Palmer Lives!

[PublicHealth]

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http://www.ncbi.nlm.nih.gov/entrez/..._uids=16423302&query_hl=1&itool=pubmed_docsum

 

[fab4fan]

Well, that settles it for me. Guess I can believe the local back-cracker who advertises being able to cure cancer, ADHD, migraines, addiction, respiratory diseases and several psychiatric disorders to boot.

 

[Weebils-Wobble]

If pt hx reveals having visited a chiropractor, of a hearing impared pt, speak in their left ear only.

A comprehensive study of 15 pts can't be ignored. 🙂

 

[FoughtFyr]

http://www.ncbi.nlm.nih.gov/entrez/..._uids=16423302&query_hl=1&itool=pubmed_docsum

Come on PH, even you can't be enamored with this article. First of all, from the conclusion of the abstract:

"A percentage of patients presenting to the chiropractor have a mild to moderate hearing loss, most notably in the right ear."​

"(M)ost notably the right ear", you saw it here first folks. If your left ear bothers you see a nautropath. For right ear problems, find a chiropractor.

But seriously, from the body of the study:

"As seen in the patient characteristics in Table 1, no patients had a chief complaint of hearing loss or impairment."​

So while the authors go to great lengths to describe how they used a reliable tool to take audiometric screenings of all of their patients, these patients did not actually complain of hearing loss.

We go on to find out:

"Examination and palpatory findings were used to define areas of joint dysfunction and each patient received a high velocity, low amplitude thrust in the thoracic, lumbar spine and locomotor system including extremities. No 'specific' adjustment was given to solely restore hearing."​

Wow. So merely being in the presence of these great healers was enough. Gosh, now I see why you love chiropractic so much. Chiropractors cure everything that ails their patients, not just the stuff that the patients seek help for. You are right. As an allopathic physician I can tell you that I very rarely sucessfully treat conditions that neither my patient nor I know they have.

Moving on:

"Results - In the patient group with hearing impairment, the total number of tones heard on initial exam was fewer in the right ear (55 tones) than the left (83 tones). The normal patient group heard approximately 120 tones in each ear on the initial visit. After a single chiropractic intervention, the total tones heard increased to 104 on the right and 111 on the left (an increase of 49 and 28 respectively)".​

Now, I had to read this several times and looked at the referenced figures repeatedly, because no where are any statistical analyses performed. Not only do the authors "lump together" the findings from all their patients (instead of listing the number of patients who improved by "x" amount, as is convention) but they don't offer any analysis in terms of p-values, confidence intervals, or any other measure of chance. Now I am not going to run the numbers, I have neither the time nor the inclination, but I have to ask how the scientific community is supposed to accept chiropractic research if they are not even going to bother to analyze their data?

I'd love to just keep on slamming this paper, but the authors beat me to it:

"The current observational study cannot prove a cause and effect relationship. The limitations to this current study are the small sample size and that there was no blinding of the investigator though patients were blinded to the fact that hearing would be tested post-chiropractic care. Furthermore, no true control group or randomization of testing sequence was employed and potential alternative explanations as to the natural history of hearing loss may explain our results, for example some learning effect of the test."​

So, by their own admission, the audiometric investigator was not blinded! Wow, yeah, that pretty much invalidates the entire thing right there. "Can you hear it now?" I mean come on, audiometry, performed bedside by a chiropractor intimately involved in the study, is not even worth gathering. And what stinks is that the paper could have been done well. Send the patients to an independant lab (or set one up in the office). Use a licenced audiometrist, or even better a speech pathologist or CIH. Send in some random controls to assess for "learning effect" and even run some folks through sham assessments or {GASP} allopathic care to serve as controls.

Of course actually starting with patients complaining of hearing loss would have been nice too! 😕

I guess once you get used to recruiting patients (despite a lack of complaints)during chiropractic school, you just can't get away from it...

- H

 

[PublicHealth]

Come on PH, even you can't be enamored with this article. First of all, from the conclusion of the abstract:

"A percentage of patients presenting to the chiropractor have a mild to moderate hearing loss, most notably in the right ear."​

"(M)ost notably the right ear", you saw it here first folks. If your left ear bothers you see a nautropath. For right ear problems, find a chiropractor.

