Talk:Chiropractic

Disruptive editing by user QuackGuru

I have been observing the editing style of a certain user, QuackGuru (talk), for quite a while now. Out of the 500 last edits on this article's page, 244 has been carried out by the same user (which is 48,8% of all edits). The editing is really disruptive, as there might be even up to 10 different edits in a row from the same user with immature edit summaries, such as "nonsense", "total nonsense", etc. There is no question why the articles have so strong opinionated bias.

Also the user is clearly more interested in pushing his own opinions rather than building a well-balanced, neutral point of view article. For example, in the narrow field of alternative medicine articles, QuackGuru is clearly switching between different wikitags according to whatever best might suit his personal views:

1. The user adds a {{copyright violation}} tag[1].
2. The user changes it to a {{citation needed}} tag[2].
3. As this didn't work out with the other editors either, now he changes the tag into {{POV-statement}}[3].
4. Finally, user Paavo273 reverts the latest attempt of QuackGuru by stating: "...Remove POV tag that replaced one or more other tags. See talk...."[4]

This applies to all the alternative medicine articles (Traditional Chinese Medicine, Chiropractic, etc.) Overall, the editing is aggressive in both terms of reverts and misuse of wikitags, as well as it is fragmented and hard to follow.

Therefore, I'd like the user to stop the disruptive editing and respect the other contributors as well. Wikipedia isn't one man's project. Should there be any difficulties with the technical side of editing, please get familiar with WP:SANDBOX[5] where he can practice editing without causing a nuisance to the other users. Jayaguru-Shishya (talk) 10:52, 2 May 2014 (UTC)

Quack has been banned before from alt-med articles and chiropractic as well for the same editorial behaviour that you describe. These style of editors have driven away several health professionals who want to improve the article due to the drama and gerrymandering behind the scenes. There does seem to be an ownership issue and a lack of balance in the edits that would reflect true neutrality. DVMt (talk) 11:10, 2 May 2014 (UTC)

The content was word for word the same as that on page three of this WHO document [6]. Thus yes there was a copyright concern and QG tagged it. He then fixed the concern by paraphrasing. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:22, 3 May 2014 (UTC)

There seems to be different interpretations of when copyvio is applied and to which research it is applied to at this article, another form of inherent bias that dominates the article. I disagreed with his edit and so does Jayguru. The main point was the fact that nearly 50% of the recent edits are by QG and they increase the fringe viewpoint which dominates at the expense of the spine and MSK. More of the same. Myself and other editors currently and in the past have had grave concerns with respect to what gets 'highlighted' at the article and it seem like the unorthodox fringe practices which constitute less than 20% gets the most weight. For instance, spinal joint dysfunction /subluxation section presents the fringe viewpoint but does not address any of the scientific research with respect to the biomechanical, histological, anatomical, physiological and neural (neuromuscular) that looks at the subluxation/joint dysfunction in a MSK context. Also, Ernst' viewpoint and critique of joint dysfunction/subluxation is arguably fringe since the ICD-10 recognizes the subluxation complex as a diagnosis. (http://www.icd10data.com/ICD10CM/Codes/M00-M99/M99-M99/M99-/M99.13). Note that it's under the MSK section of the 2014 ICD-10, which is a reliable and internationally accepted medical diagnostic compendium. The MSK viewpoint is under-represented again. DVMt (talk) 18:17, 4 May 2014 (UTC)

The source you provided that recognizes the subluxation complex as a diagnosis is unreliable.

You originally added the WP:COPYVIO to the lede on November 21, 2011.

Another account also added the copyvio to the lede on March 20, 2014. What a coincidence!?

You claimed you disagreed with my edit and so does Jayguru. What recent change to the text you disagree with. Please provide a diff. QuackGuru (talk) 18:34, 4 May 2014 (UTC)

The source is perfectly reliable. Just the fact that you give your opinions here as facts does not change it. More facts, less opinions. Jayaguru-Shishya (talk) 11:31, 5 May 2014 (UTC)

...and after the {{copyright violation}}? Then you went through two more wikitags, seeing if any of them might suit your own, opinionately driven purposes. Jayaguru-Shishya (talk) 11:31, 5 May 2014 (UTC)

Using someones elses words regardless of attribution is a "copy and paste" concern. We must paraphrase. There is no if or buts about this. We have already had the APA send us a cease and desist notice for using the DSM criteria to closely. I have meet with WHO and they do not seem interested in releasing their content under a CC license at this point in time. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:20, 4 May 2014 (UTC)

We can deal with the issues you see one by one if you wish. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:21, 4 May 2014 (UTC)

No. 244 edits out of the last 500 has been carried out by the one and same user, QuackGuru. This means that nobody will post 244 different posts discussing every single edit at the Talk Page; the problem is the user himself. Jayaguru-Shishya (talk) 11:40, 5 May 2014 (UTC)

The ICD-10 is just a classification system and is neither here nor there with respect to if Ernst is a reliable source or not.Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:42, 4 May 2014 (UTC)

