict the claim, made by a reliable source, that antiscience hampers the guidelines as well.
Eubulides (talk) 19:04, 29 July 2008 (UTC)
Re "...the other end relies on postulates which are not scientifically established". That's going to be hard to reference. Maybe this is where we can bring in the "low quality research" somehow. Though realistically, according to Murphy, they are all citing the same research but ending up with different consensus versions of guidelines. IOWs, mixers and straights have different guidelines that were consensus guidelines. The first were the Mercy Guidelines by Haldeman in the 1990s that got a lot of flack from the straights so they made their own, which included the same research but must have allowed more visits or something. Since then, I think the CCPG? guidelines were developed and again the straights have developed their own, only this time I think it is just the WCA straights(minority). My question would be, whose EBM guidelines are we talking about? -- Dēmatt (chat) 00:47, 27 July 2008 (UTC)
There is no need for the attribution. We have more than Keating saying this. It is misleading to say it is just Keating. QuackGuru 06:30, 27 July 2008 (UTC)
I think Coppertwig and Dematt are in agreement that the criticisms should be expressed clearly and objectively, and Coppertwig's suggestion "...the other end relies on postulates which are not scientifically established" is a reasonable suggestion that expresses the criticism in a way that I think is fair, and the existing references for that are good explanations of that. I'd support this, but it might be better to express things robustly but making it clear that the views are the opinions of an identifiable group e.g. "...the other end rely on postulates that are not part of mainstream science and medicine, and which, according to critics within the chiropractic profession, reveal dogmatic attitudes and uncritical thinking." The first part is a statement of fact, and I think uncontroversial in that (I think) chiropractors declare these postulates as unique and distinctive features of chiropractic; the second is a judgement declared as an opinion and attributed. Gleng (talk) 11:43, 27 July 2008 (UTC)

Ethical implications

Your solution sounds excellent to me, Gleng. I was thinking that my "not scientifically established" sounded a bit weak. "dogmatic" etc. gets the message across. What do others think?
Meanwhile, though, this end of the sentence has somehow gotten into the article, without consensus I think: "stratagems that are ethically suspect when they let practitioners maintain their beliefs to patients' detriment". This would certainly need prose attribution if it's kept. Also, the word "stratagems" seems non-NPOV to me: it seems to imply that people have some ulterior motive. (Why can't they just believe something because it seems true to them?) This addition was discussed, and the point was made that prose attribution would be needed for it, but it's been added to the article as a Wikipedian assertion. I would prefer simply deleting this part, but I might accept a NPOV version of it if one is suggested, i.e. with prose attribution and removing "stratagems". Also, it seems unclear who is being talked about: the educators at chiropractic schools perhaps? ☺ Coppertwig (talk) 14:35, 27 July 2008 (UTC)
  • "Who is being talked about" is chiropractors in general (this is true for both Chiropractic and for the source).
  • I don't recall the point being made that prose attribution would be needed for it, but obviously we can discuss it here.
  • I don't see the pejorative connotatation behind "stratagems", but we could use some similar word. How about "tactics"? It's shorter, which is better.
Eubulides (talk) 15:00, 28 July 2008 (UTC)
I saw no further discussion, other than this edit by Coppertwig which simply removed the phrase in question. As far as I can see, the phrase had been there for some time with only Coppertwig questioning it; I took the liberty of restoring it using "tactics" rather than "strategy" and switching to singular to make the grammar match better. Regardless of whether the phrase itself is kept, the citation to Nelson et al. must be kept, as it also supports the "antiscientific" part. I added another citation to that effect, though it does seem a bit overkill to cite Nelson et al. twice in the same sentence. Eubulides (talk) 15:23, 9 August 2008 (UTC)
"...the other end rely on postulates that are not part of mainstream science and medicine, and which, according to critics within the chiropractic profession, reveal dogmatic attitudes and uncritical thinking." Dogma is definitely the word we should use. I think the atrribution is reasonable as well.
For those who forgot, these are the postulates that we are talking about. Are we trying to say that wikipedia is saying that all of these are not part of mainstream science and medicine or should we attribute this same group of people? I'll go with whatever you decide as it is 50/50 for me.
  • 1. There is a fundamental and important relationship (mediated through the nervous system) between the spine and health.
  • 2. Mechanical and functional disorders of the spine (subluxation) can degrade health.
  • 3. Correction of the spinal disorders (adjustments) may bring about a restoration of health.
-- Dēmatt (chat) 17:55, 27 July 2008 (UTC)
I had thrown in the word "postulates" and was vaguely alluding to something like that, but I realize we had better not use that word unless we're clear about which postulates it means. I think Gleng's suggested edit is better; it doesn't use that word, so we're not implying that any specific statement is or is not accepted by mainstream science. Thanks for bringing up that point to clarify things, Dematt. ☺ Coppertwig (talk) 00:00, 28 July 2008 (UTC)
So where are we? I still haven't seen anything that uses the continuum example. How many chiropractors do you think actually use antiscientific reasoning. Do you think it is more than a fringe? If is isn't, then we don't have to explain their POV, but if it is more then we do, right. -- Dēmatt (chat) 13:44, 29 July 2008 (UTC)
I don't know what percentage of chiropractors use antiscientific reasoning; from reliable sources it seems to clearly be a minority, but a significant one. Eubulides (talk) 15:19, 29 July 2008 (UTC)

Eureka, I found it! The continuum statement is on page 3. Let me just go ahead and put the referenced text here:

Chiropractic colleges vary considerably in terms of the commitment their faculties and administrators make to critical reasoning, skepticism, science, and scholarship. At one end of the spectrum lies Life College (situated outside Atlanta), whose founding president, Sid Williams, D.C., is also a former president and former chairman of the board of the International Chiropractors' Association. With a student body in excess of four thousand, Williams is proud of having built the world's largest chiropractic institution. Although he speaks of the "science of chiropractic," he is notorious for his antiscientific attitudes and unsubstantiated claims; examples of his rhetoric include (American Chiropractic Association 1994):

God spoke to me in very clear language on three different occasions during a five-month period telling me to commence this work.

These conspirators would convince us that the "scientific approach" to chiropractic is the only approach acceptable to the public community, the professionals, the legislatures.

To hell with the scientists. They haven't proven a bumble bee can fly.

If you got an improved homeostasis, what damn difference does it make what diseases you're gonna be encountering. The whole germ theory comes crashing down from its tower.

Rigor mortis is the only thing that we can't help!

At the other end of the ideological continuum one finds schools such as the National College of Chiropractic (situated outside Chicago), the Los Angeles College of Chiropractic (LACC), and several others. Now celebrating its ninetieth year, the National College has been a leader in scientific and scholarly development within the profession. This commitment is particularly apparent in its founding of the JMPT, and more recently of the Journal of Chiropractic Humanities. Members of the LACC's faculty and administration have been frequent contributors to the scientific literature and collaborators with the RAND Corporation in developing systematic, evidence-based guidelines for the practice of spinal manipulation [TABULAR DATA FOR TABLE 2 OMITTED] for specific health problems (e.g., Shekelle et al. 1991). The above-average commitment to scholarship and critical thinking of the LACC and the National College are further reflected in each school's initiative in developing problem-based learning for chiropractic students. Skeptical eyebrows may be raised by some of the hypotheses entertained at these schools, but a closer examination will reveal that a healthy skepticism is also present.

So, I think it is important to note that that was 1997. Keating took aim at Sid Williams at Life College, who was subsequently kicked out of Life College as the the CCE pulled it's accreditation. I don't think we are talking about the same profession now that Keating was then. Does the Phillips 2005 source mention antiscience in relation to evidence based medicine? I do agree with Eubulides that mainstream chiropractic and mainstream medicine consider Sid Williams antiscientific and antimedicine, though I think antiintellectual would be hard to prove. He was certainly a theologin, but some of our best intellectuals are theologins. But he is gone now. Since then, I think we have evidence that chiropractic schools are all working along education that is along the evidence base and guidelines are in place and all tend to follow some sort of guidelines that are based on evidence. If we need to say anything it would be about the quality of that evidence and how it is interpreted. Thoughts? -- Dēmatt (chat) 14:23, 29 July 2008 (UTC)

  • Straight chiropractic is not dead. It is still a signficant component of chiropractic. It did not die with Williams, any more than scientific chiropractic died with Keating.
  • We cannot do our own research from third-party sources ("evidence that chiropractic schools are all working along education") to come to the conclusion that straight chiropractic is dead. That would be a clear case of WP:OR. We cannot go through random course catalogs and say "look, there's all this evidence-based stuff! the straights are dead!".
  • If we really want to make the claim that the straights are no longer significant, we have to find a reliable source that says so. But we won't be able to find one, I'm afraid.
Eubulides (talk) 15:19, 29 July 2008 (UTC)
Lord no, straight chiropractic is not dead; just that portion that feels and talks like Sid is much smaller. The question is whether it is small enough to not have to worry about their expalining their POV. But then if it is that fringe, then why are we mentioning it. It is such a conundrum. -- Dēmatt (chat) 16:13, 29 July 2008 (UTC)
If the antiscientific component is now so small as to not be significant, then we obviously can decrease the amount of space we devote to its views. (We shouldn't eliminate it, obviously; it will continue to be important, at least in the History section.) However, reliable sources, including the most-recently published edition of the leading textbook on chiropractic, continue to agree that the antiscientific component is still an issue and is still worth mentioning. We have found no reliable sources disagreeing with this, or saying that the antiscientific proportion of chiropractic has shrunk, much less shrunk to insignificance. Eubulides (talk) 19:04, 29 July 2008 (UTC)
Here is an interesting piece from the Foundation of Chiropractic Education (the superstraights!) It helps explain a lot. So we have mixers and straights, but the (now super-) straights think the straights sold out to medicine so they tried to rename as Objective straight in the late 1970s and 1980s, but have gotten really small. This is the group that all those researchers are talking about.. we should also check the WCA website. We might be able to isolate this group. Notice though that Sherman is included in this - but Sherman does have a science department as well. -- Dēmatt (chat) 01:09, 30 July 2008 (UTC)

