Talk:Chiropractic

Fix for CAM claim

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

• Chiropractic (from Greek chiro- χειρο- "hand-" + praktikós πρακτικός "concerned with action") is a complementary and alternative medicine health care profession that focuses on diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system and their effects on the nervous system and general health, with special emphasis on the spine. Chiropractic is generally considered to be complementary and alternative medicine, a characterization most chiropractors dispute.
• Complementary and alternative medicine (CAM) pPractitioners such as chiropractors are often used as a complementary form of care to primary medical intervention.
• like acupuncture, herbal medicine, and other forms of complementary and alternative medicine, chiropractic became more integrated into mainstream medicine

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

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

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

I don't think that chiropractic being a "health care profession" is disputed. -- Levine2112 ^discuss 21:40, 29 July 2008 (UTC)

Good point. "Health care profession" is an opinion that is not disputed by reliable sources. Since this proposal is not using the "Simon says" style, there is no need to remove the "health care profession" phrase from the lead. I restored it. Thanks for catching that. Eubulides (talk) 22:02, 29 July 2008 (UTC)

Why the deletion of "CAM" and "alternative" when most altmed, chiropractic, and official government sources use those categorizations? This (study) particular example of the opinions of some chiropractors about themselves is irrelevant in this regard, especially when it's based on only one study. Even if it were based on thousands of such studies, it would only serve as documentation for some chiropractors' self-opinion, in contrast to the rest of published sources. Many chiropractors maintain their aversion to being identified with mainstream medicine and they are proud of being an alternative to the big, bad, pharma controlled, drug using, MD cartel. This article is not to be written exclusively from the chiropractic perspective, since that would be an NPOV violation. This study is the only place where the identification of chiropractic as CAM and altmed is disputed, including here among editors, so why change this longstanding consensus version? If it's not broken, don't fix it. -- Fyslee / talk 04:05, 30 July 2008 (UTC)

• I agree that the article should not be written exclusively from the chiropractic perspective. But we can't ignore the chiropractic perspective either.
• I also agree that from the mainstream viewpoint, chiropractic is CAM. However, it's indisputable that "chiropractic is CAM" is controversial among chiropractors themselves. We can easily find other reliable-among-chiropractic sources to confirm this point. Here's one: "Is Chiropractic Part of CAM? The answer to this question depends on one's perspective. Chiropractic opinion is divided. Most others in the health care system, as evidenced by current policies of the US National Institutes of Health, the European Parliament in its adoption of the 1997 Lannoye Report, and the World Health Organization in its current strategies on traditional medicine and CAM, clearly see chiropractic as part of CAM." Chapman-Smith DA, Cleveland CS III (2005). "International status, standards, and education of the chiropractic profession". In Haldeman S, Dagenais S, Budgell B et al. (eds.) (ed.). Principles and Practice of Chiropractic (3rd ed. ed.). McGraw-Hill. pp. 111–134. ISBN 0-07-137534-1. {{cite book}}: |edition= has extra text (help); |editor= has generic name (help)CS1 maint: multiple names: editors list (link)
• How about if we simply mention this dispute in the lead, emphasizing the mainstream view? I've changed the draft change to the lead, to do that.

Eubulides (talk) 07:16, 30 July 2008 (UTC)

That change looks good. The dispute is about the current classifications of the profession as a form of CAM (both within and outside the profession), and the wish by many DCs to be accepted as mainstream, but even that survey showed that more of them would prefer to be classified as IM, IOW as that part of CAM that is working with the mainstream without actually being mainstream. They wish to maintain a "separate but equal" status. -- Fyslee / talk 17:30, 2 August 2008 (UTC)

No further comment, so I made the change. Eubulides (talk) 16:06, 9 August 2008 (UTC)

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

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

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

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

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

Gentlemen, I have to applaud the changes in the article. The 'complementary and alternative medicine healthcare profession' all strung together bothered me for a long time.Including the Redwood study results is good. The Greek in the box is much prettier, too. Is the article NPOV yet? --—CynRN ^(Talk) 06:17, 17 August 2008 (UTC)

I have problems with this edit. The previous version without the one study attribution was better. The article is close to NPOV. There are still a few problems left such as unnecessary attribution in the Evidence basis section. Also the lead does not explain the type of ideas. An editor added text to the reference section but not to the text of the article to explain about the ideas. QuackGuru 18:10, 17 August 2008 (UTC)

1. Your diff is old. It's been changed.

2. As to "unecessary attribution", is it this wording you are referring to: "what chiropractic commentators"? If so, it needs to be attributed to avoid violating NPOV.

3. As to "type of ideas", the text does mention the only specific idea in the source, which is "subluxation (Gatterman 1995; Leach 1994)", a no brainer. It is obviously the biggest source of debate within and about the profession.

4. The "anti-scientific and pseudo-scientific ideas (Keating 1997b)" aren't specified in the source we use, but may be in the original (Chiropractic: science and antiscience and pseudoscience, side by side. Skeptical Inquirer 1997b (July/Aug); 21(4): 37-43). That might be worth a check, since he might get more specific there. Of course there are other anti-scientific and pseudo-scientific ideas than subluxation in chiropractic, and Keating and others have criticized them, but we can't ask Keating what he was referring to in this source since he is no longer with us, honored be his name.

There are no doubt other sources that could add specifics to that section, and we could then use them to get specific without any synth violation. We could also use those words and attribute and just source them to Keating, but I understand you have objections to that, so apparentlty it's being left out until you stop objecting. Or maybe I haven't been following the discussion carefully enough. Maybe we are discussing two different areas in the article that both use the word "anti-scientific" (with or without the dash.) -- Fyslee / talk 19:48, 17 August 2008 (UTC)

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

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

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

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

He writes:

"After thirteen years of teaching and research at several chiropractic colleges, I can say with confidence that chiropractic is both science and antiscience. Yes, there is a meaningful science of chiropractic, but just as surely there is an antiscientific mindset and even a cult within chiropractic (for example, the cult of B. J. Palmer, son of the founder of chiropractic). Moreover, if University of Connecticut sociologist Walter Wardwell is correct (Wardwell 1992), the belief systems of a majority of DCs lie somewhere between these two poles: chiropractic as science versus chiropractic as unscientific, uncritical dogma and circus. Perhaps a consideration of the nature of science will aid in understanding how the chiropractic profession does and does not approximate the rigors of science."