The primary issue is the weight given to the fringe/unorthodox aspects of chiropractic vs. the mainstream/orthodox aspects. IOW, the non-MSK vs. the MSK emphasis. It's pretty clear there is a specialized focus in this particular domain of medicine, which is clearly cited. Regarding, Ernst, the dispute is not if it a reliable source, it's a) the weigh given to it, in that it is implied that Ernst's POV is the equivalent and synonymous of the medical profession. The relevance of the ICD-10, and by extension the WHO, is that is not only a reliable source, an organization and a credibility that trumps any individual researcher, especially one as controversial as Ernst. Despite the fact that evidence-based chiropractic (spine/MSK health) has been on the radar now for 10 years, with guidelines (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1839918/) and textbooks (http://www.amazon.com/Evidence-Based-Chiropractic-Practice-Michael-Haneline/dp/076373571X) and evidence-based resources (http://clinicalcompass.org) yet the attempts over the years to discuss and highlight the mainstream materials has been effectively censored. Ironically enough, Ernst is in complete denial about EB chiropractic, it seems like there is some serious cognitive dissonance. "http://edzardernst.com/2013/08/evidence-based-chiropractic-is-an-oxymoron. The collaboration between the medical and chiropractic professions have increased dramatically as well, with specialized focus on spine and musculoskeletal care. Hospital based chiropractic services are beginning to be offered (http://www.stmichaelshospital.com/programs/chiropractic/), (http://sunnybrook.ca/content/?page=sjr-patvis-prog-chiro), for spine, MSK conditions, which reflects also change in attitude and culture in recent times amongst the profession. Ernst' current POV is actually fringe, in that he is intolerant of the the chiropractic profession under any circumstances (including spine/MSK), which is essentially bigotry. He is also aiming his critiques traits that are specific to a faction (unorthodox) but the article fails address this and provide proper context. If we agree that the mainstream and majority of chiropractors practice in a manner that is spine/MSK based (81%) then why doesn't the tone and weight of the article reflect that? DVMt (talk) 00:16, 5 May 2014 (UTC)

We look at the effectiveness section and 5 out of the 6 bullet points are about MSK issues. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:05, 5 May 2014 (UTC)

Did not address my concern. Are you suggesting that 81% of the article is focused on the MSK aspects of chiropractic and the weight is representative to the majority group? Unfortunately it seems like there is more stonewalling going on, as I cannot get a straight answer. The pseudoscientific aspects dominate, so does their viewpoint despite representing less than 1/5 of practicing DCs. There was also no rebuttal of any other of my concerns and points I addressed in my previous comment addressed to you. Please address my concerns and the points that I have raised above, thank you. DVMt (talk) 02:20, 6 May 2014 (UTC)

See Chiropractic#Effectiveness. Ersnt is only one of many sources in the article. The section is current with lots of reliable sources. QuackGuru (talk) 03:22, 5 May 2014 (UTC)

Ernst is the only critical source being used, if he does represent the 'medical mainstream opinion' there must be other papers that replicate his findings and agree with his POV? The dominant voice of the article belongs to a skeptic MD whose obsessive critique of chiropractic (note the 64 article found, http://www.ncbi.nlm.nih.gov/pubmed/?term=Ernst+E+%5BAU%5D+and+Chiropractic) undermines his credibility so much that his conclusions simply aren't be reproduced by other researchers that aren't affiliated with him. DVMt (talk) 02:20, 6 May 2014 (UTC)

I believe we can overcome the strong bias in this article. It's not really good if we give one critique dominate over the wider concensus in the field. Jayaguru-Shishya (talk) 11:31, 5 May 2014 (UTC)

Yes, agreed. The article is a sham, and it's troublesome that politicking here trumps common sense. The is a gross misrepresentation of the facts, the factions, the identity, the research, the evidence, the contributions to health care (in the MSK arena and the research into joint and spinal manipulation). I'm going to create a new section for a neutral lede that doesn't trivialize and minimize the effectiveness of manipulation for MSK conditions and has far greater weight on the adverse events despite being considerably safer than the alternatives (opioids, acetaminophen, NSAIDs) whose side-effects are strangely missing from the article. DVMt (talk) 02:20, 6 May 2014 (UTC)

Besides from being banned earlier for editwarring alternative medicine articles, user QuackGuru has also been warned by administrator EdJohnston from editwarring the very alternative medicine articles here: [7]. He has been warned by another administrator, Tiptoety, as well here: [8]. "...Hi QuackGuru. Please consider this your only warning for edit warring... //// ...I'll also note that if you continue to edit war on Pseudoscience related articles, I will impose a 1RR restriction your account per the discretionary sanctions..." It is clear that the user is still continuing the same disruptive way of behaviour. Jayaguru-Shishya (talk) 11:40, 5 May 2014 (UTC)

See WP:TALK#USE and WP:TPG#YES. If you have a problem with content, then go after the content. Article talk pages are not for you to whinge on about perceived ownership or any user behavior, or to quote " Keep the discussions focused upon the topic of the talk page, rather than on the personalities of the editors contributing to the talk page.". You do not have to comment on every single edit QuackGuru has made, you just have to discuss what in the article you disagree with and how it should be changed. Cannolis (talk) 12:33, 5 May 2014 (UTC)

Yes agree with Cannolis. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:28, 5 May 2014 (UTC)

QG is has a long hx of disruptive editing. Some feel that he deserves a barnstar. Others disagree. QG has made this article incredibly difficult to edit for 6 years now, driving away a plethora of talented editors in the process. There are 2 concerned editors here and it doesn't seem like our concerns are being taken seriously, at least by the admin. I'd prefer a neutral party admin to 'oversee' the the article and the behaviours of the editors. There's a COI there.

