Shell Kinney (talk | contribs) →Edit warring and arbitration restrictions: clarify intentions and respond to specific points |
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Jehochman: If I were simply going to block anyone who ever reverted or changed the page, I can understand your concern. As I've said though, I'm not advocating some sort of "zero-tolerance" policy or tossing out judgment and common sense. Perhaps it would have been helpful if I'd been more specific about who I was warning and what would have happened in this situation. In this particular case, Hughgr and the two IP addresses would have received short blocks; Levine would have received a page ban. In essence, I (and I hope other uninvolved administrators) would like to take a harder line against tendentious editing since repeated warnings aren't resolving the problem. <font face="Tempus Sans ITC" color="#2B0066">[[User:Shell_Kinney|Shell]] <sup>[[User_talk:Shell_Kinney|babelfish]]</sup></font> 21:38, 26 December 2008 (UTC) |
Jehochman: If I were simply going to block anyone who ever reverted or changed the page, I can understand your concern. As I've said though, I'm not advocating some sort of "zero-tolerance" policy or tossing out judgment and common sense. Perhaps it would have been helpful if I'd been more specific about who I was warning and what would have happened in this situation. In this particular case, Hughgr and the two IP addresses would have received short blocks; Levine would have received a page ban. In essence, I (and I hope other uninvolved administrators) would like to take a harder line against tendentious editing since repeated warnings aren't resolving the problem. <font face="Tempus Sans ITC" color="#2B0066">[[User:Shell_Kinney|Shell]] <sup>[[User_talk:Shell_Kinney|babelfish]]</sup></font> 21:38, 26 December 2008 (UTC) |
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: Very good. As long as we understand that all reverts are not equal. If somebody is reverting damage to the encyclopedia, we should help them by applying sanctions to those who caused the damage. If somebody is violating [[WP:NPOV]], [[WP:NOR]], or [[WP:MEAT]] by performing reverts, they need to be stopped. We're going to stop the revert wars, but we do not do so blindly. [[User:Jehochman|Jehochman]] <sup>[[User talk:Jehochman|Talk]]</sup> 21:56, 26 December 2008 (UTC) |
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==Two changes to the lead== |
==Two changes to the lead== |
Revision as of 21:56, 26 December 2008
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There is a page Talk:Chiropractic/Admin log for the use of uninvolved administrators in managing this article.
Opinions differ
This edit planted a {{vague}} tag after this phrase:
- "Opinions differ as to the efficacy of chiropractic treatment".
I agree that the phrase is way too vague. I proposed a replacement in #Alternative idea for 3rd paragraph; DigitalC objected to the replacement on the grounds that the text says that SM may be effective for headache. The text I proposed does not disagree with that point, as it says that chiropractic treatment has not been "shown to be effective" for conditions other than back pain, and this is consistent with the idea that chiropractic treatment may be effective for other conditions. However, it is a good idea to mention that there's been a lot of research, with conflicting results; this is stated several times in the body and should be mentioned in the lead. To take this into account, I propose the following replacement instead:
- "Treatments used by chiropractors have been heavily researched, with conflicting results. Collectively, systematic reviews of this research have not demonstrated that spinal manipulation is effective, with the possible exception of back pain. These reviews usually cover treatments independent of profession, and thus do not evaluate chiropractic in isolation.[1]"
This replacement text summarizes Chiropractic #Evidence basis fairly well, and is well-supported by the cited source, which says this on page 8:
- "Numerous controlled clinical studies of chiropractic are now available, but their results are far from uniform. Rather than selecting single studies according to their findings, it is therefore preferable to consider the totality of this evidence. Table 3 gives an overview of the most up-to-date systematic reviews by indication. These systematic reviews usually include trials of spinal manipulation regardless of who administered it. Thus, they are not exclusively an evaluation of chiropractic. Collectively, their results fail to demonstrate that spinal manipulation is effective. The only possible exception is back pain. For this condition, manipulation may be as effective (or ineffective) as standard therapy."
Eubulides (talk) 20:57, 12 December 2008 (UTC)
- I'm getting confused by the separate locations of this discussion. From what I can tell, the latest proposal suggests that none of the treatments have been shown to be effective, with the "possible exception" of back pain. Something either is or isn't shown to be effective, and stating that SM "may be effective for headache", sounds like a "possible exception" to me. Further, does the source state that no chiropractic treatment has been "shown to be effective", or that SM has not been "shown to be effective" for conditions other than back pain? As has been noted previously, there are a lot of other treatments than SM (cryotherapy, exercise therapy, RICE, ultrasound, etc.), and we should be following the source closely on this matter. DigitalC (talk) 00:36, 17 December 2008 (UTC)
- No, saying that SM "may be effective for headache" does not at all mean that SM has been demonstrated to be effective for headache. On the contrary, it merely means that SM has not been demonstrated to be ineffective for headache. Ernst's point is that SM has not been demonstrated (in the empirical, scientific sense) to be effective for any medical condition, except possibly for back pain, where opinions differ and some reliable sources say it has been demonstrated to be effective and others say it hasn't. Ernst's claim in this area is about SM, not about exercise etc. Ernst's claim is that SM has not been shown to be effective for conditions other than back pain. I agree that we should follow the source closely; the proposed wording does that. I also agree that the separate locations of this discussion have been confusing. Eubulides (talk) 20:42, 17 December 2008 (UTC)
- As stated above, things can be shown to be effective, or shown to be ineffective. One cannot show that something is possibly effective (or ineffective with the possible exception). If a source has determined that the treatment is effective, and another source has stated that it isn't shown to be effective, then opinions differ. As noted below, I also think it might be of value to append a statement about the entire clinical encounter to your proposed text. DigitalC (talk) 02:10, 18 December 2008 (UTC)
- No, saying that SM "may be effective for headache" does not at all mean that SM has been demonstrated to be effective for headache. On the contrary, it merely means that SM has not been demonstrated to be ineffective for headache. Ernst's point is that SM has not been demonstrated (in the empirical, scientific sense) to be effective for any medical condition, except possibly for back pain, where opinions differ and some reliable sources say it has been demonstrated to be effective and others say it hasn't. Ernst's claim in this area is about SM, not about exercise etc. Ernst's claim is that SM has not been shown to be effective for conditions other than back pain. I agree that we should follow the source closely; the proposed wording does that. I also agree that the separate locations of this discussion have been confusing. Eubulides (talk) 20:42, 17 December 2008 (UTC)
- I made this change to fix the vagueness in the lead. QuackGuru 22:20, 14 December 2008 (UTC)
- That change is close to what was proposed in #Alternative idea for 3rd paragraph above, except it removed "restraint-of-trade" from "restraint-of-trade court decision". DigitalC objected to several of the components of that change; in response, I proposed the above further wording improvements in this section, which were not included in that change. Perhaps some more thought is needed in this area before installing this change? Eubulides (talk) 08:30, 15 December 2008 (UTC)
WP:LEAD violation
This controversial change deleted a sentence about chiropractic history and added vagueness to the lead. We are supposed to summarize the article in the lead. Information about history belongs in the lead. Opinions differ is very vague. Opinions are not all over the map. The lead should be able to stand on its own. QuackGuru 03:46, 15 December 2008 (UTC)
I made this change in accordance with WP:LEAD. The lead should be able to stand alone as a concise overview of the article. QuackGuru 04:04, 15 December 2008 (UTC)
- By doing so, you are edit-warring the information into the article. Please stop. Consensus does not exist to ADD the information about the AMA to the lead, and it was reverted per WP:BRD (which is not bold-revert-editwar). It was reverted to the last consensus version, unlike your recent edit-warring edit. There is nothing controversial about reverting a change that does not have consensus. Please self-revert unless/until consensus is established. DigitalC (talk) 05:44, 15 December 2008 (UTC)
- Blocking clear improvements by stating no consensus is not a valid reason for the edits made by DigitalC. Continuing to violate WP:LEAD is not productive and it should stop. Violating the lead guideline is a serious matter. It is vague to add "opinions differ" and no valid explanation has been made to delete the summary of the chiropractic history from the lead too. QuackGuru 06:00, 15 December 2008 (UTC)
- It is a misrepresentation of facts to state that I am "adding" "opinions differ". I merely reverted back to the last consensus version. (Yes, it had consensus, so you are also violating WP:CON). There is nothing vague about "opinions differ". A valid explanation for reverting the addition of trivial historical information to the lead was given above, or is this another of QuackGuru's many WP:IDHT violations? There is no consensus to add the information (thats 1 valid explanation for the revert), and it does not (per WP:LEAD) act as a "short, independent summary" of the history section of the article. The only historical information that should be in the lead should act as a short summary of the history section (thats the 2nd valid explanation for the revert). You seem to feel that violating WP:LEAD is a serious matter, so you should abide by it. DigitalC (talk) 06:37, 15 December 2008 (UTC)
- DigitalC has been informed to comply with WP:LEAD. Continuing to violate WP:LEAD is not helpful. The lead should properly summarize chiropractic history and opinions ("opinions differ") are not all over the map. Why have vagueness in the lead and delete a summary of the history from the lead. QuackGuru 06:50, 15 December 2008 (UTC)
- I agree, your continued violations of WP:LEAD are not helpful. The lead should stand as a summary of the article. The trivial AMA information is not an adequate summary of Chiropractic#History, and the AMA lawsuit is not even mentioned in Chiropractic history, nor is "unscientific cult". 0.1% of articles on Google scholar mention Chiropractic also use the term "unscientific cult", and only 1.2% of the articles discussing Chiropractic also mention both "AMA" and "lawsuit". To put this into the lead of the article is clearly violating WP:UNDUE. DigitalC (talk) 23:17, 15 December 2008 (UTC)
- I don't follow this comment.
- The existing text in the lead doesn't mention the AMA at all. How can adding discussion of the AMA make the text less adequate?
- WP:LEAD is about whether the lead summarizes the body of the article, not about whether it summarizes some other article like Chiropractic history.
- Chiropractic #History does mention the "unscientific cult" quote, for good reason, and it's not necessarily unreasonable for this to be mentioned in the lead.
- By my count, about 1/8 of the Google Scholar sources that mention "chiropractic" also mention "AMA", so it seems quite relevant to discuss the war between the AMA and chiropractic. Some wording needs to be chosen; whatever wording is chosen will be used by only a tiny fraction (possibly zero) of Google Scholar sources, but that's OK, so long as we're summarizing them accurately.
- Eubulides (talk) 07:59, 16 December 2008 (UTC)
- The lead should be a summary of the article. Not everything from the body of the article should be mentioned in the lead, otherwise every trivial fact from the body would be in the lead and the body.