"In recent years this combination of uncritical rationalism and uncritical empiricism has been bolstered by the proliferation of pseudoscience journals of chiropractic wherein poor quality research and exuberant overinterpretation of results masquerade as science and provide false confidence about the value of various chiropractic techniques. These periodicals expand on the uncritical attitudes and unproven claims for chiropractic that have long been made in the magazines published by the national membership societies of chiropractors in the United States. It is practically impossible to read any of the trade publications within chiropractic without encountering unsubstantiated claims."

"Coexisting with the obvious and ubiquitous antiscientific and pseudoscientific reasoning and rhetoric in chiropractic (Skrabanek 1988) are the genuinely critical, skeptical attitudes of the still quite embryonic research community in this profession."

"The conflict between medical doctors and DCs has also produced a penchant for marketing slogans in lieu of scientifically testable propositions. The classic example of this is the mindless reiteration that "chiropractic works," a vacuous claim which lacks specificity and is not amenable to experimental testing. However, confronted by charges that chiropractic is quackery, chiropractors have responded by insisting that "Chiropractic Works!" and have rallied satisfied patients to convince legislators and policy makers of the validity of their methods and the justness of their cause. Slogans like this are endlessly repeated not only to the public, but among DCs themselves (and to chiropractic students). To challenge the notion that "chiropractic works" is considered heresy in most corners of the profession. Rather than skepticism and critical thinking, traditional chiropractic education has sought to instill strong belief in chiropractic (Quigley 1981) among successive generations of students. In so doing the schools have strengthened the "anti-intellectual" (Coulter 1990) traditions in the profession."

-- Joseph C. Keating, Jr, PhD Chiropractic: science and antiscience and pseudoscience side by side

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

Antiscientific: suggested wording of sentence

Suggested wording: "Evidence-based guidelines" are supported by one end of an ideological continuum among chiropractors; the other end employs a priori assertions without scientific substantiation in what commentators about chiropractic describe as an "antiscientific" stand." Please comment. ☺ Coppertwig (talk) 02:15, 5 August 2008 (UTC)

That sounds very good. Speaking of a priori assertions, here's an interesting critical comment about them:

• “The whole concept of Innate of course rests on accepting on faith the basic premises without hope of any concrete proof. From a strictly scientific viewpoint, Innate must be rejected out of hand because it fails the most fundamental requirement of science, namely testability. From the standpoint of logic, the whole concept of Innate depends on the logical fallacy called word magic. Giving names and definitions to unprovable spiritual entities like Innate and soul cannot guarantee their existence.”
• From: Subluxation – the silent killer - Ronald Carter, DC, MA, Past President, Canadian Chiropractic Association, quoting from: Wardwell W. Chiropractic: History and Evolution of a New Profession. St. Louis: Mosby Year Book, 1992:29.

While that quote doesn't use the exact term "unscientific", it comes as close as is possible and certainly describes it. -- Fyslee / talk 06:28, 5 August 2008 (UTC)

Thanks. Ah: "unscientific", yes, I agree that that quote is saying that. But not what I would call "antiscientific". "Unscientific" to me means scientific reasoning is not being used. "Antiscientific" to me means they believe scientific reasoning should not be used: it may be a much smaller fringe who believe that. And I'm not sure I agree with the first sentence of the quote. You might as well say "The use of the word 'instinct' implies that scientific proof will not be used, therefore behavioural psychologists are unscientific;" that would be false, in my opinion. ☺ Coppertwig (talk) 12:05, 5 August 2008 (UTC)

Ugh! My bad. Of course unscientific and antiscientific aren't the same thing. I just lost track of the exact thread here. Consider it just another bit of information. "Unscientific" is a word that would be supported by far more RS. -- Fyslee / talk 13:44, 5 August 2008 (UTC)

That was 1992. We shouldn't confuse the lack of RCTs as being unscientific. Case studies were used a lot in those days and were acceptable first steps in the scientific process even in medicine in the previous decades. That eventually led to scholarly interest in spinal manipulation and then the subsequent RCTs which have been extensive since. So what is unscientific or antiscientific about that? The next step is to design studies to address the next hypothesis that spinal dysfunction can cause other health issues. This is more difficult, of course, and expensive, but they in the works now that the financing is coming (slowly). What is unscientific or antiscientific about that? The only thing that the "other end" of chiropractic has done is identify that there are flaws in studies that do not consider all the variables that are involved in any vital system, or should I say complex emergent system. I think that is called skepticism. I suppose there are those that believe that there is some sort of Intelligent Design involved, but that is not limited to chiropractors, nor is it an anti-intellectual position to hold, or anti-science (though unscientific might apply?). Keating: "We would not reject psychiatry as science on the grounds that Freud's theories of anxiety, repression, or the unconscious have not been adequately tested. We do not reject the meaningfulness of a science of medicine on the grounds that most medical procedures have not been experimentally validated. Nor should we apply such standards to chiropractic as a determiner of its scientific viability." -- Dēmatt (chat) 15:56, 5 August 2008 (UTC)

