On 18 Aug 2010 the GCC held a meeting where they discussed a revision to their chiropractic vertebral subluxation (VSC) guidance issued earlier in May this year.
Following the meeting the GCC have decided to change the wording of their subluxation guidance and as the initial statement was made in response to questions I raised, they were kind enough to send me a courtesy copy of the new guidance.
Copies of the guidance and cover letter can be found here: Cover Letter VSC Guidance
At first glance the changes seem minor and no doubt that is how the GCC hope it is viewed. However the wording of this revised guidance and the GCC’s rationale behind issuing it are worth a closer look.
In the covering letter the GCC say that the members of the council reflected on the following points:
- The term ‘subluxation’, as used by chiropractors, refers to functional derangements of the spine
- Functional derangements of the spine are the basis for health concerns
The outcome of the meeting was that they would drop the term ‘health concerns’ from their initial statement;
The chiropractic vertebral subluxation complex is an historical concept but remains a theoretical model., It is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease or health concerns.
Surely the GCC must have good, evidence based reasons for making this change, or is there pressure being applied from elsewhere!
On the first point the council members considered, the GCC have previously stated that:
“the word ‘subluxation’ is a synonym for terms such as joint misalignment, joint dysfunction, facet syndrome and articular derangement”.
So unless an articular derangement is drastically different from a functional derangement, little would seem to have changed. If they insist that a functional derangement is somehow different where has it come from and why was it never mentioned before.
On the second point, the GCC have previously stated that there is insufficient evidence to support the VSC as a cause for health concerns, in May this year all of the chiropractic degree training establishments stated that they do not teach the VSC as a causal factor in health concerns.
Furthermore this 2009 review (‘An epidemiological examination of the subluxation construct using Hill’s criteria of causation’) of the latest research concludes that:
“No supportive evidence is found for the chiropractic subluxation being associated with any disease process or of creating suboptimal health conditions requiring intervention”
At this point it is worth highlighting the last two words of this statement ‘requiring intervention’! Even if there is any evidence that a VSC may be a contributing factor in any health issue, there absolutely must be evidence to show that any health issue requires chiropractic intervention and that chiropractic is actually an effective treatment.
So what we have is a definition of what a subluxation is (functional derangement) combined with research reviews & GCC statements that there is no evidence to support such claims. We also have confirmation from the training establishments that they do not support or teach links between the subluxation and health concerns.
Clearly something has prompted the GCC to issue a revised guidance. Are the GCC in possession of updated research confirming a link, if so then this is truly a breakthrough and should be published ……. Or is there another reason for the U-Turn?
Many will be aware that since issuing their original guidance, the GCC has been widely criticised by chiropractors, both home and abroad and has been under pressure to withdraw or change that guidance.
As we can see here, this pressure would certainly seem to have played a major part in the GCC’s decision
http://www.chiropracticlive.com/?p=886&cpage=1#comment-1646
On 17 Aug 2010 representatives of the Alliance of UK Chiropractors (AUKC) comprised of members of the MCA, SCA and UCA met with the GCC, the main subject of this meeting seems to have been the subluxation. At the meeting the AUKC presented what they describe as ‘a substantial 120 page dossier entitled The Vertebral Subluxation Complex – The History, Science, Evolution and Current Quantum Thinking on a Chiropractic Tenet’. (this document does not appear to be publically available via the internet)
This dossier was commissioned by the AUKC and includes contributions from Christopher Kent D.C a confirmed anti-Vax campaigner and Bruce Lipton a supporter of chiropractic with some ‘fringe’ ideas on genetics . So I have sent a letter to the GCC and asked them for a copy of the 120 page dossier and their view as to the quality of dossier as a basis for evidence.
I have also asked for details of exactly why they felt compelled to issue updated guidance. If this is based on the availability of new evidence then I have asked them to supply copies. They state that the VSC is the basis for health concerns and I have asked them to list these health conditions (along with supporting evidence).
I have also asked them for assurances that the changes are ‘evidence based’ and not simply due to outside pressure!
Blue Wode
September 5, 2010
Nobby Knockers wrote: “There you go, he said it himself he has no qualification, he is unfit to judge…”
Are you being serious? As a medical doctor, Professor Ernst is qualified in the basic health *sciences* and has studied, and/or trained in, a vast array of health-related matters and procedures. Therefore it goes without saying that he’s in a better position to judge than CAM therapists.