But seriously, from the body of the study:

"As seen in the patient characteristics in Table 1, no patients had a chief complaint of hearing loss or impairment."​

So while the authors go to great lengths to describe how they used a reliable tool to take audiometric screenings of all of their patients, these patients did not actually complain of hearing loss.

We go on to find out:

"Examination and palpatory findings were used to define areas of joint dysfunction and each patient received a high velocity, low amplitude thrust in the thoracic, lumbar spine and locomotor system including extremities. No 'specific' adjustment was given to solely restore hearing."​

Wow. So merely being in the presence of these great healers was enough. Gosh, now I see why you love chiropractic so much. Chiropractors cure everything that ails their patients, not just the stuff that the patients seek help for. You are right. As an allopathic physician I can tell you that I very rarely sucessfully treat conditions that neither my patient nor I know they have.

Moving on:

"Results - In the patient group with hearing impairment, the total number of tones heard on initial exam was fewer in the right ear (55 tones) than the left (83 tones). The normal patient group heard approximately 120 tones in each ear on the initial visit. After a single chiropractic intervention, the total tones heard increased to 104 on the right and 111 on the left (an increase of 49 and 28 respectively)".​

Now, I had to read this several times and looked at the referenced figures repeatedly, because no where are any statistical analyses performed. Not only do the author "lump together" the findings from all their patients (instead of listing the number of patients who improved by "x" amount, as is convention) but they don't offer any analysis in terms of p-values, confidence intervals, or any other measure of chance. Now I am not going to run the numbers, I have neither the time nor the inclination, but I have to ask how the scientific community is supposed to accept chiropractic research if they are not even going to bother to analyze their data?

I'd love to just keep on slamming this paper, but the authors beat me to it:

"The current observational study cannot prove a cause and effect relationship. The limitations to this current study are the small sample size and that there was no blinding of the investigator though patients were blinded to the fact that hearing would be tested post-chiropractic care. Furthermore, no true control group or randomization of testing sequence was employed and potential alternative explanations as to the natural history of hearing loss may explain our results, for example some learning effect of the test."​

So, by their own admission, the audiometric investigator was not blinded! Wow, yeah, that pretty much invalidates the entire thing right there. "Can you hear it now?" I mean come on, audiometry, performed bedside by a chiropractor intimately involved in the study, is not even worth gathering. And what stinks is that the paper could have been done well. Send the patients to an independant lab (or set one up in the office). Use a licenced audiometrist, or even better a speech pathologist or CIH. Send in some random controls to assess for "learning effect" and even run some folks through sham assessments or {GASP} allopathic care to serve as controls.

Of course actually starting with patients complaining of hearing loss would have been nice too! 😕

I guess once you get used to recruiting patients (despite a lack of complaints)during chiropractic school, you just can't get away from it...

- H

I was being facetious. The article is crap.

 

[fab4fan]

Wow. So merely being in the presence of these great healers was enough. Gosh, now I see why you love chiropractic so much. Chiropractors cure everything that ails their patients, not just the stuff that the patients seek help for. You are right. As an allopathic physician I can tell you that I very rarely sucessfully treat conditions that neither my patient nor I know they have.

You medical doctors are sooooo lame. You have to rely on your meds, diagnsotic studies, surgeries, etc. to make people better, but chiros can cure just by virtue of being in the same room with the pt.

 

[PublicHealth]

 

[PublicHealth]

You medical doctors are sooooo lame. You have to rely on your meds, diagnsotic studies, surgeries, etc. to make people better, but chiros can cure just by virtue of being in the same room with the pt.

And RNs like to pass themselves off as "Clinical Directors!" Now THAT's a good one!

 

[fab4fan]

Yep, we sure can! Of course, I understand if this is a foreign concept for you, grasshopper. Do you need me to explain the difference between a clinical director and a medical director? 🙂

 

[fab4fan]

Least I ain't askeered to have a public profile.

 

[FoughtFyr]

And RNs like to pass themselves off as "Clinical Directors!" Now THAT's a good one!