- Chiropractic#History should be a summary of Chiropractic history, per WP:SUMMARY. As such, if something isn't mentioned in Chiropractic history, then it shouldn't be mentioned in Chiropractic#History, and it would definitely be undue weight to be mentioning it in the lead of Chiropractic.
- I respectfully submit that it is undue weight to mention "unscientific cult" in the lead.
- Not every article discussing Chiropractic and AMA is going to necessarily be discussing the lawsuit. For instance, about 8% of the Google Scholar sources mention "chiropractic" and "AMA", but do NOT mention "lawsuit", "court", "Wilk", "Wilks", or "anti-trust". Therefore, even if it is determined by consensus that the lead should mention the relationship between the AMA and Chiropractic, that does not necessarily mean the lawsuit should be mentioned, and it certainly does not determine that we should be using the term "unscientific cult" in the lead of the article. DigitalC (talk) 00:25, 17 December 2008 (UTC)
- I don't follow this comment.
- I agree, your continued violations of WP:LEAD are not helpful. The lead should stand as a summary of the article. The trivial AMA information is not an adequate summary of Chiropractic#History, and the AMA lawsuit is not even mentioned in Chiropractic history, nor is "unscientific cult". 0.1% of articles on Google scholar mention Chiropractic also use the term "unscientific cult", and only 1.2% of the articles discussing Chiropractic also mention both "AMA" and "lawsuit". To put this into the lead of the article is clearly violating WP:UNDUE. DigitalC (talk) 23:17, 15 December 2008 (UTC)
- DigitalC has been informed to comply with WP:LEAD. Continuing to violate WP:LEAD is not helpful. The lead should properly summarize chiropractic history and opinions ("opinions differ") are not all over the map. Why have vagueness in the lead and delete a summary of the history from the lead. QuackGuru 06:50, 15 December 2008 (UTC)
- It is a misrepresentation of facts to state that I am "adding" "opinions differ". I merely reverted back to the last consensus version. (Yes, it had consensus, so you are also violating WP:CON). There is nothing vague about "opinions differ". A valid explanation for reverting the addition of trivial historical information to the lead was given above, or is this another of QuackGuru's many WP:IDHT violations? There is no consensus to add the information (thats 1 valid explanation for the revert), and it does not (per WP:LEAD) act as a "short, independent summary" of the history section of the article. The only historical information that should be in the lead should act as a short summary of the history section (thats the 2nd valid explanation for the revert). You seem to feel that violating WP:LEAD is a serious matter, so you should abide by it. DigitalC (talk) 06:37, 15 December 2008 (UTC)
- Blocking clear improvements by stating no consensus is not a valid reason for the edits made by DigitalC. Continuing to violate WP:LEAD is not productive and it should stop. Violating the lead guideline is a serious matter. It is vague to add "opinions differ" and no valid explanation has been made to delete the summary of the chiropractic history from the lead too. QuackGuru 06:00, 15 December 2008 (UTC)
- Yes, Chiropractic #History should summarize Chiropractic history; but flaws in Chiropractic history do not obligate us to reproduce similar flaws in Chiropractic #History. We can fix the problem here first, and there later. This talk page is about Chiropractic, not about Chiropractic history, so let's take up the task of fixing the latter article in its talk page.
- I agree that we need not mention the Wilk case in the lead. However, Sciencewatcher has made a reasonable case that the long and arduous struggle between organized medicine and chiropractic is currently underplayed in the lead (the lead currently devotes only the 5 words "has battled with mainstream medicine" to this topic, out of 290 words total), and this key issue of chiropractic it could stand a bit more emphasis.
- Eubulides (talk) 20:42, 17 December 2008 (UTC)
- It is a violation of WP:LEAD to not properly summarize the article. Problems have been identified and proposals have been made to fix the problems. QuackGuru 00:43, 16 December 2008 (UTC)
- I agree wtih DigitalC here. The lead currently in place does a far better job of accurately summarizing the main tenets of the articles than the one suggested below at Talk:Chiropractic#Lead improvements, which overblows the AMA historical stance in a effort to denigrate the subject. More than a WP:LEAD violation, the proposed version below is also a WP:POVPUSH violation. Keep it neutral, folks. Keep it accurate. Keep it proportional. The current lead does just that. I see no need to change it at this time. -- Levine2112 discuss 01:08, 16 December 2008 (UTC)
- It is a violation of WP:LEAD to not properly summarize the article. Problems have been identified and proposals have been made to fix the problems. QuackGuru 00:43, 16 December 2008 (UTC)
This antagonism isn't helping things. Anyway, here are my suggestions for changes to the lead: [1] add the AMA info somewhere between "For most of its existence, chiropractic has battled with" and "in recent decades, it has gained more legitimacy". It is important historical info and should go in the lead. [2] remove the vague "Opinions differ" and put in the conclusions of the Cochrane reviews with regard to effectiveness. I would also suggest removing the efficacy studies done by chiropractors themselves and just leaving the independent reviews, such as Cochrane. This should be done in the Effectiveness section as well as in the lead. --sciencewatcher (talk) 20:04, 15 December 2008 (UTC)
- The latest proposal just got completed at Talk:Chiropractic#Lead improvements. Please have a look. QuackGuru 20:41, 15 December 2008 (UTC)
Vague tag
The {{vague}} tag stems from the vagueness objection to the "opinions differ" phrase in the lead. This objection is that the article itself gives much more detail about the effectiveness of chiropractic, and summarizing that down to just "Opinions differ as to the efficacy of chiropractic treatment" is too much reduction/condensation, so much so that the summary is vague. Please see the start of this (top-level) section for a proposed fix. Eubulides (talk) 08:30, 15 December 2008 (UTC)
- The vague tag is used inappropriately here. As noted previously, it leads to a section of the MOS dealing with accuracy of measurements. Further, I respectfully submit that there is nothing vague about the statement "opinions differ". DigitalC (talk) 22:53, 15 December 2008 (UTC)
- The statement needs clarification. It is an entirely inadequate summary of Chiropractic #Effectiveness, which contains a large quantity of solid reviews that should not be summarized merely by an "opinions differ" statement. The reviews should be summarized as a whole in the lead. As things stand, the lead gives way too little weight to the issue of effectiveness. As there seems to be some confusion here about accuracy of measurements, which is just one form of vagueness (there are others), I substituted a {{clarifyme}} tag instead. Regardless of what the tag is, the problem needs to be fixed. Eubulides (talk) 01:44, 16 December 2008 (UTC)
- As I stated below, "opinions differ" appears to be concise and accurate wording. The efficacy section includes reviews with a wide range of opinions about the efficacy of spinal manipulation. Some research says it is effective for such-and-such while other research says it is not effective for such-and-such; hence "opinions differ" seems to be concise and entirely accurate. -- Levine2112 discuss 02:02, 16 December 2008 (UTC)
- Opinions differ is vague. I don't see how the current version is be more accurate than the new proposal. The new proposal accurately summarizes the article. QuackGuru 02:07, 16 December 2008 (UTC)
- Why is it vague? Is it not accurate? Don't opinions differ? -- Levine2112 discuss 02:16, 16 December 2008 (UTC)
- Opinions differ is vague. I don't see how the current version is be more accurate than the new proposal. The new proposal accurately summarizes the article. QuackGuru 02:07, 16 December 2008 (UTC)
- Eubulides, you stated that "Regardless of what the tag is, the problem needs to be fixed." However, Levine and I feel that there is no problem to fix. There is nothing vague about stating that "opinions differ". It is an accurate, concise and reliably sourced summary. DigitalC (talk) 03:26, 16 December 2008 (UTC)
- There certainly is something vague about saying "opinions differ". What are the opinions? Who holds them and why? What is the mainstream scientific opinion? These are common questions that any reasonable reader would have. We don't see Homeopathy's lead saying "opinions differ about the efficacy of homeopathy"; such a statement would technically be concise and accurate, but it wouldn't accurately convey the mainstream opinion that homeopathy's claims of efficacy are not supported by scientific evidence. Chiropractic's lead similarly has an obligation to fairly and accurately summarize the body of the article. Currently it does not at all do that in this area: it wimps out with an "opinions differ" statement. This is a problem that should get fixed.
- Even if we were merely counting heads, which we shouldn't be, we have three editors (QuackGuru[1], Sciencewatcher[2], and I) with serious objections to the current vague wording.
