Talk:Chiropractic

Outdated and wrong

64.122.219.100 (talk) 17:57, 23 November 2013 (UTC) The information on here is not only biased but is outdated and needs updating. For your knowledge, yes there are HUNDREDS if not thousands of medical research on chiropractic. So to say, there is no research supporting chiropractic is not true. People use wikipedia all the time so the information on here needs to be correct. please change:

"Collectively, spinal manipulation failed to show it is effective for any condition.[14] The scientific consensus is that chiropractic may be on a par with other manual therapies for some musculoskeletal conditions such as lower back pain, but that there is no credible evidence or mechanism for effects on other conditions, and some evidence of severe adverse effects from cervical vertebral manipulation.["

to:

There is research supporting spinal manipulation and it has been shown to be effective for most conditions (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3563165/) also, (http://www.ncbi.nlm.nih.gov/m/pubmed/24262386/?i=1&from=Is%20chiropractic; "Evidence-Based Guidelines for the Chiropractic Treatment of Adults With Neck Pain." AuthorsBryans R, et al. Show all Journal J Manipulative Physiol Ther. 2013 Nov 19. pii: S0161-4754(13)00237-6. doi: 10.1016/j.jmpt.2013.08.010. [Epub ahead of print] Affiliation Guidelines Development Committee (GDC) Chairman; Chiropractor, Clarenville, Newfoundland, Canada."

The scientific consensus is that chiropractic may be on a par with other manual therapies for some musculoskeletal conditions such as lower back pain, and there is credible evidence for effects on other conditions (ex. treating hypertension with chiropractic has been shown to be successful)

"Spinal manipulation for the treatment of hypertension: a systematic qualitative literature review."

AuthorsMangum K, et al. Show all Journal J Manipulative Physiol Ther. 2012 Mar-Apr;35(3):235-43. doi: 10.1016/j.jmpt.2012.01.005. Epub 2012 Feb 17.

Affiliation Private Practice, Riverside, CA, USA.

And please change this line: "...and some evidence of severe adverse effects from cervical vertebral manipulation."

to: No research has been found to be specifically correlated with severe adverse effects. The research claiming this failed to state the preexisting conditions of the patient.

or just leave that sentence out because you cannot claim something that isn't completely true. Oh and it only happened a few times in history and it's not relevant to the profession at hand.

Nonsense. These changes are not acceptable. --Roxy the dog (resonate) 19:19, 23 November 2013 (UTC)

The evidence on chiropractic's is mixed. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:23, 23 November 2013 (UTC)

The evidence based on a critical evaluation of a systematic review of systematic reviews is clear. This is an authoritative source. I changed the sentence. "A critical evaluation found that collectively, spinal manipulation failed to show it is effective for any condition." This was according to a critical evaluation of a systematic review of systematic reviews. QuackGuru (talk) 02:03, 24 November 2013 (UTC)

I would expect changes be made to the description of chiropractic. The main authors are people who believe the chiropractic profession are quacks. If they researched medical studies done on chiropractic instead of finding articles that they believe should be displayed. Actually more people are realizing that chiropractic does wonders. Read the medical studies and get up to date on chiropractic instead of picking and choosing what articles fit your description of chiropractic. Ya there is controversy but how many great medical studies are successful on chiropractic? How many are against it? Successful out weigh the non successful. The research your claiming about serious adverse affects like stroke from chiropractic was already a pre existing condition and I would expect you mention that. This whole description of the profession is a joke. The evidence IS out there that the benefits FAR out weigh the adverse effects. I've personally seen hundreds of people be healed from their neuromusculoskeletal disorders by utilizing chiropractic. chronic pain gone just from seeing a chiropractor. Clinical case studies are far better than any other study done because it's with the patients not overseeing and speculating from a review. Hear it from the people. — Preceding unsigned comment added by ChiroQ (talk • contribs) 22:48, 26 November 2013 (UTC)

Please link these studies and we'll be glad to read them. Your own research and assorted testimonies won't hold any weight here by the way. Samwalton9 (talk) 22:54, 26 November 2013 (UTC)

Conversation about clarifying the lede

I have reverted 2 edits that are attempting to remove the verified fact that chiropractic is a profession; first here, then here. The first time I reverted I referred to previous consensus in the edit summary of my revert; now this second time I will point editors directly to the previous consensus so that we can hopefully avoid an edit war. You will note that the recent discussion Recent_controversial_edits_-_profession_vs._approach resulted in a clear consensus for the current version; there has been no discussion to change the consensus version.Puhlaa (talk) 16:03, 20 January 2014 (UTC)

That isn't quite the point Puhlaa, with respect. It's verifiably the case that some people, including you, earn their living as chiropractors, and that's not in dispute. But levering it into the lede of an article about chiropractic as a concept does not make for great readability. I'll edit this to restore the consensus view, as I understand it, and I then recommend that you and I both step back once more, so that your POV doesn't become an issue and I don't engage you in an edit war. Thanks.John Snow II (talk) 17:08, 20 January 2014 (UTC)

John Snow, the point is that you are removing the consensus version in favour of your own preferred version, despite your preferred version going against verified facts and consensus. Please read the link I provided above, where all involved editors agreed to include the version that you don't like... which states that chiropractic is a profession and an approach. Now that I have provided a link to the discussion which achieved the current consensus (that you are arguing against), your continued removal of the adjective "profession" is starting to appear tendentious. I have reverted your POV edit again and I would ask that you leave the consensus version alone until there has been new consensus achieved.Puhlaa (talk) 17:32, 20 January 2014 (UTC)

Somebody's COI is showing, and really shouldn't be on this page at all. --Roxy the dog (resonate) 18:01, 20 January 2014 (UTC)

Roxy and John, wikipedia is meant to represent verifiable sources that give the mainstream view. I would ask of you both, please explain why you feel that the verifiable fact that chiropractic is a profession should not be included here. In addition, please explain why the consensus version (reached previously Recent_controversial_edits_-_profession_vs._approach ) should no longer apply? Do you feel that any of the sources provided previously are not valid? Did you read Recent_controversial_edits_-_profession_vs._approach before you reverted away from the consensus version? Puhlaa (talk) 18:54, 20 January 2014 (UTC)

There is probably a good basis for calling chiropractic a "profession". Making money from the punters is, after all, one of its chief raisons d'être. Alexbrn ^{talk|contribs|COI} 19:07, 20 January 2014 (UTC)

Yep, I don't have a problem with people calling themselves chiropractic professionals if they are appropriately trained and (where applicable) registered. The point of the edit, yet again, was to improve clarity, which a lede should have in any WP article, shouldn't it? Repeatedly levering this apparent advertorialising back in looks like it reflects a personal conflict of interest, rather than the consensus. Further input from editors without such a COI would be welcome. John Snow II (talk) 19:52, 20 January 2014 (UTC)

Well I guess the key here is, John, it doesn't matter what you, or I, do or do not have a problem with; wikipedia follows reliable, mainstream sources, not my opinion or yours. Reliable sources say that chiropractic is a profession; do you have any sources to present that suggest chiropractic is not a profession? The most recent consensus, which I have already pointed to repeatedly here, was to include the ideas that it is a profession and an 'approach'. The onus is on you, John, who wants to change the lede away from the consensus version to provide sources and seek consensus. Here is what supports the term profession in the lede:

1. From NIH/NCCAM: "Chiropractic is a health care profession that focuses on..."
2. From the World Health Organization: "Chiropractic - A health care profession concerned with....."
3. From a peer-reviewed source in Archives of Internal Medicine: "Chiropractic, the medical profession that specializes in..."
4. From a peer-reviewed source in The Milbank Quarterly: "Chiropractic is the best established of the alternative health care professions."
5. In Brazil a Federal Judge has ruled that: "chiropractic is a profession and not a technique"
6. In Canadian provinces, Chiropractic is regulated under the Health Professions Act. Here is verification for Alberta, British Columbia, etc.
7. American state legislatures describe chiropractic as a health profession; For example Vermont, Tennessee, Colorado, etc.