"Clinical directors", especially in hospice, but also in most forms of home health care are almost always RNs. Home health is, part and parcel, nursing.

- H

 

[PublicHealth]

"Clinical directors", especially in hospice, but also in most forms of home health care are almost always RNs. Home health is, part and parcel, nursing.

- H

It's also a way to boost your status in public when you're a lowly nurse.

"What are you doing nowadays, Bob?"

"Oh, I'm 'Clinical Director' at the local hospice."

 

[PublicHealth]

Least I ain't askeered to have a public profile.

MS2 at NYCOM.

 

[FoughtFyr]

It's also a way to boost your status in public when you're a lowly nurse.

"What are you doing nowadays, Bob?"

"Oh, I'm 'Clinical Director' at the local hospice."

Wow, just so we understand, chiropractors and nautropaths (both completely unsupported by science) are good, and nursing, a well scientifically supported healthcare field is "lowly". Well as an MS2 I can only hope your eyes open soon or you are in for a world of hurt.

- H

 

[PublicHealth]

Wow, just so we understand, chiropractors and nautropaths (both completely unsupported by science) are good, and nursing, a well scientifically supported healthcare field is "lowly". Well as an MS2 I can only hope your eyes open soon or you are in for a world of hurt.

- H

Since when is cleaning poop out of someone's ass "scientifically supported?" There is no such thing as a "nursing intervention." Nurses, with the exception of nurse practitioners, are physician extenders in the loosest sense of the term.

My eyes ARE open. That's where you and I differ. You choose to keep your eyes shut to complementary and alternative medicine (CAM), when these modalities of treatment increasingly gaining acceptance in mainstream hospitals and among the public. NCCAM and acceptance of CAM in HMOs is evidence of the establishment's desire to control CAM services. There are a number of integrative medical practices with collaborative groups of MDs, NDs, DCs, and other providers. I am sure that they would all agree that they are in a "world of hurt."

You consistently point out that CAM is not "scientifically supported, when research in this area just now beginning to develop because of medicine's political domination of US healthcare. Americans are spending billions of dollars out of pocket for CAM. Why? Because it's offering them something that conventional medicine does not. There is so much more to health maintenance and disease prevention than drugs and surgery.

 

[fab4fan]

Oh. Ouch. I can't tell you how much that hurt. I am so wounded, I don't think I can go on. 🙄

You guys are just now getting around to doing research to support your work? Wow. What took y'all so long?

Hope you don't ever need hospitalization. I can't imagine who will take care of your needs, since nurses don't do anything but clean up poop. Hey! Maybe you can find a hospital that's just staffed with chiros! And while not glamorous, "cleaning up poop" can give you quite a bit of assessment info. on a pt., so that's actually a pretty uninformed insult, as well as a hackneyed one, to boot.

My contempt isn't for all chiros, but it is quite deep for quack chiros, like many in my area. (I particularly despised one who treated a family friend for decades for Parkinson's. He dropped dead of an MI while jogging...instant karma.)

Thanks, FoughtFyr, for the kind words about nurses.

 

[fab4fan]

MS2 at NYCOM.

Well, now that is disappointing. I work at a hospital that has mostly DOs and we get a lot of DO students. I always thought DOs were terrific; I guess I need to modify my opinion now.

 

[FoughtFyr]

Since when is cleaning poop out of someone's ass "scientifically supported?" There is no such thing as a "nursing intervention." Nurses, with the exception of nurse practitioners, are physician extenders in the loosest sense of the term.

Wow, you are kidding right? I mean this is another one of your sarcastic posts? First of all, nursing has long established and well proven benefits in patient outcomes. So much so that states have begun to regulate RN-to-patient ratios (http://www.ncbi.nlm.nih.gov/entrez/...ids=11103640&query_hl=14&itool=pubmed_docsum). A historical to modern review is here; American Nurses Association. Principles for nurse staffing: with annotated bibliography. Gallagher RM, Kany KA, compilers. Washington (DC): American Nurses Publishing; 1999, and another is here: http://www.nursingworld.org/ojin/topic22/tpc22_4.htm. But perhaps the most important is the finding that:

"Strategies to increase staffing levels of licensed and unlicensed nurses in both acute-care hospitals and nursing homes will likely lead to improved patient outcomes."​

from: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat1a.chapter.9710 an AHRQ funded study.

