Talk:Chiropractic

POV

This article misrepresents the conclusions of some of the source. This ref . PMID 21328304. {{cite journal}}: Cite journal requires |journal= (help); Missing or empty |title= (help) which states "High quality evidence suggests that there is no clinically relevant difference between SMT and other interventions for reducing pain and improving function in patients with chronic low-back pain." to state "Manual and conservative therapies commonly used by chiropractors are effective for the treatment of low back pain". I think the ref means they are not effective. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:17, 11 February 2013 (UTC)

The source states that there is no difference between interventions, meaning equivalence interventions. Also, this was not part of the review and suggests a different conclusion. [1] DVMt (talk) 01:23, 11 February 2013 (UTC)

The source says, in it's plain-language summary: "The results of this review demonstrate that SMT appears to be as effective as other common therapies prescribed for chronic low-back pain, such as, exercise therapy, standard medical care or physiotherapy." AND "In summary, SMT appears to be no better or worse than other existing therapies for patients with chronic low-back pain." Thus, to decide which interventions are best, the authors suggest that "Determining cost-effectiveness of care has high priority.". Moreover, other high-quality sources are more explicit, such as this. Puhlaa (talk) 01:29, 11 February 2013 (UTC)

When knee arthroscopy was found to be as good as conservative management for OA this did not result in the conslusion that "knee arthroscopy is effective for the treatment of knee OA" Why does the article not state that manipulation is equivalent to conservative treatment?

Much is also left out. Such as "Collectively, these data fail to demonstrate that spinal manipulation is an effective intervention for pain management." . PMID 22621391. {{cite journal}}: Cite journal requires |journal= (help); Missing or empty |title= (help) The benefits are presented as fact but their are many high quality sources which state no benefit. The best we could have is the benefits are questionable and tentative if any. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:34, 11 February 2013 (UTC)

Doc James you are arguing against scientific consensus regarding spinal manipulation and the management of back pain. Also your assertion that the "best we could have is the benefits are questionable and tentative if any" goes against the majority of the literature regarding SM and LBP. Are you aware of this? DVMt (talk) 01:39, 11 February 2013 (UTC)

It appears that this article is presenting half the literature. The half that shows benefit. While ignoring the half that does not. Our article than states without qualifications "Spinal manipulation, commonly used by chiropractors and other manual medicine practitioners are effective for the treatment of spinal pain, including low back pain, neck pain, some forms of headache and a number of extremity joint conditions such as shoulder and hip pain" supported the journal Chiropr Osteopat. Yet we have this more recent systematic review that states "Collectively, these data fail to demonstrate that spinal manipulation is an effective intervention for pain management." . PMID 22621391. {{cite journal}}: Cite journal requires |journal= (help); Missing or empty |title= (help) So I think we have a huge problem. It appears that our article just picks up the positive research and presents it while ignoring the research that disagrees. Have returned to a more neutral version. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:48, 11 February 2013 (UTC)

Since you disagree specifically with the section involved regarding the benefits, we shall critique that. I have restored the revised content which deletes over 50 added systematic reviews. — Preceding unsigned comment added by DVMt (talk • contribs) 01:51, 11 February 2013 (UTC)

Doc James, is your concern with this text in the lead?:

• "Manual and conservative therapies commonly used by chiropractors are effective for the treatment of low back pain,[2][3] and might also be effective for the treatment of lumbar disc herniation with radiculopathy,[4][5] neck pain,[6] some forms of headache,[7][8] and some extremity joint conditions [9][10]."?

Note that this text is very-well sourced and is qualified with "may be effective for...".Puhlaa (talk) 02:31, 11 February 2013 (UTC)

As per the concern of Doc James, I have removed specific reference to spinal manipulation in the UK Manual therapy review. Manual therapies though still apply. DVMt (talk) 02:32, 11 February 2013 (UTC)

It should also be noted that Doc James reference specifies 'spinal manipulation' . PMID 22621391. {{cite journal}}: Cite journal requires |journal= (help); Missing or empty |title= (help) and not manual therapy. This distinction is critical. DVMt (talk) 02:33, 11 February 2013 (UTC)

Part of the confusion was because Cochrane and Dagenais were cited instead of the UK Manual therapy report. Also since Dagenais and Rubinstein are SMT specific they aren't MT. I clarified the article here [11] to reflect this distinctionDVMt (talk) 02:51, 11 February 2013 (UTC)

Sure so the lead had left out the effectiveness of SMT entirely which is POV. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:36, 11 February 2013 (UTC)

Deletion of whole article

Jmh649 has recently deleted the whole article based on his one disagreement regarding the effectiveness of SMT for LBP. He is not a regular contributor to the article. His revision deleted 50+ mainstream systematic reviews that was added. Based on such mass deletion of sourced content I am reverting back to the stable version and we can discuss it one section at a time. DVMt (talk) 01:58, 11 February 2013 (UTC)

This . PMID 22621391. {{cite journal}}: Cite journal requires |journal= (help); Missing or empty |title= (help) source was used to dispute the smt for pain management. This author is also severely biased as he authors articles with Edzard Ernst who argues against scientific consensus regarding SMT and pain management. Also, the article clearly makes the distinction between manual therapy and manipulative therapy. Therefore in some instances non thrust soft tissue techniques are appropriate whereas SMT would not. To not make this distinction is to make a false equivalence between the two. DVMt (talk) 02:07, 11 February 2013 (UTC)

DVMt, you have reverted two experienced editors who have pointed out to you that the version you are removing is more neutral. I have restored that version and I will point out to you that we do not create articles by pushing our own preferred version against the advice of multiple other editors. That is edit-warring and not acceptable on Wikipedia. You also need to understand that you do not get to determine who can and cannot edit here. I strongly suggest you start from where we are now and try to convince the other editors how your removal of sources as strong as a Cochrane review could possibly be an improvement to the article. --RexxS (talk) 03:18, 11 February 2013 (UTC)

I understand your point regarding reviewing Cochrane and Dagenais, and also saw the disagreeing reviews you posted at WP:MED. I will propose a revision to the lead, which is really what is being disputed, as opposed to the body of the article -- and we can arrive at a mutually agreeable solution. I was disagreeing with the reverts because they deleted 50 additional systematic reviews and other sections of the article were not in dispute. I look forward to collaborating with you so we can get a consensus statement of manual therapy separate from SMT and a separate statement for SMT specifically as they are mutually exclusive in that regard. DVMt (talk) 03:23, 11 February 2013 (UTC)

{{od}Yes I removed the 60 plus edits made by a single editor DVMt. I can run through reasons for this reversal one by one.

Issues

• It stated "A 2011 study, however, demonstrated that maintenance spinal manipulative therapy is effective for the treatment of chronic nonspecific low back pain" the ref was broken but it is for this primary research paper of 60 people [12] We should not be using primary research and what was there was fair more balanced.
• It stated "Manual and conservative therapies commonly used by chiropractors are effective for the treatment of low back pain," No this is subterfuge. What chiropractors are known for and primarily do is spinal manipulation and the effectiveness has been left out of the lead all together. Only its safty is discussed. Yet we have this 2012 review of reviews that was summed up originally [13] which found no benefit.
• We have this line "Chiropractors emphasize the conservative management of the neuromusculoskeletal system without the use of medicines or surgery [1] with an emphasis on the spinal manipulation." I would not consider spinal manipulation "conservative therapy" so combining the two is incorrect. And then once this claim is made in the lead it states "might also be effective for the treatment of lumbar disc herniation with radiculopathy" basing it on a review of conservative therapy which does not mention chiropractic care [14] anywere
• We state without any qualifications that "Manual therapies, including spinal manipulation, has been found to be effective for mechanical neck pain" leaving out the evidence that it has been found not to be effective in neck pain per the review above. We have ignored this [15]
• Why did this ref disappear? It did not support manipulation for mirgraines. [16]

So my revert of these last 50 edits RESTORED a great deal of high quality evidence

Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:32, 11 February 2013 (UTC)

Proposal

The content dispute is specifically about the lead and the effectiveness of SMT in the lead. I propose that with the help of Yobol and his requests for additional sources be included in the revised lead. After we achieve a consensus on the effectiveness of SMT in the lead we can move forward. I'm going to take a little wiki-break but look forward to hearing from involved parties. DVMt (talk) 03:29, 11 February 2013 (UTC)

There were multiple issues with the changes made including an change in how chiropractic scope of practive is viewed. I am off to go skiing. But we will definitely need to discuss. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:35, 11 February 2013 (UTC)

Not a problem with discussion. It's why I brought the article to your attention. My rationale was if a representative(s) from WP:MED could review the lead and there were issues with language or the sources in question it would be good to be open about it instead of hoping edits would 'sneak by'. Enjoy the skiing. DVMt (talk) 02:06, 12 February 2013 (UTC)

POV Issues

For the sake of clarity I have copy and pasted Doc James' concerns here so they can be discussed and addressed.

Concern 1 - Use of primary research

It stated "A 2011 study, however, demonstrated that maintenance spinal manipulative therapy is effective for the treatment of chronic nonspecific low back pain" the ref was broken but it is for this primary research paper of 60 people [17] We should not be using primary research and what was there was fair more balanced.

• I agree with Doc James, secondary sources would be needed to make claims of effectiveness for maintenance care; one small primary study fails WP:MEDRS and WP:UNDUE.Puhlaa (talk) 03:20, 12 February 2013 (UTC)

Concern 2 - Is chiropractic care just spine manipulation

It stated "Manual and conservative therapies commonly used by chiropractors are effective for the treatment of low back pain," No this is subterfuge. What chiropractors are known for and primarily do is spinal manipulation and the effectiveness has been left out of the lead all together. Only its safty is discussed. Yet we have this 2012 review of reviews that was summed up originally [18] which found no benefit.