I don't think the lack of RCTs is the major issue here. You'll have to take up your dispute with Carter and the other chiropractors mentioned in the article, who in 1992 (and already much earlier), based on the current data at the time and the obvious pseudoscientific nature of some traditional metaphysical chiropractic beliefs ((IOW evidence wasn't an issue and basically could (almost...;-) never be an issue in such cases)), were already criticizing the profession for not listening to the existing evidence and not attempting to catch up with it. Osteopathy had done that many years before, but chiropractic hadn't done it at the time, and still hasn't (unlike Osteopathic medicine) officially distanced itself from those original foundational beliefs. What is happening is a gradual slide towards science, but done in such a manner as to not wake too much notice. It would be damaging for the profession to openly admit it had been based on a fictive belief, and had been warned for a long time, but hadn't heeded the warnings. It's as if there is a hope that mainstream medicine won't notice the history, and will just accept a newer version "scientific" of chiropractic, without the majority of older (and younger) chiropractors being forced to give up their old beliefs. Division is seen as harmful to the profession. Maybe when enough of the old guard are gone from their leadership positions it will happen, but I really doubt it. -- Fyslee / talk 20:25, 5 August 2008 (UTC)

I don't think the lack of RCTs is the major issue here. I guess your right, otherwise half of medicine would be called pseudoscience. I think that is really the point here afterall; that mainstream is slowly moving toward chiropractic just as chiropractic is moving toward a more scientific explanation of what they do. The issue is whether chiropractic is a safe and effective way to treat patients as compared to the alternative which would be drugs or surgery. The super straights are definitely being dragged into mainstream, but they don't seem to want to give up their beliefs. The question is whether they have to (or should)? I guess that is why we need to make sure to remain NPOV. We need to make sure both (all) POVs are stated fairly without taking sides. If one side uses pejoratives, that is their choice, but wikipedians should recognize it as just that. We should explain that POV without the pejoratives. It's not that hard. If I wanted to call someone a "bastard", I could probably convince more to my side if I said that that person "stole my wife". Then he could either call me a "dick" or explain that I "wasn't paying attention to her." Then the reader could decide for themselves by wieght of the arguments. -- Dēmatt (chat) 15:33, 6 August 2008 (UTC)

Coppertwig, do any of the sources explicitly draw a relationship between Evidence based guidelines and the use of antiscientific reasoning. I have been looking and can't put the two together, I find that both sides have guidelines, but they disagree with each other. This is the web site for one side CCGPP and this is a powerpoint review of the straight's guideline process CCP. They both look reasonable. Keating's antiscience comment was made from the CCGPP group talking about the CCP group. -- Dēmatt (chat) 16:16, 5 August 2008 (UTC)

No, I didn't see any of the sources mentioning evidence-based guidelines in that context. I didn't write the first half of the sentence: I just copied what was there. Maybe the first half of the sentence needs to be reworded. The quotes I collected were focussed on the second half of the sentence and the "antiscientific" idea. Now we need to collect quotes about the scientific end. ☺ Coppertwig (talk) 12:48, 8 August 2008 (UTC)

That sounds reasonable. Yes, I think your version is an improvement over what is in there now. I still want to look at the EBM part of that sentence and then want to look at the "antiscientists" POV. -- Dēmatt (chat) 13:13, 8 August 2008 (UTC)

Thanks, Dematt. Well, if I'm subtracting correctly it's been over 3 days, and no one has objected ^{(17:14, 9 August 2008 (UTC))} to replacing what's there now with my suggestion at the top of this section, so I'm going ahead. We can continue to work on improving it; I think this version is better and meets the objection that it wasn't only Keating that said something like that. ☺ Coppertwig (talk) 13:20, 8 August 2008 (UTC)

There was an objection.[1] The current text has been watered down even more and it is hard to understand. The prior version only had the misleading text about only one researcher. The new text is worse. QuackGuru 17:54, 8 August 2008 (UTC)

Dear QuackGuru, I apologize for saying there was no objection and have struck out some of my words. I knew you didn't like the new text, but I also knew you didn't like the prior version. I'm sorry that I didn't understand that you thought the new text was worse. Thank you for your patience and calm manner in correcting my error. Here's another suggestion; I'm not sure if some aspects of this version have already been objected to by other editors or not; I welcome comments: ""Evidence-based guidelines" are supported by one end of an ideological continuum among chiropractors; the other end uses what chiropractic commentators describe as unsubstantiated claims and "antiscientific" reasoning." ☺ Coppertwig (talk) 17:14, 9 August 2008 (UTC)

We are discussing this matter.[2] The problems with the current text is worse than the previous text. The above proposal is readable. Here is a quick suggestion. Revert back to the previous version and focus only on improving the misleading part claiming it was only Keating. Just rewrite the Keating part and not the entire sentence. There is one thing missing from all of theses proposals by Coppertwig. There is the middle of the spectrum. QuackGuru 17:30, 9 August 2008 (UTC)

Thank you, QuackGuru. I had essentially done what you just suggested, though without actually reverting the article: I had gone back to the previous version and modified it to get the suggestion above. It seems to me that you're indicating that that last suggestion is better than the current or previous version. We need to wait for comments from others before putting it into the article; meanwhile feel free to suggest other versions. OK, maybe we need to say something about the middle. Do we have enough quotes from sources for that? Would you like to suggest some words about the middle? Also, the "evidence-based" end still needs work. ☺ Coppertwig (talk) 18:37, 9 August 2008 (UTC)

Here's a version; I think the only problem is that the sentence is now too long! "An idealogical continuum among chiropractors stretches from support for "evidence-based guidelines" at one end, through such principles as vitalism, holism and rationalism, to the use of what chiropractic commentators describe as unsubstantiated claims and "antiscientific" reasoning: a system of belief which commentators have called "ethically suspect" when practitioners' beliefs are to patients' detriment." ☺ Coppertwig (talk) 22:40, 10 August 2008 (UTC)

All this attribution is making the sentence longer. It would be easier to read if we left out the attribution. The reference is the attribtution anyhow. I don't understand the reason for having the quote marks. The text is verified. I think we can remove the quote marks. QuackGuru 02:44, 11 August 2008 (UTC)

Characterizing a subset of chiropractors as "antiscientific" sounds like an opinion to me, not a fact. If it's a fact, then it's not just a word, but something about the real world that can be expressed in different words. What do you think it means? Perhaps it could be stated, without prose attribution, in different terms which would seem to have a NPOV tone. I think "antiscientific" has multiple meanings, some of which are not accurate descriptions of the subset of chiropractors being talked about. ☺ Coppertwig (talk) 23:13, 13 August 2008 (UTC)

"Antiscientific" is the most common word used by reliable sources to refer to this phenomenon; we shouldn't shy away from the word, or insist on putting it in quote marks, simply because some Wikipedia editors think it's unpleasant. In Chiropractic the word "antiscientific" has its usual meaning, as described in Antiscientific: it describes a position that is critical of science and the scientific method. What other meanings did you have in mind? Eubulides (talk) 18:37, 14 August 2008 (UTC)

I thought Gleng had referred to more than one definition. In any case, if we can establish that chiropractors from that end of the spectrum refer to themselves as "antiscientific", then it can be considered NPOV terminology; otherwise, it's an opinion expressed by outside commentators.