Puhlaa (talk) 20:35, 20 January 2014 (UTC)

As Puhlaa is at 4RR I have invited him/her to self revert and issued a final warning. Roxy the dog (resonate) 20:26, 20 January 2014 (UTC)

Not going to self-revert to a non-consensus POV version Roxy, even if it is your preferred version, sorry. However, you are welcome to report me to 3RR noticeboard and explain why you think that the consensus version should be removed without discussion first? I have simply restored the consensus version, which satisfies WP:V and WP:NPOV, until there is consensus for a change I think that maintaining the consensus version is consistent with policy.Puhlaa (talk) 20:35, 20 January 2014 (UTC)

Last chance. It is self-evident that the consensus has changed. Roxy the dog (resonate) 20:41, 20 January 2014 (UTC)

I don't see any evidence of change to consensus; I only see you and John trying to push through a change to the lede that goes against consensus and against reliable sources. I have reverted your change per WP:BRD and now I expect that there will be a discussion here (per BRD) before you try to push your preferred version through again. Puhlaa (talk) 20:54, 20 January 2014 (UTC)

No change of consensus, just support for an edit warring attempt to revert the long standing consensus version. There are abundant sources which describe chiropractic as a profession and approach. One's personal POV about chiropractic is another matter, and I'm definitely a skeptic, but we should follow the sources. -- Brangifer (talk) 03:42, 21 January 2014 (UTC)

We've maybe got off the piste here. The point was never to get into one of those endless tennis matches about sources - it was about making the lede clear enough to be readable and informative. I'm not an anti-chiro campaigner and I do not question the relevance of material about how chiros are trained, licensed and employed, so I do not have a vested-interest POV to push here. But squeezing every possible point into the intro does not look like a sensible approach and my feeling is that the consensus has in fact evolved. Thanks. John Snow II (talk) 12:10, 21 January 2014 (UTC)

It reads just fine. We have discussed this quite thoroughly and you'll need to come up with some policy based arguments for making such a change. The consensus hasn't changed just because you came out of the blue, without any discussion, and attempted to forcefully remove long standing content, and one person supported your edit war. I suggest you read the archives. -- Brangifer (talk) 16:07, 21 January 2014 (UTC)

No, it doesn't read "just fine." It's pedantic, "busy," and awkward as hell. With all sorts of terms readers are unlikely to be familiar with thrown at them in the lead, they are likely to turn away. We write for the readers not ourselves. John Snow is spot-on when he advises against "squeezing every possible point into the intro." By the way, I've never heard of a medical field described as a "complementary medicine." Sounds like something the doctor would hand out to you before you have to get a prescription filled. Badmintonhist (talk) 16:57, 21 January 2014 (UTC)

The archives are pretty clear, sources appear to win out this time. It is a great shame that these con-men, quacks and snake oil salesmen have to be lumped in with worthwhile professionals like doctors, nurses, physiotherapists. It does the real health care professionals a disservice to be compared to chiropracters. It helps to think of them with others of their ilk, professional thieves, or professional Real Estate Salesman, or Bankers, and people of no moral standards who con their customers. --Roxy the dog (resonate) 18:17, 21 January 2014 (UTC)

I can certainly agree "The archives are pretty clear, sources appear to win out" but it's not necessary to get into our personal feelings regarding the subject and I'm hoping we don't use the article Talk page for any more of that. Let's just look at what the sources say and reflect those accurately in the article. The article itself devotes a non-trivial amount of space to discussing it as a profession, and nine months ago in this discussion, authoritative reliable sources were brought that discuss chiropractic as a profession. Both those sympathetic to and skeptical of chiropractic came to a compromise agreement to mention both in the lead and that part of the article has been stable since. I don't see any significant change in the circumstances since that time. Zad68 18:34, 21 January 2014 (UTC)

That is all very well, but to say, in Wikipedia's voice, that these people are "Health Care Professionals" really sticks in my craw. --Roxy the dog (resonate) 18:52, 21 January 2014 (UTC)

I hear ya, but as you surely know, the argument you need to have is with the likes of the WHO and NIH/NCCAM. Zad68 18:56, 21 January 2014 (UTC)

I too am sympathetic, but "professional" is a problematic word. I take it just to mean "you make your money from it", but it has also somehow taken on meanings associating it with some kind of "excellence". Alexbrn ^{talk|contribs|COI} 19:03, 21 January 2014 (UTC)

I don't have a strong opinion about chiropractors one way or the other. My point was about the clumsy style of the lead. Badmintonhist (talk) 19:24, 21 January 2014 (UTC)

Alexbrn, the discussion isn't about the word "professional", but about "profession". -- Brangifer (talk) 04:06, 23 January 2014 (UTC)

For sure, but the connotations ("pro") are shared. To be clear, I'm not objecting to the word - simply saying it's much misunderstood. Alexbrn ^{talk|contribs|COI} 07:48, 23 January 2014 (UTC)

"It is generally categorized as complementary and alternative medicine (CAM),[1] a characterization that many chiropractors reject.[3]"

If you check the edit history a lot of text from the lead and the entire article has been deleted or rewritten over without explanation. QuackGuru (talk) 19:12, 23 January 2014 (UTC)

Proposal for new wording

There appears to be some interest in removing the word "profession" from the opening sentence of the lead. I think the word "profession" is supported by the sourcing and the article, but understand the existing sentence is a bit of a mouthful. Can new wording be proposed that addresses the issues raised above, so we can come to consensus on what to include and how to word it? Zad68 21:45, 21 January 2014 (UTC)

Nothing wrong with the current wording . . . Those who seem to disagree have only made a personal argument . . . they do not like that doctors make money as chiropractors. Personal feelings of editors do not outweigh what the sources say. TheDoctorIsIn (talk) 22:22, 21 January 2014 (UTC)

Proposal: Chiropractic is a complementary and alternative medicine[1] "health care approach" to healing concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health.[2] QuackGuru (talk) 02:48, 22 January 2014 (UTC)

I oppose QG's proposal based on everything just discussed above and the previous consensus-building discussion here. I don't have a problem with the first sentence as it currently stands, but it seems that some editors feel it to be a run-on sentence? If the consensus becomes that the first sentence is cumbersome, I propose simply splitting it into two sentences, without removing any of the current content.Puhlaa (talk) 04:31, 22 January 2014 (UTC)

I agree with Puhlaa and oppose QG's proposal. It's not "new" at all. OTOH, Zad's and Puhlaa's suggestions may be worth considering. By rewording, without removing any of the content, we could make the wording less awkward. I don't see it as awkward, but some do, so let's work on another way of constructing it. If it means splitting it, so be it. -- Brangifer (talk) 05:32, 22 January 2014 (UTC)

I do not object to the term "profession" in the lede. According to our own Wikipedia page on the term:

A profession is a vocation founded upon specialized educational training, the purpose of which is to supply objective counsel and service to others, for a direct and definite compensation, wholly apart from expectation of other business gain.