Signing your comments might be a good start. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:45, 9 May 2014 (UTC)

New Lede Proposal

Chiropractic is 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. Currently, chiropractic medicine is regulated and practiced in over 100 countries, however chiropractors are most prevalent in North America, Australia and parts of Europe.[1] The majority of mainstream health care and governmental organizations classify chiropractic as traditional/complementary alternative medicine[2] Most people who seek chiropractic care do so for primarily for low back pain and other neuromusculoskeletal complaints.[3] Though chiropractors have many similarities to primary care providers, they are more similar to a medical specialty like dentistry or podiatry.[5]

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 historical 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.[4] Today the monocausal view of disease has been abandoned by the profession [59]preferring a holistic view of subluxation that is viewed as theoretical construct in a "web of causation" along with other determinants of health.[6]

Although there is external and internal debate within the chiropractic profession regarding the clinical significance of joint dysfunction,[5] the manipulable lesion remains inextricably linked to the profession as basis for spinal manipulation.[6] In 1963 the American Medical Association formed a "Committee on Quackery" designed to "contain and eliminate" the chiropractic profession. In 1966, the AMA referred to chiropractic an "unscientific cult" and until 1980 and held that it was unethical for medical doctors to associate themselves with "unscientific practitioners".[38] The 1987, the AMA was found guilty of being engaged in an unlawful conspiracy in restraint of trade "to contain and eliminate the chiropractic profession." [37] In the 1980s, spinal manipulation gained mainstream recognition[39] and has spurred ongoing collaboration into research of manipulative therapies and models of delivery of chiropractic care for musculoskeletal conditions in the mainstream healthcare sector.[40][41][42]

Manual and manipulative therapies commonly used by chiropractors other manual medicine practitioners are used primarily to help treat low back pain,[7] and other neuromusculoskeletal disorders[3] Manual therapies appear to be as effective as standard medical care, exercise therapy and physiotherapy in the treatment of low back pain [8][9], and may be effective for non-specific neck pain, [10][11][12] headaches,[13][14][15]and extremity conditions.[16][17] Although serious injuries and fatal consequences can occur[18]and may be under-reported,[19] spinal manipulation is relatively safe[20] when employed skillfully and appropriately.[1] There is ongoing research investigating upper cervical manipulation and incidence of stroke.[166]

No refs are listed so hard to judge. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:44, 9 May 2014 (UTC)

Comments

This proposal eliminates a lot of the bias and neutralizes the tone. It focuses on the primary MSK role and presents evidence of NMSK management of DCs. Unlike the current version which omits that the AMA tried to destroy chiropractic and was found guilty of restraint of trade, this new version presents the history (1963 to the present which shows the changing relationships of the medical and chiropractic professions. At some point in time one of the most critical sources, that states that the monocausal (one cause, one cure) approach has been abandoned has conveniently disappeared. DVMt (talk) 23:32, 7 May 2014 (UTC)

The first sentence is the same WP:COPYVIO you originally added to the lede on November 21, 2011 using the WHO source. There is no reason to repeat past mistakes.

• World Health Organization (2005). "WHO guidelines on basic training and safety in chiropractic" (PDF). ISBN 92-4-159371-7. {{cite journal}}: Cite journal requires |journal= (help)

The second sentence is not a summary of the body: Currently, chiropractic medicine is regulated and practiced in over 100 countries, however chiropractors are most prevalent in North America, Australia and parts of Europe.[1]

The lede says: Chiropractic is well established in the U.S., Canada and Australia.[21] This is a summary of the body that says: Chiropractic is established in the U.S., Canada, and Australia, and is present to a lesser extent in many other countries.[21][9]

The WP:LEDE should summarise the body. Your proposal is not a summary of this article. For example, a good summary of Chiropractic#Cost-effectiveness is:Spinal manipulation may be cost-effectiveness for sub-acute or chronic low back pain but the results for acute low back pain were insufficient.[13] The efficacy and cost-effectiveness of maintenance chiropractic care are unknown.[14] Cheers. QuackGuru (talk) 23:53, 7 May 2014 (UTC)

No disagreement with the research added? Good. You're pointing out technical details, which can be ironed though at a later point. We're just establishing a narrative and principles. We're going to cover the past and present in an equal manner, we're going to present the mainstream of chiropractic as the majority group with the dominant voice, while acknowledging and delineating the fringe. The criticism of Ernst are directed specifically to a faction within the profession that has x,y,z practice traits and x,y,z beliefs. Besides, he is an outlier in his views, especially in his "conclusions" on the safety, effectiveness and cost effectiveness of joint and spinal manipulation". Tuchin (2013) provides a much better source to discuss chiropractic and stroke (http://www.medscape.com/viewarticle/809688_4). The AMA is on board with DCs for LBP management and that's a huge event in the profession's history. LBP is the #1 reason why patients present to chiropractors and the #1 leading cause of disability in the world (http://www.webmd.com/back-pain/news/20140325/low-back-pain-leading-cause-of-disability-worldwide-study). Residencies are coming to the US in Veterans Affairs under primarily a MSK role (http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=56655). We agree that ICD-10 is a reliable source, and that subluxation complex is listed in the MSK section and biomechanical lesions. We also see it is in Medicare and there is a specific PARTS criteria. There is the mainstream view of the subluxation within chiropractic and there is a fringe view. We present the 'mythical' version here but actually the one that is currently being studied with respect to spinal biomechanics, neuromuscular responses. How can Wikipedia's entry of Chiropractic be legitimate and reliable if exclusively relies on a fringe narrative that excludes the dominant themes within the profession today by the mainstream group? Is the mainstream, majority group primarily NMSK focused? Yes or No. As one wiki editor to another, I ask of you to please answer my question. I'd ask that you bring citations to support your claim. Cheers. DVMt (talk) 04:42, 8 May 2014 (UTC)

Great work! I think this helps us to overcome many of the problems discussed earlier. Also a great summary of body WP:LEDE. There are, however, a lot to fix in the body itself, but I'm confident we can manage that. Jayaguru-Shishya (talk) 14:47, 8 May 2014 (UTC)

Thanks! I am awaiting for a direct answer to my question to Quack re: the mainstream of the profession being primarily MSK based. I understand for some it may cause cognitive dissonance but we need to be objective about what the literature is stating in terms of practice characteristics and educational training. Speaking of which, here is an interesting video about the education chiropractors along side medical physicians (https://www.youtube.com/watch?v=O7wUJXo25JE). DVMt (talk) 15:21, 8 May 2014 (UTC)

Your proposal is similar to old text that was in the lede that was not a summary of the body. You claim your proposal is a new proposal but it looks like you trying to go back to a version similar to an older version. We should not go backwards and restore text that does not summarise the body.