Here's a suggested version with shorter sentences: "Chiropractic ideology stretches along a continuum. At one end is support for "evidence-based guidelines". Many types of principles, such as holism and naturalism, are found in the middle of the spectrum. The other end uses what chiropractic commentators describe as antiscientific reasoning and unsubstantiated claims; commentators have called this system of belief "ethically suspect" when practitioners' beliefs are to patients' detriment." ☺ Coppertwig (talk) 02:41, 15 August 2008 (UTC)

• It is bizarre to quote a phrase like "evidence-based guidelines". What's next? Why not quote "profession" and "diagnosis" while we're at it? Why not put quote marks into Chiropractic's lead sentence so that it ends up something like the following?

Chiropractic is a health care "profession" that focuses on "diagnosis", "treatment", and "prevention" of mechanical "disorders" of the musculoskeletal system and their "effects" on the nervous system and "general health", with special "emphasis" on the spine.

These questions are not entirely rhetorical: I fail to see any rhyme or reason to the overquoting being proposed. If the rule really is "If some editor thinks someone disagrees with a claim, then put the claim in quote marks." then large chunks of Chiropractic will eventually be quoted, which is silly. If the rule is something else, then I honestly don't know what it is.

• It is not at all necessary to 'establish that chiropractors from that end of the spectrum refer to themselves as "antiscientific"'. It is not our job to worry about the sensibility of fringe practitioners. It is not the job of someone proposing text to prove that it's NPOV; if that were the case, no text could ever be added to Wikipedia.
• All that is necessary is to use terminology used by reliable mainstream consensus sources. "Antiscientific" and "evidence-based guidelines" and "ethically suspect" are part of the mainstream consensus, and Chiropractic is inaccurately presenting the consensus when it puts quote marks around those phrases, just as it would be inaccurate if Chiropractic quoted terms like "profession" and "diagnosis" in the lead sentence.
• To get to the suggested wording: like Chiropractic, that version suffers from the problem that it incorrectly suggests that holism and naturalism are common in the middle of the spectrum but rare at the ends. On the contrary, holism is shared by most chiropractors of all persuasion.
• Furthermore, holism and naturalism are not that relevant in the context of the sentence, which is talking about evidence-based guidelines, their opponents, and proponents. (The current wording also shares this problem.)
• Furthermore, the proposed wording fits even worse into the context, which is talking about evidence-based medicine and guidelines.
• Furthermore, like the current wording, the suggested wording incorrectly talks about "a system of belief". The sources don't say that antiscientific reasoning and unsubstantiated claims are "a system of belief". They say that Palmer's Postulates are a system of belief, but that's quite a different thing.
• Furthermore, like the current wording, the suggested wording talks about "when practitioners' beliefs are to patients' detriment", which doesn't accurately summarize what the source actually says (namely, "when they allow the practitioner to maintain a 'faith, confidence and belief' in that paradigm to the patient's ultimate detriment").
• In short, the recent rewording has made this passage substantially worse: it has caused the passage to stray from the sources, and has introduced material that doesn't belong in a section on evidence basis.
• With all the above in mind, I suggest the following wording instead:

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

Eubulides (talk) 09:27, 15 August 2008 (UTC)

Whether it is fact or opinion is rather irrelevant. We include both as long as they are well-sourced. Unless it is basic and incontrovertible common knowledge, it needs attribution since Wikipedia is not about truth, but about well-sourced facts and opinions. -- Fyslee / talk 06:37, 15 August 2008 (UTC)

I agree that opinions and facts need sourcing; I disagree that the use of terms like "antiscientific" or "ethically suspect" requires quote marks or in-text attributions when the opinions containing those terms are not controversial (which they are not, among reliable sources). Eubulides (talk) 09:27, 15 August 2008 (UTC)

I don't like seeing too many individual words being in quotes. I'd rather see the whole sentence or sentences, which we can do under fair use, and we do all the time here at Wikipedia. There is no rule against it if done properly. We can sometimes abbreviate the quotes by ..... out the superfluous parts, leaving only the point we are trying to bring out in that section.

There are at least two reasons for using the quotes, one of which is reasonable, and the other a compromise because of editorial disputes if we don't. NPOV demands that we ensure that readers don't mistake what is written for editorial opinion. It must be clear it is the opinion of a source. That's not necessary when it's incontrovertible common knowledge. Unfortunately chiropractic patients, many chiropractors, and certain editors here consider obvious facts (to the mainstream) to be controversial, so we need to do it for them. This is also educational. That compromise also helps to defuse edit wars. Yes, it's a compromise, but the article needs to be written "from" all POV, and "to" all POV. Such a compromise won't hurt anything. -- Fyslee / talk 20:06, 15 August 2008 (UTC)

If the sources are using the Wikipedia definition of "antiscientific", then we can paraphrase it: "the other end is critical of science and the scientific method".