- Eubulides (talk) 07:59, 16 December 2008 (UTC)
- As I stated below, "opinions differ" appears to be concise and accurate wording. The efficacy section includes reviews with a wide range of opinions about the efficacy of spinal manipulation. Some research says it is effective for such-and-such while other research says it is not effective for such-and-such; hence "opinions differ" seems to be concise and entirely accurate. -- Levine2112 discuss 02:02, 16 December 2008 (UTC)
- The statement needs clarification. It is an entirely inadequate summary of Chiropractic #Effectiveness, which contains a large quantity of solid reviews that should not be summarized merely by an "opinions differ" statement. The reviews should be summarized as a whole in the lead. As things stand, the lead gives way too little weight to the issue of effectiveness. As there seems to be some confusion here about accuracy of measurements, which is just one form of vagueness (there are others), I substituted a {{clarifyme}} tag instead. Regardless of what the tag is, the problem needs to be fixed. Eubulides (talk) 01:44, 16 December 2008 (UTC)
- As Eubulides says, the problem is that the current lead doesn't summarise the effectiveness section. It should say that chiropractic hasn't shown to be effective for anything except possibly back pain. That is what the effectiveness section says, so that should go in the lead. We shouldn't fudge the facts by saying "opinions differ" just because some people don't like it. --sciencewatcher (talk) 00:54, 17 December 2008 (UTC)
- I disagree. The efficacy section - even as it stands now - includes studies and reviews which demonstrate that chiropractic and/or spinal manipulation may be effective for a variety of conditions. Then again, the efficacy section also includes studies and reviews which say that chiropractic and/or spinal manipulation has not been shown to be effective for a lot of the same variety of conditions. Hence, "opinions differ" seems to be the most concise and accurate way to state this. It would be misleading if 99% of the studies said it was effective and 1% said it was not - and vice-versa. However, the current efficacy section looks pretty evenly split. I think this is telling of chiropractic's current perception in the scientific/medical community. Essentially it is on the cusp of being alternative and mainstream. About half of the science out there says that it is effective for such-and-such and the other half says that this efficacy has not been rigorously demonstrated. Hence, we see some medical doctors working side-by-side with chiropractors and we also see some medical doctors crucifying chiropractors. And the blame isn't entirely outside the profession of chiropractic. Some of the techniques which chiropractors employ have been shown to be effective for some conditions, while other techniques have not been shown to be effective. In any case, I think the current lead makes it simple and easy and if a reader wanted to know the details of "opinions differ" than can easy jump down the the efficacy section to get fuller coverage. -- Levine2112 discuss 01:13, 17 December 2008 (UTC)
- As Eubulides says, the problem is that the current lead doesn't summarise the effectiveness section. It should say that chiropractic hasn't shown to be effective for anything except possibly back pain. That is what the effectiveness section says, so that should go in the lead. We shouldn't fudge the facts by saying "opinions differ" just because some people don't like it. --sciencewatcher (talk) 00:54, 17 December 2008 (UTC)
[unindent] I read through the effectiveness section again, and looked at some of the reviews, and I see your point. There is some evidence that chiropractic might be effective for other disorders, although the quality of studies tends to be poor and the positive results may be due to the placebo effect. --sciencewatcher (talk) 03:14, 17 December 2008 (UTC)
- Do you think that "opinions differ" needs to be clarified any way in the lead? If so, how would you suggest wording it? Or is "opinions differ" sufficient? -- Levine2112 discuss 03:41, 17 December 2008 (UTC)
- Perhaps if we say something like "Chiropractic has not been conclusively demonstrated to be effective for any health condition, although some studies show that it may be effective for some conditions, with the strongest positive evidence being for back pain. However the quality of studies tends to be low and the placebo effect may account for the positive results." with the appropriate references, of course. --sciencewatcher (talk) 19:15, 17 December 2008 (UTC)
- There is hardly anything that has been conclusively demonostrated to be effective for anything, so I don't understand the need for such a qualifier, especially one based on original research. The same goes for the supposed quality of the studies being low and the placebo effect statements. Those are unqualified opinion which we cannot present as facts. If we really want to rewrite the "opinions differ" text, I would suggest something more neutral and more based on the verifiable information presented in the article:
- Perhaps if we say something like "Chiropractic has not been conclusively demonstrated to be effective for any health condition, although some studies show that it may be effective for some conditions, with the strongest positive evidence being for back pain. However the quality of studies tends to be low and the placebo effect may account for the positive results." with the appropriate references, of course. --sciencewatcher (talk) 19:15, 17 December 2008 (UTC)
- Scientific reviews and studies have varying conclusions about the efficacy of chiropractic and/or spinal manipulation for the treatment of an array of conditions with the strongest positive evidence being for back pain.
- -- Levine2112 discuss 19:35, 17 December 2008 (UTC)
- The claim that "There is hardly anything that has been conclusively demonstrated to be effective for anything" is incorrect, if by "conclusively demonstrated" we mean the usual scientific levels of consensus (independently replicated empirical studies of high quality, with no serious dissent among reliable sources). For example, it's been conclusively demonstrated that polio vaccine is effective against polio, that water fluoridation is effective against tooth decay, and so forth.
- Neither Sciencewatcher's nor Levine2112's proposed wordings are directly supported by a reliable source. Also, Levine2112's proposed wording is still too vague; other than the words "back pain" and "spinal manipulation" it says little more than the existing text.
- I looked at all the comments, along with comments about my previously-proposed wordings, and suggest the following wording instead, which is directly supported by the cited source:
- "Studies of treatments used by chiropractors have reported conflicting results. Collectively, systematic reviews of this research have not demonstrated that spinal manipulation is effective, with the possible exception of back pain,[1]"
- The above would replace the lead's existing "Opinions differ as to the efficacy of chiropractic treatment[clarification needed][2]".
- Eubulides (talk) 20:42, 17 December 2008 (UTC)
- I don't feel that the "Collective..." sentence is supported by the current efficacy section, since some of the other conditions (aside from low back pain) described do have reviews which present evidence that demostrate the efficacy of spinal manipulation. For instance, take the 2004 and 2005 reviews under headache which found weak to good evidence supporting spinal manipulation for various forms of headaches. Also, the whiplash and neck pain section presents multiple reviews which demonstrate spinal manipulation's efficacy for each of these conditions. Also, our article presents multiple reviews demonstrating fair to good evidence of the efficacy of spinal manipulation and/or chiropractic for sciatica, radicular leg pain, adult scoliosis, asthma, cervicogenic dizziness, and baby colic. Thus I don't think it is accurate to say that collectively, systematic reviews of this research have not demonstrated that spinal manipulation is effective, with the possible exception of back pain. "Collectively" is vague and the overall sentence is thus misleading. It would be more accurate to say that the conclusions of the systematic reviews of chiropractic and/or spinal manipulation for a variety of conditions vary in terms of efficacy. -- Levine2112 discuss 23:16, 18 December 2008 (UTC)
- This greatly misstates the evidence presented in Chiropractic #Effectiveness.
- The "2004 and 2005 reviews under headache" did not find "weak to good evidence supporting spinal manipulation". Biondi 2005 (PMID 15953306) did say that the evidence for chiropractic evidence is weak. Bronfort et al. 2004 (PMID 15266458) concluded only that SM "may" be effective. The other headache reviews (Astin et al. 2002, PMID ; Lenssinck et al. 2004, PMID ) were negative. Collectively, these reviews do not demonstrate the effectiveness of SM for headache; quite the contrary.
- The "whiplash and neck pain section presents multiple reviews" is true, but it's not true that these reviews "demonstrate spinal manipulation's efficacy for each of these conditions". In this case, the negative reviews (Gross et al. 2004, PMID 14974063; Ernst 2003, PMID 14622659) included a Cochrane review and are more reliable; the positive reviews (Hurwitz et al. 2008, PMID 18204386; Vernon & Humphreys 2007, PMID 17369783) are not enough to demonstrate effectiveness in the presence of this negative evidence.
- Chiropractic does not present "multiple reviews demonstrating fair to good evidence of the efficacy of spinal manipulation and/or chiropractic for sciatica, radicular leg pain, adult scoliosis, asthma, cervicogenic dizziness, and baby colic". Let's go through those conditions one by one:
- For sciatica and radicular leg pain it talks only about assurance and advice to stay active; this is hardly specific to chiropractic. And the evidence here is only fair. In our rewrite of the low-back-pain bullet we eliminated all evidence of this low a quality, and when we get around to rewriting the "other" bullet this stuff is likely to go as well.
- For adult scoliosis the evidence is "very weak".
- For asthma we have a high-quality Cochrane review (Hondras et al. 2005, PMID 15846609) that's negative, and a lower-quality review (Hawk et al. 2007, PMID 17604553) that says the evidence is adequate to support chiropractic care (not SM in particular); if you look at table 8 of Hawk et al., the positive evidence is almost all individual case reports and the RCTs are negative or very weakly positive.
- For cervicogenic dizziness the only source we cite is Hawk et al.: again, their evidence (Table 9 in this case) has positive results mostly from individual case reports, with the RCTs reporting no significant difference in dizziness. Even Hawk et al. say that this is not enough evidence to support any particular chiropractic treatment.
- For baby colic, we cite three reviews. Two are negative (Gotlib & Rupert 2008, PMID 18789139; Husereau et al. 2003, ISBN 1-894978-11-0). One review, again Hawk et al., is positive. Again, the positive data in Hawk et al. mostly consisted of case reports; the negative came from systematic reviews.
- In reviewing the above text it may be that we are ascribing too much weight to one review (Hawk et al.) that makes a lot of claims based on data that are relatively weak.
- Collectively, these systematic reviews do not demonstrate the effectiveness of chiropractic for any medical condition except (possibly) for back pain. The results of the reviews show some signs of promise in some areas, but that's it: that's not at all a demonstration of effectiveness.
- No doubt you disagree with this analysis. But you don't have to take my word for it. We have a reliable source by a published expert in the field who has reviewed the literature on the effectiveness of chiropractic care in general and of spinal manipulation in particular, and who has concluded that the results of these reviews "fail to demonstrate that spinal manipulation is effective. The only possible exception is back pain. For this condition, manipulation may be as effective (or ineffective) as standard therapy."
- This conclusion is not controversial among reliable sources. It's pretty much the standard opinion. Reliable sources do disagree whether chiropractic has been proven to be substantially effective for back pain. For other conditions, reliable sources agree that chiropractic care is unproven.
- We have an obligation to present this standard consensus fairly and accurately. The current text, which says merely "opinions differ", does not satisfy this obligation. The proposed text does.
- Eubulides (talk) 00:36, 19 December 2008 (UTC)
- You hit the nail on the head. I disagree with your interpretation. Further, I don't see how you want to reduce Hawk's voice in the article but at the same time give Ernst - who is already cited a whopping 11 times in this article! - even more time in the lead. That will only exacerbate the weight issue we already have with Ernst. And I don't think we can assume that Ernst is any more authorative on the subject than any of the other researchers we are citing, yet we seem to be treating him that way with so many references. -- Levine2112 discuss 23:02, 19 December 2008 (UTC)
- It is not my interpretation. It is the interpretation of a reliable source, namely Ernst 2008 (PMID 18280103). And we have no reliable sources disagreeing with Ernst on this point. Hawk et al. do not disagree; they merely say that in some areas there are some signs of promise (but on this point we do have reliable reviews, including a Cochrane review, which disagree). If we could find reliable sources that disagree with Ernst on this point, that would be a different matter; but Ernst is presenting the consensus mainstream opinion here, and that is what the lead should present. Hawk et al. are presenting the minority opinion, one well worth discussing in the body; but it should not be elevated in the lead to be at the same level as the mainstream opinion. Eubulides (talk) 00:55, 20 December 2008 (UTC)
- You seem to be ignoring each of the systematic reviews which say that there is evidence that chiropractic or spinal manipulation is effective for foo. Each one of those effective disagree with Ernst's opinion. By you making a judgment that Ernst is more reliable, you are in effect ujsing OR to violate WEIGHT. Think about it. On one hand you are saying "collectively" but on the other hand you are ignoring most of the collection. -- Levine2112 discuss 01:55, 20 December 2008 (UTC)
- Please see #Systematic reviews, collectively below. Eubulides (talk) 04:24, 20 December 2008 (UTC)
- You seem to be ignoring each of the systematic reviews which say that there is evidence that chiropractic or spinal manipulation is effective for foo. Each one of those effective disagree with Ernst's opinion. By you making a judgment that Ernst is more reliable, you are in effect ujsing OR to violate WEIGHT. Think about it. On one hand you are saying "collectively" but on the other hand you are ignoring most of the collection. -- Levine2112 discuss 01:55, 20 December 2008 (UTC)
- It is not my interpretation. It is the interpretation of a reliable source, namely Ernst 2008 (PMID 18280103). And we have no reliable sources disagreeing with Ernst on this point. Hawk et al. do not disagree; they merely say that in some areas there are some signs of promise (but on this point we do have reliable reviews, including a Cochrane review, which disagree). If we could find reliable sources that disagree with Ernst on this point, that would be a different matter; but Ernst is presenting the consensus mainstream opinion here, and that is what the lead should present. Hawk et al. are presenting the minority opinion, one well worth discussing in the body; but it should not be elevated in the lead to be at the same level as the mainstream opinion. Eubulides (talk) 00:55, 20 December 2008 (UTC)
- You hit the nail on the head. I disagree with your interpretation. Further, I don't see how you want to reduce Hawk's voice in the article but at the same time give Ernst - who is already cited a whopping 11 times in this article! - even more time in the lead. That will only exacerbate the weight issue we already have with Ernst. And I don't think we can assume that Ernst is any more authorative on the subject than any of the other researchers we are citing, yet we seem to be treating him that way with so many references. -- Levine2112 discuss 23:02, 19 December 2008 (UTC)
- This greatly misstates the evidence presented in Chiropractic #Effectiveness.