Again, this removal of all terms like "pseudoscientific", "antiscientific", and "antiintellectual", is watering down the sources. We have multiple reliable sources agreeing, and no reliable source disagreeing, that a segment of chiropractic uses this sort of reasoning. This is a far more serious charge than merely "reveal dogmatic attitudes and uncritical thinking". It is not our place to seriously water down what reliable sources are saying, merely because we dislike the terms that they are using. Eubulides (talk) 15:00, 28 July 2008 (UTC)

Nonsense. It's not like we aren't either describing the same thing in NPOV format or attributing them to the proper sources. Using them just for the sake of throwing spitballs is something that chiropractors can do amongst themselves, but WP doesn't take sides. That would be embarrassing if there were such a thing as a self correcting inborn intelligence. -- Dēmatt (chat) 13:40, 29 July 2008 (UTC)
Chiropractic is not using critical words like "antiscientific" for the sake of throwing spitballs, just as it is not using supportive words like "important" and "fundamental" for the sake of throwing rose petals. It is using words supplied by reliable sources to describe important aspects of chiropractic. If the style is to put critical words like "antiscientific" in explicit quotes because they are critical, then for consistency we must put supportive words like "important" and "fundamental" in explicit quotes as well. As there are many, many more supportive than critical words in Chiropractic, this will be a big job, and will result in an article that is much harder to read. I don't favor such changes. However, it should be inarguable that if such changes are made to weaken the critical side of the article, it would be clear NPOV not to make a similar, consistent change to weaken the supportive side. Eubulides (talk) 15:19, 29 July 2008 (UTC)
We should remove words like important or fundamental or attribute them to their sources. -- Dēmatt (chat) 16:13, 29 July 2008 (UTC)
I wonder about phrasing like this as well: "Although vaccination is one of the most cost-effective forms of prevention against infectious disease,.." -- Dēmatt (chat) 17:13, 29 July 2008 (UTC)
There is no controversy among reliable sources on that point either; vaccination is right up there, along with potable water, as the main contributors to public health of the last two centuries. If we need to put quote marks and in-text attribution on this sentence, then for consistency we'll need quote marks and in-text attribution for almost all the sentences in Chiropractic; lots of them make far-more controversial points than this one. Eubulides (talk) 19:04, 29 July 2008 (UTC)
Oh no, I was just talking about getting rid of "although". You're right though, do we have a source for that? -- Dēmatt (chat) 20:45, 29 July 2008 (UTC)
  • The cited source does indeed say "Although" on exactly this point.
  • That being said, I doubt that we need to cite linking words like "and", "but" and "although". What's next, citing each comma and semicolon? Do we need to cite the white space too?
Eubulides (talk) 21:31, 29 July 2008 (UTC)
This is the source says:
  • Although most public health authorities would agree that vaccination constitutes one of the most cost-effective infectious disease control measures of the last century, few, if any, would argue that there are no problems associated with their use.23
We have:
  • Although vaccination is one of the most cost-effective forms of prevention against infectious disease, it remains controversial within the chiropractic community.
Even they attribute that to "most public health authorities" and add the disclaimer at the end.. we should, too. That way we wouldn't have to add the other POV.
-- Dēmatt (chat) 02:42, 30 July 2008 (UTC)
The source is reliable for the controversy within chiropractic, but it is not particularly reliable for the cost-effectiveness of vaccination. Is there a serious dispute about the cost-effectiveness? If so, we can easily supply several more reliable sources confirming that it is cost-effective; that's not a controversial point. Eubulides (talk) 07:16, 30 July 2008 (UTC)
Well, "few, if any, would argue that there are no problems associated with their use.23", hints at the other side of the story. IOWs, it seems to contend that a few do argue there are some problems, and chiropractors tend to side with them. Is ther esomething wrong with giving that impression. Is it not real? -- Dēmatt (chat) 03:19, 2 August 2008 (UTC)
That is a misleading summary of what public-health officials say. They all acknowledge that there are adverse effects of vaccines, but the effects are much, much smaller than the positive effects. Chiropractors who argue against vaccination do so by magnifying the adverse effects, and minimizing the positive effects, creating in the public's mind the false impression that the positive and negative effects are roughly of the same magnitude, or even that the negative effects are greater. Eubulides (talk) 06:14, 2 August 2008 (UTC)

Phillips 2005 speaking as a historian in PPC Haldeman

I've had a chance to pick up a copy of PPC Haldeman that has the Phillips 2005 use of antiscience and antiintellectual. It's on google books page 71. It is in chapter 3 called "The Evolution of Vitalism and Materialism and its Impact on Philosophy in Chiropractic" in the section labeled "vitalism in chiropractic and the twentieth century". The quote concerning antiscience and antiintellectualism seems to be referring to a period about 1920-1930. The entire chapter is interesting and most is online in the googlebooks. Unfortunately the good stuff is not, but the conclusion that Reed Phillips goes something like this:

  • "Allopathic hegemny attempted to eliminate the budding profession using legal means. Unable to withstand the frontal assault, chiropractic leadership sought refuge under the shield of an alternative vernacular... This protective shield prompted a segment of the profession to extend its comfort zone by adopting not only an antimedicine position but an antiscience stand... Although this antiintellectual position persists in a small percentage of chiropractors in the twenty-first century, the profession never developed a broad-based consensus around Stephenson's 33 principles. The current spectrum of thought ranges from these tradition concepts espoused by B.J, Stephenson, and their adherents to an equally dogmatic and complete denial of vitalistic concepts at the other end of the spectrum... Fortunately, the spectrum contains a great deal of space between the two anchoring ends, a space wherein may be found many types of principles, such as vitalism, holism, naturalism, therapeutic conservatism, critical rationalism, and thoughts from the phenominological and humanistic paradigms.... "

Stephenson's 33 principles is definitely objective or super straight - Sherman style chiropractic which, as we saw earlier, has a healthy respect for science now as well. The other end is likely the group that we would equate with the NACM, super science oriented. We have already noted that both are fringes, but they both still exist. That leaves the middle ground. I would be satisfied with anything that mentions these two extremes but keeps it in context as to the vast majority of weight that should be somewhere in the middle. Thoughts. -- Dēmatt (chat) 01:30, 2 August 2008 (UTC)

OK, how about replacing this:
"Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs what chiropractic historian Joseph C. Keating, Jr. calls "antiscientific" reasoning and unsubstantiated claims,"
with this:
"Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the middle of the spectrum contains many types of principles, such as holism and naturalism; the other end employs antiscientific reasoning and unsubstantiated claims,"
with the same citations as now (one of these citations is Phillips 2005 of course). Eubulides (talk) 06:14, 2 August 2008 (UTC)
Hmm, it seems to give the impression that only the one extreme group supports Evidence based guidelines. -- Dēmatt (chat) 21:56, 2 August 2008 (UTC)
You know, there are two sets of guidelines, one from the "left" and one from the "right". The first guidelines were the Mercy guidelines and were consensus guidelines that were considered too restrictive so the straights created another set of consensus guidelines that allowed for more leeway from doctor's experience. Recently new guidelines were created from each side. Maybe the way to handle it is that if we make a comment about one, we need to make a comment about the other. I'm sure we can find something on the WCA website or even in the FSCO website. -- Dēmatt (chat) 00:33, 4 August 2008 (UTC)
The guidelines from the straights aren't evidence-based guidelines. But we could make comments about them, yes. I'll try to think about ways to do that. Thanks for the suggestion. Eubulides (talk) 15:03, 9 August 2008 (UTC)

i read thru the archives of these talks and it seems like all we got is one source. . . Keating. . . saying that "anti-science" is still employed by any group of chiros... and today that is only a very small minority group. We need to say "Keating says..." if we say anything at all. . . but i question if the mention is even necessary. . . anti-science is a loaded term with a mixed-bag of meanings. . . and at the end of the day, this is just one guy's opinion.TheDoctorIsIn (talk) 17:24, 3 August 2008 (UTC)

This isn't correct; we have several sources, including Phillips in Principles and Practice of Chiropractic, who is an independent source and does not cite Keating. We don't have any reliable sources saying that it's a "very small minority group", only "small percentage". It's certainly a significant percentage, given that it has the resources to write its own guidelines and to prevent a consensus among chiropractic on this subject. Eubulides (talk) 15:03, 9 August 2008 (UTC)
Yeah, no matter what, it needs to be attributed to whoever said it. -- Dēmatt (chat) 00:33, 4 August 2008 (UTC)
Agreed. Though - like TDII - I am now questioning whether this depiction of a fringe minority group with the profession even needs to be given such a weighty mention. Anyhow, there does seem to be a growing consensus to including attribution to Keating - or at least a healthy majority. -- Levine2112 discuss 06:55, 5 August 2008 (UTC)
No rational reason has been given to include attribution to Keating. There is more than one researcher to verify the text. This has been explained before. QuackGuru 19:55, 5 August 2008 (UTC)
I agree with QuackGuru on this point. Attributing this text only to Keating, when there is a wide variety of reliable sources agreeing on this point, is misleading. Eubulides (talk) 15:03, 9 August 2008 (UTC)

Treatment procedures diagram

In this section there is a nice diagram of various treatment procedures. Unfortunately it looks like crap there. Wouldn't it be better to move it to the Chiropractic treatment techniques article? -- Fyslee / talk 06:52, 27 July 2008 (UTC)