Here's an argument that "antiscientific" is not neutral in tone: One test for whether something is neutral in tone is whether it's used by people on both sides of a controversy. I argue that it's rare or nonexistent for anyone to characterize their own position as "antiscientific", and to support that: "unscientific" has 50 times as many Google hits as "antiscientific", but the two-word combination "our unscientific" has about 2000 times as many Google hits as "our antiscientific", and the 4 hits for the latter are all things like "our antiscientific opponents", i.e. are not about people calling their own views antiscientific. Similarly, "unsubstantiated claims" is not neutral in tone. I can see someone saying "what I'm saying is not supported by scientific evidence," but not likely "I'm making an unsubstantiated claim". "Claim" is listed in WP:Words to avoid.

Putting quote marks around something can't be "inaccurate" if the phrase is a correct quote.

By the way, I support this edit which inserts a prose attribution elsewhere: good NPOV edit, Eubulides. For the continuum sentence we're working on: actually, I'm OK with leaving off the quotation marks as such, as long as the prose attributions are there (e.g. "what commentators describe as..."). Again: NPOV requires a neutral tone, and that Wikipedia doesn't assert opinions.

I suggest the following, which I think addresses some of Eubulides' points: Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end uses what chiropractic commentators describe as unsubstantiated claims and antiscientific reasoning, which commentators have called "ethically suspect when they allow the practitioner to maintain a 'faith, confidence and belief' in that paradigm to the patient's ultimate detriment"." Or alternatively, "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end uses what chiropractic commentators describe as unsubstantiated claims and antiscientific reasoning, which commentators have called ethically suspect when they let practitioners maintain their beliefs to patients' detriment.", which includes wording you had put in, Eubulides, for the ethics part, although I added prose attribution. ☺ Coppertwig (talk) 03:30, 16 August 2008 (UTC)

Let me start with a preliminary comment. Your closing wording seems pretty good, at least on a quick read through, and my further comments here should be taken as separate comments about your other remarks.

I feel that several straw men are being introduced.

• You write: "NPOV requires a neutral tone, and that Wikipedia doesn't assert opinions." Whatever it is you may mean, NPOV doesn't require that all content be neutral in tone. On the contrary. Yes, "'antiscientific' is not neutral in tone." So what? The tone of the authors should be preserved. We as editors should be neutral in our tone. We should not introduce our opinions and twistings of wordings to neutralize non-neutral sourced wordings. That would be improper editorializing. We should just be true to our sources. If we twist the POV wordings of our sources into something "neutral", we have violated NPOV by introducing editorial bias, IOW we are making "Wikipedia ... assert opinions." If we do that, why use sources? We use them to document that the precise opinions and wordings of the sources actually exist. It is not Wikipedia who is asserting an opinion, it is our sources.
• You also write: "it's rare or nonexistent for anyone to characterize their own position as "antiscientific"" Indeed. That would be expecting a near impossibility, which would be unusual and unreasonable. It's a straw man. We couldn't care less how they characterize "themselves" in this particular setting. We are documenting that critics say it, and that happens all the time. BUT...BUT, in this case chiropractic critics (so much for them not describing themselves as "antiscientific"! Wow! That's amazing) are actually doing that, which makes the case extremely strong. Chiropractors will brush off the accusations of outside critics as further evidence of an AMA conspiracy. It is much harder when it is chiropractic's leading historian, along with a chiropractic university president, a few professors, and some researchers, who are all saying it. THAT must not get lost in our furvor to NPOV everything by editiorially defusing the impact of what these chiropractors are saying about what is going on in their own profession.
• This reminds me of another similar situation, where accusations of quackery have been levelled at the profession since its inception, and promptly denied by the profession. Well, when the president of the American Chiropractic Association tried to claim that such claims were a myth, Keating immediately wrote a heated letter to the editor, in which he directly addressed the deception being perpetrated by the president: "The so-called "quackery myth about chiropractic" is no myth. If anyone doubts the continuity of quackery in the profession, he has only to turn to pages 31 and 35 of the same issue of Dynamic Chiropractic." and "It escapes me entirely how Dr. Downing, the ACA, MPI, and Dynamic Chiropractic can suggest that there is no quackery in chiropractic. Either these groups and individuals do not read the chiropractic literature or have no crap-detectors. I urge a reconsideration of advertising and promotion policies in chiropractic."[3] Note that Keating uses Jarvis of the National Council Against Health Fraud (NCAHF) as a source, since he knew that the NCAHF and Jarvis (it's then-president) were (and are) highly recognized experts on the subject of quackery, and they were correct about chiropractic. Chiropractic was (and is, IMO) filled with quackery. Keating was eulogized with these words: "Keating never varied in championing the good, ridiculing the quackery, and in urging us to explore and empirically test chiropractic."[4]

(Note that these are RS and can be used.) Other sources on this subject: [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16]

BTW, I have used wiki indents instead of your "br" breaks, since this makes it easier to find line breaks, at least for me. I hope you don't mind. It shouldn't make any visible difference.

Please remember that my remarks aren't about your final wording. That would take more study by me before I'd give a final opinion on them. -- Fyslee / talk 07:13, 16 August 2008 (UTC)

It's fine if the word "antiscientific" is there, tone and all, as long as it's with prose attribution. If it were there as a direct Wikipedian assertion, that's when the tone would be a problem. WP:NPOV#Impartial tone says "The tone of Wikipedia articles should be impartial, neither endorsing nor rejecting a particular point of view." With an earlier version that baldly stated that one end of the spectrum was "antiscientific", I found it jarring: I would be reading along, thinking, yes, this sounds like a normal Wikipedia article, and then suddenly, "Hey, what's this doing here? This doesn't sound like Wikipedian tone at all. This sounds like something that's just been added and hasn't been reverted out yet." It's not a disagreement with what's being claimed, only with the way it's stated. Similarly, the word "quackery" is non-neutral in tone. If it's proven or admitted that someone knowingly made false claims, a Wikipedia article can state that the person "knowingly made false claims", but not, in my opinion, that they engaged in "quackery" (without prose attribution) even if it means the same thing: the word "quackery" is generally used only by critics. OK, I'll use indents in preference to line breaks. ☺ Coppertwig (talk) 12:28, 16 August 2008 (UTC)