- I don't feel that the "Collective..." sentence is supported by the current efficacy section, since some of the other conditions (aside from low back pain) described do have reviews which present evidence that demostrate the efficacy of spinal manipulation. For instance, take the 2004 and 2005 reviews under headache which found weak to good evidence supporting spinal manipulation for various forms of headaches. Also, the whiplash and neck pain section presents multiple reviews which demonstrate spinal manipulation's efficacy for each of these conditions. Also, our article presents multiple reviews demonstrating fair to good evidence of the efficacy of spinal manipulation and/or chiropractic for sciatica, radicular leg pain, adult scoliosis, asthma, cervicogenic dizziness, and baby colic. Thus I don't think it is accurate to say that collectively, systematic reviews of this research have not demonstrated that spinal manipulation is effective, with the possible exception of back pain. "Collectively" is vague and the overall sentence is thus misleading. It would be more accurate to say that the conclusions of the systematic reviews of chiropractic and/or spinal manipulation for a variety of conditions vary in terms of efficacy. -- Levine2112 discuss 23:16, 18 December 2008 (UTC)
Systematic reviews, collectively
Following up on the claim in the previous section that I am ignoring systematic reviews:
- I am not ignoring any of the systematic reviews in question: I discussed every one of them Levine2112 brought up, and explained why they do not demonstrate that chiropractic care is effective for any condition (except perhaps back pain). In some cases the evidence they discuss is too weak to form any basis for conclusions; in some cases there are multiple reviews that disagree, with the higher-quality ones giving negative results; and so forth.
- That is why the proposed text does not say "there is no evidence that chiropractic is effective". It says "Collectively, systematic reviews of this research have not demonstrated that spinal manipulation is effective, with the possible exception of back pain", which is a high-quality and accurate summary of all the reviews.
- There is zero OR here. The proposed text accurately summarizes a reliable source, Ernst 2008 (PMID 18280103), which discusses systematic reviews on chiropractic and says (p. 8) "Collectively, their results fail to demonstrate that spinal manipulation is effective. The only possible exception is back pain."
Eubulides (talk) 04:24, 20 December 2008 (UTC)
- Let's go back to neck pain and whiplash. It seems to me that the reviews there are all concluding that there is a benefit with the various treatments which chiropractors employ or prescribe. I think you are stuck of Ernst's opinion and are trying to cite his as the authorative one. Unfortunately, this presents a WEIGHT violation. Ernst by no means is the authorative mainstream voice on this subject. Rather, he is a vocal critic. If anything, his opinons (which we cite no less that 11 times in this article!) should be taken with a grain of salt and probably cut back significantly in order to comply with WP:WEIGHT. -- Levine2112 discuss 09:07, 20 December 2008 (UTC)
- The reviews for neck pain and whiplash are not uniformly positive. As the text notes, of three systematic reviews of SM published between 2000 and May 2005, only one reached a positive conclusion, and the most-reliable review studied, the Cochrane 2004 review, found that SM and mobilization were not of demonstrable effectiveness by themselves, only when combined with exercise (and there was no evidence that the combination was any better than exercise alone).
- Ernst is not the only one who is saying this sort of thing. We also have the chiropractors Nelson et al. 2005, who say that the credibility of chiropractic manipulation for treatment of non-spinal conditions is debatable:
- Nelson CF, Lawrence DJ, Triano JJ; et al. (2005). "Chiropractic as spine care: a model for the profession". Chiropr Osteopat. 13: 9. doi:10.1186/1746-1340-13-9. PMID 16000175.
Points of contention are the credibility of clinical claims for effectiveness of chiropractic manipulation for a variety of non-spinal conditions
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: Explicit use of et al. in:|author=
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- Nelson CF, Lawrence DJ, Triano JJ; et al. (2005). "Chiropractic as spine care: a model for the profession". Chiropr Osteopat. 13: 9. doi:10.1186/1746-1340-13-9. PMID 16000175.
- We also have the chiropractors Vernon & Humphreys 2007, who also conclude that reviews and guidelines disagree for neck pain:
- Vernon H, Humphreys BK (2007). "Manual therapy for neck pain: an overview of randomized clinical trials and systematic reviews" (PDF). Eura Medicophys. 43 (1): 91–118. PMID 17369783.
At present, there is no overall consensus on the status of MTs [manual therapies] for neck pain.
- Vernon H, Humphreys BK (2007). "Manual therapy for neck pain: an overview of randomized clinical trials and systematic reviews" (PDF). Eura Medicophys. 43 (1): 91–118. PMID 17369783.
- In other words, this is not just Ernst. It is the standard consensus, not only among mainstream science and medicine, but also among mainstream chiropractic. Ernst just happens to be the current leading published expert on the effectiveness of chiropractic treatment, so he's the best guy to quote.
- Eubulides (talk) 03:47, 21 December 2008 (UTC)
- Chiropractic is more than adjusting. . . the other treatments mentioned. . . mobilization, supervised exercise, low-level laser therapy and perhaps acupuncture (though I personally do not employ it in my practice. . . I know some who do). . . these are all part of chiropractic. . . not to mention nutritional counseling, stress management, massage. . . it is like you are wanted to write off chiropractic's effectiveness based on manipulation alone when chiropractic encompasses much more.TheDoctorIsIn (talk) 21:34, 21 December 2008 (UTC)
- Yes, chiropractic is more than adjusting. But the cited source is talking about all of chiropractic care, and (rightly) focuses on adjusting (or spinal manipulation, SM), the core treatment of chiropractic. No reliable source does things differently: they all focus on SM. We need to follow what the reliable sources say. Eubulides (talk) 20:48, 23 December 2008 (UTC)
- Chiropractic is more than adjusting. . . the other treatments mentioned. . . mobilization, supervised exercise, low-level laser therapy and perhaps acupuncture (though I personally do not employ it in my practice. . . I know some who do). . . these are all part of chiropractic. . . not to mention nutritional counseling, stress management, massage. . . it is like you are wanted to write off chiropractic's effectiveness based on manipulation alone when chiropractic encompasses much more.TheDoctorIsIn (talk) 21:34, 21 December 2008 (UTC)
My reading of this. . . Levine's right on. . . we cannot say "collectively" because we are creating the collection and then making an evaluation. . . an entirely original one. Ernst is not an authoritative source and certainly a very vocal critic. . . giving his opinion to represent the scientific opinion is wrong. Obviously from just the reviews we have in this article, chiropractic has demonstrated effectiveness for more conditions than back pain.TheDoctorIsIn (talk) 01:39, 21 December 2008 (UTC)
- There must be some confusion here. We are not saying "collectively", nor are "we creating the collection". We are citing a reliable source by an expert in the field, Ernst 2008 (PMID 18280103), who discusses systematic reviews on chiropractic and says (p. 8) "Collectively, their results fail to demonstrate that spinal manipulation is effective. The only possible exception is back pain." Ernst has more recent refereeed publications in the area of the effectiveness of chiropractic treatments than anybody else does, and is certainly an authoritative source. No reliable sources have been presented to the contrary. We should not be substituting our own conclusions for his, nor should we be suppressing or downplaying them. Eubulides (talk) 03:47, 21 December 2008 (UTC)
- We could solve this by accurately quoting and attributing this to Ernst, which will give readers an excellent opportunity to check out his reputation as an authoritative source on alternative medicine in general, and chiropractic in particular. Here are two versions:
- 1. After analyzing all the systematic reviews on spinal manipulation, Ernst summed up the results in this way: "Collectively, their results fail to demonstrate that spinal manipulation is effective. The only possible exception is back pain."
- 2. Ernst has summed up his analysis of all the systematic reviews on spinal manipulation in this way: "Collectively, their results fail to demonstrate that spinal manipulation is effective. The only possible exception is back pain."
- I am certainly not opposed to attribution of that kind, but I certainly don't think that it belongs in the lead either way. It's still "one guy's opinion" which our own article seems to show is without merit. Further, I really see what TDII and DigitalC are getting at - chiropractic is more than spinal manipulation. The lead should really concentrate on the topic at hand: chiropractic. Then, if we want to go into the specifics of the efficacy of each treatment which chiropractic generally advocates and employs, we can do that in the Efficacy section. Overall though, attribution could be a helpful way to settle this debate, but I don't think that it is proper to do so in the lead as it would be giving Ernst - who is already cited at least 11 times in this article! - far too much weight. -- Levine2112 discuss 02:57, 23 December 2008 (UTC)
Ernst has known biases. . . relying on his opinion alone is wrong. . . especially in the presence of conflicting opinions.TheDoctorIsIn (talk) 21:34, 21 December 2008 (UTC)
- Who doesn't have known biases? Show me a person without biases and I'll show you a person who has no opinions worth listening to. He knows his biases (not the same as prejudices), and that's a big advantage for everyone. They have been formed by the evidence, rather than him attempting to manipulate the evidence to justify his biases. His biases were initially (as a practitioner of alternative medicine: homeopathy, spinal manipulation, etc.) favorable to altmed, and he took his professorship as an opportunity to scientifically validate those methods. Much to his consternation he found the evidence just wasn't there, and his department has continued to study and research many alternative medicine subjects. That is the only honest thing to do. His biases are to compare those methods with the available scientific evidence. Not a bad thing for his department to be doing. -- Fyslee (talk) 02:44, 23 December 2008 (UTC)
- Edzard Ernst is the most vocal critic of Chiropractic, and some of his criticisms fail the stink test. We would clearly be failing WP:NPOV to be introducing only Ernst's point of view in the lead. 118.208.203.78 (talk) 02:59, 23 December 2008 (UTC)
- Agreed. I think it is already a WP:WEIGHT violation citing Ernst the 11 times we do in the article currently. Given his opinion any more prominence may require us to retitle this article to "Chiropractic according to Edzard Ernst" and that would most surely be a POV fork indeed. -- Levine2112 discuss 08:40, 23 December 2008 (UTC)
- Please provide evidence of so-called bias or a vocal critic of chiropractic. No evidence of bias has been presented. Please show and not assert your view. Ernst does a lot of research in this area. Being a researcher does not equal bias. Claiming Ernst is bias without presenting any evidence is unhelpful. QuackGuru (talk) 18:57, 23 December 2008 (UTC)
- Chiropractic, Reply, William C. Meeker, DC, MPH, and Scott Haldeman, DC, PhD, MD, FRCP, 15 October 2002, Volume 137, Issue 8, Page 702. Exceprt: The charge of bias cuts in many directions, as Dr. Ernst is well aware.