Looks pretty good to me, but maybe that's just because of my screen resolution or choice of browsers. However, if it isn't already on Chiropractic treatment techniques, it should be there as well - and perhaps in lieu of it being here. -- Levine2112 discuss 07:22, 27 July 2008 (UTC)
I use a 24" screen with 1920 x 1200 screen resolution. It's sharp as can be, but the diagram is cramped and pushes the other text around. We shouldn't lose it, but the other article might be the place for such detail. -- Fyslee / talk 07:54, 27 July 2008 (UTC)
I agree that Fyslee the diagram (table) looks a bit ugly and cramps the text. On the other hand I did find it very interesting. If you decide to keep it here, it might be worth experimenting with smaller fonts within the table and giving it a bit of a margin?79.68.13.143 Gleng (talk) 10:06, 27 July 2008 (UTC)
I was bold and set column widths in the table, to make the whole table narrower. Feel free to ask me to self-revert. ☺ Coppertwig (talk) 14:06, 27 July 2008 (UTC)
I think that's better, but the real problem is it also need a small margin to stop the adjacent text bumping into it. I don't know how to do that.Gleng (talk) 12:40, 28 July 2008 (UTC)
I liked the old way but it's not a big deal either way. Eubulides (talk) 15:00, 28 July 2008 (UTC)
Currently, the diagram is too narrow. A small adjustment can fix it. QuackGuru 19:37, 31 July 2008 (UTC)
QuackGuru, are you advocating for adjustments now? ;) DigitalC (talk) 05:09, 1 August 2008 (UTC)
I think it would be best to make more adjustments to the Chiropractic#Treatment procedures section. I think the readers would want to know more about the different procedures and treatments chiropractors offer. QuackGuru 07:55, 1 August 2008 (UTC)
I guess we aren't used to humour here ;) - DigitalC (talk) 01:21, 4 August 2008 (UTC)
Don't get me started :-) You know how many chiropractors it takes to screw in a lightbulb? -- Dēmatt (chat) 01:28, 4 August 2008 (UTC)
One, but.... -- Fyslee / talk 04:11, 4 August 2008 (UTC)
... it takes 30 visits! Thanks for saving the punchline for me! I can say it because I was one on TV :-) -- Dēmatt (chat) 14:32, 4 August 2008 (UTC)

(<<outdent) Eubulides said, "Don't specify table widths, as that works poorly with large or small fonts." and changed it to have <br>. In my opinion, (mild preference), it works better with the width specified. With the width specified: if I keep the width of my window constant but change the font size, it changes from one line per item (with small font) to three lines per item (with big font), which I think is good, whereas with the line breaks hard-coded: it always has two lines for some items and with big font the table is too wide and pushes the rest of the text to below the table. However, I don't feel strongly about this. ☺ Coppertwig (talk) 13:09, 1 August 2008 (UTC)

I still think it's totally unnecessary here. It can be used in the actual Chiropractic treatment techniques article, which is linked here. If any listing is needed, it can be done in sentence form. BTW, that article still needs a cleanup. -- Fyslee / talk 14:20, 1 August 2008 (UTC)
  • We certainly need some content here; even with the table, Chiropractic is woefully inadequate in its coverage of what chiropractors actually do. I would favor a longer description in the text, but until that's present we can't just remove the table.
  • As for the appearance with large fonts, I suppose it depends on the browser. With mine (Firefox 3) if the table column width is specified in pixels, and you use a large font, the browser breaks up the text in bizarre ways in order to shoehorn the text into the column, e.g., by puting "Ice" on one line and "packs/cryotherapy" on another. Conversely, if the table uses line breaks rather than pixels, and you use a large font, once the table fills the screen the browser does start to insert more line breaks to get the line to fit. Inserting line breaks is bad, but specifying column width is also bad; to some extent one chooses one's poison. For what it's worth, with a normal font size the table is narrower on my browser with the line breaks than with the table width specified explicitly, and I thought the complaint was the table was too wide?
Eubulides (talk) 14:30, 1 August 2008 (UTC)
We definitely need some text, but we have a whole article for all the details. That's the way the article size can be controlled. Just take the contents of that list and make a long sentence. Simple as that. It can also be formatted in this manner. -- Fyslee / talk 14:38, 1 August 2008 (UTC)
  • Is it really that simple? Would you drop all the percentages from the discussion? What would the long sentence look like? The "% of DCs using it" column can be removed (its info is not that useful, as all the figures are above 90%) but is the "% of patients getting it" info useless?
  • Since the 2nd column was useless, I went bold and removed it. This should make it a bit easier to convert to text, at any rate.
Eubulides (talk) 17:50, 1 August 2008 (UTC)
I'm sorry, I put the second column back in because I think with all the misconceptions that all chiropractors do is use spinal manipulation, I think it is important that others see how often other techniques are used in their spinal adjustments. This is certainly not a complete list, but it's a start. -- Dēmatt (chat) 01:40, 2 August 2008 (UTC)
How about if we omit the 2nd column but put in some text saying that every technique in the table is used by more than 90% of chiropractors? Eubulides (talk) 06:14, 2 August 2008 (UTC)
I think we can say that, but we should also leave it in the table so that those that don't read the text will still get the picture. -- Dēmatt (chat) 15:00, 6 August 2008 (UTC)

Treatment procedures

I have added hidden content that can be used immediately, if we can agree on it. It is a reasonable practice to use the lead in fork articles as the content in sections of major articles. Those articles were created because the original article was too large, and this article is no exception. Here is the proposed content (the final form will be without the explanations):

SUGGEST USING THIS LEAD FROM THE "Chiropractic treatment techniques" ARTICLE AS THE SOLE CONTENT OF THIS SECTION, ALONG WITH THE "MAIN" ARTICLE LINKS.

Many chiropractic treatment techniques/modalities are available for use by chiropractors. Although the chiropractic profession is primarily based on the use of the spinal adjustment, many other techniques exist for treating the spine, as well as other joints and tissues. A modern chiropractor may specialize in spinal adjustments only, or may use a wide range of methods intended to address an array of neuromusculoskeletal and general health issues. Examples include soft tissue therapy, strength training, dry needling (similar to acupuncture), functional electrical stimulation, traction, and nutritional recommendations. Chiropractors may also use other complementary alternative methods as part of a holistic treatment approach.

WE CAN ALSO ADD THE CONTENTS OF THE TREATMENT PROCEDURES DIAGRAM IN SENTENCE FORM, AND THEN MOVE THE ACTUAL DIAGRAM WITH PERCENTAGES TO THE PROPER ARTICLE:

Diversified technique (full-spine manipulation), Physical fitness/exercise promotion, Corrective or therapeutic exercise, Ergonomic/postural advice, Self-care strategies, Activities of daily living, Changing risky/unhealthy behaviors, Nutritional/dietary recommendations, Relaxation/stress reduction recommendations,Ice pack/cryotherapy, Extremity adjusting, Trigger point therapy, Disease prevention/early screening advice

This can of course be tweaked to make it flow better, but basically we don't need more content in this section. All details should be in the other article. There is absolutely no excuse for too much detail here. -- Fyslee / talk 06:44, 2 August 2008 (UTC)

There are some good suggestions here, but some problems too that need to be addressed.
  • I agree with replacing the current text with a summary of Chiropractic treatment techniques, but that article is currently woefully limited; we shouldn't simply summarize it. We should summarize it the way it should be, not the way it currently is.
  • It is important in Treatment procedures to define spinal manipulation (SM) and spinal manipulation therapy (SMT), and to distinguish between the two. The rest of the article refers to both, and Treatment procedures are where they are defined.
  • The proposed summary uses wording (leading with "many treatments", using "although" etc.) that focuses too much on treatments other than SMT. It should say SM is the most common modality without saying "although" and without emphasizing the other treatments.
  • The proposed summary, if adding the contents of the diagram, includes a lot of duplication. The diagram contents list the most commonly-used procedures, so I propose using its list (which is sourced as being the most popular among patients) rather than rolling our own.
  • With all that in mind, I propose the summary in #Treatment procedures 2 instead.
Eubulides (talk) 14:38, 2 August 2008 (UTC)
When and if we use all this as a replacement for the existing content, we need to make sure that nothing gets deleted from here before ensuring it is already in the "...techniques" article. -- Fyslee / talk 16:53, 2 August 2008 (UTC)

Treatment procedures 2

Main articles: Chiropractic treatment techniques and Spinal adjustment

Spinal manipulation, which chiropractors call "spinal adjustment" or "chiropractic adjustment", is the most common treatment used in chiropractic care;[24] in the U.S., chiropractors perform over 90% of all manipulative treatments.[25] Many other treatment forms are used by chiropractors for treating the spine, other joints and tissues, and general health issues. The following procedures were received by more than 1/3 of patients of licensed U.S. chiropractors in a 2003 survey: Diversified technique (full-spine manipulation), physical fitness/exercise promotion, corrective or therapeutic exercise, ergonomic/postural advice, self-care strategies, activities of daily living, changing risky/unhealthy behaviors, nutritional/dietary recommendations, relaxation/stress reduction recommendations,ice pack/cryotherapy, extremity adjusting, trigger point therapy, and disease prevention/early screening advice.[24]

Spinal manipulation is a passive manual maneuver during which a three-joint complex is taken past the normal physiological range of movement without exceeding the anatomical boundary limit; its defining factor is a dynamic thrust, a sudden force that causes an audible release and attempts to increase a joint's range of motion. More generally, spinal manipulative therapy (SMT) describes techniques where the hands are used to manipulate, massage, mobilize, adjust, stimulate, apply traction to, or otherwise influence the spine and related tissues; in chiropractic care SMT most commonly takes the form of spinal manipulation.[26]

Treatment procedures 2 comments

(Please put comments about #Treatment procedures 2 here.) Eubulides (talk) 14:38, 2 August 2008 (UTC)

I took the liberty of installing #Treatment procedure 2's first sentence into Chiropractic #Treatment procedures. This edit has the following properties:
  • It removes some duplication about how chiropractors do most SM.
  • It removes the incorrect implication that only in the U.S. do chiropractors "consider themselves to be expertly qualified providers of spinal adjustment, manipulation and other manual treatments" (that is the position of the World Federation of Chiropractic).
  • It avoids duplicate wikilinks to Spinal adjustment, one in the Main articles: leader, and one in the text.
  • It leads with the mainstream term "spinal manipulation" for the treatment in question, mentioning "spinal adjustment" and "chiropractic adjustment" as terms used by chiropractors. The recent edit to lead with "spinal adjustment" was made without discussion, so this is simply going back more to the longstanding use here.
  • It's shorter. It avoids longwinded phrases like "are terms used by", "to describe their approaches to", and "is most frequently employed by".
Eubulides (talk) 14:55, 2 August 2008 (UTC)
Good work! This will summarize the whole subject, leaving all the details for the specific "... techniques" article. That's the proper way for article forks to supplement the main subject.
I think an improvement in flow could be made by moving everything about spinal manipulation/adjustment together, IOW move the second short paragraph up. Here is the proposed revision: -- Fyslee / talk 16:49, 2 August 2008 (UTC)