For example, A Cochrane review found very low to moderate evidence that spinal manipulation therapy was no more effective than inert interventions, sham SMT or as an adjunct therapy for acute low back pain.[12][10]

Another example, A critical evaluation found that collectively, spinal manipulation was ineffective for any condition.[11][11]

We should keep the most current Cochrane review (PMID 23169072) along with other reviews (PMID 21952385) about the effectiveness in the lede.

The current text in the lede passes WP:V and summarises the body.

Your proposal includes: Manual therapies appear to be as effective as standard medical care, exercise therapy and physiotherapy in the treatment of low back pain...

Rubinstein SM, van Middelkoop M, Assendelft WJ, de Boer MR, van Tulder MW (2011). Rubinstein, Sidney M (ed.). "Spinal manipulative therapy for chronic low-back pain". Cochrane Database Syst Rev (2): CD008112. doi:10.1002/14651858.CD008112.pub2. PMID 21328304.{{cite journal}}: CS1 maint: multiple names: authors list (link)

Rubinstein, SM (2012 Sep 12). "Spinal manipulative therapy for acute low-back pain". Cochrane database of systematic reviews (Online). 9: CD008880. PMID 22972127. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)

That is WP:OR and does not summarise the body. QuackGuru (talk) 16:47, 10 May 2014 (UTC)

Mainstream chiropractic and spine/MSK focus

Quack has refused to answer my question Is the mainstream, majority group primarily NMSK focused? Yes or No. despite repeated attempts to communicate with him/her, and considering the problems that are also occurring at the acupuncture page with similar editing practices, I'm going to take this question to a different venue. This is eerily similar to what was done when there was continual censorship and deletion over the inclusion of the fact that chiropractic was a 'health care profession' despite have several reliable sources that stated the obvious. The issue of weight, tone, npov with respect to this topic has been steadily increasing over the years and now it has hit a tipping point. NPOV tagging will seek remediation to discuss this critical issue. DVMt (talk) 21:03, 9 May 2014 (UTC)

This is in the lede: It has two main groups: "straights", now the minority, emphasize vitalism, innate intelligence and spinal adjustments, and consider vertebral subluxations to be the cause of all disease; "mixers", the majority, are more open to mainstream views and conventional medical techniques, such as exercise, massage, and ice therapy.[8]

The lede makes it clear that the "straights" are the minority and the "mixers" are the majority that are more open to mainstream views. QuackGuru (talk) 21:06, 9 May 2014 (UTC)

You have still not answered my question directly. Is the primary, dominant, mainstream group NMSK focused, yes or no? DVMt (talk) 21:11, 9 May 2014 (UTC)

Perhaps you can take a look at this: "Back and neck pain are the specialities of chiropractic but many chiropractors treat ailments other than musculoskeletal issues." This is currently in the lede. There's a COI there? I'm not sure what you are talking about but of course I have received numerous peer-reviewed studies by e-mail from you know who. QuackGuru (talk) 02:06, 10 May 2014 (UTC)

I'm afraid Wikipedia isn't interested about your personal emails, QuackGuru. Anyway, you have been asked a question and it seems that you are avoiding it at all costs. So what is your answer? Enough with your pointless blabber about the lede and your endless fire of links, just answer the question okay? Jayaguru-Shishya (talk) 12:55, 10 May 2014 (UTC)

"Back and neck pain are the specialities of chiropractic but many chiropractors treat ailments other than musculoskeletal issues.[10]"

The text in the lede answered the question. The specialties of chiropractic are back and neck pain but many chiropractors treat ailments other than musculoskeletal issues. QuackGuru (talk) 16:01, 10 May 2014 (UTC)

You still have not answered the question yourself QG. Your refusal to answer my question (https://en.wikipedia.org/wiki/Wikipedia:IDHT#Failure_or_refusal_to_.22get_the_point.22) is a perfect example of being tendentious and a breaking the spirit of collaborative editing. Most shockingly, you just admitted to being canvassed and de-facto meat puppet for Edzard Ernst. Congratulations. Nonmusculoskeletal complaints accounted for 10.3% of the chief complaints (http://www.ncbi.nlm.nih.gov/pubmed/11313611). Why are you, and the article, so focused on the 10% as opposed to the 90% of MSK based treatments, majority of whom are for LBP? Is that what Ernst wants you to do? DVMt (talk) 17:22, 10 May 2014 (UTC)

I don't have a personal opinion about who is the majority group but there is text in the lede and body that says back and neck pain are the specialities of chiropractic. That is a dated primary source (http://www.ncbi.nlm.nih.gov/pubmed/11313611). See WP:MEDRS. QuackGuru (talk) 17:34, 10 May 2014 (UTC)