• This chapter from this source says that the vast majority of American chiropractors use exercise prescription/promotion, trigger-point therapy, physiotherapeutic modalities, thermotherapy, disease prevention advice, etc. That most chiropractic patients receive a wide range of manual therapies, active rehabilitation and health-promotion information is also verified in these sources: [19][20]. I agree that SMT is the primary technique most commonly associated with chiropractic, and that most efficacy studies have examined SMT. However, our article should reflect the reality of chiropractic treatment, which for most patients is multi-modal conservative therapy, usually including SMT.Puhlaa (talk) 03:22, 12 February 2013 (UTC)

• My main issue is lumping all that this profession does together. Yes there are aspects that are of benefit like recommending exercise. Throwing that in with aspects that may not have benefit confuses the matter.Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:52, 12 February 2013 (UTC)

• If we agree with reliable sources that say chiropractic treatment involves multi-modal therapy, then to me it seems more confusing to limit discussions of chiropractic efficacy in our article to only spine manipulation. It is important that the article indicate that SMT is only one of many therapies used by chiropractors to treat msk conditions. That said, as the existing literature tends to focuses on spinal manipulation, most of our discussion of efficacy will inevitably be focused on SMT as well.Puhlaa (talk) 16:08, 12 February 2013 (UTC)

Concern 3 - Is spine manipulation 'conservative care'?

We have this line "Chiropractors emphasize the conservative management of the neuromusculoskeletal system without the use of medicines or surgery [1] with an emphasis on the spinal manipulation." I would not consider spinal manipulation "conservative therapy" so combining the two is incorrect. And then once this claim is made in the lead it states "might also be effective for the treatment of lumbar disc herniation with radiculopathy" basing it on a review of conservative therapy which does not mention chiropractic care [21] anywhere.

• Reliable sources seem to suggest that SMT is indeed conservative care. For example, these sources [22][23] [24] all include spine manipulation in their assessment of conservative therapies. Doc James suggests that this review of conservative therapies for disc herniation with radiculopathy did not include SMT. However, it does indeed include SMT and concludes that "Moderate evidence favours manipulation over sham manipulation", thus supporting the text, which says that it "...may be effective for treatment of disc herniation...".Puhlaa (talk) 03:25, 12 February 2013 (UTC)

• So yes Chiropractics is a type of conservative care (ie primarily spinal manipulation) but it is not "conservative management" which is broader in scope. Yes the paper above does indeed mention manipulation but not chiropractic manipulation.Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:40, 12 February 2013 (UTC)

• The systematic review above includes studies that examined manipulation performed by any practitioner; the methodology section does not indicate that studies that included chiropractors were excluded. It seems that most of the sources examining SMT as a treatment for msk conditions have NOT considered it necessary to separate examinations of spine manipulation by who is administering the procedure. Cochrane reviews lump all manipulation studies together, as such I fail to see your justification for using the 'type of practitioner' as an issue here? The only review that I have seen that explicitly separates-out chiropractic manipulation from others was this one. It found: "...it is interesting to note that SMT was administered by DCs in all of the studies that reported greater pain reduction in the SMT group over control groups at one or more time points".Puhlaa (talk) 16:26, 12 February 2013 (UTC)

"I would not consider spinal manipulation "conservative therapy" so combining the two is incorrect." It doesn't matter what you would consider "conservative therapy", it only matters that reliable sources consider spinal manipulation to be conservative therapy/conservative management. DigitalC (talk) 19:47, 21 February 2013 (UTC)

Concern 4 - Does the evidence say spine manipulation is effective for neck pain?

We state without any qualifications that "Manual therapies, including spinal manipulation, has been found to be effective for mechanical neck pain" leaving out the evidence that it has been found not to be effective in neck pain per the review above. We have ignored this [25].

• The text in the lead (that was reverted) was qualified and said "...might also be effective for ... neck pain" and this is supported by this Cochrane review. The Cochrane review says, in the “Authors Conclusions”: "Cervical manipulation and mobilisation produced similar changes. Either may provide immediate- or short-term change; no long-term data are available. Thoracic manipulation may improve pain and function." The text in the body should also be qualified to say "May be effective for neck pain". This source, indicated by Doc James, should be included in the article, but should not get more weight than the Cochrane review, or other sources that are consistent with the Cochrane review. I think that MEDRS says that Cochrane reviews are better than other reviews.Puhlaa (talk) 03:29, 12 February 2013 (UTC)

Yes was referring to lower in the article. I think we can say "the effects of spinal manipulation are controversial, some fail to find any benefit while other find it is equivalent to mobalization" Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:09, 12 February 2013 (UTC)

The wording "the effects of SMT are controversial" can be improved IMO because the effectiveness isn't really controversial in itself although there is disagreement over the how effective may be (superior/equivalent/inferior. As such, I propose that we qualify the statement such as "SMT may be effective for..." Also, the controversial element of SMT specifically is for upper cervical manipulation. Furthermore, as Puhlaa indicated elsewhere, if SMT is contraindicated, then other modes of treatment could be applied that are within the scope of chiropractors (i.e. massage, mobilization, education, exercise, etc. DVMt (talk) 17:51, 12 February 2013 (UTC)

Concern 5 - Disappearing sources

Why did this ref disappear?[26] It did not support manipulation for mirgraines. [18] So my revert of these last 50 edits RESTORED a great deal of high quality evidence.

• The critical Ernst reference should not have been removed, if it indeed was. However, it also does not deserve to be given equivalent weight as this Cochrane review, which is a better source. Moreover, other sources seem to agree with the Cochrane review, thus, the Ernst source could be seen as going against the general scientific consensus.Puhlaa (talk) 03:41, 12 February 2013 (UTC)

The Cochrane review was from 2004 the Ersnt review is from 2011. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:00, 12 February 2013 (UTC)

WP:MEDRS says "Cochrane Library reviews are generally of high-quality and are routinely maintained even if their initial publication dates fall outside the above window." Also, the conclusions of this 2011 source are consistent with the findings of the Cochrane review.Puhlaa (talk) 04:57, 12 February 2013 (UTC)

And all three of them agree that the evidence is poor. So maybe we should just state what they all agree on "the evidence for an effect on migraines is poor" Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:44, 12 February 2013 (UTC)

As opposed to 'poor' perhaps more neutral wording such as 'low levels of evidence' might be preferred as that is the language typically used in EBM. DVMt (talk) 17:54, 12 February 2013 (UTC)

Agreed with DVMt - The level of evidence is low, but the evidence itself is not poor. It may be stated that "Low levels of evidence suggest that spinal manipulation is effective for treating migraines". etc. DigitalC (talk) 19:52, 21 February 2013 (UTC)

See also - http://www.ncbi.nlm.nih.gov/pubmed/21640251 "Evidence suggests that chiropractic care, including spinal manipulation, improves migraine and cervicogenic headaches" DigitalC (talk) 20:05, 21 February 2013 (UTC)

And http://www.ncbi.nlm.nih.gov/pubmed/15266458 "For the prophylactic treatment of migraine headache, there is evidence that spinal manipulation may be an effective treatment option with a short-term effect similar to that of a commonly used, effective drug (amitriptyline)." "For the prophylactic treatment of chronic tension-type headache, amitriptyline is more effective than spinal manipulation during treatment." "However, spinal manipulation is superior in the short term after cessation of both treatments." But they also state, " This conclusion rests upon a few trials of adequate methodological quality. Before any firm conclusions can be drawn, further testing should be done in rigorously designed, executed, and analyzed trials with follow-up periods of sufficient length." — raekyt 21:19, 21 February 2013 (UTC)

Other remarks

I do not have the time to sort through all of DVMt's edits that were reverted by Doc James, Yobol and RexxS. However, I follow WP:BRD and if Doc James, etc., take issue with the edits, then the burden now lies with DVMt to justify his edits. In my opinion, the 5 concerns listed to date by Doc James do not seem like enough justification for blanket reverting DVMt's edits, but as noted by Doc James, there are more concerns than those he listed; as such, I would encourage him to further clarify why he chose to remove all of DVMt's work. I note that DVMt made an attempt to seek input on his edits at the project medicine page and received a blanket revert of all of his work for a response.... Regardless of all this, per WP:BRD, the burden now lies with DVMt and I suggest that he/she initiate discussion for the changes, slowly so we can follow, to try and achieve consensus.Puhlaa (talk) 03:53, 12 February 2013 (UTC)

Comment

Please recall that I did in fact voluntarily bring this up at WP:MED to get additional input so there can be consensus (at least as of Feb 2013), from a scientific point of view, regarding spinal manipulation. My reasoning for doing so is because there are other professions such as osteopathic medicine, physical therapy and naturopathic medicine (in addition to some MDs) who practice manipulative therapy. For consistency across WP the consensus achieved here logically should be consistent with their 'views' on SMT and effectiveness (for example the osteopathic manipulative medicine article with respect to SMT should be consistent with chiropractic and physical therapy with respect to SMT and effectiveness. I apologize for the reverts yesterday, it was not to remove your dispute on the issues that were raised but rather on the massive amount of research, time and energy spent on collecting a lot of new reviews, but also in organizing the article and having it written an an encyclopaedic manner. It was unwise on my part as I got caught up in the emotion and strayed from WP editing principles. Again, I do not want to violate WP:OWN and I fully support collaborate editing, which is why I brought the article to your attention in the first place. I hope that yesterdays debacle doesn't erode good faith on either side. So again, I'm sorry for last night. I do hope I've been able to communicate my concern though when you reverted all the work (not just the section in question) which removed over 50 additional citations added into non-disputed parts of the article such as philosophy, training, etc. DVMt (talk) 04:42, 12 February 2013 (UTC)

Proposed Lead

Chiropractic' is a complementary and alternative medicine discipline concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual and manipulative therapy and its role in joint dysfunction/subluxation . Currently, chiropractors practice in over 100 countries[[27]], however chiropractors are most prevalent in North America, Australia and parts of Europe. The majority of mainstream health care and governmental organizations classify chiropractic as traditional/complementary alternative medicine Most people who seek chiropractic care do so for primarily for low back pain.