It would be interesting to know what valid reasons you think Ernst would have to be biased in his judgments of CAM therapies when common sense would suggest that CAM therapists – whether “qualified”, or having decided to directly start working under their preferred CAM title (e.g. some homeopaths) – would be the ones struggling to be impartial in their evaluations of the evidence.
Blue Wode
September 5, 2010
shurma Wallace wrote: “‘Trained to do spinal manipulations’ by who, where and what on earth does that mean…”
Professor Ernst, MD, was the Head of the Department of Physical and Rehabilitation Medicine in the University of Vienna’s Medical Faculty. It was there that he not only became very familiar with physical therapies, but that he was also trained in spinal manipulation and applied it clinically. See the end of his ‘Systematic Review of Case Reports of Serious Adverse Events Following Manipulation of the Cervical Spine (1995–2001)’ here:
http://www.mja.com.au/public/issues/176_08_150402/ern10520_fm.html
What that means is not only is Professor Ernst an experienced physician, but he is also a scientist who clearly likes to apply the cautionary principle (as in thorough risk/benefit assessments) in the interests of patient safety.
Nobby knockers
September 5, 2010
“August 2010: H:MC21 has translated the interview that Edzard Ernst gave to the German National Association of Homeopathic Physicians in April in which he admits he has no qualifications in homeopathy, despite having having claimed repeatedly that he is a trained”
“Are you being serious? As a medical doctor, Professor Ernst is qualified in the basic health *sciences* and has studied, and/or trained in, a vast array of health-related matters and procedures. Therefore it goes without saying that he’s in a better position to judge than CAM therapists.”
“It would be interesting to know what valid reasons you think Ernst would have to be biased in his judgments of CAM therapies when common sense would suggest that CAM therapists – whether “qualified”, or having decided to directly start working under their preferred CAM title (e.g. some homeopaths) – would be the ones struggling to be impartial in their evaluations of the evidence.”
Quite clearly this shows he is a liar. Medics have training in pathology not health it amazes me you are so blinded by his bullshit.
Blue Wode
September 5, 2010
@ Nobby Knockers
No, it doesn’t show that Ernst is a liar. What it does show is your penchant for twisting things.
shurma wallace
September 5, 2010
What Ernst has no idea about is what an ‘alternative’ actually is. In real science an alternative is another way of looking at the problem.
If we take painkillers for example, Ernst sees the alternative as another way of fooling the pain receptors. An alternative would look for the cause of the pain.
Ernst has the backing of pharma shits because he is a medical science prostitute, he is blind to anything remotely non marketable. If he was trained in Homeopathy for example he wouldn’t have given everyone Arnica in his desert island study that produced a completely flawed piece of work.
Apparently his mum and dad were Homeopaths, looks like a classic case of teenage rebellion.
Ernst’s problem is that no one is allowed to audit his ‘work’, actually he does no research of his own just cook and match style psuedo science, perhaps we should start a religion called Ernstafarians, using the good book Barmed, the gospel according to Lancet and not forgetting the visionary predictions oft predicted by the sooth sayers of Fleet Street, ‘In 10 years all will be cured with miracle pill’.
Again more ‘interpretation’ Ernst hasn’t trained in any ‘health sciences’ basic or advanced. He trained at the font of disease management, he has about as much idea on how to stay healthy as an oncologist does.Brings on an ancient saying ‘If one sucketh the cock of the devil do not show suprise if he comes on your head’.
Sorry the ‘trained in a hospital’ anecdote doesn’t wash, this is where the medical arrogance trip comes in, watching someone crack a back a few times has nothing to do with it.
The bias that Ernst has is as a direct effect of his training, he is the kind of guy who thinks arthritis is idiopathic! Therefore the only logical treatment is suppression of pain pathways!
Common sense tells me that Ernst is a bully in his own lunchtime, disliked by most of his peers and just lost his job. Anyone can get a job at a drug company, just look at any street corner downtown, they’re all at it.
Nobby Knockers
September 5, 2010
Blue Woo,If Eddie found that cracking a few backs in hospital didn’t work its not too much of a surprise really is it, likewise if he prescribed homeopathy in the same way that he would prescribe a drug does it not surprise you that it does not work. That’s one of the problems with “proper doctors” (whatever they are) just because they have medical degree they think they have the franchise on healthcare, when as Shurma pointed out all they can do is find pathology and manage symptoms. Why would pharma ever look for a cure? Its not good for their bottom line. Eddie was a corporate plant by pharma, he failed miserably at his task now he has had to go back home to Glaxo with his tail between his legs, come on get real don’t be taken in by him.