Treatment procedures 3

Main articles: Chiropractic treatment techniques and Spinal adjustment

Spinal manipulation, which chiropractors call "spinal adjustment" or "chiropractic adjustment", is the most common treatment used in chiropractic care;[24] in the U.S., chiropractors perform over 90% of all manipulative treatments.[27] Spinal manipulation is a passive manual maneuver during which a three-joint complex is taken past the normal physiological range of movement without exceeding the anatomical boundary limit; its defining factor is a dynamic thrust, a sudden force that causes an audible release and attempts to increase a joint's range of motion. More generally, spinal manipulative therapy (SMT) describes techniques where the hands are used to manipulate, massage, mobilize, adjust, stimulate, apply traction to, or otherwise influence the spine and related tissues; in chiropractic care SMT most commonly takes the form of spinal manipulation.[26]

Many other treatment forms are used by chiropractors for treating the spine, other joints and tissues, and general health issues. The following procedures were received by more than 1/3 of patients of licensed U.S. chiropractors in a 2003 survey: Diversified technique (full-spine manipulation), physical fitness/exercise promotion, corrective or therapeutic exercise, ergonomic/postural advice, self-care strategies, activities of daily living, changing risky/unhealthy behaviors, nutritional/dietary recommendations, relaxation/stress reduction recommendations,ice pack/cryotherapy, extremity adjusting, trigger point therapy, and disease prevention/early screening advice.[24]

Treatment procedures 3 comments

(Please put comments about #Treatment procedures 3 here.) -- Fyslee / talk 16:49, 2 August 2008 (UTC)

  • I suggest moving the proposed section to a subpage of the talk page, with a link here. For example we could have Talk:Chiropractic/Treatment_procedures/, for both the proposed sections and their discussions. DigitalC (talk) 01:19, 4 August 2008 (UTC)
  • The source used does not conflate Diversified with full-spine adjusting. Diversified is a technique-system, and when used does not necessarily entail full-spine adjusting. (Although, it does not limit the area treated, like HIO does). DigitalC (talk) 01:19, 4 August 2008 (UTC)
  • Re: "its defining factor is a...". Should this be changed to "its definings factors are: ..." ? - DigitalC (talk) 01:25, 4 August 2008 (UTC)
  • Also note that the source uses Diversified, not diversified. These are two different things (divisified being the LACK of a technique system). DigitalC (talk) 01:31, 4 August 2008 (UTC)
We need to have everyone involved, including editors who just happen by and wouldn't have that page on their watchlist.
This is more about a total exchange of content for the section, so let's not get bogged down in details yet. After that exchange has occurred we can get down to the nittygritty of certain finer details, like about Diversified. BTW, as to Diversified, I have suggested an article title change to Diversified technique. If we can agree on that, it can be done immediately and easily. Please let your views be known there. -- Fyslee / talk 04:06, 4 August 2008 (UTC)
The title change has been effectuated. -- Fyslee / talk 14:06, 5 August 2008 (UTC)
Okay, a little bit of nittygritty ;-) The grammar is correct as it is referring to "a" dynamic thrust ("its defining factor is a dynamic thrust"). I have capitalized Diversified above. NOW let's get back to looking at the larger picture. Doesn't the above look better than what we have now, which only mentions Spinal manipulation, and uses an awkward diagram for the rest? This is neat and clean. -- Fyslee / talk 04:26, 4 August 2008 (UTC)
I think I got it from Eubulides that if we are going to work on it, we may as well get it right. Perhaps the sentence should be reworded as "its defining factor is a dynamic thrust, which is a sudden force that causes an audible release and attempts to increase a joint's range of motion."? Something seems wrong about the way it is worded now. - DigitalC (talk) 05:06, 4 August 2008 (UTC) +
The wording is proper English grammar, but it is condensed and your suggestion would make it easier for many (especially non-English speakers) to understand. Actually that should be on the article page, and here we should cut all modifiers out of the section. That would solve the problem here. People who want to know more about Diversified can use the wikilink. -- Fyslee / talk 05:26, 4 August 2008 (UTC)
As for whether it looks better than what we have now, I am confused. I don't see an akward diagram. Do you mean the table to the right? If so, then yes, it looks much better, and I agree with removing the paragraph about the history of manipulation. It doesn't seem to belong under treatment procedures. DigitalC (talk) 05:15, 4 August 2008 (UTC)
Sorry about causing confusion. Yes, I do mean the table. I like it, but I don't think it looks good here. -- Fyslee / talk 05:27, 4 August 2008 (UTC)
I agree that we need to have everyone involved. However, just having the hot topic point towards the sub-page (what happened to our list of hot-topics?), or having a section here with just a link to the subpage should allow everyone that has this on their watchlist or editors that just happen by to see it. DigitalC (talk) 05:06, 4 August 2008 (UTC)
I was just hoping to save the need for a long discussion, which would make the need for a subpage irrelevant. We should avoid them and reserve them for very large topics. This isn't one of them. -- Fyslee / talk 05:26, 4 August 2008 (UTC)
I was thinking that not just Treatment procedures 3 should be moved to the subpage, but everything under the heading of Talk:Chiropractic#Treatment_procedures_diagram. It is a fairly lengthy section already. DigitalC (talk) 05:43, 4 August 2008 (UTC)

No further comment and there seems to be consensus here, so I inserted the above text (with "which is" added) into Chiropractic #Treatment techniques and moved its previous contents to a new section Chiropractic treatment techniques #Overview. One thing that bugs me about the result, though: Chiropractic #Treatment techniques was changed from a section header to a subsection header, which makes it the only subsection of Chiropractic #Scope of practice. It's weird to have a section with a single subsection, and it's not clear that Treatment techniques should be a subsection of Scope of practice. I propose changing Treatment techniques back to being a top-level section header. Eubulides (talk) 15:50, 9 August 2008 (UTC)

Antiscientific: quotes

This is a table of quotes re one end of chiropractic being antiscientific (and maybe also quotes about the other end being scientific, and about the middle), most recent year at the top. The table is just for us to look at on this talk page while we think up new wording for the "antiscientific" sentence in the article. Feel free to edit this table. Some of these quotes were provided on this talk page by Dematt and Eubulides. (I've put "antiscientific", "pseudoscisntific" and "unsubstantiated" in bold type to make them easier to find.) (01:35, 9 August 2008 (UTC))☺ Coppertwig (talk) 21:49, 4 August 2008 (UTC)

Authors Work Quotes
Keating JC Jr, Charlton KH, Grod JP, Perle SM, Sikorski D, Winterstein JF(2005) "Subluxation: dogma or science?[5]
  • "some members of the profession have developed scientific skills, and a literature bearing on the usefulness of spinal manipulation, generated by chiropractors and others, has evolved"
  • "many chiropractors preeminent theoretical construct remains unsubstantiated, and largely untested."
  • "In the absence of scientific validation, the propagation of unsubstantiated claims for many chiropractors favorite mediating variable is an obstacle to scientific credibility and cultural authority for the profession."
  • "Lastly, the ACC claims that chiropractors use the "best available rational and empirical evidence" to detect and correct subluxations. This strikes us as pseudoscience, since the ACC does not offer any evidence for the assertions they make, and since the sum of all the evidence that we are aware of does not permit a conclusion about the clinical meaningfulness of subluxation."
  • "These assertions were published as a priori truths (what many chiropractors have traditionally referred to as "principle"), and are exemplary of scientifically unjustified assertions made in many corners of the profession"
  • "There is nothing inherently dogmatic or anti-scientific in the notion that an articular lesion may have health consequences, or that correction of joint dysfunction may relieve symptoms and/or improve health."
  • "The dogma of subluxation is perhaps the greatest single barrier to professional development for chiropractors. ...Commitment to this dogma undermines the motivation for scientific investigation of subluxation as hypothesis, and so perpetuates the cycle."
Phillips 2005 Principles and Practice of Chiropractic[28]
  • (page 71. chapter 3 "The Evolution of Vitalism and Materialism and its Impact on Philosophy in Chiropractic" section "vitalism in chiropractic and the twentieth century".) "to extend its comfort zone by adopting not only an antimedicine position but an antiscience stand... Although this antiintellectual position persists in a small percentage of chiropractors ...The current spectrum of thought ranges from these tradition concepts espoused by B.J, Stephenson, and their adherents to an equally dogmatic and complete denial of vitalistic concepts at the other end of the spectrum... Fortunately, the spectrum contains a great deal of space between the two anchoring ends, a space wherein may be found many types of principles, such as vitalism, holism, naturalism, therapeutic conservatism, critical rationalism, and thoughts from the phenominological and humanistic paradigms...." (more quoted by Dematt [34])
  • (page 72, latest edition)"This protective shield apparently prompted a segment of the profession to extend its comfort zone by adopting not only an antimedicine but an antiscientific stand.... Although this antiintellectual position persists in a small percentage of chiropractors in this twenty-first century, the profession never developed a broad-based consensus around Stephenson's 33 principles."
Tanvetyanon (2005) PMID 15956016 (letter)
  • "Finally, alternative care often seems to shelter an antiscience attitude. For instance, women with breast cancer who believe that cancer spreads by air and that chiropractic care is an effective anticancer therapy often present at a late stage, which is associated with great suffering, short survival, and staggering cost of care."
Carter 2000

Subluxation - The Silent Killer[29]