That makes really clear the point what you just said DVMt. Given the fact that QuackGuru is constantly refusing to answer the question, it is reasonable to make the conclusion that he doesn't have a say in the matter and we can continue editing the article in order to remove the current strong bias in the article. Thanks. Jayaguru-Shishya (talk) 13:50, 11 May 2014 (UTC)

I'm not asking you about your opinion I'm asking you about the facts. Secondary sources are of course preferred when they exist. When they don't we can use a primary source, especially given this context which is not making a judgment on the efficacy of a medicine/therapy/intervention, but rather to highlight practice characteristics. So, the 10.3% source is perfectly valid, and reliable in the context that it is being used. So, now we have several facts: 1. Roughly 90% of chiropractic patients are for musculoskeletal disorders, primarily low back pain. 2. The mainstream, or orthodox group in the profession, representing 81% of the profession, practices primarily in musculoskeletal medicine, most of which are spinal disorders. 3. The majority (73) of chiropractors see themselves as conservative spine care specialists.. Here is another question: How long have you been a meat puppet for Edzard Ernst? You are pushing and unduly weighing his research. This is a serious concern. DVMt (talk) 22:23, 10 May 2014 (UTC)

I replied to the dated text you want to add/restore that contains WP:OR among other problems. See Talk:Chiropractic#Comments. I previously told you the primary source fails MEDRS. The proper place to discuss alleged COI (WP:COI) is at Wikipedia's Wikipedia:Conflict of interest/Noticeboard. Cheers. QuackGuru (talk) 02:38, 11 May 2014 (UTC)

I disagree. Jayaguru-Shishya (talk) 13:50, 11 May 2014 (UTC)

Quack, doesn't come even close to failing MEDRS. Still dodging my questions I see. More proof of the chiropractic profession and MSK focus "These data support the theory that patients seek chiropractic care almost exclusively for musculoskeletal symptoms and that chiropractors and their patients share a similar belief system." http://www.ncbi.nlm.nih.gov/pubmed/11805694.

"Drawing on practices with the patient and practice characteristics identified in this study to conduct outcomes studies on nonmusculoskeletal conditions is a possible direction for future research."[12] That is definitely a study and thus fails MEDRS.

We don't need to include a theory from an older source from 2002[13] when we have newer information currently in the lede and body that is straight-out assertive. QuackGuru (talk) 07:03, 12 May 2014 (UTC)

It's not theory, it's practice. You're again trying to omit reliable sources that specifies to what extent fringe practices are (IOW, non MSK). 9/10 DCs primarily treat MSK issues since 9/10 patients present to the for MSK issues, most prevalent, spinal pain. You again point to Ernst, which is outlandish behaviour as you admitted to being in contact with him (COI and meat puppetry, possibly) but he is representing the fringe opinion. The "straight out" assertive component is rather bogus, as I've demonstrated above. You, and other enablers, including an admin, have deliberately stymied any discussion that centres on the current practice characteristics of the profession, such as the primary focus on spinal disorders and seeking to become the primary care spinal clinicians. I've tried in good faith with you here, but your editing behaviour seems to be congruent with this [14]. I'll repeat this again. Roughly 90% of chiropractic patients are for musculoskeletal disorders, primarily low back pain. 2. The mainstream, or orthodox group in the profession, representing 81% of the profession, practices primarily in musculoskeletal medicine, most of which are spinal disorders. 3. The majority (73) of chiropractors see themselves as conservative spine care specialists.. We assert facts, QG. You just can't censor the ones that you don't like. DVMt (talk) 00:13, 13 May 2014 (UTC)

"These data support the theory that patients seek chiropractic care almost exclusively for musculoskeletal symptoms and that chiropractors and their patients share a similar belief system."[15]

We assert the facts not a theory when we have better sources that do assert the same type of information.

We can't add original research or use the primary source[16] you wish. QuackGuru (talk) 01:55, 13 May 2014 (UTC)

There is no OR, and there are no other sources that yields the same information. Also MEDRS only applies when making medical claims such as efficacy or safety. WP:RS is sufficient for text that discusses social concepts or defining the profession. Secondary sources are not required for non-medical claims. So those sources are in play for the article. Also, regarding spinal joint dysfunction, the monocausal view of disease has been abandoned by the profession ( Bergmann, T.F., Perterson D.H (2011). Chiropractic Technique: Principles and Procedures. Elsevier. ISBN 9780323049696.) preferring a holistic view of subluxation that is viewed as theoretical construct in a "web of causation" along with other determinants of health. Henderson, C.N.R (October 2012). Journal of Electromyography and Kinesiology 22 (5): 632–642. DVMt (talk) 23:42, 13 May 2014 (UTC)

I previously explained there is similar text in the article about the focus on musculoskeletal issues. I know it is not exactly the same information they way you want it.

There is no reason to cherry pick primary sources when we already have WP:SECONDARY sources. The WP:RS guideline that I helped write and update is correct for this situation. QuackGuru (talk) 01:34, 14 May 2014 (UTC)

There is no WP:OR. The sources are great and we can proceed with them. Jayaguru-Shishya (talk) 17:13, 14 May 2014 (UTC)

Quack you're being tendentious again. The NPOV tag stays until it's resolved. Also, I was looking over the article carefully and a lot blibs that you're using or either taken out of context or were incorrectly paraphrased. It seems a big chunk of this article is unreliable. If we don't follow the sources or paraphrase them correctly or cherry pick a sentence within the source and use it out of context then this destroys the credibility of not only the article, but WP as well. DVMt (talk) 15:58, 15 May 2014 (UTC)