- Please provide evidence of so-called bias or a vocal critic of chiropractic. No evidence of bias has been presented. Please show and not assert your view. Ernst does a lot of research in this area. Being a researcher does not equal bias. Claiming Ernst is bias without presenting any evidence is unhelpful. QuackGuru (talk) 18:57, 23 December 2008 (UTC)
- Agreed. I think it is already a WP:WEIGHT violation citing Ernst the 11 times we do in the article currently. Given his opinion any more prominence may require us to retitle this article to "Chiropractic according to Edzard Ernst" and that would most surely be a POV fork indeed. -- Levine2112 discuss 08:40, 23 December 2008 (UTC)
- Edzard Ernst is the most vocal critic of Chiropractic, and some of his criticisms fail the stink test. We would clearly be failing WP:NPOV to be introducing only Ernst's point of view in the lead. 118.208.203.78 (talk) 02:59, 23 December 2008 (UTC)
- Ernst Fails to Address Key Charges, Joseph Morley, Anthony L. Rosner, Daniel Redwood. The Journal of Alternative and Complementary Medicine. April 1, 2001, 7(2): 127-128. Excerpt: Professor Ernst fails to address directly some of the most serious examples we cited as evidence of apparent bias and academic misconduct.
- Profession Responds Quickly to Negative U.K. Study on Spinal Manipulation, Dynamic Chiropractic, May 22, 2006. Excerpt: The biases in this study are painfully apparent, rendering the sweepingly negative "findings" little more than the authors' personal opinions.
- New Zealand College of Chiropractic response to "Dr Who?" editorial, Kelly, B. New Zealand Medical Journal, 22 August 2008, Vol 121, No 1280. Excerpt: ...Ernst, a former specialist in physical medicine and rehabilitation who has long demonstrated extreme bias against chiropractic...
- So, I'm not asserting that Ernst is biased. These sources from the research community are making this assertion. Whether he is or not is not the issue. The issue is whether we should be given any more prominence to the opinion of an accused biased author whom we have already cited no less than 11 times in our article here. His opinion is clearly not the authoritative one, so presenting as though it were in the lead certainly creates an even greater WP:WEIGHT violation. -- Levine2112 discuss 19:19, 23 December 2008 (UTC)
- Those are opinions. No evidence of bias of the research has been given. I don't see any specific bias of Ernst's research. Anyone can have an opinion of Ernst's research. The links above show there is commentary about Ernst and not a bias by Ernst. On Wikipedia, we edit according to the references presented. QuackGuru (talk) 19:29, 23 December 2008 (UTC)
- Please read the references in full. They either give us good reason to present these analyses of Ersnt's opinions or not to operate under the assumption that Ernst's opinions are the authoratative ones. I'd prefer the latter (so this article doesn't devolve into a shit-show). Opinions are opinions, and we have shown Ernst's opinions, we have shown Ernst's opinions contradicted by other pieces of research, and we have shown that some find Ernst's opinions to be biased. That said, you can no longer credibly state that "No evidence of bias of the research has been given" when clearly evidence has now been given just above. Whether you agree with these pieces of evidence is entirely up to you. But neither your agreement nor mine is consequential in the writing of this article. -- Levine2112 discuss 19:59, 23 December 2008 (UTC)
- No evidence that Ernst's research is bias has been presented. If an editor thinks Ernst is bias that is there personal opinion but on Wikipedia we edit according to policy. Please ses WP:RS. Ernst passes the RS test with flying colors. QuackGuru (talk) 20:08, 23 December 2008 (UTC)
- Without doubt, the research of Ernst presented in this article currently are all reliable sources, per WP:RS. No one is making a claim that they are not. However, just the same, all of the research currently presented in the article are also reliable sources. Some of that research contradicts Ernst's opinion: "Collectively, their results fail to demonstrate that spinal manipulation is effective. The only possible exception is back pain." As such, we should not present this opinion of Ernst's in the lead as though it were the authoritative view. That's how we edit according to policy; WP:NPOV to be precise.
- No evidence that Ernst's research is bias has been presented. If an editor thinks Ernst is bias that is there personal opinion but on Wikipedia we edit according to policy. Please ses WP:RS. Ernst passes the RS test with flying colors. QuackGuru (talk) 20:08, 23 December 2008 (UTC)
- Please read the references in full. They either give us good reason to present these analyses of Ersnt's opinions or not to operate under the assumption that Ernst's opinions are the authoratative ones. I'd prefer the latter (so this article doesn't devolve into a shit-show). Opinions are opinions, and we have shown Ernst's opinions, we have shown Ernst's opinions contradicted by other pieces of research, and we have shown that some find Ernst's opinions to be biased. That said, you can no longer credibly state that "No evidence of bias of the research has been given" when clearly evidence has now been given just above. Whether you agree with these pieces of evidence is entirely up to you. But neither your agreement nor mine is consequential in the writing of this article. -- Levine2112 discuss 19:59, 23 December 2008 (UTC)
- Those are opinions. No evidence of bias of the research has been given. I don't see any specific bias of Ernst's research. Anyone can have an opinion of Ernst's research. The links above show there is commentary about Ernst and not a bias by Ernst. On Wikipedia, we edit according to the references presented. QuackGuru (talk) 19:29, 23 December 2008 (UTC)
- Your continued claim that "No evidence that Ernst's research is bias has been presented," is patently and obviously false. One only needs to looked over the four reference presented above. Each presents evidence that Ernst's chiropractic/spinal manipulation research is biased. Whether you agree with that this evidence is credible is entirely up to you and inconsequential at Wikipedia. So saying that no evidence has been presented is not a credible point any longer. If you'd like to admit that evidence has in fact been presented, that would be a wonderfully positive thing to do. Then again, if you wish to continue to assert that the evidence does not exist, then please know that I will now ignore your statements to that effect. Thanks. -- Levine2112 discuss 20:22, 23 December 2008 (UTC)
- Just review my response below. I never said that Ersnt is patently false. Please reread my comments above. All I am saying is that his belief that chiropractic is only maybe beneficial for just low back pain is contradicting by sources such as as Cochrane which asserts that a chiropractic prescription (SM, mobilization, exercise) may also be beneficial for neck disorders. This seemingly contradicts Ernst's statement. As such, Ernst's opinion is not necessarily representative of current mainstream thinking, which would mean that Ernst's opinion should not be presented as an authoritative and definite statement of chiropractic. Rather, if used at all, it should be attributed and thus presented as an opinion. -- Levine2112 discuss 20:52, 23 December 2008 (UTC)
[unindent] You just need to read the conclusions of the Cochrane reviews to see exactly what the effectiveness is for each condition. Some of the reviews, such as those done by chiropractors, I would take with a pinch of salt. Clearly they are going to paint their treatment in a more favourable light than independent reviewers. Take headache for example (PMID 15266458). Cochrane concludes that although there is some evidence that SM may be effective for headaches, "The clinical effectiveness and cost-effectiveness of non-invasive physical treatments require further research using scientifically rigorous methods. The heterogeneity of the studies included in this review means that the results of a few additional high-quality trials in the future could easily change the conclusions of our review." So if you don't like Ernst (and I'm not entirely happy with him myself) you can just combine the conclusions of the Cochrane reviews to get a NPOV summary of the effectiveness. --sciencewatcher (talk) 20:11, 23 December 2008 (UTC)
- We should also include the conclusions of the other reviews as well in our attempt to summarize a statement for the lead. For instance, " a 2004 Cochrane review found that SM and mobilization are beneficial only when combined with exercise, the benefits being pain relief, functional improvement, and global perceived effect for subacute/chronic mechanical neck disorder." So here we have Cochrane saying that the chiropractic prescription (SM, mobilization and excercise) are beneficial for pain relief, functionality and global perceived effect of mechanical neck disorders. This is the kind of evidence which would contradict the Ernst-only statement in the lead, where he asserts chiropractic is only maybe beneficial for back pain. -- Levine2112 discuss 20:28, 23 December 2008 (UTC)
- The 2004 Cochrane review (Gross et al. 2004, PMID 14974063) did not find any benefit to spinal manipulation alone. It could be that all the benefit was due to exercise. Of course we cannot mention that possibility in the lead (that's OR); but neither can we highlight this review in the lead, over and above all the other reviews on the subject.
- There are dozens of systematic reviews on treatments used by chiropractors. We cannot summarize them all in the lead; there's not enough room. We cannot pick and choose between them; that's synthesis. What we can do, and what the proposed text does, is to summarize a peer-reviewed synthesis of all these reviews, a synthesis that is mainstream opinion.
- It shouldn't be too surprising that the chiropractic community reacts strongly against Ernst, who has presented critical evaluations of the field. However, Ernst remains the leading published researcher on the topic of chiropractic effectiveness, which is the reason we cite him so often. His opinion is an important part of the mainstream, and we should not exclude citations to him from the lead merely because chiropractors object to his work.
- Again, no reliable sources have been presented that dispute this particular claim by Ernst, which is a mainstream opinion.
- We have often disputed whether to include Ernst, with supporters of chiropractic strongly opposed to citing Ernst; the above comments merely repeat stuff that we've seen before. I don't sense that any editor in this discussion is in the "gathering evidence" phase. It may well be that mediation is the best way to proceed here.