It does not imply scientific validity. It is often confused by the public as meaning that, but we should not let the public misunderstandings of terms dictate how we use words on WP. So, I am okay with the term, as long as the article discusses in depth some of the disproven or controversial aspects of Chiropractic. --Harizotoh9 (talk) 07:29, 23 January 2014 (UTC)

It appears the word "profession" was select sourcing. The lead must summarise the body properly. QuackGuru (talk) 19:12, 23 January 2014 (UTC)

• My evaluation (as an involved editor) of the consensus regarding this is that "profession" should remain in the lead, although it's still an open question as how best to word it. There are several clear policy- and source-based supports for keeping it; most of those who have been supporting its removal were doing so in the interest of clarity, and didn't really question its applicability to the article topic. This can be addressed with copyediting as opposed to removal. So we should be looking for proposals to improve the clarity of the existing wording, while retaining "profession". Suggestions from those who think the wording could stand improvement? Zad68 02:34, 24 January 2014 (UTC)

Not pseudoscience

There may be some aspects of chiropractic which are considered pseudoscientific . . . but as a whole the majority of the profession . . . yes it is a profession . . . is evidence-based and scientific. TheDoctorIsIn (talk) 21:18, 21 January 2014 (UTC)

Per WP:FRINGE/PS, Chiropractic is not generally considered a pseudoscience and therefore should not be categorized as such. TheDoctorIsIn (talk) 22:20, 21 January 2014 (UTC)

That sounds like the curate's egg. Oh, some parts of chiropractic are evidence-based! The "profession", I can live with; there is no doubt that some make a career out of it. bobrayner (talk) 23:09, 21 January 2014 (UTC)

Regardless of your personal feelings about chiropractic . . . the scientific community does not generally consider chiropractic to be pseudoscience . . . therefore categorizing this article as pseudoscience is a violation of WP:FRINGE/PS. This article (Chiropractic#Effectiveness) alone shows that there is a reasonable amount of academic debate still existing about chiropractic. Show me that the scientific community does generally consider chiropractic to be a pseudoscience . . . otherwise there is nothing to talk about here. TheDoctorIsIn (talk) 00:14, 22 January 2014 (UTC)

The ideas of innate intelligence and the chiropractic subluxation are regarded as pseudoscience.[9] This is in the lead. QuackGuru (talk) 02:43, 22 January 2014 (UTC)

QG is correct, so that part is settled. The next issue is whether we can categorize the whole profession as pseudoscience. No, we can't, for many reasons. It's too complex to label the whole profession in that way, especially since there is a move away from previously held positions. We would also violate the PSI Arbcom decision by doing that, so we should simply keep the content we have which mentions the pseudoscientific elements still held by some chiropractors, but the template and category have got to go. In fact, chiropractic should be removed from the template, as that too is a violation of the Arbcom decision. I'm doing that right now. -- Brangifer (talk) 05:39, 22 January 2014 (UTC)

Hmmm. Not sure about that; that it's a profession is unrelated to its scientific soundness (there are, after all, professional homeopathy practitioners). And insofar as it deals with science, its theories are pseudoscientific are they not? Before such a major change as this it would be wise to get a wider view, perhaps at WP:FT/N. Alexbrn ^{talk|contribs|COI} 06:06, 22 January 2014 (UTC)

Way to early for BullRangifer to charge in changing things without proper discussion and consensus. I agree with Alexbrn - any change to the Wiki voioce on this needs much wider discussion. I oppose btw. Chiropractic is pseudoscience to the core. --Roxy the dog (resonate) 12:28, 22 January 2014 (UTC)

Just to chip in, the majority of sources I can find refer to chiropractic as either pseudoscience or in one case "struggling to throw off the shackles of the pseudoscience it was born from". It definitely deserves the category tag.SPACKlick (talk) 13:01, 22 January 2014 (UTC)

The only arguments being made here to keep the incorrect categorization are mostly based on personal opinion . . . "I feel that chiropractic is pseudoscience therefore is should be categorized as such" . . . if you are saying that the majority of the reliable scientific sources are calling chiropractic a pseudoscience, then please show us those sources . . . this article shows that there is a lot of fair to high quality research out there with conflicting conclusions about the effectiveness of chiropractic for this or that ailment . . . Vertebral subluxation and innate intelligence are very much pseudoscientific and those articles should be categorized as such . . . nobody is arguing otherwise . . . however, modern chiropractic is making all attempts to leave those concepts in the past . . . condemning all of chiropractic as pseudoscience for these historical theoretical concepts would be to some degree similar to calling medical science a pseudoscience based on the practices of bloodletting and leeching. TheDoctorIsIn (talk) 05:49, 23 January 2014 (UTC)

For most of its existence, chiropractic has been sustained by pseudoscientific ideas such as subluxation and innate intelligence[16] which are not based on solid science.[9] See Chiropractic#Conceptual basis. If a chiropractor would leave their history in the past they would be called a physical therapist. QuackGuru (talk) 06:33, 23 January 2014 (UTC)

The operative word here is "history" . . . Chiropractic is not currently generally considered pseudoscience. Please provide a reliable scientific source stating otherwise . . . this article shows that there is a lot of fair to high quality research out there with conflicting conclusions about the effectiveness of chiropractic for this or that ailment . . . this means that the scientific status of chiropractic is inconclusive at this point . . . seemingly there is some scientific evidence to support it while there is also scientific evidence to refute it. TheDoctorIsIn (talk) 18:31, 23 January 2014 (UTC)

Verging into WP:NOTAFORUM.

What specific improvements to the article are being suggested? If none are, then this topic should be closed. --Harizotoh9 (talk) 07:16, 23 January 2014 (UTC)

The improvement is to fix the miscategorization of this topic as a pseudoscience . . . as it stands now this article is in violation of WP:FRINGE/PS . . . removing the miscategorization would therefore be an improvement. TheDoctorIsIn (talk) 18:31, 23 January 2014 (UTC)

"this article is in violation of WP:FRINGE/PS" ← how? Alexbrn ^{talk|contribs|COI} 19:18, 23 January 2014 (UTC)

3. Questionable science: Hypotheses which have a substantial following but which critics describe as pseudoscience, may contain information to that effect; however it should not be described as unambiguously pseudoscientific while a reasonable amount of academic debate still exists on this point.

Given all of the fair to high quality research out there with conflicting conclusions about the effectiveness of chiropractic for this or that ailment . . . clearly there is a reasonable amount of academic debate about the scientific aspects of chiropractic . . . however the article is currently categorizing (an unambiguous description) as pseudoscience . . . therefore the article is currently in violation of WP:FRINGE/PS. TheDoctorIsIn (talk) 23:34, 23 January 2014 (UTC)

I agree with what TheDoctorIsIn has just said and agree that it violates WP:FRINGE to try and characterize the entire profession as pseudoscience. I believe that BullRangifer also mentioned that it violates some ArbCom decision to label the profession as pseudoscience outright; perhaps he could ellaborate on that? Moreover, a RS in JAMA Int Med suggests that "Today, a substantial number of chiropractors are anxious to sever all remaining ties to the vitalism of innate intelligence. For these practitioners, the notion of the innate serves only to maintain chiropractic as a fringe profession and to delay its "transition into legitimate professional education, with serious scholarship, research, and service." And the body of our wiki article mentions that traditional straights are the minority. Thus, while it is great to mention the pseudoscientific heritage, traditions, etc., it is equally, perhaps even more important to indicate that a significant shift has/is occurring for 'a substantial part of the profession'. Puhlaa (talk) 02:08, 24 January 2014 (UTC)

• There are two questions, 1) Should Category:Pseudoscience be removed from the article; 2) Should Chiropractic be removed from the {{Pseudoscience}} template and therefore have that template not appear at this article. I really think they're two separate questions and need to be considered individually. Categories are more broad and not as selective as a template. The Pseudoscience category has 280 pages in it and 28 subcategories, each with their own pages; the template lists only 30 specific examples.

  I think there's a decent case for keeping the category, if there's reliable sourcing that indicates that some fundamental aspects of the topic are generally considered pseudoscience. I haven't reviewed the sourcing well enough to know for sure, but I do see a few sources supporting it in the article. I don't think it's a requirement for inclusion in a category that the article topic falls 100% within it. For example, there are plenty of biographies for people involved in more than one discipline that have multiple categories, like Michelangelo is in categories for both painters and sculptors.