I know its hard when someone who you have looked up to as a peer is suddenly revealed as a fake and a fraud but its not your fault that you were taken in by him, don’t feel too bad about it. Lots of people on these type sites have been its like being taken in by a religion which abuses you by getting you to do their dirty work.
Blue Wode
September 5, 2010
shurma wallace wrote: “What Ernst has no idea about is what an ‘alternative’ actually is. In real science an alternative is another way of looking at the problem.”
Since Skeptic Barista’s post looks at the lack of evidence for chiropractic ‘subluxations’, are you saying that the chiropractic (alternative) method of investigation is just as valid as the scientific method of investigation? Here’s a run through of both:
BTW, I’m sure if you’ve ever required an intervention such as an anaesthetic, insulin, or a course of antibiotics, you’ll have been extremely thankful for The Scientific Method.
shurma wallace
September 5, 2010
So that’s how they came to the conclusion that Arthritis was caused by deficiency in COX 2 inhibitors and then killed 160,000 people world wide.
I’ve often wondered how medical science got to these conclusions and why it was totally different to the rest of proper science, now Eddy’s back at the whipping post can’t wait for more ‘results’.
Nobby Knockers
September 5, 2010
Interesting you could swap the word chiropractic with the word vaccine.
Nobby Knockers
September 5, 2010
Actually you could do exactly the same with the phrase “drug treatment”, this is where your theory falls on its arse I’m afraid Blue Woo.
Blue Wode
September 5, 2010
Nobby, your attempts to derail this discussion are not working. We both know that scientific medicine (including vaccines) saves and prolongs lives and that chiropractic (the subject of this blog post) does not.
BTW, you could also swap the word ‘chiropractic’ with the words homeopathy, Bach flower remedies, chelation therapy, colonic irrigation, craniosacral therapy/cranial osteopathy, ear candling, magnet therapy, reflexology, reiki, shiatsu, spiritual healing, and most traditional Chinese medicine.
shurma wallace
September 5, 2010
Nobby, your attempts to derail this discussion are not working. We both know that scientific medicine (including vaccines) saves and prolongs lives and that chiropractic (the subject of this blog post) does not. Blue wode
Number one myth- you have no evidence that vaccines have saved lives, they don’t do the follow up studies that show vaccines prevent the diseases they were designed to prevent, in fact the only follow up study ever done on a vaccine the BCG showed that more people got TB in the group that got the vaccine, so Germany banned it. Here in woo medical England every Asian baby gets in on the day of birth, ever wondered if that is a factor in the TB stats? Of course you wouldn’t, you’re a medical scientologist believer and they never question the gospel according to medieval vaccine methods.
latest evidence of flu jab too from Cocharaine is, guess what it’s bullshit, BNF says you can’t even use it to control epidemics, page 650, so what is it useful for then?
Number two medical anecdote Iatrogenic disease is the 3rd highest killer in the USA – In their study, Leape and his colleagues examined patient records at hospitals throughout the state of New York. Their 1991 report found that one of every 200 patients admitted to a hospital died as a result of a hospital error.
That number of deaths is the equivalent of what would occur if a jumbo jet crashed every day; it is three times the 43,000 people killed each year in U.S. automobile accidents.
“It’s by far the number one problem” in health care, said Leape, an adjunct professor of health policy at the Harvard School of Public Health.
Researchers such as Leape say that not only are medical errors not reported to the public, but those reported to hospital authorities represent roughly 5 to 10 percent of the number of actual medical mistakes at a typical hospital.
“The bottom line is we have a system that is terribly out of control,” said Robert Brook, a professor of medicine at the University of California at Los Angeles.
No one needs to derail you Blue Woo, you’re not even on the tracks! There is enough here to keep the ASA busy for years.
Blue Wode
September 5, 2010
@ shurma wallace
Those drugs were taken off the market when found to be unsafe, weren’t they? However…
Nobby Knockers
September 5, 2010
“We both know that scientific medicine (including vaccines) saves and prolongs lives”
I’m not so sure about that, it also kills or harms a lot of people. Rates of TB fell by 93% from 1855 to 1953 which preceded vaccination. The greatest public health improvements have been brought about by hygeine, sanitary and nutritional improvements and have nothing to do with vaccination (or chiropractic).