- Eubulides (talk) 20:48, 23 December 2008 (UTC)
- Exercise is part of the chiropractic prescription. So whether is was the spinal manipulation, the mobilization, the exercise or some combination, it goes to support the efficacy of chiropractic (the subject of this article) in the treatment of neck disorders. This contradicts Ernst's claim. We are not disputing whether or not to include Ernst, only whether or not to give him as much prominence as we currently do. Eleven citations to any researcher is a lot for any one article, let alone one who has been contradicted by other reliable sources, and consistently accused of professional bias. -- Levine2112 discuss 20:55, 23 December 2008 (UTC)
- Exercise is not always part of the chiropractic prescription. Ernst's citation is not contradicted by other reliable sources. No evidence of professional bias has been given. An opinion of Ernst is not evidence of any bias. QuackGuru (talk) 21:20, 23 December 2008 (UTC)
- The proposed change has been added to the article. Please see Talk:Chiropractic#Comments on lead improvements. QuackGuru (talk) 19:09, 24 December 2008 (UTC)
- Exercise is not always part of the chiropractic prescription. Ernst's citation is not contradicted by other reliable sources. No evidence of professional bias has been given. An opinion of Ernst is not evidence of any bias. QuackGuru (talk) 21:20, 23 December 2008 (UTC)
- Exercise is part of the chiropractic prescription. So whether is was the spinal manipulation, the mobilization, the exercise or some combination, it goes to support the efficacy of chiropractic (the subject of this article) in the treatment of neck disorders. This contradicts Ernst's claim. We are not disputing whether or not to include Ernst, only whether or not to give him as much prominence as we currently do. Eleven citations to any researcher is a lot for any one article, let alone one who has been contradicted by other reliable sources, and consistently accused of professional bias. -- Levine2112 discuss 20:55, 23 December 2008 (UTC)
Lead improvements
For most of its existence, chiropractic has battled with mainstream medicine, sustained by ideas such as subluxation[3] that are not based on solid science.[1] Vaccination remains controversial among chiropractors.[4] The American Medical Association called chiropractic an "unscientific cult"[5] and boycotted it until losing a 1987 antitrust case.[6] Chiropractic has had a strong political base and sustained demand for services; in recent decades, it has gained more legitimacy and greater acceptance among medical physicians and health plans,[6] and evidence-based medicine has been used to review research studies and generate practice guidelines.[7] Many studies of treatments used by chiropractors have been conducted, with conflicting results. Collectively, systematic reviews of this research have not demonstrated that spinal manipulation is effective, with the possible exception of back pain.[1] The efficacy and cost-effectiveness of maintenance chiropractic care are unknown.[8] Although spinal manipulation can have serious complications in rare cases,[9][10] chiropractic care is generally safe when employed skillfully and appropriately.[11]
Comments on lead improvements
In order to reach WP:GA status we should improve the lead. This is mandated under WP:LEAD which says: The lead should be able to stand alone as a concise overview of the article. QuackGuru 19:14, 15 December 2008 (UTC)
- I agree the lead needs improving, particularly the vague part. However, the above text is identical to the text proposed in #Alternative idea for 3rd paragraph. I don't see the point of repeating the same proposal here: that would merely lead to duplication of comments. Let's continue the discussion above instead of restarting it here. Eubulides (talk) 19:41, 15 December 2008 (UTC)
- The talk page is too long. I think we should archive all the other discussions about the lead and put a summary of the discussion here. We can also provide links to the archive of the old discussions if they were archived. This proposal is slightly different. It uses the word antitrust instead of the phrase that is hard to understand. It is better to be concise. QuackGuru 19:48, 15 December 2008 (UTC)
- Sorry, I didn't see that wording change. I suggest replacing "antitrust court decision" with "antitrust case"; that's shorter and to the point, and the wikilink to United States antitrust law will help explain things. As described in #Opinions differ above, I also suggest expanding "Chiropractic spinal manipulation has not been shown to be effective for any medical condition with the possible exception of back pain;[1]". Here's a suggested rewording: "Many studies of treatments used by chiropractors have been conducted, with conflicting results. Collectively, systematic reviews of this research have not demonstrated that spinal manipulation is effective, with the possible exception of back pain. These reviews usually cover treatments independent of profession, and thus do not evaluate chiropractic in isolation.[1]" Eubulides (talk) 20:09, 15 December 2008 (UTC)
- I made this change to the proposed text. This is concise and in accordance with WP:LEAD. QuackGuru 20:35, 15 December 2008 (UTC)
- I don't think that this version is an improvement of the current lead in place in the article. This does a worse job at accurately summarizing the body of the article and seems to be focusing only on the negative POV. I'd say that this lead fails WP:LEAD, WP:POVPUSH and most notably WP:NPOV. What is wrong with the current lead? It seems to do a fine job of accurately summarizing the article in a more neutral way than the version suggested above. The current lead is able to stand alone as a concise overview of the article. So, what's the issue. Can the current lead not stand alone right now? If you think so, please specify why. Is the current lead not a concise overview of the article? If you think so, again please specify why. Please be SPECIFIC. For instance, I've read the efficacy section - and "opinions differ" seems to be a very concise and accurate way to describe the efficacy of chiropractic for various conditions. I see some research which says it is effective for such-and-such and I see some research which says it is not effective for such-and-such; hence, "opinions differ". -- Levine2112 discuss 01:11, 16 December 2008 (UTC)
- I made this change to the proposed text. This is concise and in accordance with WP:LEAD. QuackGuru 20:35, 15 December 2008 (UTC)
i don't care for this new lead very much. . . it seems to be pushing the negative.TheDoctorIsIn (talk) 07:32, 16 December 2008 (UTC)
- Please see my followup comments in #Vague tag above. Eubulides (talk) 07:59, 16 December 2008 (UTC)
- I made this change to fix the vagueness in the lead. The lead should be a concise overview and a reflection of the article. QuackGuru (talk) 19:05, 24 December 2008 (UTC)
- While I'm in favor of that change overall, it did more than just fix the vagueness in the lead; it also shortened the 1st sentence in the paragraph and added a new sentence about the AMA's opposition. It's better to not combine changes like this, particularly in this controversial area where no consensus has been reached. We have seen some opposition to all those changes, in one form or another; I think it would be better to consider those two sets of changes separately rather than all together. Also, given that discussion has been going around in circles about these changes, it'd probably be better to take this up in mediation. Eubulides (talk) 20:13, 24 December 2008 (UTC)
- I made this change to fix the vagueness in the lead. The lead should be a concise overview and a reflection of the article. QuackGuru (talk) 19:05, 24 December 2008 (UTC)
- I support this change and consensus is growing for a lead that properly summarizes the article. See WP:CCC. One of the arguments against improving the lead is that Ernst is a vocal critic which is false. Ernst is a leading researcher of chiropractic. The references added to the lead support the newly added text. The history section should be summarized in the lead. The AMA thingy is notable part of history and belongs in the lead. Editors should remember that the lead is a summary of the article and per WP:LEAD, should stand alone. Opinions differ is way too vague. QuackGuru (talk) 19:41, 25 December 2008 (UTC)
Hypertension study
Here's a relatively new study which implies a link between hypertension and upper cervical manipulation as performed by chiropractors: Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients, Journal of Human Hypertension (2007). According to ABC News, this study suggests that a specific type of neck adjustment may reduce hypertension. And according to WebMD, this placebo-controlled study suggests that a special chiropractic adjustment can significantly lower high blood pressure. The lead researcher, George Bakris, MD director of the University of Chicago hypertension center states, "This procedure has the effect of not one, but two blood-pressure medications given in combination. And it seems to be adverse-event free. We saw no side effects and no problems." This study is published in a respected peer-reviewed journal and it is well-documented by third-party news sources. I'd like to see it incorporated into the Efficacy section somehow. -- Levine2112 discuss 18:39, 17 December 2008 (UTC)
- How come they say it is "double blind" if they don't actually check to see if the patients were successfully blinded? It's well established that sham chiropractic procedures are generally distinguishable from the actual procedure by patients. Also, because the clinician is aware of which procedure the patient is getting then surely it is single-blind and not double-blind? It is a reliable journal, so I must just have missed something. --sciencewatcher (talk) 19:03, 17 December 2008 (UTC)
- I don't think it is "well established" that sham manual procedures are generally distinguisable from actual manual procedures, and I don't think one could use conclusions from one sham technique to discuss another sham technique.
- The study discusses in depth how the patients we sufficiently blinded. Yes, the journal is reliable and the lead research, Bakris, is kind of giant in the field. He has three board certifications, is the editor of another major scientific journal, and sits on the review board of several others. This study is just that - a study. It is not a review. No review of these kinds of studies exist yet - or I am unaware of any. That said, when we include this material, we should cite commentary such as this one which qualifies the findings with:
- In conclusion, the study by Bakris et al. provides new interesting information on the favourable blood pressure lowering effects of microvascular decompression caused by chiropractic procedure. Before recommending this therapeutic strategy in the current clinical practice, however, it seems reasonable to wait for the results of large-scale clinical trials aimed at defining the long-term effects of the intention on clinic and ambulatory blood pressure as well as on some surrogate end points, such as cardiac and vascular target organ damage.
- Sound reasonable? If so, let's work on the actual text to insert. -- Levine2112 discuss 19:43, 17 December 2008 (UTC)
- Sorry, but you haven't answered my questions. I read through the full text of the study, including the info about blinding, and nowhere did it mention any survey of patients asking which procedure they thought they had had. Without such a survey the study is pretty much worthless. And why did they call it "double blind" when it is clearly and obviously single blind? As you say, it appears to be a respected peer-reviewed journal so I must be missing something here. Someone please point out my errors or misunderstanding... And as Eubulides says below, we really shouldn't be quoting primary sources for effectiveness anyway. --sciencewatcher (talk) 20:48, 17 December 2008 (UTC)
- Your question about blinding aren't relevant to inclusion or exclusion on WP. We don't use original research to determine the quality of study before including it (otherwise we wouldn't be including many of the Ernst studies), although you may want to see my OR on this study below. They may not have done a post-sham survey because this was only a pilot study. As Eubulides explained below, it was double blinded in that both the patient and the person evaluating the blood pressure were blinded. DigitalC (talk) 00:07, 18 December 2008 (UTC)
- By "double blinding" I expect that they mean that both the patients and the followup evaluators were blinded (although it is weird that they don't explicitly say this about the evaluators in their "Post-intervention assessment" section). The chiropractor administering the treatment obviously was not blinded. I agree that they should have surveyed patients as to which procedure they thought they had. Also, as per Hancock et al. 2006 there may well be questions whether the sham treatment was actually a sham. But of course our opinions of this pilot study count for far less than a peer-reviewed published expert review would. Eubulides (talk) 22:31, 17 December 2008 (UTC)
- Your question about blinding aren't relevant to inclusion or exclusion on WP. We don't use original research to determine the quality of study before including it (otherwise we wouldn't be including many of the Ernst studies), although you may want to see my OR on this study below. They may not have done a post-sham survey because this was only a pilot study. As Eubulides explained below, it was double blinded in that both the patient and the person evaluating the blood pressure were blinded. DigitalC (talk) 00:07, 18 December 2008 (UTC)
- Sorry, but you haven't answered my questions. I read through the full text of the study, including the info about blinding, and nowhere did it mention any survey of patients asking which procedure they thought they had had. Without such a survey the study is pretty much worthless. And why did they call it "double blind" when it is clearly and obviously single blind? As you say, it appears to be a respected peer-reviewed journal so I must be missing something here. Someone please point out my errors or misunderstanding... And as Eubulides says below, we really shouldn't be quoting primary sources for effectiveness anyway. --sciencewatcher (talk) 20:48, 17 December 2008 (UTC)
- Claims that chiropractic treatment are effective against high blood pressure (hypertension) have been reported in the literature for many years; see, for example Plaugher & Bachman 1993 (PMID 8263434) and Beck et al. 2003 (PMID 12754366). Claims to the contrary have also been presented. I've also seen a case report of chiropractic neck adjustment causing (unintended) lower blood pressure, leading to paralysis of eye muscles (which, luckily for that patient, eventually turned out to be temporary); see Kurbanyan & Lessel 2008 (PMID 18156388).