It seems to me that the {{NPOV}} tag is reflecting a previously resolved NPOV dispute. I haven't been active on this article for a few months, nor on Wikipedia as a whole for a few weeks, so I won't remove it, myself. If my analysis is correct, the NPOV tag should not be there. — Arthur Rubin (talk) 20:51, 15 May 2014 (UTC)

It seems to that you're not reading this talk page starting with the bias in the article thread. There are several issues that I, along with others previously, that have raised concerns and never got dealt with, in addition to a litany of others. On a personal note, I hope your wife is doing better, and wish you and her the best. DVMt (talk) 22:44, 15 May 2014 (UTC)

User QuackGuru's recent violation of WP:Three revert rule

Greetings! It seems that the user QuackGuru just violated the WP:3RR in the alternative medicine articles. He has been warned already before about this by administrator EdJohnston[17], as well as administrator Tiptoety[18]:

Hi QuackGuru. Please consider this your only warning for edit warring on Traditional Chinese medicine. While it is obvious that you have intentionally not gone over three reverts in one day, please be reminded that the edit warring policy does not specify a specific number of reverts, and simply engaging in a long term pattern of edit warring can result in a block. I'll also note that if you continue to edit war on Pseudoscience related articles, I will impose a 1RR restriction your account per the discretionary sanctions authorized at Wikipedia:Requests for arbitration/Pseudoscience. Tiptoety talk 16:55, 29 April 2014 (UTC)

As Tiptoety's warning makes it really clear, there is not any "specific amount of edits that you can do each day". It does not even matter whether you continue that disruptive behaviour on just one or even more articles. QuackGuru has been specifically warned about edit warring Pseudoscience related articles. As far as I have been involved in developing some other alternative medicine articles, such as traditional Chinese medicine or acupuncture, I have noticed the same editing behaviour by QuackGuru even there.

Yesterday, QuackGuru was already warned two times:

• at 07:13, 14 May[19],
• and at 17:38, 14 May[20].

However, it seems that the same editing pattern keeps repeating with QuackGuru:

• at 21:02, 9 May 2014 on this very article, Chiropractic, QuackGuru made a revert on {{POV}} tag[21].
• At 19:18, 14 May 2014, he made his second revert on this very same article, on that very same thing[22].

As stated by WP:3RR: ".... The three-revert rule ... is not a definition of what "edit warring" means, and it is perfectly possible to edit war without breaking the three-revert rule, or even coming close to doing so..."

However, today QuackGuru also made his 3rd revert, so even the bright line of three reverts applies.

1. Here you can see him inserting the {{MEDRS}} tags: [23][24]
2. Here you can see the tags being removed by another user, DVMt: [25]
3. Finally here, QuackGuru crosses the line and reverts the last edit by DVMt: [26]

WP:3RR is extremly clear on this:

The 3RR says an editor must not perform more than three reverts, in whole or in part, whether involving the same or different material, on a single page within a 24-hour period.

So gentlemen, what shall we do with QuackGuru? Jayaguru-Shishya (talk) 19:33, 15 May 2014 (UTC)

Making consecutive edits by tagging the same source is not a revert. I did not make 3 reverts and you are refusing to collaborate. See WP:BOOMARANG. QuackGuru (talk) 19:53, 15 May 2014 (UTC)

I agree. I've tried for 2 weeks to try to discuss the salient issues with QuackGuru and he simply ignores my points while removing sources he doesn't like and preventing inclusion of sources that supports the claims being made (such as 10.3% of patients who present to DCs for non-MSK issues). Support a report to the admins for edit warring and conduct detrimental to wikipedia's mission. DVMt (talk) 22:41, 15 May 2014 (UTC)

I originally added the source myself and tagged the source and self-reverted my own original edit and both of you and not collaborating here. It would help to focus on article content using reliable sources rather than your personal favorites. QuackGuru (talk) 05:11, 16 May 2014 (UTC)

Removal of the MEDRS tags and failure to collaborate

I tagged the primary source (PMID 24512507) in the article and fixed a wikilink but it was reverted without a valid reason and I was falsely accused of a 3RR violation. QuackGuru (talk) 19:43, 15 May 2014 (UTC)

Please see the thread above. Jayaguru-Shishya (talk) 19:49, 15 May 2014 (UTC)

I agree. QG poisons the well here and he is a constant at disruptive and unprofessional behaviours. He's also admitted he's a meat puppet for Ernst which is as clear as a policy as we can get. He's tried to censor my sandbox as well. Just goes to show he will do anything to censor material that he does not agree with. My sandbox consists of over 50 new sources most of them reviews but it displays the focus on MSK and science behind joint dysfunction and spinal manipulation. DVMt (talk) 22:38, 15 May 2014 (UTC)

@DVMt: that is a lie. (See WP:SPADE; I'm not saying you are generally a liear, just that the statement is false, and that you have no evidence that it was true.) QG never said he "was a meatpuppet for Ernst". I also question whether the reference would meet {{MEDRS}}, as it is a self-proclaimed alt-med publication. However, it doesn't seem to me it needs to meet {{MEDRS}}; in context, whether or not this is a medical article overall, that paragraph is not about medicine or alternative medicine. More important, though, the stated reasons both for tagging and for untagging the reference are completely wrong. — Arthur Rubin (talk) 00:55, 16 May 2014 (UTC)

The source is still a primary source. I previously explained we require secondary sources but DVMt thinks any source is fair game for non-medical claims. QuackGuru (talk) 01:07, 16 May 2014 (UTC)