I think we are basically in agreement. Readers shouldn't be in doubt about who says what, especially about controversial or strong wordings. In this case, we have leading chiropractors and leaders criticizing what they see going on in their own profession. They admit the outside critics are correct and they want to clean chiropractic up and make it acceptable. They know that this type of behavior, which is very traditional, needs to stop. Only then will they be able to get the cultural authority they desire. Another leader who makes the same points is Carter, a former president of the Canadian Chiropractic Association, who replies to a common claim "Subluxation – the silent killer", by showing how claims[17][18] about vertebral subluxations are killing the profession. Of course he is siding with Keating who describes how damaging "chiropractic gobbledygook", "shenanigans", and "outrageous claims" [19] are for the profession. (More RS...!) -- Fyslee / talk 15:09, 16 August 2008 (UTC)

(Handshake.) ☺ Coppertwig (talk) 15:47, 16 August 2008 (UTC)

Antiscientific: suggested rewording 2

Coppertwig's last proposal:

Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end uses what chiropractic commentators describe as unsubstantiated claims and antiscientific reasoning, which commentators have called ethically suspect when they let practitioners maintain their beliefs to patients' detriment.

still has problems.

• It says "commentators" twice, which is overkill.
• In the context where someone is saying something, "commentator" is an empty word. It is the same as saying "someone". It would be better to reword the sentence to avoid this empty word.
• The phrase "chiropractic commentators" isn't accurate, as not all the "commentators" in question are chiropractors. Notably, Keating himself was not a chiropractor. Other non-chiropractor "commentators" have made similar points, e.g., Cooper & McKee 2005 (PMID 12669653), or Giordano in Giordano & Keating 2005 (doi:10.1016/j.jmpt.2004.12.018).
• Perhaps the phrase "chiropractic commentators" was intended to mean "commentators on chiropractic" rather than "commentators who are chiropractors"? If so, the phrase is still empty: in the context of someone making comments it still just means "someone". Either way, the phrase is ambiguous, which is to be avoided.
• Here is a proposed rewrite that addresses the above issues, while (I hope) still addressing the issue of not making the opinion seem to be that of the Wikipedia editors.

Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end uses what are considered unsubstantiated claims and antiscientific reasoning which are ethically suspect when they let practitioners maintain their beliefs to patients' detriment.

Eubulides (talk) 07:28, 17 August 2008 (UTC)

Evidence basis rewrite

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

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

Evidence basis rewrite comments

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

Article length

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

Thanks for taking a look at the problem and commenting on it at Wikipedia:No original research/noticeboard #Chiropractic section on evidence basis. No other outside editor has commented there in the two weeks the notice has been up, and I suspect further comments there are unlikely, so I took the liberty of removing the SYN tag in response to your comments. I agree with you that the relationship between chiropractic and conventional medicine should be clarified; that's another item for the to-do list. Eubulides (talk) 23:15, 13 August 2008 (UTC)

I am going to restore the tag. One outside editor's opinion (especially a new editor) does not justify removing the SYN tag. -- Levine2112 ^discuss 23:17, 13 August 2008 (UTC)

I'm sorry, Levine2112, but given that we've sought an opinion on the NOR/N noticeboard and received one, I have to support the removal of the SYN tag. However, would everyone please stop editwarring about it and discuss it here on the talk page please? Levine2112, in order to keep the tag there, there would have to be a well-defined problem that has a method of solving it. Since we've already gotten an outside opinion, and the editors here are clearly not going to agree to removing all the information about SM as you would prefer, I don't see what solvable problem the tag is intended to address. ☺ Coppertwig (talk) 23:40, 13 August 2008 (UTC)

For argument's sake, let's say another outside editor shows up with an opinion that the tag should stay. Then would the tag be introduced? -- Levine2112 ^discuss 23:50, 13 August 2008 (UTC)

I have no opinion on that question at this time. If it actually happens I may form an opinion considering the specifics of the situation. The focus should be on improving the article, not on whether the tag is present or not. ☺ Coppertwig (talk) 12:53, 14 August 2008 (UTC)

Ethics: fact or opinion?

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

Yes, it needs atribution, and the other POV needs its rebutal statement since we all seem to agree that they are not fringe and therefore need their POV expressed without taking sides. Good luck, though. -- Dēmatt (chat) 15:12, 10 August 2008 (UTC)

Nah, attribution weakens the text and the source. QuackGuru 02:40, 11 August 2008 (UTC)

Our options are attributed opinion, or no opinion. We cannot assert the opinion as a fact. - DigitalC (talk) 23:43, 11 August 2008 (UTC)

Quite correct. We must attribute it. Wikipedia is not about truth, but about well-sourced facts and opinions. -- Fyslee / talk 06:32, 15 August 2008 (UTC)

There is no dispute that opinion must be attributed. The dispute is over what style to use to provide attribution. The Simon-says style, which requires lots of quoting and in-text attribution, is not required in Wikipedia; it's not even typical for Wikipedia. Eubulides (talk) 09:27, 15 August 2008 (UTC)

This isn't an all-or-nothing situation. Simon says style quoting is very typical, is allowed, and is absolutely necessary some of the time. Sure, let's not overdo it, but it shouldn't be forbidden, and the more controversial the subject, the more we need to do it. This article happens to contain some very controversial stuff, so it will contain more than some other articles. That's life. -- Fyslee / talk 20:10, 15 August 2008 (UTC)

I agree it's not all-or-nothing, and that it shouldn't be forbidden. But the current situation in Chiropractic uses Simon-says quote marks only for criticisms of chiropractic. It does not use it for comments supportive of chiropractic. It is clearly POV to insist on Simon-says quote marks only when summarizing one side of the controversy. Eubulides (talk) 07:28, 17 August 2008 (UTC)