  • Carter quotes Nelson: "Craig F. Nelson, D.C. another outspoken educator recently lamented that “the number of chiropractors who are animated by 19th century pseudoscience seems to be growing rather than shrinking, and these chiropractors will abandon their philosophy when hell freezes over.”[29]
Jonas 1998, PMID 9496994
  • "Patients who use CAM do not harbor antiscientific or anticonventional medicine sentiments"
  • Comments: Dubious quote according to Eubulides. An outright falsehood according to Fyslee, but unsurprising coming from Jonas...
Keating (1997) Chiropractic: science and antiscience and pseudoscience side by side (Skeptical Enquirer)[3]
  • "chiropractic is a continuing enigma partly because of its diverse intellectual and anti-intellectual traditions." (p. 1)
  • "chiropractic is both science and antiscience." (p. 1)
  • "a particular, "scientific" attitude is reasonably well established among clinical scholars and investigators in other fields, and can be found among a subset of chiropractors." (p. 2)
  • "It is practically impossible to read any of the trade publications within chiropractic without encountering unsubstantiated claims." (p. 3)
  • "Coexisting with the obvious and ubiquitous antiscientific and pseudoscientific reasoning and rhetoric in chiropractic (Skrabanek 1988) are the genuinely critical, skeptical attitudes of the still quite embryonic research community in this profession. The clinical science attitude (bottom of Table 2) has been growing slowly among DCs during the past two decades." (p. 3)
  • "Chiropractic colleges vary considerably in terms of the commitment their faculties and administrators make to critical reasoning, skepticism, science, and scholarship. At one end of the spectrum lies Life College..." (p. 4)
  • "Antiscientific attitudes" (p. 4)
  • "Chiropractic is confusing because it simultaneously encompasses science, antiscience, and pseudoscience. " (p. 7)

Quotes re middle of spectrum (need more here):

Authors Work Quotes
Gatterman, 1995 A Patient-Centered Paradigm: A Model for Chiropractic Education and Research [30]
  • "A patient-centered paradigm emerged, incorporating the principles of vitalism, holism, humanism, conservatism, naturalism, and rationalism."
  • "Patient-centered research must reach beyond the randomized controlled trial, involving designs where clinicians apply their own patient-centered therapy in a "real world" assessment."

Quotes re "scientific" or "evidence-based guidelines" end of continuum to support first half of sentence (need more here):

Authors Work Quotes
Ted J. Kaptchuk, OMD; David M. Eisenberg, MD 1998 Chiropractic: Origins, Controversies, and Contributions. Arch Intern Med.[31]
  • "Most comparison trials show manipulation to be better, and no trial finds it to be significantly worse, than conventional treatments. As 1 researcher-scholar44(p368) put it, "more orthodox therapy, such as standard physical medicine or analgesics, despite being more ‘scientific,' is not better.""
  • ""Mixers" tend to be more open to conventional medicine and to mainstream scientific tenets."
William C. Meeker, DC, MPH, and Scott Haldeman, DC, PhD, MD, FRCP(C) (2002) Chiropractic: A Profession at the Crossroads of Mainstream and

Alternative Medicine. 5 February 2002 Annals of Internal Medicine Volume 136 • Number 3 p.223

*"In

today’s dynamic health care milieu, chiropractic stands at the crossroads of mainstream and alternative medicine. Its future role will probably be determined by its commitment to interdisciplinary cooperation and science-based practice."

Quotes re ethics

Authors Work Quotes
Nelson et al. (2005) Chiropractic as spine care: a model for the profession[4]
  • "The imbalance in knowledge means that the doctor not only must not

lie to a patient (the ethical duty of veracity) but also must take pains to ensure that what they tell the patient is the truth..."

  • "Neither a chiropractor nor any other healthcare provider practicing

under the protection of a licensed profession has the ethical right to promote unscientifically unreasonable beliefs."

  • "The segment of the profession that continues to hold firmly to

Palmer's Postulates do so only through a suspension of disbelief. Given that one of the philosophical pillars of science is skepticism, a suspension of disbelief or a lack of skepticism, is evidence of antiscientific thinking [5,6]. These stratagems to avoid the truth that Palmer's Postulates are unproven might be beneficial to the chiropractor, but are ethically suspect when they allow the practitioner to maintain a "faith, confidence and belief" in that paradigm to the patient's ultimate detriment."

List of hot topics

Add new topics to the bottom of the list. Each topic should focus on a section of the article where major changes are needed, or on a new section to be added to the article. A topic will remain "hot" for at least 96 hours and no longer than 3 weeks. People can change which section of this talk page a topic is linked to, as long as it's essentially the same topic – or provide more than one link for a topic.

(Re-added by ☺ Coppertwig (talk) 13:56, 10 August 2008 (UTC)) 14:32, 17 August 2008 (UTC)

Evidence basis rewrite

The practice of evidence based medicine involves integrating the doctor's clinical judgement, based on his experience and expertise, with the best available external clinical evidence. Such evidence includes evidence from randomized trials and meta-analyses, and evidence from more specific studies relevant to particular cases.[1] Chiropractors have access to several databases of information to foster good patient care practice[2] including DCConsult and the Index of Chiropractic Literature. Chiropractors also use consensus guidelines developed by experts in the field.

Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs a priori assertions without scientific substantiation in what commentators about chiropractic describe as an "antiscientific" stand.[3]

Evidence basis rewrite comments

The above draft appears to be a work in progress that is nearly identical to Talk:Chiropractic/Archive 25 #Evidence basis rewrite. The comments in Talk:Chiropractic/Archive 25 #EBM alternative still apply to this draft. In particular, a problem with this draft is that it is a misleading summary of evidence-based medicine, as it promotes the notion that evidence-based medicine is individual chiropractors using whatever clinical trial results they want to, in order to justify their own preconceptions about the best treatment. That is not what EBM is about. Eubulides (talk) 18:50, 14 August 2008 (UTC)

Article length

I suggested on OR page that this article could be shortened with the general reader in mind. I've re-read the article now with additional care, and I no longer believe this. I continue to believe the article has no problems with OR. More generally, it's my personal view that the distinction between medicine and chiropractic ought to be sharpened and made more clear. —Preceding unsigned comment added by Calamitybrook (talk • contribs) 18:57, 8 August 2008 (UTC)

Thanks for taking a look at the problem and commenting on it at Wikipedia:No original research/noticeboard #Chiropractic section on evidence basis. No other outside editor has commented there in the two weeks the notice has been up, and I suspect further comments there are unlikely, so I took the liberty of removing the SYN tag in response to your comments. I agree with you that the relationship between chiropractic and conventional medicine should be clarified; that's another item for the to-do list. Eubulides (talk) 23:15, 13 August 2008 (UTC)
I am going to restore the tag. One outside editor's opinion (especially a new editor) does not justify removing the SYN tag. -- Levine2112 discuss 23:17, 13 August 2008 (UTC)
I'm sorry, Levine2112, but given that we've sought an opinion on the NOR/N noticeboard and received one, I have to support the removal of the SYN tag. However, would everyone please stop editwarring about it and discuss it here on the talk page please? Levine2112, in order to keep the tag there, there would have to be a well-defined problem that has a method of solving it. Since we've already gotten an outside opinion, and the editors here are clearly not going to agree to removing all the information about SM as you would prefer, I don't see what solvable problem the tag is intended to address. ☺ Coppertwig (talk) 23:40, 13 August 2008 (UTC)
For argument's sake, let's say another outside editor shows up with an opinion that the tag should stay. Then would the tag be introduced? -- Levine2112 discuss 23:50, 13 August 2008 (UTC)
I have no opinion on that question at this time. If it actually happens I may form an opinion considering the specifics of the situation. The focus should be on improving the article, not on whether the tag is present or not. ☺ Coppertwig (talk) 12:53, 14 August 2008 (UTC)

Simon-says in 2nd sentence

Following up on Talk:Chiropractic/Archive 25 #Simon-says in 1st paragraph, the suggestion that section made for the 2nd sentence of the 1st paragraph was not objected to, so I installed that edit, except I added wikilinks and therefore changed "neurological system" to "nervous system" as the latter is the more common term and is the name of the Wikipedia article on the nervous system. Eubulides (talk) 20:51, 14 August 2008 (UTC)

Fix for CAM claim

Regardless of one's opinion of the "Simon says" style, which would require quote marks and explicit text attribution for most of the sentences in Chiropractic, it's clear that something needs to be done about the very first claim in chiropractic (the claim that chiropractic is CAM), as this claim is disputed by most chiropractors in a recent survey described by Redwood et al. 2008 (PMID 18435599). The problem occurs in several places in Chiropractic, and here are proposed changes to fix it. These changes do not use the "Simon says" style; obviously further changes would be needed to conform to it. Italics are used for proposed insertions, strikeouts for deletions, and roman text for unchanged parts of the text.

Also, move the following sentence from the end of Chiropractic #Utilization and satisfaction rates, where it does not really belong, to the beginning of Chiropractic #Scope of practice:

  • Mainstream health care and governmental organizations such as the World Health Organization consider chiropractic to be complementary and alternative medicine (CAM).[32] However, a A 2008 survey stated that 69% of DC chiropractors disagree with the categorization of chiropractic as CAM, with 27% having some preference for the term "integrated medicine".[33]

Eubulides (talk) 19:04, 29 July 2008 (UTC)