I’m not sure why you quote Singh he was proved as bogus.
shurma wallace
September 5, 2010
Not until the profit margin started falling, you are soooo in denial. If you are trying to imply that the good old decent pharma realised they had made a boo boo and stepped in to sort it all out, do the decent thing that’s crap.
Oh and because Roche lost the Tamiflu data oh dear we can’t audit what another pile of crap that was, but that’s ok, they are so publicly spirited we can totally trust them to just say ‘it was brilliant millions of lives were saved’.
I have no interest in your message from the grundlebun, since when was comment by twats in the pay of the media of any use to anyone? Surely you don’t believe that?
Hey this is interesting Blue Wode is an anagram of BOWEL DUE, are you trying to tell us something, go on I love criptic crap.
Blue Wode
September 5, 2010
@ Nobby Knockers
You’re not doing yourself any favours when you resort to insults.
Nobby Knockers
September 5, 2010
You’re right, my apologies, I shouldn’t plummet to the same depths as Singh.
Zeno
September 5, 2010
And what depths would that be? Has he issued any personal insults to anyone?
shurma wallace
September 5, 2010
Do you mean simple Simon, the guy that wrote a book with Eddy?
shurma wallace
September 6, 2010
Hey Barista, have you read ‘Halloween science’ by William Alderson? It totally debunks Eddy and Si in their ‘Trick or treatment’ booky.
You can download it as a free pdf http://www.homeopathyworkedforme.org/#/halloween-science/4533482584
You’ve been stitched up by Eddy and Si!
Blue Wode
September 7, 2010
This is all readers require to know about William Alderson…
Homeopaths Attempt to Rubbish Ernst and Singh with Dismal Critique
http://www.quackometer.net/blog/2009/04/homeopaths-attempt-to-rubbish-ernst-and.html
shurma wallace
September 7, 2010
Hey I am amazed that you quote the quack boy Barrett here, in your ‘can’t reply so the diss is moved to the end post below’ he is sooo been hauled over the coals by the courts in the USA. Click on to this link:
http://www.quackpotwatch.org/
Let readers decide for themselves, bet you haven’t got the guts to read Halloween science, must be like reading the anti bible!
Blue Wode – Bowels due, which one is it?
Blue Wode
September 5, 2010
shurma wallace wrote: “…the BCG showed that more people got TB in the group that got the vaccine…”
Didn’t scientists discover that the BCG protected more than experts thought it did?
shurma wallace wrote: “Iatrogenic disease is the 3rd highest killer in the USA – In their study, Leape and his colleagues examined patient records at hospitals throughout the state of New York. Their 1991 report found that one of every 200 patients admitted to a hospital died as a result of a hospital error. That number of deaths is the equivalent of what would occur if a jumbo jet crashed every day; it is three times the 43,000 people killed each year in U.S. automobile accidents.”
Has it occurred to you that that claim could be extremely misleading? The following is lifted from Dr Harriet Hall’s excellent article, Death By Medicine:
Anyway, shurma, what on earth does your argument have to do with the elusive evidence for the chiropractic ‘subluxation’ and the GCC’s strangely fluctuating stance on it?
Nobby Knockers
September 6, 2010
Blue Woo wrote “There is NOTHING comparable in the world of alternative medicine” Sure there is nothing no alternative approach has the funding from big pharma, do you think they do it for the love of it? Of course then there is the peer review process which is flawed. You hold these ideals as if its a religion to you, when are you going to realise how bent “medical science” is? You really need to stop believing in everything pubmed and Cochrane collaboration espouse, to you guys if its not had an RCT its not science, you try to make any alternative fit the orthodox system like exchanging NSAIDs for a herbal tea, sure if that’s CAM its bollocks, but you or at least Ed & Si can’t see past the fact that an individualised treatment that is patient centered rather than centered on disease cannot be tested by using RCT’s and the academics paid to test this have not learn’t this either even when they are told that a specific RCT will not work they still go ahead with it as no one with your tunnel vision can see outside of the circle.