- However, I'd like to remind editors (again) that as per WP:MEDRS we should be using reliable reviews to source medical claims like this, rather than dipping directly into primary studies such as the above, as primary studies are individually not all that reliable.
- As it happens, we are already citing a review (Hawk et al. 2007, PMID 17604553) which surveys 10 primary studies on the subject and says (p. 498) that "chiropractic care is not of great clinical utility to a broad population of hypertensive patients". Hawk et al. did not review this new study (as it's too new) but I am skeptical that this one extra study would have significantly changed their conclusions.
- To summarize all this I suggest we add "high blood pressure" to the list of conditions in the penultimate sentence of Chiropractic #Effectiveness, which summarizes Hawk et al. Here's what the resulting sentence would look like:
- "A 2007 systematic review found that few studies of chiropractic care for nonmusculoskeletal conditions are available, and they are typically not of high quality; it also found that the entire clinical encounter of chiropractic care (as opposed to just SM) provides benefit to patients with asthma, cervicogenic dizziness, and baby colic, and that the evidence from reviews is negative, or too weak to draw conclusions, for a wide variety of other nonmusculoskeletal conditions, including ADHD/learning disabilities, dizziness, high blood pressure, and vision conditions.[12]"
- Eubulides (talk) 20:42, 17 December 2008 (UTC)
- Perhaps we should append some of this information to your proposed addition to the lead, such as "it also found that the entire clinical encounter of chiropractic care (as opposed to just SM) provides benefit to patients with asthma, cervicogenic dizziness, and baby colic, and that the evidence from reviews is negative, or too weak to draw conclusions, for a wide variety of other nonmusculoskeletal conditions." DigitalC (talk) 00:48, 18 December 2008 (UTC)
- I don't think we can put such a blanket statement into the lead. Let's take asthma for an example. The claim that chiropractic is beneficial for asthma is not well-supported by reliable sources. Chiropractic already mentions Hondras et al. 2005 (PMID 15846609), a Cochrane review that concluded there's insufficient evidence that manual therapy benefits asthma; this is by far the most-authoritative review of the subject. As for the entire context of clinical care, there's also Markham & Wilkinson 2004 (PMID 15115165), Bielory et al. 2004 (PMID 15603200), also with negative results. Emphasizing Hawk et al. 2007 (PMID 17604553) by putting it into the lead, while ignoring the Cochrane review and others, would not be presenting mainstream opinion fairly. The situation for dizziness and colic is similar. Part of the problem here is that Hawk et al. rely heavily on low-quality studies (case reports, for example), which as we know are prone to publication bias, whereas the Cochrane reviews and others insist more strongly on high-quality evidence. Eubulides (talk) 17:22, 18 December 2008 (UTC)
- It is a statement that is already in the article, and supported by a reliable source. We shouldn't be second guessing the sources here. You are comparing apples to oranges when stating that "Hondras et al. 2005 (PMID 15846609), a Cochrane review that concluded there's insufficient evidence that manual therapy benefits asthma". The review we have ISN'T talking about manual therapy - it is talking about the entire Chiropractic clinical encounter. Please note that not all Chiropractic treatment is manual therapy - (eg: Ultrasound, IFC, LLLT, advise to stay active, nutrtiional counselling, ergonomic advice, exercise prescription, etc. etc.). Again, we don't conduct OR to determine the quality of the study, and the studies that Hawk et. al used are irrelevant to our use of Hawk et al. in the lead. This is coming off as a POV-push. 118.208.203.78 (talk) 22:30, 19 December 2008 (UTC)
- What we have in the article are two reliable sources which disagree, and one is more reliable than the other. Hawk et al. 2007 (PMID 17604553) base their asthma-related claims entirely on studies involving manipulation, not necessarily chiropractic manipulation (one study was osteopathic), so it is apples-to-apples in terms of what is being studied. The main difference is that Hawk et al. have much lower quality standards, and accept individual case reports as evidence, whereas the Cochrane review (Hondras et al. 2005, PMID 15846609) insists on high-quality trials. We certainly can discuss the reliability of sources here, on the talk page, and by any reasonable standard the Cochrane review is higher quality than Hawk et al. It would greatly misrepresent the state of affairs to summarize in the lead only the claims of Hawk et al., the less-reliable source here. Eubulides (talk) 00:55, 20 December 2008 (UTC)
- One is more reliable than the other? According to whom? Original research much?TheDoctorIsIn (talk) 01:41, 21 December 2008 (UTC)
- It's common knowledge that Cochrane reviews are generally of high quality; see WP:MEDRS #Use up-to-date evidence and WP:MEDRS #Search, for example. In this particular case the difference is striking: Hawk et al. spends a relatively small amount of space on asthma, and relies on low-quality evidence, whereas Hondras et al. focuses entirely on asthma and does not rely on low-quality evidence. Eubulides (talk) 03:47, 21 December 2008 (UTC)
- One is more reliable than the other? According to whom? Original research much?TheDoctorIsIn (talk) 01:41, 21 December 2008 (UTC)
- What we have in the article are two reliable sources which disagree, and one is more reliable than the other. Hawk et al. 2007 (PMID 17604553) base their asthma-related claims entirely on studies involving manipulation, not necessarily chiropractic manipulation (one study was osteopathic), so it is apples-to-apples in terms of what is being studied. The main difference is that Hawk et al. have much lower quality standards, and accept individual case reports as evidence, whereas the Cochrane review (Hondras et al. 2005, PMID 15846609) insists on high-quality trials. We certainly can discuss the reliability of sources here, on the talk page, and by any reasonable standard the Cochrane review is higher quality than Hawk et al. It would greatly misrepresent the state of affairs to summarize in the lead only the claims of Hawk et al., the less-reliable source here. Eubulides (talk) 00:55, 20 December 2008 (UTC)
- It is a statement that is already in the article, and supported by a reliable source. We shouldn't be second guessing the sources here. You are comparing apples to oranges when stating that "Hondras et al. 2005 (PMID 15846609), a Cochrane review that concluded there's insufficient evidence that manual therapy benefits asthma". The review we have ISN'T talking about manual therapy - it is talking about the entire Chiropractic clinical encounter. Please note that not all Chiropractic treatment is manual therapy - (eg: Ultrasound, IFC, LLLT, advise to stay active, nutrtiional counselling, ergonomic advice, exercise prescription, etc. etc.). Again, we don't conduct OR to determine the quality of the study, and the studies that Hawk et. al used are irrelevant to our use of Hawk et al. in the lead. This is coming off as a POV-push. 118.208.203.78 (talk) 22:30, 19 December 2008 (UTC)
- I don't think we can put such a blanket statement into the lead. Let's take asthma for an example. The claim that chiropractic is beneficial for asthma is not well-supported by reliable sources. Chiropractic already mentions Hondras et al. 2005 (PMID 15846609), a Cochrane review that concluded there's insufficient evidence that manual therapy benefits asthma; this is by far the most-authoritative review of the subject. As for the entire context of clinical care, there's also Markham & Wilkinson 2004 (PMID 15115165), Bielory et al. 2004 (PMID 15603200), also with negative results. Emphasizing Hawk et al. 2007 (PMID 17604553) by putting it into the lead, while ignoring the Cochrane review and others, would not be presenting mainstream opinion fairly. The situation for dizziness and colic is similar. Part of the problem here is that Hawk et al. rely heavily on low-quality studies (case reports, for example), which as we know are prone to publication bias, whereas the Cochrane reviews and others insist more strongly on high-quality evidence. Eubulides (talk) 17:22, 18 December 2008 (UTC)
- Perhaps we should append some of this information to your proposed addition to the lead, such as "it also found that the entire clinical encounter of chiropractic care (as opposed to just SM) provides benefit to patients with asthma, cervicogenic dizziness, and baby colic, and that the evidence from reviews is negative, or too weak to draw conclusions, for a wide variety of other nonmusculoskeletal conditions." DigitalC (talk) 00:48, 18 December 2008 (UTC)
- Its an interesting problem, in that per WP:NPOV/WP:UNDUE, we should mention something about this study, as it has received a LOT of press coverage (unfortunately, IMHO). However, as Eubulides states above, we shouldn't include it per WP:MEDRS. When it comes to OR, I think this study is flawed in its basic design, and not due to blinding concerns outlined by Sciencewatcher. I would like to see the research on the construct validity (correct term?) of supine leg length checks for determining atlas "mal-alignment". If that study was a wikipedia article, I would be dropping [citation needed] tags through its introduction section. Perhaps I need to go and read the studies they have cited, but I certainly don't follow their conclusions in the introduction section such as "Thus, alterations in Atlas anatomy can generate changes in the vertebral circulation that may be associated with elevated levels of BP.". I don't think we should be citing pilot studies in the article no matter what, and it would be best to see if a review of this article with the other research on SM for BP comes forward. DigitalC (talk) 23:59, 17 December 2008 (UTC)
- Okay. Then let's wait. In general though, WP:MEDRS does not prohibit us from using primary research as sources; it just recommends the use of reviews if available. Here is a case where no review on the subject is available. -- Levine2112 discuss 23:02, 18 December 2008 (UTC)
- I agree that we should wait. Particularly in this case, where a review on the subject is available. But even if no review were available, we should be quite leery of mentioning individual studies that make extraordinary claims. Eubulides (talk) 00:36, 19 December 2008 (UTC)
- I made this change to add high blood pressure using an existing reference currently in the article. See WP:MEDRS. QuackGuru (talk) 21:33, 23 December 2008 (UTC)
- I agree that we should wait. Particularly in this case, where a review on the subject is available. But even if no review were available, we should be quite leery of mentioning individual studies that make extraordinary claims. Eubulides (talk) 00:36, 19 December 2008 (UTC)
- Okay. Then let's wait. In general though, WP:MEDRS does not prohibit us from using primary research as sources; it just recommends the use of reviews if available. Here is a case where no review on the subject is available. -- Levine2112 discuss 23:02, 18 December 2008 (UTC)
Chiropractic management of low back pain
There is a new study on low back pain. QuackGuru (talk) 20:20, 23 December 2008 (UTC)
- This is a wonderful piece of research. Thank you for sharing it. This is a nice review of literature and can certainly be incorporated into the "Low back pain" subsection of the Efficacy portion of our article. Any suggested wording? -- Levine2112 discuss 20:39, 23 December 2008 (UTC)
- Done. Chiropractic #Effectiveness already cites that study, once under the low-back-pain bullet and once under "other". I wrote that several months ago. Eubulides (talk) 20:48, 23 December 2008 (UTC)
- Yes. I see it now. Thanks. -- Levine2112 discuss 20:59, 23 December 2008 (UTC)
- Done. Chiropractic #Effectiveness already cites that study, once under the low-back-pain bullet and once under "other". I wrote that several months ago. Eubulides (talk) 20:48, 23 December 2008 (UTC)
Simon Singh to put chiropractic on trial in UK
We should probably mention this here in this article. Some sources for reading:
The original BCA brochure: http://www.chiropractic-uk.co.uk/gfx/uploads/textbox/Happy%20families.pdf
April 2008 - Simon Singh's "Comment is Free" piece in the Guardian (removed from Guardian site, but here hosted on a Russian server!): http://svetlana14s.narod.ru/Simon_Singhs_silenced_paper.html
August 2008 - The news of the claim: http://www.telegraph.co.uk/news/newstopics/mandrake/2570744/Doctors-take-Simon-Singh-to-court.html
August 2008 onwards - Material on the web summarised at: http://holfordwatch.info/2008/08/16/british-chiropractors-join-the-legal-intimidation-party/
November 2008 - Summary of BCA's Legal Claim: http://jackofkent.blogspot.com/2008/11/on-bcas-case-against-simon-singh.html
November 2008 - Summary of Simon Singh's Defence: http://jackofkent.blogspot.com/2008/11/on-putting-chiropractic-on-trial.html
November 2008 - Article on the influential Quackometer site: http://www.quackometer.net/blog/2008/11/chiropractic-folly-and-nature-of.html
And on the Blog of philosopher Stephen Law: http://stephenlaw.blogspot.com/2008/11/simon-sigh-sued-by-british-chiropractic.html
December 2008 - Case features in Private Eye.