That shouldn't be the case. I suspect it has ended up this way because any criticisms are hotly contested at every step. That happened at the Quackwatch and Stephen Barrett articles, with actual attempts to delete the articles because of claims by critics of them not being notable enough! That of course created a demand for better documentation (more RS refs and Simon-says quoting), which resulted in very well-sourced articles and extensive proof of their great notability and acceptance by mainstream RS. That was a big Pyrrhic victory for critics, who have hopefully learned that the mainstream is usually right for a reason, namely because it is right. Challenging mainstream POV ends up costing critics far more than it is worth. The same thing is probably at work here. I don't think it's any deliberate thing, and any preferential treatment should be corrected. Any dubious positive claims should be very well sourced and attributed, and if any claims and wordings are contested, then do the same as we do with critical statements. From a mainstream POV, this is very positive, as RS are generally much more available from mainstream sources than from fringe sources, which often fail V, RS, and NOR requirements. MastCell has written something tangentially related to this subject:

• Look, the fact is that advocates of fringe or minoritarian viewpoints have a tough road to hoe on Wikipedia. This is supposed to be a serious encyclopedia. Serious and respected encyclopedias and reference works are generally expected to provide overviews of scientific topics that are in line with respected scientific thought. Wikipedia aspires to be such a respected work. WP:WEIGHT codifies this. Of course minority or fringe viewpoints can be represented and covered, but advocates who relentlessly push for favorable treatment of widely discredited fringe viewpoints and refuse to bow to any sort of consensus or Wikipedia policy don't last long (or rather, they shouldn't but often do). MastCell ^Talk 00:08, 29 October 2007 (UTC) [20]

-- Fyslee / talk 23:35, 17 August 2008 (UTC)

Simon-says in 2nd sentence

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

2nd paragraph not supported by the source

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

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

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

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

Chiropractic philosophy includes the following perspectives:

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

Simon-says in 1st sentence of lead

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

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

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

That sounds pretty good. One other quibble..... why not move this part (from Greek chiro- χειρο- "hand-" + praktikós πρακτικός "concerned with action") to the footnotes? It makes for difficult reading. I wish we would make that the standard in Wikipedia articles. Many of them suffer from this ugly stuff. -- Fyslee / talk 06:44, 15 August 2008 (UTC)

To help with the quibble I moved the etymology to a quote box. Eubulides (talk) 09:27, 15 August 2008 (UTC)

Beautiful solution! The lead reads much better know. -- Fyslee / talk 20:12, 15 August 2008 (UTC)

Quotations within citations

This change introduced the following quote within a citation:

'Conclusion: The majority (69%) of the chiropractors in this sample rejected being characterized as CAM practitioners, showing some preference for the term IM (27%).'

This quote is slightly incorrect (it doesn't match the source), but more importantly it's not needed. It simply mimicks what is in the main text, which is this:

'A 2008 survey stated that 69% of DC chiropractors disagree with the categorization of chiropractic as CAM, with 27% having some preference for the term "integrated medicine."'

The quote in question is freely readable. This sort of style is not at all needed, and if used consistently would double the length of the article.

It is useful to include quotes at some times, if the source is not freely readable and the point is controversial or obscure. But this isn't one of those cases, so I reverted the change.

Come to think of it, perhaps the use of quote= could overcome our impasse over how to attribute words like "antiscientific" that are controversial to some editors here. Eubulides (talk) 19:30, 16 August 2008 (UTC)

It may be controversial to some editors but it is NOT controversial among reliable sources. We should edit according to the sources. Reference number nine has quotes that should be removed. The text should explain what type of ideas (pseudo-scientific) that are barriers to chiropractic and not in a footnote. QuackGuru 19:39, 16 August 2008 (UTC)

The part about ideas is still vague. Me thinks the reader will be left in the dark about the kind of ideas that are barriers to chiropractic. This should first be explained in the text and not in the footnote. QuackGuru 17:53, 17 August 2008 (UTC)

I don't see inappropiate vagueness here. The text accurately summarizes what the source says; the source gives one example, and the lead does too. The footnote doesn't give any more examples than the source does. (I think the quote in the footnote is unnecessary, but it's not a big deal either way.) This is the lead, after all: it's supposed to briefly summarize the source. The lead shouldn't go into a lot of detail. Eubulides (talk) 21:02, 18 August 2008 (UTC)

"In one study"

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

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

This further set of edits (again, made without discussion in advance) simply makes this worse in this regard. This is the lead! It is not the place to get bogged down in details like that, and to give a misleading summary of the details to boot. I made this change to solve the problem in a much more succinct way (basically, changing "most" to an inarguable "many"). The lead should summarize the body: it shouldn't contain details that are not in the body. Eubulides (talk) 07:28, 17 August 2008 (UTC)

You are reading far more into my qualifier than is implied, and than would necessarily be understood by others. Let's avoid hyperbole here. Just make sure that the impression isn't given that the survey participants consider chiropractic to be mainstream. On the contrary. Only "20% of practitioners and 6% of faculty considered chiropractic mainstream medicine." The study is only one study, with a poor reply rate, covering only part of the profession, the liberal part at that. It is very unrepresentative. It would be improper to extrapolate the results to the whole profession. The "fringe" is not a small percentage and is part of the whole. It has a much greater influence than its numbers would imply. That (degree of "influence") is from a RS. A truly representative survey would have included all schools and types of chiropractors. It is just "one study", which implies nothing more than that one shouldn't put more confidence in it than it is worth. Yes, it "would not overturn the conclusion that most [of the surveyed] chiropractors dispute the characterization of chiropractic as CAM." Yet IM is part of CAM! One can't read more into it than that. Extrapolation would be improper. To balance what's now included, maybe we should include the part that says that only "20% of practitioners and 6% of faculty considered chiropractic mainstream medicine." And that's liberal chiros speaking! That is a staggering minority. -- Fyslee / talk 06:42, 17 August 2008 (UTC)

Thanks for the comment. You've pointed out that it was possible to misread the old version as implying that most chiropractors think chiropractic is mainstream. This was a misreading I hadn't thought of. Does the current version (with "many" instead of "most") sufficiently forestall this problem? Eubulides (talk) 07:28, 17 August 2008 (UTC)

My main point (with adding "one study"), which I didn't make very clearly, is about attribution. "Many" is certainly an improvement. Since this is in the lead, we can't elaborate much, so I suggest that in the second instance where this study is being used as a ref, we include the "20% of practitioners....." part mentioned above. That way no one will misunderstand. -- Fyslee / talk 07:35, 17 August 2008 (UTC)

OK, thanks, then I propose that in Chiropractic #Utilization and satisfaction rates we replace this:

A 2008 survey stated that 69% of DC chiropractors disagree with the categorization of chiropractic as CAM, with 27% having some preference for the term "integrated medicine."

with this:

A 2008 study reported that 31% of surveyed chiropractors categorized chiropractic as CAM, 27% as integrated medicine, and 12% as mainstream medicine.