  I think the case for keeping chiropractic in the template is weaker, because it's more selective. Does the authoritative reliable sourcing consider chiropractic to be a foremost example of pseudoscience? I am genuinely unsure. Zad68 03:00, 24 January 2014 (UTC)

I think it is worth noting that if you remove the pseudoscience from chiropractic, what you have left is massage. --Roxy the dog (resonate) 05:36, 24 January 2014 (UTC)

The aspects which are pseudoscientific can be labelled as such in this article, and they are. They can also, per the PSI ArbCom, be categorized as such in their own articles. To label a whole profession is problematic. This isn't homeopathy, a classic example of pseudoscience. That's why I think we should remove chiropractic from the template, remove the template, and remove the category. That way we won't be in conflict with the PSI ArbCom decision, while still labeling the pseudoscientific elements as such, which the PSI ArbCom allows. This is a simple solution which does not remove our properly sourced obligation to label the PSI elements for what they are. -- Brangifer (talk) 05:38, 24 January 2014 (UTC)

The main point I think is that (as we say in the very opening sentence) Chiropractic is both an approach and a profession, and because it has this dual aspect the categorizations we use will apply apply to either those aspects. So some categories (such as "Physical exercise") apply to the "approach" rather than the "profession" aspect of chiropractic. So it is with "pseudoscience". The fact that "Chiropractic" has its own entry in Shermer's encyclopedia of pseudoscience gives us a central RS-based reason why this category applies. I'm not bothered about the template. Alexbrn ^{talk|contribs|COI} 06:37, 25 January 2014 (UTC)

Brangifer's analysis is precisely correct . . . If we follow the guidelines of Wikipedia and the reality of Chiropractic today there is really no other way to interpret the way forward here. Alexbrn . . . do you recognize that science does support chiropractic spinal manipulation as a benefit for some limited conditions and there are a variety of other conditions where there is weak to moderate evidence supporting it? And there are conditions for which science positively refutes chiropractic manipulation as a treatment. This is not just about physical exercise, nutritional counseling . . . This is about the scientific door not being closed on chiropractic spinal manipulation . . . it's very much open as research continues. The scientific debate continues . . . Therefore per FRINGE categorizing chiropractic as pseudoscience is a Wikipedia rule violation and worse . . . it is factually incorrect. TheDoctorIsIn (talk) 06:55, 25 January 2014 (UTC)

There is no scientific debate: the question of whether the precepts underlying chiropractic are pseudoscientific is settled: they are. Separately to that, some parts of the chiropractic movement are trying to de-emphasize those aspects or make a land-grab to "own" generic spinal manipulation, as we relate in our article here. What is the difference between "spinal manipulation" in general and what you call "chiropractic spinal manipulation"? According to reliable sources that consider the matter, it is pseudoscience - chiropractic's defining differentiatior. Alexbrn ^{talk|contribs|COI} 07:06, 25 January 2014 (UTC)

Spinal manipulation is chiropractic. Other professions may do it, but manipulation of the spine is chiropractic . . . The land-grab goes the other way . . . as spinal manipulation is found to be scientifically effective for a variety of ailments other healthcare professions are co-opting the techniques. Chiropractic has gotten results in some cases . . . The original hypothesis as to why these results were occurring has been falsified . . . However the techniques remain and science is now finding out the actual why and how these manipulation cause these benefits for some ailments. TheDoctorIsIn (talk) 07:23, 25 January 2014 (UTC)

Non-chiropractors have long performed spinal manipulation in the limited number of scenarios where it is merited. According to RAND, even in 1991, 6% of the spinal manipulations in the US were performed by non-chiropractors. The fact that chiropractic is being investigated (and found wanting) does not bear on the question of whether it is pseudoscience. Homeopathy is still being "investigated". But in the end, we need to avoid original research and go by reliable sources on pseudoscience which consider the question of whether or not chiropractic should be so categorized. As I say, it's got an entry in Shermer's volumes. What other sources directly address this question? Alexbrn ^{talk|contribs|COI} 07:40, 25 January 2014 (UTC)

Chiropractic is linked with "pseudoscience". When it is no longer linked with pseudoscience they would be called a physical therapist and the word "chiropractor" would no longer be used. On the contrary, you have not established consensus to delete it from the template. It was in the template for a long time. QuackGuru (talk) 07:11, 25 January 2014 (UTC)

Massive deletion and manipulation of text throughout the article

Previous lead sentence. Chiropractic is a form of alternative medicine[1] that emphasizes diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially the spine, under the hypothesis that these disorders affect general health via the nervous system.[2] It is generally categorized as complementary and alternative medicine (CAM),[1] a characterization that many chiropractors reject.[3]

https://en.wikipedia.org/w/index.php?title=Chiropractic&oldid=442127826

Check the edit history. The lead is currently a mess and the body of the article was severely hacked.

All over the article text is missing. For example, this was in the history section: Serious research to test chiropractic theories did not begin until the 1970s, and is continuing to be hampered by what are characterized as antiscientific and pseudoscientific ideas that sustained the profession in its long battle with organized medicine. QuackGuru (talk) 19:34, 23 January 2014 (UTC)

You are introducing redundancy into the lead with this edit. Why have you added a second reference to Chapman-smith in the first paragraph of the lede? Before your edit it said: "Chiropractic is a complementary and alternative health profession... (1)." and now you have also added "Chiropractic is generally classified as CAM...(1)" These are saying the same thing, why do you feel they are both needed? One of the two needs to be removed, I have removed the one you added.Puhlaa (talk) 20:08, 23 January 2014 (UTC)

QG, it seems that with this edit you may have also removed the text that Alexbrn had included following this discussion. He was editor who wanted text that represented the Villanueva-Russell included in the scope section, you should probably read the archived talk. I think your edit has removed that source? You were banned from editing for a year and a lot changed while you were banned, perhaps just restoring the article to what it looked like before you were banned is not the best idea? Some of the changes were agreed to be improvements.Puhlaa (talk) 20:18, 23 January 2014 (UTC)

Villanueva-Russell is a good source. The point here is that the "WHO" document is produced by chiroporactors and paints an idealized picture of chiro (TL;DR "we just do spines, sensible us"); Villanueva-Russell's more up-to-date material suggests many chiros are still ploughing the systemic health claim furrow. I would junk the WHO document entirely; it's a non-independent out-of-date source. Alexbrn ^{talk|contribs|COI} 21:19, 23 January 2014 (UTC)

The 2011 research by Yvonne Villanueva-Russell is in the article now.

Editors at the time thought the lead should not be changed. This edit changed the lead using the "WHO" document produced by chiropractors.

The Villanueva-Russell source and other sources are better sources. The text must be written to match the source or sources now. QuackGuru (talk) 21:41, 23 January 2014 (UTC)

There was no consensus to remove the WHO source from the lede, previous discussion I linked found consensus to include the V-R source in the 'scope' section. The WHO source is the best descriptive source we have for an article that is meant to represent a world view. I have restored the WHO source to the lede, will need to discuss (again) if you want such a good source removed in favour of sources that are US-centric. Puhlaa (talk) 22:06, 23 January 2014 (UTC)

I don't see consensus to remove the "Nelson" source from the lead. Most of this article was hacked. Show me where was the consensus that the Nelson source was a bad source. The Villanueva-Russell source is recent source. Do you believe the Who is a non-independent and out-of-date source or do you think is it an independent and recent source. QuackGuru (talk) 00:52, 24 January 2014 (UTC)

QG, you pointed to a [2011 edit that removed Nelson from the lede and asked me to show you the consensus for that change? This is irrelevant, the article has come a long way over 3 years. The consensus now is that Nelson is not in the lede, if you think Nelson should be added back into the lede (as you did in this edit today ), I think you will need consensus. I am not saying it cannot be added to the lede, but it seems like a fairly US-centric source and it is regarding a specific topic (scope of practice in the US), thus it is not helpful as a source for the generic definition of chiropractic in the lede. The Villanueva-Russell source is also about scope of practice of US chiropractors, thus, while it could have it's place in the lede, it is not a good source for a general definition of the global profession, where you had placed it. The WHO source is vetted by an internationally recognized, mainstream medical organization (The World Health Organization) and it is an attempt to standardize the terminology/training/safety/etc of the chiropractic profession internationally. Moreover, the source says that the:

"WHO took every precaution to verify the information contained in this publication" and

"WHO acknowledges its indebtedness to over 160 reviewers, including experts and national authorities and professional and nongovernmental organizations, in over 54 countries who provided comments and advice on the draft text.".