Chiropractic was founded in 1895 by magnetic healer, D.D. Palmer, in Davenport, Iowa, United States. Chiropractic theory on spinal joint dysfunction/subluxation and its putative role in non-musculoskeletal disease has been a source of controversy since its inception in 1895. The controversy is due in part to chiropractic's vitalistic and metaphysical origins, and use of terminology that is not always amenable to scientific investigation. Far reaching claims and lack of scientific evidence supporting spinal joint dysfunction/subluxation as the sole cause of disease has led to a critical evaluation of a central tenet of chiropractic and the appropriateness of the profession's role in treating a broad spectrum of disorders that are unrelated to the neuromusculoskeletal system. Although there is external and internal debate within the chiropractic profession regarding the clinical significance of joint dysfunction/subluxation, the manipulable lesion remains inextricably linked to the profession as basis for spinal manipulation.

While spinal manipulation is widely seen as a reasonable treatment option for biomechanical disorders of the spine, such as neck pain and low back pain, the use of spinal manipulation to treat non-musculoskeletal complaints remains controversial. Manual and conservative therapies commonly used by chiropractors may be effective for the treatment of low back pain and may be effective for the treatment of lumbar disc herniation with radiculopathy, neck pain, some forms of headache, and some extremity joint conditions. There is insufficient evidence or known mechanisms for effects of chiropractic manipulation on non-musculoskeletal conditions. The efficacy and cost-effectiveness of maintenance chiropractic care are unknown. There is considerable debate regarding the safety of the core clinical act of chiropractors: spinal manipulation, particularly with the uppercervical spine. Although serious injuries and fatal consequences can occur and may be under-reported, these are generally considered to be rare as spinal manipulation is relatively safe when employed skillfully and appropriately.

Comments on revised lead

I think it's best if we look at the lead and work from there. As Puhlaa mentioned, everything was reverted but the primary concern is proper language for effectiveness. We can add our comments here to discuss proposed changes to the lead. DVMt (talk) 04:30, 12 February 2013 (UTC)

Some comments:

1. The first sentence is a very editorialized version of the WHO source. The first sentence is controversial and needs a good source to have any stability. I suggest maintaining a definition more closely resembling the high-quality WHO source and include the source for the first sentence.
2. That chiropractic is a complementary and alternative medicine profession needs to be included in the first sentence in order to satisfy WP:NPOV. The last stable version of the article qualified the WHO definition of chiropractic with the fact that it is a CAM; ie., "Chiropractic is a CAM health care profession concerned with....."
3. Third sentence says "chiropractic medicine", which is sure to cause conflict; maintain NPOV by sticking to chiropractic profession, chiropractors or doctors of chiropractic (where appropriate)
4. I cant find anywhere in the WHO source that supports the text "Currently, chiropractic medicine is regulated and practiced in over 100 countries, however chiropractors are most prevalent in...". I apologize if I missed it, if so, can you quote the appropriate text. Otherwise, an appropriate source would be needed for this text.
5. Last sentence of first paragraph says "...and other neuromuscular complaints". To maintain NPOV and avoid conflict, the lead should maintain WP:UNDUE and stick to the majority issue that has scientific consensus, that is back pain. Back pain is the reason for 80% of visits and unquestionably notable for our lead. However, all other conditions combined is only 20% of visits and may not be noteworthy for the lead. I suggest removing "and other NMSK complaints" to help ensure stability of your text and avoid conflicts.

There is more, perhaps I will have another look tomorrow. Hopefully others will also have comments. Puhlaa (talk) 06:04, 12 February 2013 (UTC)

• With respect to "While spinal manipulation is widely seen as a reasonable treatment option for biomechanical disorders of the spine, such as neck pain and low back pain, the use of spinal manipulation to treat non-musculoskeletal complaints remains controversial." It would be more accurate to say "spinal manipulation is more or less equivalent to conservative treatment for musculoskeletal complaints,[28][29] the use of spinal manipulation to treat non-musculoskeletal has not been found to result in benefit"[30] Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:20, 12 February 2013 (UTC)
• I think this bit is balanced "There has been considerable debate over the safety of the core clinical act of chiropractors: spinal manipulation, particularly with the cervical spine.[20] Although serious injuries and fatal consequences can occur and may be under-reported,[21] these are generally considered to be rare with spinal manipulation being relatively safe[22] when employed skillfully and appropriately.[1]"Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:18, 12 February 2013 (UTC)

• How about "spinal manipulation is equivalent to other conservative therapies for musculoskeletal complaints,[31][32] the use of spinal manipulation to treat non-musculoskeletal controversial and inconclusive(cite budgell 2012, ernst 2008).
• There has been considerable debate over the safety of the core clinical act of chiropractors: spinal manipulation, particularly with the [upper] cervical spine.[20] Although serious injuries and fatal consequences can occur and may be under-reported,[21] these are generally considered to be rare with spinal manipulation being relatively safe[22] when employed skillfully and appropriately.[1] I think that specifically mentioning the upper cervical spine would be more beneficial to readers to inform themselves. DVMt (talk) 18:14, 12 February 2013 (UTC)

I disagree that the first sentence is controversial, and it doesn't need a source for it, as long as it accurately summarizes the information from the body of the article (See WP:LEAD). DigitalC (talk) 21:00, 21 February 2013 (UTC)

Proposed manual and manipulative therapy effectiveness (final paragraph in lead)

Manual and conservative therapies commonly used by chiropractors may be effective for the treatment of low back pain as well as lumbar disc herniation with radiculopathy, neck pain, some forms of headache, and some extremity joint conditions. In general, spinal manipulation is equivalent to other conservative measures for musculoskeletal complaints.[33][34]. There is insufficient evidence regarding the effectiveness of spinal manipulation on non-musculoskeletal conditions.[35]. The efficacy and cost-effectiveness of maintenance chiropractic care are unknown. There is considerable debate regarding the safety of the core clinical act of chiropractors,pinal manipulation, particularly with the upper cervical spine. Although serious injuries and fatal consequences can occur and may be under-reported, these are generally considered to be rare as spinal manipulation is relatively safe when employed skillfully and appropriately.

References

Comments

This is a proposed synthesis of a new, improved and neutral review of manual and manipulative therapy based on the concerns raised by Doc James and Puhlaa. Due to the high scientific nature of this section, please keep in mind that WP:COMPETENCE applies. DVMt (talk) 20:14, 15 February 2013 (UTC)

Also keep in mind, WP:NPOV, WP:WEIGHT, WP:DUE, WP:SPA, WP:COI. — raekyt 05:13, 21 February 2013 (UTC)

Edit request on 14 February 2013

This edit pertains to the professional identity of chiropractic. Dr. Bill Meeker DC, President of Palmer College of Chiropractic West Campus, recently conducted a poll pertaining to the professional identity of chiropractic. He found that when asked if chiropractic has a professional identity, 40% of those polled said no, 56% said not sure, and 4% said yes. Commonly, when chiropractic is defined it is often lengthy and full of jargon. This leads to confusion and ambiguity within the public. People look to Wikipedia for simple definitions and explanations to all types of subject matter. After three years of work, Dr. Bill Meeker DC developed an identity statement. All that I ask is that the first line of the entry for chiropractic on Wikipedia is the professional identity statement that was developed. This way, when the public looks to Wikipedia for information on chiropractic, it is presented in a descriptive yet easy to understand manner. Here is the statement:

"Chiropractic is the primary care profession for spinal health and well being."

You can find this statement here: http://www.palmer.edu/Palmer/Pages/Page.aspx?id=454#Identity_Statement

If you could please address this request, I'd greatly appreciate it. This edit will help simplify the public's view of chiropractic.