My eyes ARE open. That's where you and I differ. You choose to keep your eyes shut to complementary and alternative medicine (CAM), when these modalities of treatment increasingly gaining acceptance in mainstream hospitals and among the public.

Umm, nursing is a practice that is already well accepted. And since you seem to only believe that someing is good if the NIH is involved I refer you to: http://ninr.nih.gov/ninr/

And my eyes are wide open. Naturopaths (your latest favorite) strongly advocate for homeopathy. Edzard Ernst, a British Professor of CAM, and a once strident supporter of CAM recently opined (in: http://observer.guardian.co.uk/uk_news/story/0,6903,1669982,00.html):

"'Homeopathic remedies don't work,' he told The Observer. 'Study after study has shown it is simply the purest form of placebo. You may as well take a glass of water than a homeopathic medicine.' Nor is Ernst's disdain confined to homeopathy. Chiropractic, which involves spine manipulation to treat illnesses, and the laying on of hands to 'cure' patients, are equally invalid, he says."​

Mind you, this guy is a CAM expert and has written extensively, and generally positively, on the subject.

NCCAM and acceptance of CAM in HMOs is evidence of the establishment's desire to control CAM services.

No, that is evidence that consumers want these services. Kevin Trudeau has sold millions of books based on consumer desire, doesn't mean he knows squat about healthcare.

There are a number of integrative medical practices with collaborative groups of MDs, NDs, DCs, and other providers. I am sure that they would all agree that they are in a "world of hurt."

Actually the "world of hurt" I was referring to was your when you attempt to bring your "nurse=poop-scooper" attitude to your clinical training and later into your practice.

Just to make you aware, unlike chiropractic, "traditional" medicine has many patient safety mechanisms in place, and most of them are nursing related. Nurses play a HUGE and vital role in medicine and woe is the lowly student doctor who fails to realize this...

You consistently point out that CAM is not "scientifically supported, when research in this area just now beginning to develop because of medicine's political domination of US healthcare. Americans are spending billions of dollars out of pocket for CAM. Why? Because it's offering them something that conventional medicine does not.

Yep, it does offer something "more" - better marketing. Just ask Kevin Trudeau. Look, I have yet to meet a CAM provider that will clearly state that "nothing can be done" or "this will heal itself in time". Thus, people go to them. When a "cure" is effected by a tincture of time, they (the CAM provider) take the credit. When someone is going to die despite treatment, they make sure they do so less wealthy.

There is so much more to health maintenance and disease prevention than drugs and surgery.

Absolutely. Without question. That is why I have an MPH. Both my wife and I have spent the better part of our careers in health education. My wife helped roll out "Risk Watch" a joint U.S. Fire Administration / NFPA childhood injury prevention program. We have both worked extensively in tobacco control and prevention. We have both spoken on cardiovascular health, and I am currently doing research into the toxicities of particulate pollution. And the "poop-scooping" nurses you respect so little have led the way in most public health efforts to date! Margret Sanger, Clara Barton, Dorothea Dix, and Virginia Henderson to name a few of these public health pioneers off the top of my head. Nursing organizations (including the ANA and ENA) spend HUGE amounts of money each year on public education and advocacy efforts. Where are your CAM friends in all this? Chiropractors make lots of money from MVCs but I never see them in NHTSA car seat safety courses or conferences (like nurses are). I don't see them advocating against drinking and driving (like nurses do). I've never heard of them lobbying for better traffic barrier devices, roadway lighting or other roadway improvments (like nursing lobbies have). But hey, they have certainly helped when it helps them. Almost every chiropractic office was offering "free" spinal screenings in returns for donations after Katrina (Nothing like hawking your wares under the guise of charity. 👎). All nurses did was go down and provide almost immeasurable hours of patient care (oops, I forgot, they were actually "poisoning" all of the folks they immunized).

But let's not even get started on the anti-immunization, anti-floridization views of the national chiropractic associations or their total absence of public safety mechanisms as a profession.

You need to find a different screen name.

- H