I think it is a great and authoritative and impartial source for a general definition of chiropractic and a general discussion of the training standards and licensing for the profession internationally. Are you aware of another source on the topic by an international medical body that could be used to introduce a topic of international significance instead of the WHO source? Puhlaa (talk) 02:38, 24 January 2014 (UTC)

Many chiropractors reject with the characterization that chiropractor is considered CAM. This text should be restored.

"No single profession "owns" spinal manipulation and there is little consensus as to which profession should administer SM, raising concerns by chiropractors that other medical physicians could "steal" SM procedures from chiropractors.[16]"

The lead already says profession enough times with this sentence above.

"The other great divide within chiropractic concerns the question of whether or not chiropractic is a primary care profession. Unfortunately, just as the word "philosophy" is routinely misused, so is the concept of "primary care." Paradoxically, even the extremes of the profession on the philosophy question (e.g., Sherman College and National University) both endorse the notion of chiropractic as a primary care profession. This agreement does not suggest that chiropractic, as primary care is a valid and compelling concept. Rather, it suggests that the concept has been unexamined and hastily adopted. This section will examine the meaning of primary care as it applies to chiropractic."[1]

The Nelson source is a good independent source that explains the controversy. It is relevant the Nelson source was deleted without consensus. An editor knew something happened to the article. The lead should not say it is a profession in the first sentence in WP's voice when there is disagreement. Do you think we should assert it as an objective fact in the first sentence when there is disagreement. QuackGuru (talk) 20:17, 24 January 2014 (UTC)

As I said above, I am not against Nelson or V-H sources being used, but it is not helpful to point to 2011 edits for discussions of 2014 content; please keep the discussion geared towards a current, specific proposal(s). If you make a clear proposal for the addition of Nelson and V-H to the lede then we can discuss the merits of that proposal. I have mentioned already that they are not good sources for the first sentence, which is a general definition of the international profession.

With regard to restoring old text to the lede that discussed the controversy over the term CAM (ie: many DCs surveyed rejected the term); RS seem to agree that chiropractic is considered a CAM profession; I think that the disagreement by DCs over the CAM characterization is not really noteworthy for the lede. Similarly, the debate over primary care is purely academic and dependent on what definition of primary care is used (the term is often mis-used). I dont think we should use this term in the lede at all. Puhlaa (talk) 22:03, 24 January 2014 (UTC)

See the lede here. It summarises the body. The current lede does not summarise the body at all. Would you like me to summarise the body in the WP:LEAD. It would only take a couple of minutes to update the lede. Chiropractic is a "form" of alternative medicine. We can't assert it as alternative medicine or CAM in the lede when it is "generally" considered CAM. These differences are noteworthy. "Chiropractic is an alternative medicine[1]" is WP:OR. The source does not assert it as alternative medicine. Chiropractic is a form of alternative medicine. This is neutrally written and passes V policy. Larry Sanger created simply policies for editors to adhere to but Wikipedia administrators do not enforce V or NPOV policy. So now the very first sentence in the article is OR. It is very helpful to point to 2011 edits when the problems happened. I asked you to show where was the consensus to delete the Nelson source but you failed to show there ever was consensus. For what seems link a number of years, you have been arguing against many editors against improving the lede sentence when editors know sources disagree. For example, you accused User:JzG in 2011 of vandalising the lede sentence when all along you are the editor who violated NPOV. I already explained we can't say it in WP's voice. See WP:ASSERT. Editors have previously pointed out the problems with using the Who source in the lede. When chiropractic is viewed as a marginal healthcare profession[40], we can't assert it in the lede sentence that chiropractic is a healthcare profession. You are beating a dead horse over this for a very long time now. Please move on. QuackGuru (talk) 06:20, 25 January 2014 (UTC)

QG, I have tried my best to adress each of your points:

1) You said "The current lede does not summarise the body at all. Would you like me to summarise the body in the WP:LEAD?"

• Response: I think the lede is a mostly good summary of the body, but there is always room for improvement. For example, I think the last paragraph of the lede is innacurate and OR. I am working on making a specific proposal for changes there.

2) You said: "Chiropractic is a "form" of alternative medicine. We can't assert it as alternative medicine or CAM in the lede when it is "generally" considered CAM. These differences are noteworthy. "

• Response: I do not see the notable difference between 'CAM' and 'a form of CAM' and 'generally considered CAM' that you suggest.

3) You said: "Chiropractic is an alternative medicine[1]" is WP:OR. The source does not assert it as alternative medicine."

• Response: You state in point (2) that the source says it is "is a form of alternative medicine". As I said above, I do not really see the notable difference between 'CAM' and 'form of CAM' and 'generally considered CAM'.

4) You pointed to WP:ASSERT and said: “When chiropractic is viewed as a marginal healthcare profession[40], we can't assert it in the lede sentence that chiropractic is a healthcare profession."

• Response: The lede sentence does not assert what you claim; the lede sentence says it "is an alternative medicine healthcare profession". Chiropractic is considered a 'marginal' healthcare profession because it is generally considered 'CAM' and 'CAM' is not part of the mainstream - Please see This recent mainstream source which says in the first 2 sentences of the abstract "Chiropractic is the best established of the alternative health care professions. Although marginalized for much of the 20th century, it has entered the mainstream of health care, gaining both legitimacy and access to third-party payers." Our lede does not try to say that it is a mainstream profession, our lede maintains that it is a "CAM healthcare profession", as such, I do not think that our lede is asserting anything that is inconsistent with the RS. Our lede sentence is a good summary of current RS. Puhlaa (talk) 02:18, 26 January 2014 (UTC)

The lede says it is a "alternative medicine healthcare profession" but a newer 2011 source say it is tied to a marginal professional status. When there is disagreement you can't assert it as fact in the lede that it is an alternative medicine healthcare profession. It is generally considered CAM but not CAM or alternative medicine. The OR should be removed from the lede. The source you stated is from 2003. It is not used in the lede sentence and it is not a recent source. The first part of the lede sentence is still OR and there is a disagreement among sources. You haven't given a reason to assert it as fact in the first sentence when there is a disagreement. The part "alternative medicine[1] health care profession" is putting two sources together that to come to a new conclusion. It is WP:SYN. Chiropractic is an alternative medicine[1]" is WP:OR but your response did not address the OR. It is not about you don't see the notable difference. It is about OR and sources disagree. The previous lede summarised the body. The current lede is poorly writing and does not summarise the body well at all. The WHO source is not consistent with newer sources. For example, it says under Chiropractic: "A 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." Now we are going to have to replace it. QuackGuru (talk) 04:42, 26 January 2014 (UTC)

"concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health." This is what the WHO source says.

"concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health." This is what the current article says. This is a COPYRIGHT violation. QuackGuru (talk) 18:24, 26 January 2014 (UTC)

QG, you said: "The lede says it is a "alternative medicine healthcare profession" but a newer 2011 source say it is tied to a marginal professional status. When there is disagreement you can't assert it as fact in the lede that it is an alternative medicine healthcare profession."

Response: Did you read the newer source? The newer source you refer to is Yvonne_VRussell. You keep suggesting the phrase "The dilemma of remaining tied to a marginal professional status must be balanced against considerations of integration." is inconsistent with our lede. However, I dont think you have read the full text? I tried to explain this concept to you in my last response, perhaps I wasn't clear. In the full text of Yvonne_VRussell’s source, she explains what she means by 'marginal':

"In health care, orthodox medicine has “professional dominance” and possesses the largest jurisdiction , although much discussion of the decline of this hegemonic power has also occurred in the literature. Complementary and Alternative Medicine (CAM) has established itself as a “marginal profession” in relation to this framework."Yvonne_VRussell

Yvonne_VRussell is clearly using ‘marginal’ to describe a CAM professions placement relative to the mainstream and in this source she is specifically discussing the CAM health profession 'chiropractic'. This description of chiropractic is perfectly consistent with other sources, like [2],[3],[4],[5], which have been presented to you previously.