I don't think that chiropractic being a "health care profession" is disputed. -- Levine2112 discuss 21:40, 29 July 2008 (UTC)
Good point. "Health care profession" is an opinion that is not disputed by reliable sources. Since this proposal is not using the "Simon says" style, there is no need to remove the "health care profession" phrase from the lead. I restored it. Thanks for catching that. Eubulides (talk) 22:02, 29 July 2008 (UTC)
Why the deletion of "CAM" and "alternative" when most altmed, chiropractic, and official government sources use those categorizations? This (study) particular example of the opinions of some chiropractors about themselves is irrelevant in this regard, especially when it's based on only one study. Even if it were based on thousands of such studies, it would only serve as documentation for some chiropractors' self-opinion, in contrast to the rest of published sources. Many chiropractors maintain their aversion to being identified with mainstream medicine and they are proud of being an alternative to the big, bad, pharma controlled, drug using, MD cartel. This article is not to be written exclusively from the chiropractic perspective, since that would be an NPOV violation. This study is the only place where the identification of chiropractic as CAM and altmed is disputed, including here among editors, so why change this longstanding consensus version? If it's not broken, don't fix it. -- Fyslee / talk 04:05, 30 July 2008 (UTC)
  • I agree that the article should not be written exclusively from the chiropractic perspective. But we can't ignore the chiropractic perspective either.
  • I also agree that from the mainstream viewpoint, chiropractic is CAM. However, it's indisputable that "chiropractic is CAM" is controversial among chiropractors themselves. We can easily find other reliable-among-chiropractic sources to confirm this point. Here's one: "Is Chiropractic Part of CAM? The answer to this question depends on one's perspective. Chiropractic opinion is divided. Most others in the health care system, as evidenced by current policies of the US National Institutes of Health, the European Parliament in its adoption of the 1997 Lannoye Report, and the World Health Organization in its current strategies on traditional medicine and CAM, clearly see chiropractic as part of CAM." Chapman-Smith DA, Cleveland CS III (2005). "International status, standards, and education of the chiropractic profession". In Haldeman S, Dagenais S, Budgell B et al. (eds.) (ed.). Principles and Practice of Chiropractic (3rd ed. ed.). McGraw-Hill. pp. 111–134. ISBN 0-07-137534-1. {{cite book}}: |edition= has extra text (help); |editor= has generic name (help)CS1 maint: multiple names: editors list (link)
  • How about if we simply mention this dispute in the lead, emphasizing the mainstream view? I've changed the draft change to the lead, to do that.
Eubulides (talk) 07:16, 30 July 2008 (UTC)
That change looks good. The dispute is about the current classifications of the profession as a form of CAM (both within and outside the profession), and the wish by many DCs to be accepted as mainstream, but even that survey showed that more of them would prefer to be classified as IM, IOW as that part of CAM that is working with the mainstream without actually being mainstream. They wish to maintain a "separate but equal" status. -- Fyslee / talk 17:30, 2 August 2008 (UTC)
No further comment, so I made the change. Eubulides (talk) 16:06, 9 August 2008 (UTC)

<outdent>Phillips 2005 makes an interesting assertion that seems true on the surface at least: "Spinal adjustment or manipulation to relieve back pain and restore joint and muscle function is now mainstream, but the same treatment methods to empower the body to regulate visceral fundtion such as respiration and digestion, and to improve overall health and wellness are CAM." -- Dēmatt (chat) 20:03, 5 August 2008 (UTC)

Interesting and very discerning observation by Phillips. -- Fyslee / talk 20:28, 5 August 2008 (UTC)

I agree with this edit which removes the assertion that chiropractic is CAM, and inserts instead "Chiropractic is generally considered to be complementary and alternative medicine", for better conformance with WP:NPOV. Thank you for making this change, Eubulides. (Incidentally, I also support this edit which changes "principle" to "belief" etc. in the philosophy section.) ☺ Coppertwig (talk) 13:48, 10 August 2008 (UTC)

I agree with this edit by QuackGuru which reverted Hughgr's edit. The footnoted source, Redwood, says of those faculty and practitioners who responded, 69% do not consider chiropractic to be CAM. It also says 27% thought chiropractors should be classified as IM (integrated medicine). Note it says "integrated", not "integrative"; and I think "integrated medicine" should not be capitalized; but more important, it does not report a majority considering chiropractors to be IM. It does, however, support the version QuackGuru reverted to, that most chiropractors dispute the CAM designation.

I also agree with this edit by Dematt, though I'm going to delete the word "even" (not NPOV). ☺ Coppertwig (talk) 01:09, 17 August 2008 (UTC)

Gentlemen, I have to applaud the changes in the article. The 'complementary and alternative medicine healthcare profession' all strung together bothered me for a long time.Including the Redwood study results is good. The Greek in the box is much prettier, too. Is the article NPOV yet? --—CynRN (Talk) 06:17, 17 August 2008 (UTC)
I have problems with this edit. The previous version without the one study attribution was better. The article is close to NPOV. There are still a few problems left such as unnecessary attribution in the Evidence basis section. Also the lead does not explain the type of ideas. An editor added text to the reference section but not to the text of the article to explain about the ideas. QuackGuru 18:10, 17 August 2008 (UTC)
1. Your diff is old. It's been changed.
2. As to "unecessary attribution", is it this wording you are referring to: "what chiropractic commentators"? If so, it needs to be attributed to avoid violating NPOV.
3. As to "type of ideas", the text does mention the only specific idea in the source, which is "subluxation (Gatterman 1995; Leach 1994)", a no brainer. It is obviously the biggest source of debate within and about the profession.
4. The "anti-scientific and pseudo-scientific ideas (Keating 1997b)" aren't specified in the source we use, but may be in the original (Chiropractic: science and antiscience and pseudoscience, side by side. Skeptical Inquirer 1997b (July/Aug); 21(4): 37-43). That might be worth a check, since he might get more specific there. Of course there are other anti-scientific and pseudo-scientific ideas than subluxation in chiropractic, and Keating and others have criticized them, but we can't ask Keating what he was referring to in this source since he is no longer with us, honored be his name.
There are no doubt other sources that could add specifics to that section, and we could then use them to get specific without any synth violation. We could also use those words and attribute and just source them to Keating, but I understand you have objections to that, so apparentlty it's being left out until you stop objecting. Or maybe I haven't been following the discussion carefully enough. Maybe we are discussing two different areas in the article that both use the word "anti-scientific" (with or without the dash.) -- Fyslee / talk 19:48, 17 August 2008 (UTC)

[outdent] Here's an old one from the archives that lists the specifics from Keating's article (mentioned above):

Here it is "backed up" from as inside the profession as one can get, and can be presented as his opinion:

Joseph C. Keating, Jr, PhD, chiropractic historian and professor, uses the following words to describe aspects of the profession when he analyzes chiropractic, its research, thinking, practices, and journals:

  • a continuing enigma
  • science
  • antiscience
  • pseudoscience
  • quackery
  • anti-intellectual traditions
  • unscientific
  • irrational
  • confusion
  • antiscientific mindset
  • cult
  • chiropractic's foibles
  • religious overtones
  • humbug
  • uncritical dogma
  • circus
  • showmanship
  • marketing
  • unsubstantiated claims
  • pseudoscience journals
  • uncritical rationalism
  • uncritical empiricism
  • fuzzy thinkers
  • health fraud
  • student loan defaults
  • paranoia
  • xenophobia
  • nonskeptical attitudes
  • "anti-intellectual" traditions

He writes:

"After thirteen years of teaching and research at several chiropractic colleges, I can say with confidence that chiropractic is both science and antiscience. Yes, there is a meaningful science of chiropractic, but just as surely there is an antiscientific mindset and even a cult within chiropractic (for example, the cult of B. J. Palmer, son of the founder of chiropractic). Moreover, if University of Connecticut sociologist Walter Wardwell is correct (Wardwell 1992), the belief systems of a majority of DCs lie somewhere between these two poles: chiropractic as science versus chiropractic as unscientific, uncritical dogma and circus. Perhaps a consideration of the nature of science will aid in understanding how the chiropractic profession does and does not approximate the rigors of science."
"In recent years this combination of uncritical rationalism and uncritical empiricism has been bolstered by the proliferation of pseudoscience journals of chiropractic wherein poor quality research and exuberant overinterpretation of results masquerade as science and provide false confidence about the value of various chiropractic techniques. These periodicals expand on the uncritical attitudes and unproven claims for chiropractic that have long been made in the magazines published by the national membership societies of chiropractors in the United States. It is practically impossible to read any of the trade publications within chiropractic without encountering unsubstantiated claims."
"Coexisting with the obvious and ubiquitous antiscientific and pseudoscientific reasoning and rhetoric in chiropractic (Skrabanek 1988) are the genuinely critical, skeptical attitudes of the still quite embryonic research community in this profession."
"The conflict between medical doctors and DCs has also produced a penchant for marketing slogans in lieu of scientifically testable propositions. The classic example of this is the mindless reiteration that "chiropractic works," a vacuous claim which lacks specificity and is not amenable to experimental testing. However, confronted by charges that chiropractic is quackery, chiropractors have responded by insisting that "Chiropractic Works!" and have rallied satisfied patients to convince legislators and policy makers of the validity of their methods and the justness of their cause. Slogans like this are endlessly repeated not only to the public, but among DCs themselves (and to chiropractic students). To challenge the notion that "chiropractic works" is considered heresy in most corners of the profession. Rather than skepticism and critical thinking, traditional chiropractic education has sought to instill strong belief in chiropractic (Quigley 1981) among successive generations of students. In so doing the schools have strengthened the "anti-intellectual" (Coulter 1990) traditions in the profession."
-- Joseph C. Keating, Jr, PhD Chiropractic: science and antiscience and pseudoscience side by side

-- Fyslee / talk 20:25, 17 August 2008 (UTC)

Ethics: fact or opinion?

I oppose this edit, which adds " a tactic that is ethically suspect when it lets practitioners maintain their beliefs to patients' detriment.[4]". I had thought I was not the only one opposing it, but I may have been mistaken; in any case, I hope people will express their opinion on it in this section.
WP:NPOV says "Assert facts, including facts about opinions—but do not assert the opinions themselves." This clause seems to me to be asserting an opinion. Here's a suggested rewording to make it conform to NPOV: "a system of belief which commentators have called "ethically suspect" when practitioners' beliefs are to patients' detriment." ☺ —Preceding unsigned comment added by Coppertwig (talk • contribs) 13:48, 10 August 2008