Sorry @Arthur Rubin:, I disagree completely with your assertion. BMC is a completely reliable source. I know your expertise is in math, but do you have clinical competency in MSK medicine? The reference is legit, and I referred to an independent medical editor. Re: meat puppetry, if it walks like a meat puppet, and talks like a meat puppet... DVMt (talk) 01:32, 16 May 2014 (UTC)

Tag restored against CON again

See diff. QuackGuru (talk) 01:23, 16 May 2014 (UTC)

There is no consensus. Consensus has changed and you have addressed none of my concerns as above. NPOV tag stays and that is seconded by a current editor, Jayguru as well. Regards, DVMt (talk) 01:27, 16 May 2014 (UTC)

Most editors are against having the NPOV tag. You got no CON. I tried explaining to you secondary sources are preferred. QuackGuru (talk) 01:33, 16 May 2014 (UTC)

Looking at the current discussion, I don't see any consensus whatsoever. The opposite actually. You don't need to explain secondary sources because I understand them full well. Why are you trying to censor a paper that clearly identifies the 81% of DCs who practice NMSK? How about we go to an independent noticeboard and get a broad consensus? DVMt (talk) 01:39, 16 May 2014 (UTC)

It is simple. Use secondary sources. Problems solved. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:47, 16 May 2014 (UTC)

I wish it were that simple, James. The reliable source isn't being used to make a medical claim, it's been used to identify factions within the profession. Are you stating this source cannot be used under any circumstance? Yes/No. DVMt (talk) 01:57, 16 May 2014 (UTC)

I originally made the mistake of adding the primary source to the article. I self-reverted my own mistake and clearly explained in my edit summary it was a primary source. QuackGuru (talk) 01:59, 16 May 2014 (UTC)

By this logic, every single primary source in the article needs to be deleted. Do you agree? DVMt (talk) 02:02, 16 May 2014 (UTC)

I agree with WP:CON for the current sources. QuackGuru (talk) 02:04, 16 May 2014 (UTC)

There is no con. The current sources includes numerous primary sources. We can't cherry pick to remove sources that we don't agree with. DVMt (talk) 02:07, 16 May 2014 (UTC)

CON does not have to be unanimous. QuackGuru (talk) 02:09, 16 May 2014 (UTC)

If you find a good source and I can add it to the article ASAP. QuackGuru (talk) 02:16, 16 May 2014 (UTC)

Thank you, captain obvious. You've done nothing to try to build any consensus. Time for ArbCom take a look here. You refuse to to acknowledge the massive problems here, refuse to accept there is evidence-based chiropractic, refuse to accept that 4/5 DCs practice primarily MSK, refuse to accept that only 10% of DCs treat non MSK cases, refuse to compromise, or build consensus through collaboration but rather impose your rigid interpretations and lobby accusations against editors who disagree with you. This behaviour isn't specific to chiropractic either. All alt-med articles. Didn't your bans teach you anything? DVMt (talk) 02:17, 16 May 2014 (UTC)

That was an WP:IDHT violation. The answer is simple and you were told about using reliable sources before. Do you understand now? QuackGuru (talk) 05:05, 16 May 2014 (UTC)

Actually, it seems to me that there is a strong consensus here that the tag should stay. You violated WP:3RR QuackGuru. It's all in the diffs above. The source discussed here, as long as it's no making any claims on medical efficacy, IMO a primary source can be used. Therefore, there should be no problem with that. Jayaguru-Shishya (talk) 13:46, 16 May 2014 (UTC)

If you think that QuackGuru violated WP:3RR, go file a report at WP:AN3, if not, drop it. Your continual attempts to poison the well and use bullying tactics to change the article is starting to be annoying. When you have a minute, you should also review the policies on primary and secondary sources because you don't seem to understand them.--McSly (talk) 14:58, 16 May 2014 (UTC)

Perhaps if McSly was editing here and not doing a random drive by, he/she would understand that QG has been disruptive and tendentious in this whole process. DVMt (talk) 15:56, 16 May 2014 (UTC)

Well, you are wrong. I would explain it to you but 1) this section is already way outside the WP:TALK parameters and 2) I feel it would be a complete waste of my time so I won't bother.--McSly (talk) 22:16, 16 May 2014 (UTC)

Fringe pushers with obvious COI do not a consensus make. -Roxy the dog (resonate) 22:41, 16 May 2014 (UTC)

Don't feed the trolls DVMt (talk) 22:50, 16 May 2014 (UTC)

Removal of chiropractic from pseudoscience category

This is the preferred categorization https://en.wikipedia.org/wiki/Wikipedia:Requests_for_arbitration/Pseudoscience#Alternative_theoretical_formulations. The time has come. Chiropractic management is primarily for MSK disorders and back and neck pain specifically. The fringe faction or specific traits of those practitioners are clearly delineated now, and there is no doubt that chiropractic care for MSK is not fringe. DVMt (talk) 15:59, 16 May 2014 (UTC)

Really? because it looks to me that the crazy is alive and well in the chiropractic world.--McSly (talk) 22:19, 16 May 2014 (UTC)

This would be considered fringe. You seem to be conflating what constitutes 'mainstream chiropractic practice' (MSK) and fringe chiropractic practice (non-MSK). Regards, DVMt (talk) 22:21, 16 May 2014 (UTC)

The questionable source in the article supports "minority", not "fringe". 15% is a bit large for "fringe". — Arthur Rubin (talk) 22:29, 16 May 2014 (UTC)

If someone were to write a separate article on MSK chiropractic, that might not be pseudoscience. Any article including the history should note that it was pseudoscience when it started, putting it convincingly into the category. — Arthur Rubin (talk) 22:32, 16 May 2014 (UTC)