Bottom line, there are good reliable sources that call chiropractic a health profession [6] [7] ; an alternative healthcare profession [8]; a marginal (CAM) healthcare profession [9]; and even a medical profession [10]. In the year you were blocked from editing chiropractic there were editors who wanted the CAM designation included in the first sentence, there were also editors who wanted the profession status included in the first sentence. You can see that the consensus version that currently exists was able to achieve both, while staying consistent with the sources available. I think that future discussion would be more fruitful if you just made specific proposals based on RS that we can reasonably discuss. Puhlaa (talk) 20:08, 26 January 2014 (UTC)

You are not collaborating at this talk page because you ignored my concerns about the SYN and copyright violations. Editors cannot have a reasonable discussion with you here. The WHO source did not verify the claim "alternative medicine healthcare profession". As I said before putting two sources together to come to a new conclusion is SYN. Do you agree it was SYN and copyright violations in the lede sentence. If we use the Yvonne VRussell source it could start by saying "Chiropractic is a marginal heath care profession in the field of complementary and alternative medicine whose practitioners emphasize..." QuackGuru (talk) 18:43, 28 January 2014 (UTC)

Proposal

Current lede sentence: Chiropractic is a health care profession in the field of complementary and alternative medicine whose practitioners emphasize manual manipulation of the spine, sometimes with the unevidenced claim this can treat a wide variety of human ailments.[1]

Proposal to replace lede sentence. '''Chiropractic''' is a form of [[alternative medicine]]<ref name=Chapman-Smith/> that emphasizes diagnosis, treatment and prevention of mechanical disorders of the [[musculoskeletal system]], especially the [[vertebral column|spine]], under the hypothesis that these disorders affect general health via the [[nervous system]].<ref name=Nelson/> It is a marginal [[complementary and alternative medicine]] [[health care profession]].<ref name="V-H"/> QuackGuru (talk) 05:34, 29 January 2014 (UTC)

As author of that current lede sentence, let me just explain a couple of the thoughts behind it:

• By saying what chiros do right after mentioning "profession", I hopes to make clear that chiropractic is both a method and a profession while avoiding the mouthful of explicitly saying so
• I think the "sometimes unevidenced" wording is useful as it lets readers know we have something suspect here. I think it's important for this to be apparent early so this doesn't look like a legitimate form of medicine until we arrive at the criticism paragraph. Alexbrn ^{talk|contribs|COI} 05:46, 29 January 2014 (UTC)

The part "sometimes with the unevidenced claim this can treat a wide variety of human ailments.[1] is too vague. There is also a lot of stuff missing from the first paragraph and entire lede that is more specific and better written. The part "It is a marginal complementary and alternative medicine health care profession." can be expanded using the Yvonne VRussell’s source. QuackGuru (talk) 06:26, 29 January 2014 (UTC)

There are a lot of proposals and discussion now in this one thread, perhaps some new threads with clear proposals could be started? I am replying here to QG comment at 18:43 on Jan 28.Puhlaa (talk) 06:44, 29 January 2014 (UTC) QG, I have already explained to you that I do not think our lede sentence has any synthesis! Our lede says: “’’ Chiropractic is an alternative medicine health care profession’’” We have RS source that says”’’ Chiropractic is the best established of the alternative health care professions’’”. You claim that the WHO source does not support that chiropractic is an alternative healthcare profession, but the WHO starts it’s chiropractic guidelines with a foreword all about traditional/alternative/complementary medicine. Remember I pointed you to this consensus-building discussion that generated the current lede sentence; you will see that editors pointed-out this fact then as well.

You want to add the term 'marginal' to the first sentence of the lede along with the alternative medicine description. I have already shown you that Yvonne_VRussell explains in her source what she means by 'marginal' – alternative medicine professions are 'marginal' to mainstream medicine, just as they are also 'alternative' to mainstream medicine. There is no need to describe chiropractic as 'marginal' AND 'alternative' in the lede sentence, as you propose, when they are referring to the same characteristic – their position relative to mainstream medicine.

With regard to you newest concern; I dont think we are violating any copyright policy by using a half-sentence from the WHO guidelines source. However, if you feel strongly that this is a big problem, perhaps you could show good intent and start a thread for a clear proposal for how to address your copyright concerns without also trying to change all the other components of the lede sentence where there are no problems and where we have good consensus. For example, there is no reason, based on WP:copyright to remove the WHO source, or to remove the general description of chiropractic the WHO gives us; but perhaps we can re-word the general description so that you are confident we are not copying the WHO too closely. Puhlaa (talk) 06:44, 29 January 2014 (UTC)

I would say a new consensus needs to be developed for the lede, this is appropriate as new RS is available. The WHO source is not appropriate MEDRS as it is biased as discussed by Alexbrn above. I agree with the editors who have expressed concern that chiro being described as a healthcare profession early in the lede can create an improper impression, "healthcare profession" is suggestive of mainstream healthcare. - - MrBill3 (talk) 06:57, 29 January 2014 (UTC)

You stated "We have RS source that says”’’ Chiropractic is the best established of the alternative health care professions’’”." That is not the WHO source. The WHO source does not explicitly say it is an "alternative medicine health care profession". A cut and paste copy of the WHO source is a copyright violation. But that is not the main issue here. We have better independent sources. QuackGuru (talk) 07:05, 29 January 2014 (UTC)

QG, the source used in the article, from "Principles and Practice" also verifies the text in the lede; chiropractic as a CAM profession. If you are struggling with the lack of sources used in the lede, we could discuss adding some of the many sources that have been discussed that support the current lede. The V-H source and the source from Milbank Quarterly, which is a very respectable medical journal, could simply be added to the lede with the current source and it would be consistent with our current text. However, each of these sources is all about US chiropractic. Chiropractic is an international profession and this article is supposed to represent a world view. The current sources, Chapter:International status, standards, and education of the chiropractic profession and the WHO guidleines are of international relevance and consistent with the text. As such, while I am open to adding US-centric sources, I am not open to deleting internationally relevant sources until new internationally relevant sources are available. Puhlaa (talk) 07:43, 29 January 2014 (UTC)

MrBill, you only need to look at the threads above to see the list of international sources that all support the description of chiropractic as a profession and the vast majority of editors have acknowledged this fact. Also, the WHO source is definitely not biased, but I agree that this is Alexbrn's view. I have suggested we take the WHO source to the RS noticeboard in previous discussions on this same topic...perhaps this is the time to get a good consensus on the value of this document for it's use here? I think it is the best source we have for this article, with regard to international education and safety standards for the chiropractic profession. Puhlaa (talk) 07:43, 29 January 2014 (UTC)

QG, I am not sure why you decided to split this discussion with this edit now into "Proposal", when it is a continuous discussion with the thread above. Now my replies to your comments are split between two threads. Perhaps you could start a new thread each time BEFORE you start a new proposal or discussion, instead of changing topics within a thread quickly before other editors have time to reply to your original topic and then splitting the thread? It gets hard for other editors to follow when discussion are split and then no one will join in the discussion. Puhlaa (talk) 07:47, 29 January 2014 (UTC)

The WHO source can't be used to verify the text because it is SYN. It must be deleted. We can't add a source. We can replace the source with another source. The Milbank Quarterly is from 2003. The V-H source is more recent. QuackGuru (talk) 07:55, 29 January 2014 (UTC)