Yes, it needs atribution, and the other POV needs its rebutal statement since we all seem to agree that they are not fringe and therefore need their POV expressed without taking sides. Good luck, though. -- Dēmatt (chat) 15:12, 10 August 2008 (UTC)
Nah, attribution weakens the text and the source. QuackGuru 02:40, 11 August 2008 (UTC)
Our options are attributed opinion, or no opinion. We cannot assert the opinion as a fact. - DigitalC (talk) 23:43, 11 August 2008 (UTC)
Quite correct. We must attribute it. Wikipedia is not about truth, but about well-sourced facts and opinions. -- Fyslee / talk 06:32, 15 August 2008 (UTC)
There is no dispute that opinion must be attributed. The dispute is over what style to use to provide attribution. The Simon-says style, which requires lots of quoting and in-text attribution, is not required in Wikipedia; it's not even typical for Wikipedia. Eubulides (talk) 09:27, 15 August 2008 (UTC)
This isn't an all-or-nothing situation. Simon says style quoting is very typical, is allowed, and is absolutely necessary some of the time. Sure, let's not overdo it, but it shouldn't be forbidden, and the more controversial the subject, the more we need to do it. This article happens to contain some very controversial stuff, so it will contain more than some other articles. That's life. -- Fyslee / talk 20:10, 15 August 2008 (UTC)
I agree it's not all-or-nothing, and that it shouldn't be forbidden. But the current situation in Chiropractic uses Simon-says quote marks only for criticisms of chiropractic. It does not use it for comments supportive of chiropractic. It is clearly POV to insist on Simon-says quote marks only when summarizing one side of the controversy. Eubulides (talk) 07:28, 17 August 2008 (UTC)
That shouldn't be the case. I suspect it has ended up this way because any criticisms are hotly contested at every step. That happened at the Quackwatch and Stephen Barrett articles, with actual attempts to delete the articles because of claims by critics of them not being notable enough! That of course created a demand for better documentation (more RS refs and Simon-says quoting), which resulted in very well-sourced articles and extensive proof of their great notability and acceptance by mainstream RS. That was a big Pyrrhic victory for critics, who have hopefully learned that the mainstream is usually right for a reason, namely because it is right. Challenging mainstream POV ends up costing critics far more than it is worth. The same thing is probably at work here. I don't think it's any deliberate thing, and any preferential treatment should be corrected. Any dubious positive claims should be very well sourced and attributed, and if any claims and wordings are contested, then do the same as we do with critical statements. From a mainstream POV, this is very positive, as RS are generally much more available from mainstream sources than from fringe sources, which often fail V, RS, and NOR requirements. MastCell has written something tangentially related to this subject:
-- Fyslee / talk 23:35, 17 August 2008 (UTC)

Treatment techniques now top-level again

In Talk:Chiropractic/Archive 25 #Treatment procedures 3 comments I suggested changing Chiropractic #Treatment techniques back to being a top-level section header. Nobody objected, so I just now did that. Eubulides (talk) 07:28, 17 August 2008 (UTC)

Whatever. I did forget to comment as I intended. It is perfectly proper to have only one subsection, and when the subject matter is related it really is preferable, but it's not that big a deal. It's a matter of collecting similar content in one section by using subsections, which makes the TOC useful. -- Fyslee / talk 07:39, 17 August 2008 (UTC)

Formatting of quotes

One thing I have noticed is that the manner in which quotes are formatted is sometimes different in the same articles many places here at Wikipedia. That used to apply here as well. This is an unfortunate way in which editorial POV can creep into an article. An editor can insert a quote and make it more noticeable than other quotes. It may even happen with no ulterior motives than personal preference for a certain method of formatting, but it's still not right. Some quotes are indented in the simple and normal ":" or "*" manners and others are indented and formatted using the <blockquote> or {{quote}} template formats. I have undone such formatting (the last two) in several places where I have found it. I am currently proposing to do this at Quackwatch, but will wait for comments before doing anything.

I think all quotes should use the simple wiki markup ":" or "*" methods of indenting, unless there is some special reason not related to editorial POV for doing otherwise. It isn't proper to highlight some quotes in big quote boxes, while others are kept more obscure, sometimes even hidden as part of the inline text, even though the quotes are several lines long. I think MOS allows both methods, but I find it to be misused at times, and would rather avoid making POV differences. -- Fyslee / talk 04:14, 18 August 2008 (UTC)

Any responses on this? If not, I'll proceed as suggested. -- Fyslee / talk 01:29, 19 August 2008 (UTC)
The only extended quote I noticed in Chiropractic was the one in Chiropractic #Vertebral subluxation, which already uses the ":" style, with the extended quote in double-quotes. So I don't see what change you're proposing here. Eubulides (talk) 07:29, 19 August 2008 (UTC)

2nd paragraph not supported by the source

I started to review the 2nd paragraph of the body of Chiropractic for Simon-says issues, and immediately ran into a more serious problem: the 2nd paragraph is not at all supported by the cited source. Here's the 2nd paragraph:

Chiropractic philosophy goes beyond manipulating the spine. Like naturopathy and several other forms of complementary and alternative medicine, chiropractic assumes that all aspects of a patient's health are interconnected, which leads to the following perspectives:[34]

However, the cited source does not say that chiropractic philosophy goes beyond manipulating the spine. Nor does it say that naturopathy and several other forms of CAM assume that all aspects of a patient's health are interconnected. Nor does it say that chiropractic assumes that all aspects of a patient's health are interconnected.

Some variant of the 2nd paragraph's claims can no doubt be supported by reliable sources somewhere, but in rereading the paragraph, I don't see how it adds anything to the text: the previous paragraph already made the point that chiropractic philosophy goes beyond manipulating the spine, and the next bullet talks about holism, which is the theory that aspects of a patient's health are interconnected. So the 2nd paragraph is redundant. Worse, the wording in the 2nd paragraph is that of a sales pitch for chiropractic, which is to be avoided in an encyclopedia article. Therefore, I propose replacing the 2nd paragraph with this:

Chiropractic philosophy includes the following perspectives:[34]

Eubulides (talk) 21:11, 14 August 2008 (UTC)

No further comment, so I made the change. Eubulides (talk) 22:48, 20 August 2008 (UTC)

Simon-says in 1st sentence of lead

In reviewing #Simon-says in 2nd sentence, I noticed a similar problem in the lead's summary of that sentence. The first sentence in the lead appears to endorse the chiropractic theory that mechanical disorders of the musculoskeletal system have a leading role in general health. The cited source talks about this theory in its section "What is the Chiropractic Hypothesis", so I propose the following simple solution, supported by the source, which is to add the word "hypothesized" to the lead sentence, as follows (the added word is italicized):

Chiropractic (from Greek chiro- χειρο- "hand-" + praktikós πρακτικός "concerned with action") is a health care profession that focuses on diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system and their hypothesized effects on the nervous system and general health, with special emphasis on the spine.[4]

Eubulides (talk) 22:11, 14 August 2008 (UTC)

That sounds pretty good. One other quibble..... why not move this part (from Greek chiro- χειρο- "hand-" + praktikós πρακτικός "concerned with action") to the footnotes? It makes for difficult reading. I wish we would make that the standard in Wikipedia articles. Many of them suffer from this ugly stuff. -- Fyslee / talk 06:44, 15 August 2008 (UTC)
To help with the quibble I moved the etymology to a quote box. Eubulides (talk) 09:27, 15 August 2008 (UTC)
Beautiful solution! The lead reads much better now. -- Fyslee / talk 20:12, 15 August 2008 (UTC)

No further comment, so I made the change. Eubulides (talk) 22:48, 20 August 2008 (UTC)

"In one study"

This edit introduced a qualifier "in one study" that is not needed within the context in the lead. The body already explains the fact that it's one study; it's not necessary to emphasize that in the lead. The study shows that an overwhelming majority of those surveyed reject the CAM label for chiropractic. It was just a survey, of course, but in that particular context the phrase "in one study" makes it look like the overwhelming consensus is that chiropractic is CAM, and that there's just one leeetle study that contradicts the consensus; but this is an inaccurate summary of the situation. Let's remove that phrase from the lead.

The edit's log message said "only one study of a limited group (did it include both straight and mixer schools?)". The people surveyed included "all D.C. faculty at 3 institutions and all the practitioners in a PBRN [chiropractic practice-based research network] database, and the institutions were in 3 widely diverse geographic areas. In terms of the representativeness of the philosophical position of the respondents, NUHS and SCUHS are considered to be on the liberal end of the spectrum of chiropractic philosophy, and Cleveland is considered to be on the conservative side of the spectrum, although not at the extreme end. Thus our sample may represent some bias toward a more liberal philosophy." So it's safe to say that this was a survey of mainstream chiropractic, and not the fringe straights. However, even if all straights think chiropractic is CAM (an extremely unlikely hypothesis), this would not overturn the conclusion that most chiropractors dispute the characterization of chiropractic as CAM. Eubulides (talk) 19:48, 16 August 2008 (UTC)