December 2008 - Useful round up on Dr Aust's site: http://draust.wordpress.com/2008/12/23/it%E2%80%99s-quiet%E2%80%A6-too-quiet/
December 2008 - And strong support from Phil Plait of Bad Astronomy: http://blogs.discovermagazine.com/badastronomy/2008/12/24/uk-quackery-on-trial/
ScienceApologist (talk) 20:42, 24 December 2008 (UTC)
- While this topic is clearly notable, it's not clear that it is important enough to mention a merit in Chiropractic itself. The most important trial in the history of chiropractic (namely the 1906 Morikubo trial) isn't mentioned in Chiropractic; why should the far less important Singh case be mentioned? I suggest adding this material to Chiropractic history instead; or (if there's enough text) you could create a new article for it, perhaps using Wilk v. American Medical Association as a model. Please keep WP:Recentism in mind when this is done. Eubulides (talk) 21:35, 24 December 2008 (UTC)
Edit warring and arbitration restrictions
I am confident that everyone here is aware that edit warring is not acceptable practice on Wikipedia. Despite repeated warnings, article protection and special Arbitration restrictions, some editors seem to be unwilling or unable to modify their problematic behavior. In order to avoid this persistent disruption to the article and to editors who are willing to edit collaboratively, from this point there will be no additional warnings issued. Any further actions deemed by an uninvolved administrator to be edit warring will be met with either a block or article ban.
Due to the holidays, I will wait a day or two to ensure everyone has read this notice before unlocking the article. Shell babelfish 08:35, 26 December 2008 (UTC)
- This is just a method for the POV-pushing group to get their way. I give up on this article, let the cruft stay. This is precisely what is wrong with Wikipedia. The anti-science crowd gets these restrictions placed, which allows them to push their fringe theories. Seriously, I'm not going to waste energy on this cruft-ridden article. Eubilides and Quackguru apparently have more energy and patience than I do. Good luck to them. OrangeMarlin Talk• Contributions 15:26, 26 December 2008 (UTC)
- It would help if the actions that Shell considers disruptive were explicitly pointed out so that we could discuss what about them was "disruptive". I see two edits that markedly improved the article followed by reverts by users who, it has been pointed out for months, have obvious pro-alt-medicine agendas. The typical pattern is that a proposal is made, it is rejected for vague and sometimes truly disingenuous reasons by the pro-alt-med crowd, the others try to discuss around their disruption, the change is imposed, and the pro-alt-med crowd reverts claiming "no consensus". How can we reach consensus when their is such a tacit ignorance of the discussion? We cannot. It is simply not fair that the pro-alt-med group get away with this tactic.
- To that end, I do not think it fair when users who are observing the article who are not in the pro-alt-med camp and who are respected Wikipedians who take the time to carefully consider the situation try to undo the actions of the pro-alt-med crowd are lumped together with them. What has happened is that the pro-alt-med crowd have found a loophole: since they can unilaterally "block" consensus on any issue the claim will be constantly made "edit warring happened on both sides". It seems to me that when User:Hughgr reverted, he should have immediately been reverted back and blocked. That was the disruptive action and no administrator took any action against him. He got away with it, so it was only natural that User:Levine2112 would act similarly. We are lacking an effective and swift administrative response to the disruption happening at this article.
- Let me propose the following: when someone plans on making an edit, they discuss it first on the talk page. QG did this. The normal means of "consensus" are simply not possible with the tactics employed by the pro-alt-med camp, so we need to take their objections (and object they ALWAYS do) with the appropriate grain of salt. Sometimes they will have valuable input, but because WP:CON has been so abused at this page, they are simply used to disagreeing with every proposal made that is not their own. This sort of obstructionism should be ignored. After a reasonable length of time (and in my view, QG left a reasonable length of time), the edit, if there are no substantive objections, should be in-placed.
- If the pro-alt-med crowd really feel strongly that the edit should be reverted, the onus should now be on them to start a discussion of it on the talkpage. A new discussion that is separate from the last discussion that spells out clearly the reasons they want to revert. Then they should be required to find a third opinion: an outside editor not in the pro-alt-med crowd to support them. If it is a truly good reason someone who isn't famous for their support of chiropractic should support it. A similar process of discussion should commence and if consensus is formed, a revert should happen. However, I believe that the person with the third-opinion should be the one reverting: not the pro-alt-med crowd.
- If that process is taken seriously then we will find an end to the tired problems on this page. Anyone not following this procedure should be blocked immediately.
- That's my proposal.
- ScienceApologist (talk) 15:58, 26 December 2008 (UTC)
- Your proposal doesn't spell out clearly in what situations it would apply. The controversial template already requests discussion on the talk page before editing. It's normal per BRD for new material to be reverted until there is sufficient discussion. We need to try to find real consensus, but if after a period of time that doesn't succeed, compromise or rough consensus can apply. ☺Coppertwig(talk) 18:17, 26 December 2008 (UTC)
- ScienceApologist (talk) 15:58, 26 December 2008 (UTC)
- I oppose your approach, Shell. Think of something else that does not put tendentious editors on equal footing with editors who are trying to create quality content. Jehochman Talk 18:19, 26 December 2008 (UTC)
If everyone is done telling me what a horrible idea it is to enforce the arbitration restrictions already in place, perhaps we could talk about what this really means. ;) The point of "no more warnings" is to stop the tendentious editors who have already been warned repeatedly yet still hamper both the development of the article and other editors who are working in good faith. Please try to assume that I'm not advocating blocking folks willy-nilly here and that administrators helping out at this page do have some sense.
In regards to points that ScienceApologist made: This is exactly what is meant to stop. The blind reverting is spectacularly unhelpful as is the inability of some editors to put the stick down and back away from the horse. Clearly in this case, sock/meat puppets were used to continue reverting and give appearances of a larger group disputing the change that in reality, received no substantive argument on the talk page. This warning is meant to inform editors using such tactics that if this happens again, their sock/meat puppets will be blocked without further discussion and they will get a break from editing this page.
Coppertwig: There is always a place for BRD, however, that is not what happened here this time, nor any of the other times this article needed to be locked to stop reverting warring. This warning is not a request to throw out common sense and normal editorial processes, but instead strictly about revert warring and the use of sock/meat puppets to assert ownership on article content. Many editors here are using the talk page to discuss changes first because they know their edits will be immediately reverted, sometimes even when talk page discussion already exists.
Jehochman: If I were simply going to block anyone who ever reverted or changed the page, I can understand your concern. As I've said though, I'm not advocating some sort of "zero-tolerance" policy or tossing out judgment and common sense. Perhaps it would have been helpful if I'd been more specific about who I was warning and what would have happened in this situation. In this particular case, Hughgr and the two IP addresses would have received short blocks; Levine would have received a page ban. In essence, I (and I hope other uninvolved administrators) would like to take a harder line against tendentious editing since repeated warnings aren't resolving the problem. Shell babelfish 21:38, 26 December 2008 (UTC)
- Very good. As long as we understand that all reverts are not equal. If somebody is reverting damage to the encyclopedia, we should help them by applying sanctions to those who caused the damage. If somebody is violating WP:NPOV, WP:NOR, or WP:MEAT by performing reverts, they need to be stopped. We're going to stop the revert wars, but we do not do so blindly. Jehochman Talk 21:56, 26 December 2008 (UTC)
Two changes to the lead
In response to the recent edit war I have started a new section Talk:Chiropractic/Mediation #Two changes to the lead. Eubulides (talk) 10:06, 26 December 2008 (UTC)
References
Please keep this section at the bottom. TO ADD A NEW SECTION, just click the EDIT link at the right and add the new section ABOVE this one. Then copy the heading into the edit summary box.
(The following resolve otherwise-dangling references: [5] [1] [6] [3] [4] [7] [2] [8] [9] [10] [11] )
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