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{Continued from previous post}...
O.k., once again, you take me out of context. I was discussing things with people I've already had these debates with. As you have proven yourself incapable of a search here, I will post an overview below. But if you think you have a paper that "proves" chiropractic for anything feel free to post it. I'll be happy to analyze and discuss it with you.
Show me the evidence…
The "American Academy of Pain Management" is not a medically recognized board certifying organization. Only the American Board of Anesthesiology Subspecialty Certification in Pain Management is recognized by the American Board of Medical Specialties. The "other" organization commonly accepted is "The American Board of Pain Medicine", to my knowledge neither has had a DC as their president. A DC as the president of a DC organization – no great shakes.
Well, "some NSAID's for awhile and then come to me if it doesn't resolve" is hardly the standard of care. And again, show me quality, peer-reviewed literature to prove these statements and maybe you will convince me.
I expect no less.
Well, actually we take it VERY seriously (hence those accrediting agency's emphasis on it. Who do you think runs those agencies?). I address every patient's pain.
Ahh, yes, we mess up, so go to the less trained providers who have no QI/QA oversight and no standards of care with no scientific basis behind them and get "better" care…
- H
As far as you analysis of research and chiropractic, stick to diabetic comas and MI's. . .I have frankly heard evidence-based chiropractors make better analyses of the literature and criticisms.
O.k., once again, you take me out of context. I was discussing things with people I've already had these debates with. As you have proven yourself incapable of a search here, I will post an overview below. But if you think you have a paper that "proves" chiropractic for anything feel free to post it. I'll be happy to analyze and discuss it with you.
FoughFyr said:Since you have so much time on your hands, why don't you find each of the peer-reviewed research papers I have posted?
No, guess you don't want that many data in one place. O.k., I will do it. Have a good laugh at how "FF uses WCA/Rondberg for most of his 'data'."
By my count I have cited four WCA articles (albeit multiple times each) and 23 peer reviewed journals (also multiple times each). Good to see that "most" of my data is from the WCA!
BTW - I went back to 12-28-04; there were no additional WCA citations in that time frame although there were repeats of the ones you posted.
- H
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OP: http://forums.studentdoctor.net/showpost.php?p=2687469&postcount=49
"Archives of Pediatrics & Adolescent Medicine
----------------------------------------------
Volume 151(5) May 1997 pp 527-528"
OP: http://forums.studentdoctor.net/showpost.php?p=2687469&postcount=48
"For example, there is a study which I have posted many times that suggested that 17% of chiropractors who identified themselves as treating children would treat a case of neonatal fever without referral to an MD/DO or more appropriately to an ED. (see: http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=10768681&query_hl=8 ) Neonatal fever is a defacto emergency. No attempt should be made to treat as an outpatient – yet 17% of chiropractors who treat children would try."
OP: http://forums.studentdoctor.net/showpost.php?p=2561300&postcount=1
"Even SCARIER..."
http://www.jcca-online.org/client/cca/JCCA.nsf/objects/V49-1-46/$file/jcca-v49-1-046.pdf" - A chiropractic journal no less!
OP: http://forums.studentdoctor.net/showpost.php?p=2573803&postcount=19
"Now chiropractic and stroke."
from:http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=12743225
from:http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=12692699
from:http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=15513007
from:http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=12466778 - Your favorite journal; JMPT (that fun lovin' group of chiro-bashers!)
"I thought there were "no side effects" to chiropractic? Yep it never happens, but the chiropractic journals describe when and how. I guess they are used to reporting on fictional things (like subluxations) anyway..."
from:http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=14586598
"To be fair, there is an article describing why there is such a different opinion of the level of risk chiropractic manipulation represents."
from:http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=14589464
OP: http://forums.studentdoctor.net/showpost.php?p=2605708&postcount=59
"Great, now we are paying for "unproven" methods to be available to all. You know, given the amount of the population that screams "I can't afford health care" this program seems to me to be a step backward. Especially when you consider the following:
Trends in Alternative Medicine Use in the United States, 1990-1997
Eisenberg GM, Davis RB, Ettner SL, etal
From: Journal of the American Medical Association
Volume/Edition: 280 (18)
Pages/Time: 1569-1575
Source/Year: November 1998"
OP: http://forums.studentdoctor.net/showpost.php?p=2318810&postcount=16
"In that study (see: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9761802), the findings were 'In children with mild or moderate asthma, the addition of chiropractic spinal manipulation to usual medical care provided no benefit.'"
"From my favorite (Cochrane reviews) on 'Manual Therapy for Asthma':
'From 393 unique citations, 59 full text articles were retrieved and evaluated, which resulted in nine citations to five RCTs (290 patients) suitable for inclusion. Trials could not be pooled statistically because studies that addressed similar interventions used disparate patient groups or outcomes. The methodological quality of one of two trials examining chiropractic manipulation was good and neither trial found significant differences between chiropractic spinal manipulation and a sham manoeuvre on any of the outcomes measured. Quality of the remaining three trials was poor. One small trial compared massage therapy with a relaxation control group and found significant differences in many of the lung function measures obtained. However, this trial had poor reporting characteristics and the data have yet to be confirmed. One small trial compared chest physiotherapy to placebo and one small trial compared footzone therapy to a no treatment control. Neither trial found differences in lung function between groups.'"