This further set of edits (again, made without discussion in advance) simply makes this worse in this regard. This is the lead! It is not the place to get bogged down in details like that, and to give a misleading summary of the details to boot. I made this change to solve the problem in a much more succinct way (basically, changing "most" to an inarguable "many"). The lead should summarize the body: it shouldn't contain details that are not in the body. Eubulides (talk) 07:28, 17 August 2008 (UTC)
You are reading far more into my qualifier than is implied, and than would necessarily be understood by others. Let's avoid hyperbole here. Just make sure that the impression isn't given that the survey participants consider chiropractic to be mainstream. On the contrary. Only "20% of practitioners and 6% of faculty considered chiropractic mainstream medicine." The study is only one study, with a poor reply rate, covering only part of the profession, the liberal part at that. It is very unrepresentative. It would be improper to extrapolate the results to the whole profession. The "fringe" is not a small percentage and is part of the whole. It has a much greater influence than its numbers would imply. That (degree of "influence") is from a RS. A truly representative survey would have included all schools and types of chiropractors. It is just "one study", which implies nothing more than that one shouldn't put more confidence in it than it is worth. Yes, it "would not overturn the conclusion that most [of the surveyed] chiropractors dispute the characterization of chiropractic as CAM." Yet IM is part of CAM! One can't read more into it than that. Extrapolation would be improper. To balance what's now included, maybe we should include the part that says that only "20% of practitioners and 6% of faculty considered chiropractic mainstream medicine." And that's liberal chiros speaking! That is a staggering minority. -- Fyslee / talk 06:42, 17 August 2008 (UTC)
Thanks for the comment. You've pointed out that it was possible to misread the old version as implying that most chiropractors think chiropractic is mainstream. This was a misreading I hadn't thought of. Does the current version (with "many" instead of "most") sufficiently forestall this problem? Eubulides (talk) 07:28, 17 August 2008 (UTC)
My main point (with adding "one study"), which I didn't make very clearly, is about attribution. "Many" is certainly an improvement. Since this is in the lead, we can't elaborate much, so I suggest that in the second instance where this study is being used as a ref, we include the "20% of practitioners....." part mentioned above. That way no one will misunderstand. -- Fyslee / talk 07:35, 17 August 2008 (UTC)
OK, thanks, then I propose that in Chiropractic #Utilization and satisfaction rates we replace this:
A 2008 survey stated that 69% of DC chiropractors disagree with the categorization of chiropractic as CAM, with 27% having some preference for the term "integrated medicine."
with this:
A 2008 study reported that 31% of surveyed chiropractors categorized chiropractic as CAM, 27% as integrated medicine, and 12% as mainstream medicine.
The "12%" is the combination of the "20%" and "6%" figures you mentioned above (the combination was done by the source, of course). I doubt whether it's necessary for us to break it down into practicing DCs vs. faculty chiropractors. Please notice that I am taking the liberty of proposing other minor changes as well, e.g., normalizing to positive figures like 31% rather than negative ones like 69% (which the source also does, of course), and removing unnecessary quote marks and adding a wikilink to Integrated medicine. Eubulides (talk) 09:16, 17 August 2008 (UTC)
This is looking better. I do suspect a typo above. That 12% should be 26%. I don't have the whole study available. May we get a link to it? The figures above still don't add up: 26% + 31% + 27% ? What is the real breakdown? -- Fyslee / talk 14:28, 17 August 2008 (UTC)
It's not a typo. 6% of the 71 faculty and 20% of the 61 practitioners in the survey considered chiropractic to be mainstream medicine; this averages out to be 12% (the "12%" was computed by the source). Aside from the 31%, 27%, and 12% mentioned in the proposed sentence, the study reported 14% "not CAM" but with no alternative suggested; 7% Any, depending on practitioner; 5% Its own category; 2% Primary care providers; 2% Categorize by level of education; and 2% no opinion. Responses do not total 100% due to "missing values and rounding". The only link I can provide to the article is what is on Chiropractic now; the article is copyrighted and I don't have the rights to reproduce it. Eubulides (talk) 21:02, 18 August 2008 (UTC)
Aha! That explains it. Thanks for the info. -- Fyslee / talk 01:27, 19 August 2008 (UTC)
No further comment, so I installed that change. Eubulides (talk) 21:32, 21 August 2008 (UTC)

References

(The following resolve otherwise-dangling references: [4] [13] [20] )

  1. ^ a b c "Evidence based medicine: what it is and what it isn't -- Sackett et al. 312 (7023): 71 -- BMJ". Retrieved 2008-07-25.
  2. ^ a b c "DCConsult: Start Page". Retrieved 2008-07-26.
  3. ^ a b c d e f Keating JC Jr (1997). "Chiropractic: science and antiscience and pseudoscience side by side". Skept Inq. 21 (4): 37–43. Retrieved 2008-05-10.
  4. ^ a b c d e f g h Nelson CF, Lawrence DJ, Triano JJ; et al. (2005). "Chiropractic as spine care: a model for the profession". Chiropr Osteopat. 13: 9. doi:10.1186/1746-1340-13-9. PMID 16000175. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link)
  5. ^ a b c d Keating JC Jr, Charlton KH, Grod JP, Perle SM, Sikorski D, Winterstein JF (2005). "Subluxation: dogma or science?". Chiropr Osteopat. 13: 17. doi:10.1186/1746-1340-13-17. PMID 16092955.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link)
  6. ^ a b c Phillips RB (2005). "The evolution of vitalism and materialism and its impact on philosophy". In Haldeman S, Dagenais S, Budgell B et al. (eds.) (ed.). Principles and Practice of Chiropractic (3rd ed. ed.). McGraw-Hill. pp. 65–76. ISBN 0-07-137534-1. {{cite book}}: |edition= has extra text (help); |editor= has generic name (help)CS1 maint: multiple names: editors list (link)
  7. ^ a b c d "Vitalism". Retrieved 2008-07-16.
  8. ^ a b c Starr, Paul (1982). The social transformation of American medicine. New York: Basic Books. ISBN 0-465-07934-2.
  9. ^ a b Keating J. D.D. Palmer's Lifeline [2]
  10. ^ a b c d e f g h Martin SC (1993). "Chiropractic and the social context of medical technology, 1895-1925". Technol Cult. 34 (4): 808–34. doi:10.2307/3106416. PMID 11623404.
  11. ^ a b c d e f Keating JC Jr, Cleveland CS III, Menke M (2005). "Chiropractic history: a primer" (PDF). Association for the History of Chiropractic. Retrieved 2008-06-16.{{cite web}}: CS1 maint: multiple names: authors list (link)
  12. ^ Palmer DD (1911-05-04). "Letter to P.W. Johnson, D.C." (PDF). Retrieved 2008-06-29.
  13. ^ a b Kaptchuk TJ, Eisenberg DM (1998). "Chiropractic: origins, controversies, and contributions". Arch Intern Med. 158 (20): 2215–24. doi:10.1001/archinte.158.20.2215. PMID 9818801.
  14. ^ Cherkin D (1989). "AMA policy on chiropractic". Am J Public Health. 79 (11): 1569–70. PMC 1349822. PMID 2817179.
  15. ^ a b c d Cooper RA, McKee HJ (2003). "Chiropractic in the United States: trends and issues". Milbank Q. 81 (1): 107–38. doi:10.1111/1468-0009.00040. PMID 12669653. {{cite journal}}: Unknown parameter |doi_brokendate= ignored (|doi-broken-date= suggested) (help)
  16. ^ Autobiography of Andrew Still
  17. ^ Palmer DD (1911-05-04). "Letter to P.W. Johnson, D.C." (PDF). Retrieved 2008-06-29.
  18. ^ Cherkin D (1989). "AMA policy on chiropractic". Am J Public Health. 79 (11): 1569–70. PMC 1349822. PMID 2817179.
  19. ^ Martin SC (1994). "'The only truly scientific method of healing': chiropractic and American science, 1895–1990". Isis. 85 (2): 206–27. PMID 8071054.
  20. ^ a b c Keating JC Jr (2005). "Philosophy in chiropractic". In Haldeman S, Dagenais S, Budgell B et al. (eds.) (ed.). Principles and Practice of Chiropractic (3rd ed. ed.). McGraw-Hill. pp. 77–98. ISBN 0-07-137534-1. {{cite book}}: |edition= has extra text (help); |editor= has generic name (help)CS1 maint: multiple names: editors list (link)
  21. ^ Gay RE, Nelson CF (2003). "Chiropractic philosophy". In Wainapel SF, Fast A (eds.) (ed.). Alternative Medicine and Rehabilitation: a Guide for Practitioners. New York: Demos Medical Publishing. ISBN 1-888799-66-8. {{cite book}}: |editor= has generic name (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)
  22. ^ a b American Chiropractic Association. "History of chiropractic care". Retrieved 2008-02-21.
  23. ^ Gay RE, Nelson CF (2003). "Chiropractic philosophy". In Wainapel SF, Fast A (eds.) (ed.). Alternative Medicine and Rehabilitation: a Guide for Practitioners. New York: Demos Medical Publishing. ISBN 1-888799-66-8. {{cite book}}: |editor= has generic name (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)
  24. ^ a b c d Christensen MG, Kollasch MW (2005). "Professional functions and treatment procedures". Job Analysis of Chiropractic. Greeley, CO: National Board of Chiropractic Examiners. pp. 121–38. ISBN 1-884457-05-3. {{cite book}}: |access-date= requires |url= (help); |format= requires |url= (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)
  25. ^ "About chiropractic and its use in treating low-back pain" (PDF). NCCAM. 2005. Retrieved 2008-03-24.
  26. ^ a b Winkler K, Hegetschweiler-Goertz C, Jackson PS; et al. (2003). "Spinal manipulation policy statement" (PDF). American Chiropractic Association. Retrieved 2008-05-24. {{cite web}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  27. ^ "About chiropractic and its use in treating low-back pain" (PDF). NCCAM. 2005. Retrieved 2008-03-24.
  28. ^ Phillips RB (2005). "The evolution of vitalism and materialism and its impact on philosophy". In Haldeman S, Dagenais S, Budgell B et al. (eds.) (ed.). Principles and Practice of Chiropractic (3rd ed. ed.). McGraw-Hill. pp. 65–76. ISBN 0-07-137534-1. {{cite book}}: |edition= has extra text (help); |editor= has generic name (help)CS1 maint: multiple names: editors list (link)
  29. ^ a b Ronald Carter, DC, MA, Past President, Canadian Chiropractic Association. "Subluxation - the silent killer." J Can Chiropr Assoc 2000; 44(1)
  30. ^ Meridel I Gatterman. The Journal of Alternative and Complementary Medicine. December 1, 1995, 1(4): 371-386. doi:10.1089/acm.1995.1.371.
  31. ^ Chiropractic: Origins, Controversies, and Contributions. Ted J. Kaptchuk, OMD; David M. Eisenberg, MD Arch Intern Med. 1998;158:2215-2224. [3]
  32. ^ a b Chapman-Smith DA, Cleveland CS III (2005). "International status, standards, and education of the chiropractic profession". In Haldeman S, Dagenais S, Budgell B et al. (eds.) (ed.). Principles and Practice of Chiropractic (3rd ed. ed.). McGraw-Hill. pp. 111–34. ISBN 0-07-137534-1. {{cite book}}: |edition= has extra text (help); |editor= has generic name (help)CS1 maint: multiple names: editors list (link)
  33. ^ a b Redwood D, Hawk C, Cambron J, Vinjamury SP, Bedard J (2008). "Do chiropractors identify with complementary and alternative medicine? results of a survey". J Altern Complement Med. 14 (4): 361–8. doi:10.1089/acm.2007.0766. PMID 18435599.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  34. ^ a b Mootz RD, Phillips RB (1997). "Chiropractic belief systems". In Cherkin DC, Mootz RD (eds.) (ed.). Chiropractic in the United States: Training, Practice, and Research. AHCPR Pub No. 98-N002. Rockville, MD: Agency for Health Care Policy and Research. pp. 9–16. OCLC 39856366. {{cite book}}: |access-date= requires |url= (help); |editor= has generic name (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)
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