Wil (talk) 02:04, 14 February 2013 (UTC)

Seriously doubt that this definition has wide-spread acceptance in the medical community, and I have serious issues with it myself. Sooo.. Deined on, WP:NPOV, WP:WEIGHT, WP:DUE, etc... — raekyt 03:01, 14 February 2013 (UTC)

The source is reliable and verifiable. It should be included on the notability alone, Palmer being the "fountainhead" or first ever chiropractic school. I read it in one of the articles I reviewed here by Joseph Keating. DVMt (talk) 03:17, 14 February 2013 (UTC)

Is there a reliable secondary source that indicates how influential Meeker is in particular, or that indicates that this definition is widely used within the chiropractic community? If so, then it could probably be included with attribution to Meeker: "Bill Meeker defines chiropractic as..." As this is a primary source it is insufficient for replacing the article's definition of chiropractic, which really needs to be sourced to independent reliable secondary sources. Zad68 03:58, 14 February 2013 (UTC)

Good point Zad68. A more neutral source comes from the World Health Organization, the one currently being used in opening sentence. DVMt (talk) 16:25, 14 February 2013 (UTC)

And you know that's a lie, the WHO document is ANYTHING but neutral. It's entirely a chiropractic lobbyist paper, nothing neutral about it. — raekyt 16:27, 14 February 2013 (UTC)

Are you disputing the credibility and neutrality of the WHO? What's in it for them? DVMt (talk) 17:11, 14 February 2013 (UTC)

Not everything that comes out of the WHO is credible or neutral, of course. — raekyt 16:18, 21 February 2013 (UTC)

This is a very new development for Palmer to have developed this "identity". It does however fit with the World Congress of Chiropractic or World Federation of Chiropractic's identity. It has been covered in secondary sources, reliable secondary sources, but not ones that would meet WP:RS. (See:The Chiropractic Report, probably Dynamic Chiropractic) DigitalC (talk) 21:10, 21 February 2013 (UTC)

Deletion of consensus material

Despite there being consensus here for the first two paragraphs of the revised lead, User:Raeky has deleted the consensus material here[36] citing a radical departure. I request that the user self-revert for undoing consensus material that is not being disputed. As per Doc James primary concerns was the citations and language surrounding the benefit of spinal manipulation for specific musculoskeletal conditions. DVMt (talk) 03:53, 14 February 2013 (UTC)

You're already treading on dangerous WP:TE user grounds... almost every one of your edits to this article has ultimately been reversed, yet you keep editing and reinserting it. I suggest you follow policies and stop trying push a WP:POV. — raekyt 04:03, 14 February 2013 (UTC)

I don't think you understand Raeky. The material you deleted has consensus as noted above in comments for revised lead. The concerns of both Doc James and Puhlaa were addressed a few days ago. Also, insinuations that these are not good faith edits, that I'm pushing a POV is nonsense. I espouse a scientific point of view (SPOV) to achieve NPOV in contentious articles. The sources nor the language of the first two paragraphs is in dispute. Given that neither the language or sources are in dispute by both the chiropractor and medical doctor for the first two paragraphs, how do you disagree with them? DVMt (talk) 04:08, 14 February 2013 (UTC)

Show me where anyone said to change the first sentence from "Chiropractic is a form of complementary and alternative medicine[1] concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health." to Chiropractic is a traditional/complementary and alternative medicine health care profession[1] concerned with the structural diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health." I don't see any consensus to make any changes just a beginning of a discussion to change something? The accusation that your pushing a POV is pretty self-evident I think to anyone who has been watching your edits here, and the statement that your approaching WP:TE, well I think it will be more evident as you go on and eventually we'll have to deal with it. That's my personal opinion there of course. — raekyt 04:15, 14 February 2013 (UTC)

The WHO basic guidelines on chiro are not in dispute which the citation you are opposing. The classification as traditional/CAM is not in dispute. The source specifically states "traditional/CAM". Thus, are you dispute the term 'health care profession'? That is also in the source. Even Edzard Ernst calls chiropractic a 'profession' in his 2008 Critical evaluation of chiropractic. The Ernst source in not in dispute. The language of the first two paragraphs are not in dispute. The sources in those 2 paragraphs aren't in dispute. In fact, they have reach consensus and it has been so for days, not minutes, as you implied at your talk page. So what exactly are you disputing Raeky? The burden is on you to state it clearly and specifically. Also, I might add, a POV pusher does not go to WP:MED and ask for RfC on the article itself. Doc James has kindly volunteered his time to address his concerns and hammer out a consensus on sources and language. DVMt (talk) 04:28, 14 February 2013 (UTC)

I'm objecting to your dramatic apparently unilateral changes to the lead sentence without any discussion on it's wording beforehand... — raekyt 04:30, 14 February 2013 (UTC)

Raeky you are being tendentious, I have asked you specifically what source or wording to you dispute? I might remind you that you are close to violation of WP:IDHT. DVMt (talk) —Preceding undated comment added 04:43, 14 February 2013 (UTC)

Still waiting for you to show me where the consensus was reached for those changes to the lead... We've talked about the WHO source before, it's definitely less than ideal was the consensus. — raekyt 04:48, 14 February 2013 (UTC)

I have shown it and described it. You are now in violation of IDHT. Also you have not provided any evidence for basis that there is NOT a consensus at talk. On the contrary the medical doctor and chiropractor agree on the language and sources of the opening 2 paragraphs. Consensus does not require unanimity. For the revised edit, supportive parties include a medical doctor (Doc James) a chiropractor (Puhlaa) and a veterinarian (DVMt). Only you are opposed to the edit in question. I can count 3 violations of WP alone now. WP:AGF, WP:MEDRS, WP:IDHT DVMt (talk) 04:55, 14 February 2013 (UTC)

Oh my a WP:TE editor is stacking up violations on me, whatever shall I do? No matter what "violations" you want to accuse me of, or no matter whatever consensus you've come up with in your head, it doesn't change that you're reinserting "health care profession" into the lead sentence again. I believe last discussion that was had on it (Talk:Chiropractic/Archive_35#Is_chiropractic_a_.27health_profession.27.3F) did NOT lead to a consensus for it's inclusion. SO again, EXACTLY where was this consensus for the wording your claiming, and by EXACTLY i mean an actual LINK to it, ideally the Diff showing the change being made or a link to the discussion at least. Your wearing on my nerves here. — raekyt 04:59, 14 February 2013 (UTC)

Let's hear a non WP:SPA agree with your change before we entertain the notion that you have support for any of this POV pushing. So far, I've only seen Doc James revert your massive whitewash of the article, I'm surprised you count him as a supporter. TippyGoomba (talk) 05:04, 14 February 2013 (UTC)

Thank you for identifying your concern the wording 'health care profession'. Doc James did not specifically mention this, however I will replace it with 'discipline' as previously agreed upon until there is clarification on the matter. Also, TG, I did not state he was a supporter of me. I stated that there was consensus for the first two paragraphs. Indeed Doc James reversed the article in its entirety which is why we are discussing it at talk. He specifically stated his concerns are we are addressing them. The remainder of the revised article shall too be up for discussion if he has additional concerns. How is collaboration between Doc James and Puhlaa whitewashing? I'm just helping them find the language. DVMt (talk) 05:10, 14 February 2013 (UTC)

Two WP:SPA and one other editor who hasn't even really weighed in on it one-way or the other for the BULK of those changes, is NOT consensus. You proposed that GIANT change just a couple days ago, and there's very low participation here. You can't ASSUME there is consensus yet. It's plainly obvious there isn't. So don't go making that massive change until its been given plenty of time to be discussed. — raekyt 05:13, 14 February 2013 (UTC)

The massive whitewash that was reverted. TippyGoomba (talk) 05:16, 14 February 2013 (UTC)

The bulk of the changes are not even being discussed. How can there be 'massive change' given that 95% of the article remains? Merely the first two paragraphs which has achieved consensus. However I will removing the wording 'traditional' and 'health care profession in the revised lead. You both will not dispute with those changes I assume. DVMt (talk) 05:25, 14 February 2013 (UTC)c

Depends on what else you change, why are you removing the infobox? — raekyt 05:27, 14 February 2013 (UTC)

I'm ok with the infobox being removed, it's awkward, but the "Alternative medical systems" box should be the first box on the page and needs to remain. — raekyt 05:29, 14 February 2013 (UTC)

I agree. I didn't realize it was gone to be honest. Ill combine the alternative medical systems box with the the chiropractic cauduceus. DVMt (talk) 05:41, 14 February 2013 (UTC)

Have been busy. I have little opinion on the non medical aspects of the article (such as history). I will review further but might take me a few days. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:30, 15 February 2013 (UTC)

Proposed lead: revisions paragraph 1

Chiropractic' is a complementary and alternative medicine health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual and manipulative therapy and its role in joint dysfunction/subluxation . Currently, chiropractors practice in over 100 countries in all regions of the world, however chiropractors are most prevalent in North America, Australia and parts of Europe. Most people who seek chiropractic care do so for primarily for low back pain.

Is Chiropractic a Health Profession? Take 2

• Wow, "health care profession" is back.... WP:POVPUSH much? — raekyt 15:35, 14 February 2013 (UTC)
  • First sentence: Chiropractic is a CAM, should be stated, not "a form of". Third the 2005 WHO source is very poor and should NOT be used to support the first sentence. — raekyt 15:43, 14 February 2013 (UTC)

• Can you point me to the discussion of the WHO document that explains why it's sub-par? Zad68 15:51, 14 February 2013 (UTC)

• Talk:Chiropractic/Archive_35#Spine_or_not.3B_a_reverted_edit — raekyt 15:52, 14 February 2013 (UTC)

• As for "health care profession" being used to describe Chiropractic, for me to accept that I'd need RELIABLE sources that the MAINSTREAM medical community accepts it as a health care profession. Sources that have a COI with chiropractic (i.e. from chiropractors or people who lobby for them like the WHO document) is IMO not sufficient to state it. — raekyt 16:14, 14 February 2013 (UTC)

• And the recent discussion on this: Talk:Chiropractic/Archive_35#Is_chiropractic_a_.27health_profession.27.3F. — raekyt 16:17, 14 February 2013 (UTC)

• I rather prefer the current version to this. If we weeded out all of the POV, I suspect we'd get exactly the current version. TippyGoomba (talk) 16:20, 14 February 2013 (UTC)
  • Most likely, so why not start there... is there anything wrong with the current version? — raekyt 16:23, 14 February 2013 (UTC)

Raeky, you have specifically mentioned the use of the WHO source in the first sentence as a reason for reverting DVMt's edits to the lead, however, in the same thread you endorse the current version, which also uses the WHO source for the first sentence. I agree with your assessment that the first sentence is currently good, except that I think that it should include the fact that chiropractic is a health profession. We had this discussion before, but I never heard back from you after I asked you to verify your claim that "It is a review article so it is not peer-reviewed" at the end of this thread.Puhlaa (talk) 18:12, 14 February 2013 (UTC)

Multiple reliable sources call Chiropractic a health profession, I have listed multiple high-quality sources below to provide WP:V. This information belongs in the article according to policy.