Chiropractic is full blooded Pseudoscience. No question about it, and fringe pushers cannot change that. -Roxy the dog (resonate) 22:40, 16 May 2014 (UTC)

Interesting proposal, Arthur. MSK chiropractic is essentially evidence-based chiropractic since that's where the majority of the research lies. Unorthodox, or fringe constitutes 19%. Dissidents is another word. What I do know is we can't label the whole profession 'pseudoscientific'. What about my proposal about alternative theoretical formulations? Roxy, spoken like a true extremist. DVMt (talk) 22:48, 16 May 2014 (UTC)

Vertebral subluxations (or nonallopathic lesions; you can't eliminate non-science just by renaming the terms) are still pseudoscience, although some orthopedic subluxations do exist. I wouldn't go as far as Roxy, but there are enough "mainstream" (as generally observed) chiropractors who use the "subluxation" lingo that the field still fits into pseudoscience. If the governing boards and most schools completely rejected "subluxations", I might agree it might no longer be pseudoscience, although it's still not entirely evidence-based. Mainstream medicine isn't entirely evidence-based, so I wouldn't reject chiropractic solely on that basis. — Arthur Rubin (talk) 23:04, 16 May 2014 (UTC)

This is the elephant in the room. Mainstream chiropractic views subluxation as a synonym for joint dysfunction or a mechanical problem with the spine segments. Fringe chiropractic views it as interference with the life force and is a cause for disease. The current subluxation article doesn't reflect both views. Regardless of who provides the manipulation, be it a DC, DO, PT they are all attempting to restore mobility and reduce pain at a specific part of the spine, hence the term 'manipulable lesion' or IOW that site that you're applying the manipulation. The difference between a chiropractic subluxation (aka joint dysfunction) is that there is no structural damage to the corresponding joints and soft and connective tissues. It's a functional problem. Orthopedic subluxations are literally unstable joints that are hyper mobile with structural damage and an absolute contraindication to manipulative techniques. I should point out that the ICD-10 recognizes the subluxation complex as a diagnosis under the musculoskeletal section under biomechanical lesions [27]. This, again, reinforces the MSK aspect that is considered 'mainstream' unless we don't consider the ICD-10 and the WHO credible sources. DVMt (talk) 15:56, 18 May 2014 (UTC)

Arthur Rubin (talk · contribs), do you have anything to add? DVMt (talk) 15:56, 18 May 2014 (UTC)

If it could be established by mainstream (and I mean generally recognized as mainstream, without assuming that Chiropractic is mainstream) medical reliable sources that spinal joint disfunction, not amounting to orthopedic subluxations, can cause damage to the body, and (even from Chiropractic sources), that "straight" chiropractic are no longer accepted by the profession, then there would be some justification for removing the pseudoscience characterization. You have provided plausible evidence for the first, but there's still none for the second. At best you have provided evidence that "straight" chiropractic forms a small minority, but that doesn't show they aren't accepted within the profession. A profession which accepts pseudoscientists is still pseudoscientific, even if their numbers are few. — Arthur Rubin (talk) 19:18, 18 May 2014 (UTC)

Arthur Rubin (talk · contribs), take a peek in my sandbox to see spinal joint dysfunction research --biomechanics, theory, etc. As a scientist you know well that there is continuum in science --pseudoscience -> junk science ->fringe science, etc. It's not really fair to 4/5 practitioners that practice "mainstream" (defined as primarily spinal/MSK based) to be labelled pseudoscientific bc of a rogue faction that has no support within or outside the profession. Hence, the proposal for alternative theoretical formulations. Or, even having two categories, but so long as we clearly delineate what specific aspects of clinical practice are considered fringe. I'm open to suggestions. DVMt (talk) 15:06, 19 May 2014 (UTC)

The text is sourced

The tag is bogus. See Chiropractic#Controversy.

""Straights" tend to rely exclusively on spinal adjustments, to emphasize innate intelligence, and to subscribe to the notion that subluxation "is the leading cause of disease in the world today."42[28] The text in the body is also sourced. For example: "“Innate intelligence” evolved as a theological concept, the representative of Universal Intelligence (=God) within each person.36 D.D. Palmer was convinced he had discovered a natural law that pertained to human health in the most general terms. Originally, manipulation was not a technique for treating spinal or musculoskeletal problems, it was a cure for all human illness: “95% of all diseases are caused by displaced vertebrae, the remainder by luxations of other joints.”37"[29]

Palmer DD (1910). The Chiropractor's Adjuster: Text-book of the Science, Art and Philosophy of Chiropractic for Students and Practitioners. Portland, OR: Portland Printing House Co. OCLC 17205743. A subluxated vertebra ... is the cause of 95 percent of all diseases ... The other five percent is caused by displaced joints other than those of the vertebral column.

This is a commonly known fact and there are many sources that can verify the same text. QuackGuru (talk) 17:42, 22 May 2014 (UTC)

According to Daniel D. Palmer, the founder of chiropractic, subluxation is the sole cause of disease and manipulation is the cure for all diseases of the human race.[10][214][original research?]

The source does not state this. This is a misrepresentation of the research. What else did you take liberties with paraphrasing? This is very concerning indeed. DVMt (talk) 23:09, 22 May 2014 (UTC)

Strange comment i n the Practice Guidelines

A 2006 study suggested continuing education enhances the scientific knowledge of the practitioner.[76][Unreliable fringe source?]

Seems disembodied and irrelevant. The study itself is a nondescript workshop evaluation that somehow seems to be published in a journal. Shall we get rid of it? 203.38.24.65 (talk) 08:19, 23 May 2014 (UTC)