There are no medicine bashers here, you’re malicious attacks on the chiropractors has been motivated by a personal attack on a man you revere, I would be surprised if any of you have ever been to one when you have had a significant problem which you need help with, an acute low back can be extremely disabling all you get from the GP is 5 mins and some cocodamol, why do you think people seek an alternative. Yes there are some who are unscrupulous and hopefully they will be weeded out by the GCC, like all professions you get your odd bad apple. The GCC will collapse under the financial encumbrance of all the investigations as it has to do, the chiros will be better off to the tune of £1000 per year and no regulatory body, they will regulate themselves then.
Zeno
September 6, 2010
Nobby
You appear to know little about the GCC and how they operate.
And since the GCC’s Council is already 7/14 chiropractors, their Education Committee 3/6 chiropractors, their Investigating Committee 8/12 chiropractors and their Health/Professional Conduct Committee 7/18 chiropractors, I’m not sure they’re not regulating themselves already.
If the job of the GCC is to protect the public, maybe now’s the time to make it a tad more independent of those it’s trying to regulate. Should an effective regulator not be independent and be seen to be independent?
Unless, of course, you don’t think their main job is to protect the public?
shurma wallace
September 7, 2010
Uh Zeno, no money means no pay means no staff means no regulator, unless of course you lot want to work for nothing?
I heard the GCC had to remortgage their property cos of T boy, that doesn’t sound like an org on the case and dealing with it, does it.
Your second paragraph makes no sense, all that number/number stuff and a weird sentence about therefore they are regulating themselves.
Is this the kind of number woo that Singh talks of? By the way if they don’t exist they can’t protect anyone, unless of course you believe in guardian angels?
Zeno
September 7, 2010
Uh, shurma, you still have no clue about the GCC and I’m surprised you’re not able to understand a few simple numbers.
Well, perhaps not.
You have shown yourself utterly unable to follow arguments, utterly unable to engage in the discussion and utterly unable to be civil.
The only thing your somewhat meagre ‘contribution’ here has been good for is providing some light entertainment to myself, Skeptic Barista, Blue Wode and passing visitors. And an object lesson how not to argue.
Blue Wode
September 6, 2010
Nobby Knockers wrote: “…why do you think people seek an alternative”
I think I have a pretty good grasp on the reasons as to why people seek alternatives. If you would like to have a more comprehensive understanding on the issue I would suggest that you have a read through the late Barry Beyerstein’s classic essay, ‘Social and Judgmental Biases That Seem to Make Inert Treatments Work’. It is a thorough analysis of alternative medicine and common errors of reasoning:
http://www.sram.org/0302/bias.html
shurma wallace
September 7, 2010
Considering your confirmation bias in the church of woo and concurrent medical arrogance, your pompous assumption that anyone will take any notice of you is very predictable,perhaps you should let any readers read it for themselves, we don’t want people to be tarred with the brush of psuedo science persuasion.
This is a big theme pointed out in this book, Eddy and Si are the masters of peer pressure persuasion, no wonder you can’t see it, did you read it or just ask one of your mentors? That’s how this medical science bull keeps going, who you know not facts or what you know.
Most people know Eddy and Si are frauds, the vast majority of the public haven’t read the tricky book anyway, unless I missed it on a no 1 seller list. Eddy got the sack anyway as he was so crap at his job.
Blue Wode
September 7, 2010
shurma, I suggest you visit the link below. I think you’ll find that it offers a more suitable platform for your issues:
http://www.rantfoo.com/
shurma wallace
September 7, 2010
Wode I suggest you either present your thoughts on this issue, unless you can’t cope with reading any of the references I have posted, or go back to skeptics uk forum. I bothered to wade through the ref you gave to SBM and identified major flaws in the reasoning so you can pull your finger out and get with the programme too.
So far you have offered nothing but religious allegiance as a ‘defence’ and that is simple not scientific. ‘House of numbers’, Halloween science offers good critique of why the ‘evidence’ that is attempting to dismiss alternatives is totally flawed. Quackwatch Barrett offers nothing but dying platitudes, quackpotwatch exposes this fraud.
It is up to you to provide the evidence that the orthodox view on health and disease is not palliative disease management. I and many others have looked at the validation methods for medical science and found them more than wanting.The ‘evidence’ you attempt to present to dismiss the alternatives is flawed, misconceived and demonstrates no understanding of the subject matter.
shurma wallace
September 7, 2010
Trying to argue with a preacher is impossible, you hide behind ivory towers, you couldn’t argue for toffee.
Zeno
September 7, 2010
Oooh! I love toffee!
yoda freeman
October 1, 2010
Hi Alan
Had any good emails from the other side yet?