The "12%" is the combination of the "20%" and "6%" figures you mentioned above (the combination was done by the source, of course). I doubt whether it's necessary for us to break it down into practicing DCs vs. faculty chiropractors. Please notice that I am taking the liberty of proposing other minor changes as well, e.g., normalizing to positive figures like 31% rather than negative ones like 69% (which the source also does, of course), and removing unnecessary quote marks and adding a wikilink to Integrated medicine. Eubulides (talk) 09:16, 17 August 2008 (UTC)

This is looking better. I do suspect a typo above. That 12% should be 26%. I don't have the whole study available. May we get a link to it? The figures above still don't add up: 26% + 31% + 27% ? What is the real breakdown? -- Fyslee / talk 14:28, 17 August 2008 (UTC)

It's not a typo. 6% of the 71 faculty and 20% of the 61 practitioners in the survey considered chiropractic to be mainstream medicine; this averages out to be 12% (the "12%" was computed by the source). Aside from the 31%, 27%, and 12% mentioned in the proposed sentence, the study reported 14% "not CAM" but with no alternative suggested; 7% Any, depending on practitioner; 5% Its own category; 2% Primary care providers; 2% Categorize by level of education; and 2% no opinion. Responses do not total 100% due to "missing values and rounding". The only link I can provide to the article is what is on Chiropractic now; the article is copyrighted and I don't have the rights to reproduce it. Eubulides (talk) 21:02, 18 August 2008 (UTC)

Aha! That explains it. Thanks for the info. -- Fyslee / talk 01:27, 19 August 2008 (UTC)

Treatment techniques now top-level again

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

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

Formatting of quotes

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

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

Any responses on this? If not, I'll proceed as suggested. -- Fyslee / talk 01:29, 19 August 2008 (UTC)

The only extended quote I noticed in Chiropractic was the one in Chiropractic #Vertebral subluxation, which already uses the ":" style, with the extended quote in double-quotes. So I don't see what change you're proposing here. Eubulides (talk) 07:29, 19 August 2008 (UTC)

Holism bullet rewrite

There are some problems with the Holism bullet in Chiropractic #Philosophy:

• It contains words like "appreciates" and "recognizes" that convey approval of the chiropractic worldview; this runs afoul of WP:NPOV.
• It contains two direct quotes from the source, but doesn't put these quotes in quote marks. The quotes are "appreciates multifactorial nature of influences (structural, chemical, and psychological) on the nervous system" and "recognizing dynamics between lifestyle, environment, and health" (for the latter, the source says "recognizes" rather than "recognizing" but the difference is trivial).
• Its use of the word "treats" is confusing, as it can easily be misunderstood to be referring to treatment, as in medical treatment.
• It uses "patient", which WP:MEDMOS #Audience frowns on.

The two quotes are from a public-domain source, so it's legal to quote them without using quote marks, but it's not polite. Also, the quotes don't really fit that well in this context and they are too long; they can be compactly summarized instead. So I propose fixing the problem by replacing the holism bullet with the following:

• (See below for an updated proposal.) Holism assumes the individual is an integration of body, spirit, and mind, whose health is influenced by lifestyle and environment.

The phrase "integration of body, mind, and spirit" appears in the source. Eubulides (talk) 21:55, 18 August 2008 (UTC)

I think this is a REALLY bad change. I will have to look at sources, but that "integration of body, mind, and spirit" is certainly not NPOV. What we have in there currently is much better. If it can be reworded to remove the words which you feel are a problem, that is one thing, but completely changing the context is a separate matter. The wording that is in there now is along the lines of bio-psycho-social holism—which is a mainstream view. - DigitalC (talk) 23:28, 18 August 2008 (UTC)

While I acknowledge that PPC does use the phrase "integration of body, mind, and spirit", I still feel that this is not NPOV. Looking at [21], we see "We are not doctors for particular diseases, or particular organs, or particular stages in the life cycle — we are doctors for people. People are complex, and live in complex communities in a complex world. All aspects of this world have an impact on the health of the people in it." This is much closer to what holism in Chiropractic is about. - DigitalC (talk) 00:30, 19 August 2008 (UTC)

Fair enough, but Chiropractic #Philosophy already has a "patient-centered" bullet, which captures the doctors-for-people-not-diseases point. Also, that same source then goes on to talk about the "spiritual dimension", and how that's controversial, and many people prefer "existential". So how about this bullet instead?

• Holism assumes that health is affected by everything in people's complex environments; some sources also include a spiritual or existential dimension.

Eubulides (talk) 07:29, 19 August 2008 (UTC)

External Links

I was disappointed by the available external links and would like to add something that balances the pro-chiropractic links that are currently available via dmoz. Unfortunately, I'm not really sure what links would be appropriate. Would like to discuss this further if possible. [E.g., if Cochrane reviews are cited in references section it may not be considered appropriate to link to Cochrane library in this section as well. Perhaps there is a webpage that has a broad overview of chiropractic that would be considered appropriate?] 325jdc (talk) 11:56, 20 August 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: )

Vaccination section must go

Chiropractic as a profession does not advocate against immunisation. This section does not belong in the article. --Surturz (talk) 12:31, 20 August 2008 (UTC)