The WHO source verifies the second part of the sentence and is also consistent with the first part of the sentence. I have explained repeatedly that there is no Synthesis violation in the lede sentence and your repeatedly listing those policies without any rationale does not add credibility to your argument. With regard to the 'newness' of V-H, it would be against WP:MEDDATE to automatically give preference to V-H just because it is a few years newer when there is no disagreement with the other sources we use; since the Milbank Q. and the V-H sources both agree that chiropractic is an alternative medicine health profession there is no disagreement. However, as I said already, I don't really care which, or if any, of these US-centric sources we agree to add to the lede, as long as the internationally relevant sources stay - unless you have newer internationally relevant sources that we can discuss? Puhlaa (talk) 08:11, 29 January 2014 (UTC)

Statement by an admin re. ArbCom sanctions

• I think there is a strong case to be made for Puhlaa being excluded from directly editing this article. The lengthy history of non-consensus edits advocating an idealised form of chiropractic whihc is at odds with common practice, places Puhlaa firmly on the wrong side of WP:FRINGE. Puhlaa, for the next month, I suggest you propose all changes on talk first, with existing text, suggested replacement, reasons for the change, and sources. I suggest you do this one small change at a time. If you do not, then I think you will find that arbitration enforcement sanctions will be requested, whihc will likely exclude you form the article altogether. Consider this a free drink at the Last Chance Saloon; the next one will not be free. Guy (Help!) 09:28, 25 January 2014 (UTC)

Edit warning

I am not pleased with the shift from reasoned discussion at this article over the past many months to the petty edit warring of late. Consider this a heads up. My next step is to fully protect the page for a week if necessary, to encourage that happening (or get another admin to do so as I used to edit this article). After that, if individual editors can't resist the urge to make and repeat making changes without consensus, there may be blocks (or bans) as needed. The key here is to have reasoned discussion, and you know what that looks like. If you're getting frustrated or making knee-jerk reverts, you are probably not in a good position to be reasonable so step back and ask for help from others. If you are trying to shape the page so that it looks the way it looked before months of discussion helped it evolve, you are probably not being reasonable. For formality's sake, this page is already under ArbCom Discretionary Sanctions, which means sanctions can be more swift or broad than usual. I'm not threatening action or any one person... just shift the path towards reasoned discussion with reasonable editors and take the extra time to do it right. Cheers, Ocaasi ^{t | c} 02:16, 24 January 2014 (UTC)

Thanks for the reminder Ocaasi!Puhlaa (talk) 02:42, 24 January 2014 (UTC)

Yes, thanks. Discussion should take priority over solo, bold, editing. Any edits which are controversial should be reverted on sight per BRD, and the slightest deviation from BRD (it's not BRBRD, or BRRRRRD) should call forth an immediate block (even if only for one day). There is no need to go all the way to 4RR in such a situation, nor should we have to waste time with a report at the editwarring noticeboard. -- Brangifer (talk) 05:43, 24 January 2014 (UTC)

You knew something happened to the article. Do you see the summary of the body in 2011 when you were editing. Now look at the lead today. Do you think the current version summarises the body properly or the previous version before the article was hacked. QuackGuru (talk) 20:26, 24 January 2014 (UTC)

I completely support this. Puhlaa is an advocate of chiropractic, and an adherent of a school which rejects some of chiropractic's wildr claims. For a long time, Puhlaa has been trying to reshape the article in terms that represent chiropractic as this subgroup wishes it to be, rather than as it actually is - most chiropractors in most countries are simply quacks, promoting their non-existent spinal subluxaitons as the cause of many forms of disease, claiming to treat colic and asthma, engaging in anti-vaccine advocacy, and causing the occasional stroke along the way. I'd be very happy is chiro was as Puhlaa wishes it to be, but that day is a long way off yet. Guy (Help!) 09:23, 25 January 2014 (UTC)

While I agree with your assessment that Puhlaa supports evidence-based chiropractic, I also want to point out that the Discretionary Sanctions specifically suggest we "Avoid discussing other editors, discuss the article instead." Ocaasi ^{t | c} 12:33, 25 January 2014 (UTC)

Take a look at the lede in 2011 and the rest of the article. Currently the lead does not summarise the body properly but how can I or any editor fix the problems when there is much resist to improving the article for far too long. We need to identify what is causing these problems and stop this from happening again. If we don't stop this now it will only continue in the future again. QuackGuru (talk) 18:00, 25 January 2014 (UTC)

Yu can't discuss the issue without addressing the source of the issue. If Puhlaa does not materially change approach, then Puhlaa will end up with a topic ban. It's not a problem of an article needing to be brought under discretionary sanctions (it already is), but a problem of a specific editor consistently making edits that are not in line with policy. My preference is for Puhlaa to start proposing changes on talk instead of editing the article directly, because I do not want Puhlaa to be slapped down; it's much easier to maintain NPOV on articles about quackery if at least some believers take part in debates about content. That doesn't mean we should compromise our standards, but we are here to document, not to debunk, and the involvement of believers halps us to stay honest. That said, if a specific editor cannot restrain themselves form making problematic edits then eventually we have to take action. Guy (Help!) 11:17, 26 January 2014 (UTC)

The problem here is the first sentence is SYN because it is putting two different sources to come to a new conclusion and the current article has been undermined. Puhlaa is against restoring what I think is well written summary to the lede. I can combine parts of the well written lede with the updated parts of the new lead to have a proper summary of the body. QuackGuru (talk) 18:17, 26 January 2014 (UTC)

QG, I have already explained that there have been lots of discussion/editing since 2011, to both the article body and lede. Also, an administrator mentioned at the start of this thread that "If you are trying to shape the page so that it looks the way it looked before months of discussion helped it evolve, you are probably not being reasonable". QG, why do you keep suggesting that we should restore a 2011 version of the lede when the article has evolved a lot since then? Your most recent criticism is that the lede combines 2 sources; there was a good discussion and a consensus developed to combine the first two sentences almost 2 years ago! I find it counterproductive to a reasonable discussion, and even insulting, when you suggest that ~3 years of editing and discussion has resulted in an article that is "hacked" or "undermined".Puhlaa (talk) 20:44, 26 January 2014 (UTC)

Discussion did not help improve this article months ago or years ago because the current lede is much shorter and not a good summary. The lede previously had a lot more information in it that was deleted without discussion or reasonable discussion. Where was the discussion to chop in the lede in half. You have ignored there is SYN in the lede sentence and copyright problems. I think chiropractors over the last few years have deteriorated this article. It counterproductive to continue a discussion with an editor who does not understand there is SYN and other problems with the lede. QuackGuru (talk) 22:04, 26 January 2014 (UTC)

Some concerns from a bunch of numbers

Hi all, I've got some problems with the sections I've posted below (from the SAFETY section):

"Chiropractic care in general is safe when employed skillfully and appropriately. Manipulation is regarded as relatively safe, but as with all therapeutic interventions, complications can arise, and it has known adverse effects, risks and contraindications. Absolute contraindications to spinal manipulative therapy are conditions that should not be manipulated; these contraindications include rheumatoid arthritis and conditions known to result in unstable joints.[2]

Sustained chiropractic care is promoted as a preventative tool, but unnecessary manipulation could present a risk to patients. Some chiropractors are concerned by the routine unjustified claims chiropractors have made.[9]"

First I'm not sure chiropractic care is seen as generally safe anymore (eg.). What is the general consensus to changing this statement to be a little less sure of itself?

Secondly what is meant by "when employed skillfully and appropriately"? This seems, to me, like a way of saying "When chiropractic care is administered safely it is safe" a subtly worded case of begging the question.

Thirdly the second sentence contradicts the first - if Chiropractic treatment is safe why would anyone be concerned with ongoing treatment?

Fourthly the reference in this sentence (from Edzard Ernst) implies that it is Chiropractors that are concerned by their own claims - the article written by Ernst doesn't mention that it is Chiropractors who are concerned specifically with the claims, and is highly critical of the efficacy of the whole field.