1. From the WHO source: "Chiropractic - A health care profession concerned with....."
2. From a peer-reviewed source in Archives of Internal Medicine: "Chiropractic, the medical profession that specializes in..."
3. From a peer-reviewed source in The Milbank Quarterly: "Chiropractic is the best established of the alternative health care professions."
4. From a peer-reviewed source in Arthritis Research & Therapy: "many patients seek care directly from health-care professionals other than their family doctor; for example, at least one third of back pain patients in Denmark now choose to see a chiropractor as their..."
5. From NIH/NCCAM: "Chiropractic is a health care profession that focuses on..."
6. From a Provincial government source: "Chiropractic has been a designated health profession under the Health Professions Act...."
7. From private insurance company WSIB: "The WSIB has completed a review of the fees paid to 12 health professions." *Note that chiropractic is #3 on the list of 12 health professions.
8. This source examined the attitudes/behaviours of health care professionals, of which, chiropractic is included.

— Preceding unsigned comment added by DVMt (talk • contribs) 17:23, 14 February 2013 (UTC)

• I agree with DVMt that chiropractic is considered a health profession by multiple reliable sources, as verified above. DVMt, I have amended your list above with a few additional reliable sources; I hope you dont mind. Puhlaa (talk) 18:03, 14 February 2013 (UTC)

This is not a question answered predominantly with reference to their recognition by other healthcare professionals but rather in terms of their legal status, recognition by representative, state or international bodies, public usage, education (and other bars to professional entrance) and relationship to health insurers. It's not a question about the efficacy of chiropractic methods or it's scientific status. Frankly, they could be killing people every day and it wouldn't matter to such a definition. Are there registration acts in relevant jurisdictions covering chiropractors? Are they described therein as health professionals or under some analogous term? Do health insurance companies pay out for chiropractic treatment? Do studies of public usage indicate a popular perception that they provide a form of treatment aimed at the improvement of "health"? Is there occupational closure in terms of entry to the profession (chiropractic schools cover that)? Do they have professional assocations and self-describe themselves as operating in the field of health? Do these associations have legal status or recognition by state or representative international bodies? Is chiropractics recognised or defined by representative international or state bodies involved in healthcare? The appropriate secondary sources should cover these issues. In my opinion, the WHO, as an international representative body involved in global healthcare, while insufficient on its own, is an appropriate source to support such a statement irrespective of whether, or whether anyone thinks, that such a definition is the result of lobbying, bribery or extortion. The next thing to determine would be whether other large international or state bodies, (the EU, US Federal law, etc) also recognise chiropractics as a health care profession. FiachraByrne (talk) 14:32, 20 February 2013 (UTC)

Seriously, this seems like WP:TE to me. How can anyone dispute that chiropractic is a health care profession? DigitalC (talk) 21:48, 21 February 2013 (UTC)

"Chiropractors, like other health care professions, whose clinical specialty is to detect and diagnose musculoskeletal and nervous system problems..." http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3391779/ DigitalC (talk) 21:55, 21 February 2013 (UTC)

NPOV Noticeboard

I have request comments from outside the article here [37] regarding the whether or not the sources support the claim of health care profession, and is the sources are reliable. Feel free to discuss there or add additional citations that support or refute the premise. DVMt (talk) 18:08, 14 February 2013 (UTC)

with no links to current and past discussions? That's not good practice, I would add them now exept it's a bit hard on my phone... — raekyt 18:26, 14 February 2013 (UTC)

Agree with Raeky that it would be good to link to the last time we discussed if Chiropractic is a health profession here so that editors new to the discussion can gain context. Editors will then note that after the same sources were presented in the archived discussion, it seemed that only Raeky was left arguing that chiropractic is not a health profession. However, the argument he/she last presented was that the sources provided were not reliable because review articles are not peer reviewed? I asked him/her to fact-check this claim, but then never heard back? It is my opinion that the sources provided in the list above are all reliable according to WP:RS and clearly WP:verify that chiropractic is a health profession. It will be helpful to see if other editors think that chiropractic is, or is not a health profession.Puhlaa (talk) 18:42, 14 February 2013 (UTC)

Not quite accurate, I said they're all sources from chiropractors, not something that shows that the medical community from outside the confines of chiropractic regards it as such. I also stated that review articles in a journal is generally NOT peer review in the full sense. Theres an editorial process at the journal to review it but are generally not sent out for a formal review process as a research paper would be. Theres also a much wider latitude of allowable topics in review articles that wouldn't normally be accepted as a submitted research paper. For source #2, Dr. Ted Kaptchuk is a CAM doctor, so not exactly far removed from the subject, and a review article. Source #3, Dr. Richard Cooper seems legit, and I don't know what kind of journal/paper it is, it's a weird layout but it uses "alternative health care profession" as the wording, which isn't quite the same as "a health care profession." Paper #4, Dr. Nadine Foster is also a mainstream doctor, but I think it's a stretch t to take her wording to state "chiropractic is a health care profession." I think it's probably your poorest source in that list to support that position based on the wording. Sources #1, the biased propaganda lobbyist piece, Source #5-7 are not mainstream medical sources, so basically irrelevant for the topic, and #8 is a paper by a PhD candidate in Physiotherapy so not yet a doctor, and a review article. Are these the best sources you have to make this claim? — raekyt 23:06, 14 February 2013 (UTC)

Eisenberg is an MD, not a 'CAM' doctor, from Harvard Medical School no less. Where as your sources that suggest the WHO is 'biased, propaganda lobbyist piece'? It is a peer-reviewed production and is signed off by an MD. Also, I really don't think you understand, in the academic sense, what a 'review' paper is. Any article that is published in a scientific journal indexed at PubMed has to go through 'peer review' prior to publication. Systematic reviews are the analysis of many papers on a given topic (hence the 'review') and have more weight because they are secondary sources. With respect to the 'latitude of wider topics' this is conjecture and speculation not to mention being completely wrong and irrelevant. When other professions, other than chiropractors such as MDs and PTs refer to chiropractic as a 'health profession' that is significant in itself. The burden is on you, Raeky, to prove your cases that all these sources, indexed in PubMed, are not reliable sources. All we have so far is your opinion on the matter which is irrelevant given that we are looking at facts. WP:V, WP:MEDRS, and WP:RS are the guidelines we are going by. DVMt (talk) 23:54, 14 February 2013 (UTC)

Raeky, of all the sources listed above, the one you agree is most reliable is #3, which states that chiropractic is an alternative health care profession. I assume that you realize that DVMt's proposal was for the text to read "Chiropractic is a complementary and alternative health care profession", as such I am not sure why you are concerned? Moreoever, I disagree entirely with your assessment of the sources provided. First, review articles are definitely peer-reviewed and such secondary sources are preferred according to WP:MEDRS; 3 of the listed sources are secondary sources, thus highest quality according to MEDRS. Secondly, I don't see agree that any of the sources are from chiropractors, they are almost all from well-respected medical bodies and/or journals. That "Kaptchuk is a CAM doctor" is irrelevant according to MEDRS, the source is a review, published in a well-respected mainstream journal. We are still now left at the same point as the last time this discussion arose. Hopefully we will hear from some uninvolved editors so that we can move forward.Puhlaa (talk) 23:56, 14 February 2013 (UTC)

We are unfortunately in the exact same spot as last time where Raeky disagrees with the quality of the sources despite being WP:MERDS compliant. She is presenting her opinion as fact to discredit reliable sources. Obviously the claim of 'health care profession' is verifiable and is not inherently POV in itself as we are directly quoting the source. The burden still remains on Raeky to prove that it is not a CAM health profession. Cautiously optimistic that this can be resolved. DVMt (talk) 03:36, 15 February 2013 (UTC)

Reliable sources noticeboard

Given that Raeky is challenging the veracity, integrity and reliability of the sources, I have opened up a discussion here [38]. I don't know if the protocol for there is different that WP:NPOV, but if there's any changes that need to be made just let me know. Thanks! DVMt (talk) 03:56, 15 February 2013 (UTC)

Let the record indicate that the RS noticeboard unanimously declared, on the sources provided (and additional sources they found) that chiropractic is a 'health care profession'. The discussion can be seen here[ http://en.wikipedia.org/wiki/Wikipedia:Reliable_sources/Noticeboard#Is_chiropractic_a_health_care_profession.3F]. If there aren't any other specific challenges to the first two paragraphs of the lead I will be inserting it following time for commentary. DVMt (talk) 19:58, 15 February 2013 (UTC)

I have inserted the revised first two paragraphs of the lead based on the discussions here and at WP:RS. DVMt (talk) 16:36, 16 February 2013 (UTC)

Second Sentence

You want to change it from "Chiropractors primarily practice manual therapy, with an emphasis on manipulation of the spine." to "There is an emphasis on manual and manipulative therapy and its role in joint dysfunction/subluxation." The current second sentence is more accessable to the layman, it doesn't use words like "dysfunction/subluxation," can those be wikilinked to definitions so the reader can understand them? and what is wrong with the current version? — raekyt 16:42, 16 February 2013 (UTC)