OP: http://forums.studentdoctor.net/showpost.php?p=2268005&postcount=8
Here are links to the abstracts: http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=12221360 and http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7638657.
OP: http://forums.studentdoctor.net/showpost.php?p=2183403&postcount=46
"Chiropractors were included in two types of these studies, those of low back pain, and those looking at workingmans' compensation costs. see: http://www.annals.org/cgi/content-nw/full/127/1/52/T2 Their findings were hardly supportive of chiropractic."
"The study abstract is here: http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=15477432. While the study is interesting for it's size, there are serious design problems. I quote from the journal editor's comments in the same issue.
'The study design does not permit the definite determination of a cause-effect relationship between access to chiropractic and a more budget-effective approach to musculoskeletal care, pointing rather to the coexistence of the 2 phenomena in a managed-care population. Furthermore, the lack of a random element in defining the populations with and without access to chiropractic care may have partly compromised the validity of the results. The favorable health profile of the 'chiropractically insured' is of particular concern. They comprise a younger and healthier population and, thus, are likely to have better outcomes and fewer health expenses. Even though the authors attempt to correct for this discrepancy, it is worrisome to assume the generalizability of the perceived cost-savings to a sicker, older cohort. In addition, the study portrays a population specific to a particular health care plan and within a particular state and, perhaps, not typically representative of other states or of patients who are insured by Medicaid or Medicare. Another generalizability issue arises from the lack of information regarding patient ethnicity, making the extrapolation of the authors' conclusions to minority populations problematic.'"
OP: http://forums.studentdoctor.net/showpost.php?p=2183516&postcount=47
"The study is here: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9801210 with a follow-up study here: http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=11940622. Now there are two problems with this as far as your argument is concerned. First, this test was not given to first year out chiropractic graduates, so it doesn't say that chiropractors would do any better. Second, it was administered to interns, who still had an average of three to five years of training remaining. The test itself was validated by administration to eight senior orthopedic surgery residents, all of whom passed. So what have we proven? MD/DOs do a residency for a reason. It is an integral part of our training. Big deal. I'd have granted you that without a study."
OP: http://forums.studentdoctor.net/showpost.php?p=2135577&postcount=95
"Now as an (I assume) educated person, what is your opinion/reaction to these studies?"
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7884327&dopt=Abstract
http://www.cmaj.ca/cgi/content/full/166/12/1531
http://www.cmaj.ca/cgi/content/full/166/12/1544
http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=11340209
OP: http://forums.studentdoctor.net/showpost.php?p=2139393&postcount=120
"No, what I am referring to is summarized here: http://nccam.nih.gov/health/chiropractic/index.htm#app2
Three systematic reviews that concluded "Overall, the evidence was seen as weak and less than convincing for the effectiveness of chiropractic for back pain. Specifically, the 1996 systematic review reported that there were major quality problems in the studies analyzed; for example, statistics could not be effectively combined because of missing and poor-quality data. The review concludes that the data 'did not provide convincing evidence for the effectiveness of chiropractic.' The 2003 general review states that since the 1996 systematic review, emerging trial data 'have not tended to be encouraging…. The effectiveness of chiropractic spinal manipulation for back pain is thus at best uncertain.' The 2003 meta-analysis found spinal manipulation to be more effective than sham therapy but no more or no less effective than other treatments."
Chiropractic remains and will remain an effective form of pain and mobility management for chronic and permanent degenerative spinal conditions.
Show me the evidence…
That's why a DC served as past president of the American Academy of Pain Management (I think a MD is now president).
The "American Academy of Pain Management" is not a medically recognized board certifying organization. Only the American Board of Anesthesiology Subspecialty Certification in Pain Management is recognized by the American Board of Medical Specialties. The "other" organization commonly accepted is "The American Board of Pain Medicine", to my knowledge neither has had a DC as their president. A DC as the president of a DC organization – no great shakes.
Acute conditions? Whiplash, yes. LBP - probably better with some NSAID's for awhile and then come to me if it doesn't resolve.
Well, "some NSAID's for awhile and then come to me if it doesn't resolve" is hardly the standard of care. And again, show me quality, peer-reviewed literature to prove these statements and maybe you will convince me.
But then again, I may be talking out my lower orafice here.
I expect no less.
Pain management is not something that you hospital practicioners take seriously, now, is it? You had to have your accrediting agencies actually post posters around the hospital that the "patient has a right to pain control." What seems intuitive to DC's and most of the public, you actually had to have mandated and be reminded.
Well, actually we take it VERY seriously (hence those accrediting agency's emphasis on it. Who do you think runs those agencies?). I address every patient's pain.
Frankly, if you sit back and actually examine yourself, you'll discover the reason we exist isn't because we are so hot or because DD thought up subluxation; it's the fact you do such a crappy job sometimes.
Ahh, yes, we mess up, so go to the less trained providers who have no QI/QA oversight and no standards of care with no scientific basis behind them and get "better" care…
- H