I'd also like to get rid of the weasel words throughout; perhaps this is a start:

Due to a lack of rigorous research and systematic under-reporting of negative affects it is difficult to gauge the safety of Chiropractic therapy 1. Most chiropractic practitioners report high levels of safety with their therapies (another ref) As with all therapeutic interventions, complications can arise, and it has known adverse effects, risks and contraindications.

I feel this is more in line with research, and also with the rest of the section which goes into detail about some of the risks associated with Chiropractic therapy. 203.38.24.65 (talk) 05:30, 28 January 2014 (UTC)

"Chiropractic care in general is safe when employed skillfully and appropriately" is a meh kind of statement. We might as well say "Chiropractic care in general is safe when done safely". What source is behind this spin? Alexbrn ^{talk|contribs|COI} 06:58, 28 January 2014 (UTC)

That is the text straight out of the current article. I'm not sure if you are asking me to source it? If so you might want to read my post above (where you are almost paraphrasing me funnily enough). 203.38.24.65 (talk) 07:21, 28 January 2014 (UTC)

It's that 2005 "WHO" document behind it (again). This is not a reliable source and needs filleting out of the article I think. Alexbrn ^{talk|contribs|COI} 07:27, 28 January 2014 (UTC)

Are you saying the first sentence came out of a WHO article? There is no reference provided in text so I thought it was just unnecessary verbiage (at best). 203.38.24.65 (talk) 07:31, 28 January 2014 (UTC)

Well, the whole para is sourced to that document (which is actually a document by chiropractors painting an idealized vision of what they should be doing). I didn't verify the precise text though. Alexbrn ^{talk|contribs|COI} 07:35, 28 January 2014 (UTC)

Well the statement is straight out of the sourced document (slightly paraphrased). I'm not sure of the provenance of the WHO document (although it's references are very out of date), regardless I feel that we could find reliable sources that confirm both points of view. I think the current statement that it is "generally safe" is over-confident given sources positing the opposite and pointing out the lack of quality research on the issue. That's why my proposed new text is kind of 'on the fence'. 203.38.24.65 (talk) 07:44, 28 January 2014 (UTC)

Well, the BBC source is not strong enough for biomedical information (see WP:MEDRS). Something from PMID 23069244 (say) would be better:

Much is known about common adverse events following SMT. These events have been described in prospective, multicenter studies. In general, adverse events are mild to moderate in intensity, have little to no influence on activities of daily living ... Serious (or life-threatening) adverse events following SMT are, on the other hand, extremely rare. Because they are rare, less is known about them ...

(Add) But the systematic review behind the BBC report is definitely worth mentioning. We have enough here for something of a re-write. Alexbrn ^{talk|contribs|COI} 08:18, 28 January 2014 (UTC)

(EC) Ok, the article I provided points back to this study which paints a different picture to the one above. Both articles note that the research into the issue has used less rigorous methodologies and findings are not clear:

In that regard, to our knowledge, only 4 case-control studies22, 23, 24, 25 have been identified that have examined this issue, 3 of which demonstrated a strong association.22, 24, 25 However, these studies did not exclude the possibility that the observed association was related to protopathic bias (ie, a form of bias that occurs when there is a lag in time from the appearance of the initial symptoms and start of treatment yet before the actual diagnosis).

My feeling is that the similarity across articles is that the research is poor and this should be noted in the article, but I'm not sure if this is original research or contravenes whatever other WP policies I'm ignorant of. 203.38.24.65 (talk) 08:27, 28 January 2014 (UTC)

Furthermore these two studies are not the only ones to come to this conclusion, so do this one, this one and this article has a useful summary in its introduction. 203.38.24.65 (talk) 08:40, 28 January 2014 (UTC)

Puhlaa discusses recent edits by Alexbrn

Alexbrn, I would like to discuss this series of recent edits you made. Improvements to the article, in my opinion, were the addition of the sceptical source to the ‘further reading’ section, done with these 2 edits and the addition of criticism to the ‘Conceptual basis’ section done with this edit. I did not modify these edits in any way. I did find some edits controversial and I have reverted them, per WP:BRD. I have tried to clearly explain what I reverted and why. Puhlaa (talk) 06:55, 29 January 2014 (UTC)

Deletion of 2 reliable sources and associated text

These edits removed text from the body of the “Scope of Practice” section and replaced it with text using a different source. I have reverted these edits because there is no consensus to remove the WHO and Nelson sources from this section at this time, nor the text that was associated with the sources. However, I believe that there is merit to the additions. I suggest we add the ad your new text back into the article without removing the existing text.

My suggestion: “Chiropractors emphasize the conservative management of the neuromusculoskeletal system without the use of medicines or surgery,[11] with special emphasis on the spine.[ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1185558/] They generally emphasize spinal manipulation but sometimes offer other treatments, such as advice on diet and lifestyle, provide exercises, or perform acupuncture.[12]" Puhlaa (talk) 06:55, 29 January 2014 (UTC)

Re-write of the lede sentence

These edits removed the WHO guidelines and the general description/definition of chiropractic from the lede and replaced it with text about unsupported claims of efficacy and a source from The National Health Service – chiropractic. My concerns:

1. The WHO guidelines that were removed is the best source we have for this article. It is the only source we have that is vetted by an international medical organization. Key features of the WHO source: "WHO took every precaution to verify the information contained in this publication" AND "WHO acknowledges its indebtedness to over 160 reviewers, including experts and national authorities and professional and nongovernmental organizations, in over 54 countries who provided comments and advice on the draft text". The general description/definition the WHO guidelines provides is impartial and relevant for the profession in every country where it is licensed.
2. I cannot seem to WP:Verify the text that was added to replce the general description of chiropractic from the NHS source. I cannot find anything that says "sometimes with the unevidenced claim this can treat a wide variety of human ailments".
3. The added text gives considerable WP:weight to controversy about claims of efficacy by placing this controversy in the first sentence of the lede. However, the NHS source that was added gives the most weight - it starts it article with - the same general definition/description of chiropractic that these controversial edits removed from our lede sentence – that used by the WHO guidelines (and apparently by the GCC in the UK).Puhlaa (talk) 06:55, 29 January 2014 (UTC)

In answer,

1. The chiropactors' guidelines published by the WHO document are old (2005) and partial; there are later stronger sources so that document should not be used so prominently here.
2. The NHS text has "Some chiropractors, however, treat a wider range of conditions, including asthma, infant colic, irritable bowel syndrome and many others" and "There is no evidence that treatments offered by chiropractors are effective for other conditions [than musculoskeletal ones]".
3. Yes, we need to include controversy per WP:LEDE; even more importantly our policy on pseudoscience obliges us to ensure it is apparent to readers when something fringe is being presented. Your version is a bit of a whitewash. Alexbrn ^{talk|contribs|COI} 08:08, 29 January 2014 (UTC)

Hey Alexbrn, thanks for your response. I have continued to organize my comments numerically,

1. I agree that the WHO guidelines are from 2005, but no newer source of equal quality exists yet and I think that probably the WHO hasn't changed their mind on the contents yet, or they would publish a new version. I suggest we go to the RS noticeboard and get a consensus on this source! We have had this debate so many times and it would be so much easier if we just got an impartial consensus and abide by it until the next round of RS shows up. Do you want to draft an impartial request that could be posted there?
2. Thank you for verifying the text you added. I trust it is there; but can you tell me what section you see that content? Is it the first paragraph of the NHS source? Is it the first page? I suggest that we rely on RS like this one for guidance on how much weight to give each topic. If RS like this one put the controversy at the top then I definitely think we should as well. I think I saw the WHO definition at the top of the NHS source :)
3. We have a discussion of this controversy over efficacy in the second paragrah of our lede: "Far-reaching claims and lack of scientific evidence supporting spinal dysfunction/subluxation as the sole cause of disease[8][9] 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"[10] We could certainly discuss expanding that section if you think it is not sufficient. Puhlaa (talk) 08:25, 29 January 2014 (UTC)