Yes, they can be wiki-linked. Given that joint dysfunction/subluxation is a central part of chiropractic, it should be included as, again, it's quoting the source. I will wiki-link it. DVMt (talk) 16:51, 16 February 2013 (UTC)

But are the technical terms best to use in the second sentence, assuming the reader has no knowledge of chiropractic what so ever? — raekyt 16:53, 16 February 2013 (UTC)

You ask me to WL so I do it and then you revert discussed material. You did not challenge anything other than 'health care profession'. The terms being used are in plain English. What again are your specific concerns with the additions? DVMt (talk) 17:02, 16 February 2013 (UTC)

You can change the FIRST sentence... the rest is still open for discussion, which hasn't occurred yet. — raekyt 17:03, 16 February 2013 (UTC)

Please don't be condescending and tell me what I can and cannot do. The revised lead has been posted here since Feb 10/13 and the only concerns brought up where by Doc James regarding effectiveness of SMT. Again, I will ask you directly: what are your specific concerns (please list them). You are being too vague. Are you disputing the sources? Are you disputing the language? DVMt (talk) 17:08, 16 February 2013 (UTC)

Language, according to WP:MOSINTRO the language used should be the most accessable as possible. I don't think the way you have it worded is the BEST language for someone who doesn't know these terms. Technical terms can be used in the body of the article, but shouldn't be in the lead. — raekyt 17:16, 16 February 2013 (UTC)

Ok, but remember MEDMOS applies here. What is your proposal? Manual and manipulative therapy is straight forward and joint dysfunction/subluxation is straight forward. Subluxation appears in the second paragraph too. We can't separate joint dysfunction/subluxation from chiropractic which would violate WP:NPOV. Can you restore the cauduceus? You accidentally deleted it by reverting 2 edits (the caudeceus add we discussed 2 days ago) instead of just the material you opposed. Thanks! DVMt (talk) 17:20, 16 February 2013 (UTC)

That's how I'd perfer the cauduceus be added, I said days ago that the CAM box should be first, and ideally only box at the top. And again what's wrong with the current second sentence, it sounds fine to me? — raekyt 17:28, 16 February 2013 (UTC)

We can't add the cauduceus to the CAM info box though as I mentioned in the edit summary. I have simply added the term joint dysfunction/subluxation as it appears in the source. Do oyu not think that joint dysfunction/subluxation should be part of the lead? DVMt (talk) 17:34, 16 February 2013 (UTC)

I think they're slightly technical terms which would make the lead less accessible... — raekyt 17:44, 16 February 2013 (UTC)

'Manipulation of the spine' is already in the current form and that is a 'technical term'. Raeky, this article falls under WP:MEDRS so there are going to be technical terms discussed. Even you say you concern is 'slight'. Do you have alternate language that is supportive by a MEDRS source? Otherwise we can't stray too much from the citation in risk of WP:NPOV. DVMt (talk) 17:51, 16 February 2013 (UTC)

MEDRS is for reliable sourcing, but WP:MOS, WP:LEAD and WP:MEDMOS take priority for actual article wording. Technical terms are fine, but should be avoided in the lead, the lead should always be most accessible. The term "manipulation of the spine" is accessible because everyone can understand that, but the term dysfunction/subluxation is a bit technical. The current second sentence is accessible to the general public. Also keep in mind WP:MEDMOS states the audience is the general public. I'm not even sure what the dysfunction part means in this context. Subluxation is a partial dislocation of a joint I think, basically I think it's saying it's problems or slight dislocation of joints. Is there anything incorrect with the current wording? — raekyt 18:01, 16 February 2013 (UTC)

I can see your confusion regarding joint dysfunction/subluxation. Chiropractors and medical doctors use the term differently which is why the generic term 'joint dysfunction' is used interchangeably with subluxation. Orthopedic (medical) subluxations are indeed slight dislocation of joints, whereas joint dysfunction isn't a dislocation just joint that isn't moving well in biomechanical terms. How about "Chiropractors emphasize manual and manipulative therapy and its role in joint dysfunction". — Preceding unsigned comment added by DVMt (talk • contribs) 18:09, 16 February 2013 (UTC)

How about, "Chiropractors emphasize manual and manipulative therapy for the treatment of joint dysfunctions" ? — raekyt 18:12, 16 February 2013 (UTC)

Agreed. I will make the change. DVMt (talk) 18:20, 16 February 2013 (UTC)

Remaining rest of paragraph

I don't have an issue with the remaining changes in this paragraph. — raekyt 18:25, 16 February 2013 (UTC)

Make a section like this for 2nd paragraph? — raekyt 18:27, 16 February 2013 (UTC)

Ok, sounds good. Paragraph 2:

Proposed revision: Paragraph 2

Proposed Change

Chiropractic was founded in 1895 by magnetic healer, D.D. Palmer, in Davenport, Iowa, United States. Chiropractic theory on spinal joint dysfunction/subluxation and its putative role in non-musculoskeletal disease has been a source of controversy since its inception in 1895. The controversy is due in part to chiropractic's vitalistic and metaphysical origins, and use of terminology that is not always amenable to scientific investigation. Far reaching claims and lack of scientific evidence supporting spinal joint dysfunction/subluxation as the sole cause of disease has led to a critical evaluation of a central tenet of chiropractic and the appropriateness of the profession's role in treating a broad spectrum of disorders that are unrelated to the neuromusculoskeletal system. Although there is external and internal debate within the chiropractic profession regarding the clinical significance of joint dysfunction/subluxation, the manipulable lesion remains inextricably linked to the profession as basis for spinal manipulation.

Current Paragraph

Chiropractic was founded in 1895 in Davenport, United States, by magnetic healer D.D. Palmer who posited that dysfunctional spinal joints dubbed vertebral subluxations was responsible for disease by interfering with innate intelligence, the body's natural healing mechanism. Early graduates of Palmer's chiropractic rejected his "straight" monocausal view that all disease originated from the spine and opened competing schools which incorporated mainstream diagnostic approaches which incorporated spinal manipulations with other adjunctive forms of therapy such as massage and exercise.

Comments

This revision replaces a 1993 article with 2012 review and adds a tertiary source to replace unsourced text and concisely examines the controversy of chiropractors using SMT for visceral disorders. It also accurately describes the 2 central tenets of chiropractic which is spinal manipulation and joint dysfunction; how each are inter-related and are the basis for each other, which is also cited in the 2012 review. This revised paragraph adds much important WP:MEDRS sources, which are from 2005-2012. The language is neutral, it does not criticize or support chiropractors, it merely explains objectively what they believe in, their rationale for SMT, and the controversy surrounding the profession. DVMt (talk) 19:01, 16 February 2013 (UTC)

If there is no opposition I will insert the 2nd paragraph as there does not seem to be any opposition to the sources or language. DVMt (talk) 17:00, 17 February 2013 (UTC)

Might take a few days for people to even see it, theres not much traffic here and I don't know how much time I have today. — raekyt 17:15, 17 February 2013 (UTC)

I'll give it another 24 hours or so. I don't think that paragraph should be too controversial; it adds good secondary sources (much needed) and covers the topic well. I believe the language is NPOV too. Anyways, as per our work on the first paragraph we can hammer it out here. DVMt (talk) 17:19, 17 February 2013 (UTC)

As there is no opposition to insertion with the revised 2nd paragraph I have inserted it. Onto the 3rd and final paragraph of the proposed, revised lead! DVMt (talk) 17:04, 18 February 2013 (UTC)

Proposed final paragraph of lead: effectiveness of manual and manipulative therapy

Manual and manipulative therapies may be effective for the treatment of low back pain, lumbar disc herniation with radiculopathy, neck pain, some forms of headache, and some extremity joint conditions. In general, spinal manipulation is equivalent to other conservative measures for musculoskeletal complaints.[39][40]. There is insufficient evidence regarding the effectiveness of spinal manipulation on non-musculoskeletal conditions.[41]. Spinal manipulation is generally regarded as cost-effective treatment of musculoskeletal conditions when used alone or in combination with other treatment approaches. There is considerable debate regarding the safety of spinal manipulation, particularly with the upper cervical spine. Although serious injuries and fatal consequences can occur and are likely to be under-reported, these are generally considered to be rare as spinal manipulation is relatively safe when employed skillfully and appropriately.

References

Comments

This is a proposed synthesis of a new, improved and neutral review of manual and manipulative therapy based on the concerns raised by Doc James and Puhlaa. Due to the high scientific nature of this section, please keep in mind that WP:COMPETENCE applies. DVMt (talk) 20:14, 15 February 2013 (UTC)

Some comments:

- First sentence, should "Manual and conservative therapies..." be changed to "Manual and manipulative therapies commonly used by chiropractors..."?

- First sentence, "...may be effective for the treatment of low back pain as well as...". I think that a comma could replace the "...as well as..."

- First sentence, [this] source could be added to help wp:verify the "neck pain" claim. I don't think that any text needs to be added to the proposal, just the source.

- Should the newest systematic review on safety of cervical manipulation be included as a source somewhere in the discussion of safety?

Note: The references in the reflist do not match those in the proposal text, but I am unsure how to fix this for you...sorry Puhlaa (talk) 00:57, 17 February 2013 (UTC)

I have changed the first sentence to include manipulative and inserted the comma. Thank you that reads better and reflects the content well. Feel free edit or place the new safety review where you think it might be good. I'm not sure how to get the references to start off 'fresh' for the new subsection. I will hopefully figure it out! Regards, DVMt (talk) 05:17, 17 February 2013 (UTC)

I have asked Zad68 and Doc James to comment a few days ago. I don't want to bother them, but this proposal has been here for 4 days now without comment from them. Suggestions to proceed? DVMt (talk) 02:41, 20 February 2013 (UTC)

How about "Spinal manipulation has been found to be more or less equivalent to conservative management for musculoskeletal complaints.[42][43] The use of manipulation to treat non-musculoskeletal issues has not been found to result in benefit"[44] One needs a proper comparator to take into account the placebo effect. The above paragraph does not give one. As this is more or less what we already have which is better than what is proposed I have restored what was there before. I would like to see clear consensus preferably via a RfC at least before you change it again. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:48, 21 February 2013 (UTC)

Unfortunately your proposal omits the majority of the sources we have proposed above. Also, the proposed language is unacademic and does not reflect the language and tone used within the source itself. Your suggestion regarding a proper comparator is not in the sources stated. Do you have a source that states this on directly compares SMT and placebo? We agree with the RfC. How do you we ensure competence and neutrality of editors? These should be discussed prior to initiating the RfC process. DVMt (talk) 05:20, 21 February 2013 (UTC)

We are a general source encyclopedia and are not trying to write in "journal level" prose which is much of the time incomprehensible. We are trying for an easy to understand lead which the version I have proposed achieves. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:46, 21 February 2013 (UTC)

This raises two big red flags. First, that's a cop-out that the saying a MEDRS should be dumbed down to the point where it looses coherence, and second, what is hard to understand about the proposed revision? MMT may not be a priority of yours, but it's a topic that hold great interest to many people and we are doing it a disservice by reducing effectiveness and safety down to 2 sentences that use 3 instead of 17 sources. Please state what problem you have exactly with the language or wording of the proposed revision so that the RfC can be better served by clearly delineating your position. DVMt (talk) 16:16, 21 February 2013 (UTC)

You need to be EXTREMELY careful throwing around WP:COMPETENCE, because that can EASILY break WP:CIVIL, and that's a serious problem. Also I don't think you understand WP:NPOV, it doesn't mean we give equal weight to all arguments. Carefully re-read it. — raekyt 05:26, 21 February 2013 (UTC)

No one is 'throwing' around competence, but when we're discussing effectiveness and safety of any given intervention, based on evidence-based medicine principles, you need to have extreme competence in a the subject. Hence, the RfC should target qualified professionals. We don't need a bunch of dogmatic skeptics weighing in and 'vote stacking' the RfC. This is an extremely important and scientific topic which has never been resolved at WP. Once we can get a true scientific consensus going with the RfC there can be peace over this intervention which could easily be argued has gone mainstream. DVMt (talk) 05:38, 21 February 2013 (UTC)

Only thing I can do is give you advice, calm down on calling people incompetent, and I HIGHLY advise you not too, ever. And re-read WP:NPOV because your not understanding it. If you all proceed with a RfC I can assure you that you're not going to be able to cherry pick editors that are pro-chiropractic to backup your WP:FRINGE views. — raekyt 05:44, 21 February 2013 (UTC)

As for the last paragraph, "spinal manipulation is relatively safe." The word "relatively" is a weasel word, relative to what? Also the word "pseudoscience" needs to appear in the lead, and the scientific consensus needs to be predominately featured. You're white-washing the article of anything critical and that's a SERIOUS problem for conflict of interest single purpose accounts. — raekyt 05:09, 21 February 2013 (UTC)

The source (Cochrane 2012) used the term 'relatively' safe. We can just call it safe if that's what you want. The article is not white-washing anything critical, the 2nd paragraph in the lead goes over the controversy of subluxation in detail. This is actually expanded upon in the revised article. This is the third time you've insulted me by accusing me of white-washing the article amongst other personal attacks. You're constantly attacking me personally, the editor, as opposed to the edit. And the fact that you didn't even think a systematic review was peer reviewed suggests that, with respect to the 'medical' side of things, you may be over your head. DVMt (talk) 05:27, 21 February 2013 (UTC)

As for your training as a vet I have probably more scientific background than you with finishing my final semester as a undergraduate biology major and being accepted into a top university for a masters program in botany, I'm not totally ignorant as you seem to suggest. Please be mindful of WP:AGF and WP:CIVIL, accusing people of being incompetence can result in blocks and being brought up at WP:DR or WP:ANI. It's also interesting that you're not aware of the way academic journals work after your vet schooling, or not. Reviews do not get the same review process as a research paper, and if you don't believe me go find out yourself by doing a bit of research. — raekyt 05:35, 21 February 2013 (UTC)

I have my Bachelors of Science (Hons). in Biology then my Doctor of Veterinary Medicine degree. 8 years of university. I have incorporated animal chiropractic in my practice and have done extensive research on the subject since. There's a difference between a rational skeptic and dogmatic skeptic. If you indeed say that you abide by science and the scientific method then follow the sources. Read them, investigate them and draw your arguments from the sources. Otherwise it may come off as hot-air to editors. As for your upcoming MSc. in Botany, good luck. But for now that's really just speculating. Also, a systematic review means that it is a review of all research papers on a given topic and specific question. Your suggestion that systematic reviews aren't 'research papers' is rather astonishing. Then you tell me I should do a bit of research? There's really no words to describe it. So a picture [45] instead. DVMt (talk) 06:16, 21 February 2013 (UTC)

I disagree with the wording suggested by Raeky, ""Spinal manipulation has been found to be more or less equivalent to conservative management for musculoskeletal complaints" because spinal manipulation is a type of conservative management. As such, the sentence does not make sense. I would also remind all editors to AGF and avoid ad hominem attacks. DigitalC (talk) 22:13, 21 February 2013 (UTC)

Sure than how about "Spinal manipulation has been found to be more or less equivalent to other types of conservative management with respect to musculoskeletal complaints" Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:42, 21 February 2013 (UTC)

Philosophy of Chiropractic

Is Philosophy of Chiropractic a POV fork of Chiropractic? bobrayner (talk) 23:48, 18 February 2013 (UTC)

No more so than Chiropractic controversy and criticism. It was approved by WP:MED a few days ago. DVMt (talk) 23:52, 18 February 2013 (UTC)

That's odd; I see no mention of Philosophy of Chiropractic on Wikipedia talk:WikiProject Medicine. I'll ask there. bobrayner (talk) 00:01, 19 February 2013 (UTC)

I'm mistaken, but yes, we shall ask if MEDRS applies. Good call. DVMt (talk) 00:06, 19 February 2013 (UTC)

My apologies. It was approved already by WP:MED. See here [46]. DVMt (talk) 00:43, 19 February 2013 (UTC)

I wouldn't really call that approval; WhatamIdoing just gave it a rating. Based on the length of the current article I guess there's a rationale for creating sub-articles that could develop aspects of the topic. However, some of the material in the parent article is excluded from the "Philosophy of chiropractic" article; if it were integrated into the new child article it should remove, I think, any concerns that a POV fork had been created. FiachraByrne (talk) 00:56, 19 February 2013 (UTC)

Perhaps 'reviewed' would have been a choice of words. The point remains, that WP:MED rated the article and must be edited per WP:MEDRS standards. There is no "philosophy of" section in the current article. The closest thing we have is a "straight vs mixer' debate which is currently lacking in gravitas and depth (as well as sources) for this huge debate within the profession. Perhaps certain sections can be incorporated and modernized? DVMt (talk) 01:11, 19 February 2013 (UTC)

Back to the point, then. What do other editors think? Is Philosophy of Chiropractic a POV fork of Chiropractic? I'm concerned that it mainly exists to show what chiropractic thinks about itself, plus a bit of cherrypicked stuff from the outside world where it's favourable, without really showing what independent sources think about chiropractic. bobrayner (talk) 06:39, 19 February 2013 (UTC)

I'd be concerned about WP:WG as well. For both issues, I don't see a reason this stuff can't be integrated into the main article. TippyGoomba (talk) 08:23, 19 February 2013 (UTC)

The concerns about creating a walled garden are legitimate but there's no reason existing criticism and detail from this article section on "Concepts" could not be incorporated into the "Philosophy of chiropractic" article. There's no doubt the "Philosophy of chiropractic" article requires a significant rewrite as it reads from an internalist rather than encyclopedic perspective. Also, much of the text from the Philosophy of Chiropractic article appears to have been copy-pasted from the Doctor of Chiropractic article; aside from issues of attribution there's no necessity to duplicate this information over several articles. FiachraByrne (talk) 09:25, 19 February 2013 (UTC)

The "philosophy of chiropractic" article has now been expanded to include various other things which are definitely not philosophy. Strangely, the main thing it hasn't inherited from the main Chiropractic article is the balanced coverage of efficacy, safety, and whether or not chiropractic is snake oil. bobrayner (talk) 17:28, 19 February 2013 (UTC)

I agree that there are content problems with the article (probably best to discuss on that article's talk page). Also, it would seem that content was at least partially created through a copy and paste from the article Doctor of Chiropractic. I wouldn't see efficacy and safety issues as so relevant to an article on chiropractic theory if they're adequately covered here - criticism should be directed where relevant at how that theory might contradict scientific norms, accepted systems of knowledge, etc.FiachraByrne (talk) 17:41, 19 February 2013 (UTC)

The reason why this article is under dispute (NPOV) is the fact that we are trying to get a balanced look efficacy and safety. There has been a RfC sent already to 3 MDs who are overviewing the proposed text for the lead (see paragraph 3) which covers both efficacy and safety. That will clearly delineate the claims of effectiveness and safety of manual and manipulative therapies. DVMt (talk) 17:47, 19 February 2013 (UTC)

Philosophy of Chiropractic is a newly-minted pov-fork with, what, three or four watchers? Meanwhile the Chiropractic article has 550 watchers. I think our chances of outside input and broad-based discussion are better on this talkpage. bobrayner (talk) 19:49, 19 February 2013 (UTC)

I agree that the discussion about philosophy of chiro should be held at the other talk page. Interestingly, Bob says it's a POV fork but does not consider Chiropractic controversies and criticism a POV fork. Bob could you please clarify if you do think that the controversies and criticicms is a POV-fork. Also, besides the obvious red-herrings here, does Bob disagree with the WP:MEDRS compliant sources? Why does Bob remove systematic reviews? Bob can you shed some light on your rationale? DVMt (talk) 20:01, 19 February 2013 (UTC)

To get back on topic... Anyone feel like merging Philosophy of Chiropractic into this article or is there some reason for its existence I've missed in my careless reading of the discussion above? TippyGoomba (talk) 03:46, 20 February 2013 (UTC)

Whatever the concerns, the extra-workload in monitoring, the repetition of content from other chiropractic articles, or the inclusion of irrelevant material in the current article, it's a notable topic [47] and it should be possible to construct an article in its own right that solely covers chiropractic theory/philosophy with relevant critiques of same. More work for the dwindling editorial corps, of course. I'd also reemphasise that a lot of the relevant content is already contained in (was copied from) the article Doctor of chiropractic and indeed in the main article. FiachraByrne (talk) 03:08, 21 February 2013 (UTC)

I'm in it for the long haul, there was a job started in mid-Jan for a main article rewrite (the last significant one was in 2008 according to DigitalC). A five year update is good. How about we insert the updated straight vs. mixer section first, with the history. That should be non-controversial and pretty straight forward. I do want to follow WP:PSMED with the Mos and formatting for medical specialities. DVMt (talk) —Preceding undated comment added 03:20, 21 February 2013 (UTC)

Whoisinthewhatnow? Insert what? Insert where? FiachraByrne (talk) 03:41, 21 February 2013 (UTC)

Edit request on 19 February 2013

You should include the latest Cochrane review.

It found chiropractic SMT no better than sham treatment.

http://www.ncbi.nlm.nih.gov/pubmed/23169072

209.52.84.50 (talk) 16:37, 19 February 2013 (UTC)

 Not done: This is not an absolute "no" response to this request, but this request requires 1) specific text to add to the article, and 2) consensus for this addition since it adds controversial information to the article. —KuyaBriBri^Talk 17:17, 19 February 2013 (UTC)

Well, useful to point out anyway and, as it's a Cochrane review, its findings should be incorporated into the article.FiachraByrne (talk) 17:20, 19 February 2013 (UTC)

If you see fit to incorporate the OP's request I will not object. Cheers, —KuyaBriBri^Talk 17:45, 19 February 2013 (UTC)

I'll leave it to someone more competent to do so. FiachraByrne (talk) 02:51, 21 February 2013 (UTC)

Cochrane reviews most definitely must be incorporated. DVMt (talk) 17:48, 19 February 2013 (UTC)

Of course, this is an entirely notable and reliable source. — raekyt 05:22, 21 February 2013 (UTC)

Proposal: Straight and Mixer (2013 update)

"Straight" chiropractic

Also known as 'subluxation-based' and 'principled chiropractic', chiropractors educated from this paradigm espouse traditional Palmer principles and philosophy. Historically straight chiropractors regarded spinal joint dsyfunction/subluxation as the primary cause of "dis-ease" and could be corrected via specific chiropractic adjustments. This monocausal view of disease has been abandoned by the profession preferring a holistic view of subluxation that is viewed as theoretical construct in a "web of causation" along with other determinants of health. Palmerian philosophy focused on metaphysical constructs such as Innate Intelligence and Universal Intelligence to explain the effects of the chiropractic adjustment, whose intent was the reduce/correct spinal subluxations and improving the functioning of the nervous system. The subluxation was said to be "the cause of 95 percent of all diseases... the other five percent is caused by displaced joints other than those of the vertebral column." Misalignment of the vertebrae was believed to be cause impingement of the nerve root, a theory which has long been debunked Subluxation-based chiropractors view traditional chiropractic lexicon such as "analysis" and "adjustment" and as a critical distinction of chiropractic despite lack of prevalence of these terms in the chiropractic literature Subluxation-based chiropractors have been criticized both internally and externally for far-reaching claims of "killer" subluxations, pseudoscientific reasoning, dogmatic approaches unethical business practices that invoke religious themes and high-volume treatments for a variety of conditions that lack supportive scientific evidence. This metaphysical and dogmatic and singular approach to chiropractic care has been criticized for failing to engage in critical and rational thinking and embracing evidence-based medicine. Straight chiropractors use a subluxation-based model as opposed to the patient-centered model now favored in health care. Although they are the minority within the profession, they are considered to have a disproportionate influence as "purists".

"Mixer" chiropractic

Mixers form the majority of chiropractors and attempt to combine the materialistic reductionism of science with the metaphysics of their predecessors and with the holistic paradigm of wellness; While D.D. Palmer considered vertebral misalignment to be the hallmark feature of subluxation, mixer pioneer Solon Langworthy asserted that intervertebral hypomobility, not misalignment, was subluxation’s cardinal biomechanical feature. This contrasting mechanistic emphasis, intervertebral misalignment vs. hypomobility, formed one the basis for a heated polemic in the profession. Although both misalignment and hypomobility are currently recognized as biomechanical features of subluxation, hypomobility has garnered much more attention in recent years. Mixers were disdained by the Palmers who disapproved of their use of instrumentation and mixing chiropractic diagnostic and treatment approaches with osteopathic, naturopathic and allopathic viewpoints. By embracing a mechanistic viewpoint, mixers are able balance the vitalistic notions with critical reasoning skills that led to legitimate scientific investigation of chiropractic principles. Mechanistic underpinnings have led to testable hypotheses that structure affects function via the nervous system by the scientific study of joint dysfunction (subluxation) and the biological mechanisms underlying manipulative therapies Scientific chiropractors suggests that a mechanistic view will allow chiropractic care to become integrated into the wider health care community. In contrast to subluxation-based chiropractors, evidence-based chiropractors favor and incorporate mainstream medical diagnostic and treatment approaches such as exercise, nutritional supplementation, Rehabilitation, self-care, physiotherapeutic modalities, and other natural approaches. A majority of mixers retain belief that spinal dysfunction/subluxation may be involved in somato-visceral disorders. This group may represent the 'silent majority' of centrists who embrace evidence-based medicine but feel comfortable retaining elements of the subluxation complex that have not been validated through empirical evidence.

Comments

Are you proposing adding this to an article that is already >100k? (last edit made it 118,063 bytes). Per WP:TOOBIG the article is already WAY to big and ALMOST DEFINITELY needs divided and chopped up. Articles shouldn't exceed 50k, it's already over TWICE that. So obviously, no for adding this text to the article without serious cuts to it's content. — raekyt 05:21, 21 February 2013 (UTC)

It will be replacing the current version and has taken several sources from other parts of the article and incorporated them in the appropriate way. Prior to Doc James reversion, the article stood at a lean 91k down 30 over all and reflects all the sources accurately. We're going to go over them one by one. Unless you oppose specific sources, this material is essential to the article. Please specifically cite what changes you would like to see and what sources you are challenging. DVMt (talk) 05:52, 21 February 2013 (UTC)

The reason why you had half a dozen editors revert your changes was that we do not think your changes "reflected all the sources accurately." Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:54, 21 February 2013 (UTC)

I haven't even looked at the sources, but the existing History section is 2.6k this is 4.4k, almost twice the size. So it's headed in the wrong direction if we're trying to bring this article to a manageable size. Like 40k needs to be cut. Would a History of Chiropractic article be unreasonable, if something like it doesn't already exist, and WP:SPLIT out the history, and maybe split out other parts as well? — raekyt 05:58, 21 February 2013 (UTC)

That's incorrect Doc. Only you reverted the article in its entirety. Prior to that it stood for 10 days without any reversion. You assumed that sources were being misused despite not even having read the content in question. If you're not reading it and checking the sources directly, than how is it possible to make any accurate judgment on the material? DVMt (talk) 06:22, 21 February 2013 (UTC)

No, we have Yobol in this edit [48] and RexxS in this edit [49] who reverted all of it as well. We have other reverts of your changes by Raeky in this edit [50] and Alexbrn in this edit [51] plus me which brings us to 6 different editors who disagree with your changes.

I did read the content and changes in question which is how I determined that the sources were being missed. And than I noticed that high quality sources that reflected less than positively on chiropractics had gone missing. So I restored said sources to the last stable version of the article per WP:BRD

With respect to it standing for 10 days with NO changes, uh, you made a 15 edits the day before and 4 edits the day before that and 8 edits the day before that? Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:38, 21 February 2013 (UTC)

Raeky I'm not opposed to the idea of a split once the proposed revision gets a hard look. Like I mentioned you said that 40k needed to go 30k is achieved with the 2013 revision. I think we could pare it down even more and if we can't a split is perfectly reasonable. DVMt (talk) 06:27, 21 February 2013 (UTC)

10 days? How about WP:NORUSH? Also, notice how only a single WP:SPA came to your defense when your massive white-wash was reverted. Anyway... back to the purposed edit... I actually think that this distinction between straight and mixer isn't adequately covered in the article. This relates to DVMt's white-washing efforts, he wants the article to be more about the science and less about the magic. But imagine if someone tried to edit the mystical bullshit out of the Yoga article. TippyGoomba (talk) 06:33, 21 February 2013 (UTC)