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RfC: Is the "subject" of spinal manipulation relevant to chiropractic?

Subject and "Rules of engagement"

• Is the "subject" of spinal manipulation relevant to chiropractic?

• I contend that it is, and that the profession and its top researchers think so too. So far no reliable mainstream or chiropractic sources have been mentioned here that dispute this point. What think ye, honored ladies and gentlemen? -- Fyslee / talk 05:00, 9 October 2008 (UTC)

Nota bene! Please follow these "Rules of engagement":

1. This RfC is NOT about "research" (we are discussing that elsewhere), only the "subject" of spinal manipulation and its relation to the chiropractic profession. More discussion of that matter can occur after and outside of this RfC.

2. This RfC is NOT about any relation between generic spinal manipulation and chiropractic spinal manipulation. We are also discussing that elsewhere. More discussion of that matter can occur after and outside of this RfC.

If these subjects are mentioned here, the comment will likely be removed and the contributor requested to resubmit the comment without such mentions. Such comments will only derail the discussion and be a repetition of other discussions. This discussion is delimited by well-defined and narrow boundaries. It must remain focused. Your cooperation will be appreciated. -- Fyslee / talk 05:00, 9 October 2008 (UTC)

The words "relevant" and "related" are synonyms, and "relevant" is used in that sense above. If this is a problem for some, then that can be discussed. It is already mentioned below because of the use of the word "related" in the OR policy, even though this RfC is not about the OR policy or other policies.

This RfC is limited to the bare question, as it reads. This is about logic and about knowledge of chiropractic and its main treatment method. -- Fyslee / talk 14:21, 9 October 2008 (UTC)

ADDENDUM: Invalid "vote(s)". As originally noted immediately above, "this RfC is limited to the bare question, as it reads." The question is a stand-alone question. If other contexts are influencing your decision, then your "vote" doesn't count and is invalid. Either answer the question, or don't vote at all. Deal with the other issues elsewhere or later. -- Fyslee / talk 13:45, 17 October 2008 (UTC)

RfC comments

• Agree, as stated above. -- Fyslee / talk 05:00, 9 October 2008 (UTC)

• Agree that spinal manipulation is directly related to chirorpractic, and is relevant to chiropractic. Eubulides (talk) 07:00, 9 October 2008 (UTC)

• Comment. Since WP:OR consistently uses the words "directly related" rather than "relevant", I suggest that you rephrase the question by uniformly substituting the words "directly related" for "relevant". Otherwise, other editors might say that even if the conclusion is that SM is relevant to chiropractic, that doesn't mean that it's directly related to chiropractic. Eubulides (talk) 05:36, 9 October 2008 (UTC)

• I had thought of that, but since they are synonyms (and "relevant" sounds better in that question), we might be better served to get the word "relevant" added to the language of the OR policy. Do you see a significant difference -- relevant<-->related. "Definiton: Relevant: Related to the matter at hand." Anyone who disputes my wording can take it up with the dictionaries. Is this a solid argument, or am I wrong here? -- Fyslee / talk 06:21, 9 October 2008 (UTC)

• WP:OR recently went through some sort of dispute over whether it should use "relevant" or "directly related", so I expect that some editors think there's an important difference between the two terms. In that case, why not just stick with the terms that WP:OR uses? It might avoid future confusion. Or, if you prefer, we can mention both terms in the RfC. Eubulides (talk) 06:50, 9 October 2008 (UTC)

• I have added a comment about the terminology matter above. Anyone who has already commented is welcome to refactor or enlarge their comments accordingly. I see that the RfC bot hasn't picked up this RfC yet, but it should do so within the next 24 hours, so this will already be a part of what outside commentators will find here. -- Fyslee / talk 14:21, 9 October 2008 (UTC)

• The RfC bot cannot handle more than two RfCs on the same talk page. It lists only the first one on the page. This is a longstanding bug in the bot which has not been fixed. I have added this RfC manually to Wikipedia:Requests for comment/Maths, science, and technology. Eubulides (talk) 14:55, 9 October 2008 (UTC)

• If it helps, we can archive the older RfC on this page. I think that one has been milked long past its expiration. -- Levine2112 ^discuss 23:28, 9 October 2008 (UTC)

• I wasn't aware of that glitch. Maybe that is a good idea to archive the old RfC. -- Fyslee / talk 04:33, 10 October 2008 (UTC)

• Done. Eubulides (talk) 04:48, 10 October 2008 (UTC)

• BTW, this RfC isn't about OR or other policies. It is limited to the bare question, as it reads. This is about logic and knowledge of chiropractic. -- Fyslee / talk 06:24, 9 October 2008 (UTC)

• Disagree. No such conclusion can be made, because the question is too vague and due to the constraints put on the discussion. Further, you state that this RfC is not about research, but then state that its "top researchers" think it is relevant. Overall, the answer is "not necessarily". DigitalC (talk) 07:49, 9 October 2008 (UTC)

::* Comment about invalid "vote(s)". The question is a stand-alone question. IF other contexts are influencing your decision, then your "vote" doesn't count and is invalid. Either answer the question, or don't vote at all. Deal with the other issues elsewhere or later. -- Fyslee / talk 13:42, 17 October 2008 (UTC) ^{Stricken to please Coppertwig. -- Fyslee / talk 15:51, 18 October 2008 (UTC)}

• Comment. The opinions of others are welcome here, including the opinions of researchers about the "subject". It is the circular discussions about research itself we wish to avoid here. It should be easy to answer the above question. It's a no-brainer. There is nothing wrong with answering more than once, or adding qualifiers to an "agreed" answer. This isn't a deletion discussion, or other type of discussion where "voting" twice is not allowed. You can make multiple comments after making your one "agree" or "disagree" remark. You can even make a "yes and no" type answer, so go for it. Your understanding of this matter is valued. -- Fyslee / talk 14:30, 9 October 2008 (UTC)

• Agree. My personal experiences with this term has been with using chiropractic care, so I associate this to a chiropractor. --CrohnieGal^Talk 11:38, 9 October 2008 (UTC)

• Agree that spinal manipulation is directly related to chiropractic, and is relevant to chiropractic.--—CynRN ^(Talk) 18:38, 9 October 2008 (UTC)

• Agree SM is the main mode of treatment in Chiropractic, while other things are related to Chiropractic as well, SM forms the core of this form of medical practice and is therefore directly related to the topic. Tim Vickers (talk) 18:53, 9 October 2008 (UTC)

• No. In terms of Wikipedia, spinal manipulation is not "relevant" to chiropractic. Chiropractic spinal manipulation is relevant to chiropractic. Disagree. The profession and its top researchers don't necessarily agree either. In fact, we have highlighted reliable sources demonstrating such disagreement in the professional and research worlds. -- Levine2112 ^discuss 20:46, 9 October 2008 (UTC)

::* Comment about invalid "vote(s)". The question is a stand-alone question. If other contexts are influencing your decision, then your "vote" doesn't count and is invalid. Either answer the question, or don't vote at all. Deal with the other issues elsewhere or later. -- Fyslee / talk 13:42, 17 October 2008 (UTC) ^{Stricken to please Coppertwig. -- Fyslee / talk 15:51, 18 October 2008 (UTC)}

• Comment:I see nothing invalid about Levine2112's vote. This is Wikipedia, so it would be nonsensical and off-topic to ask people to answer separately from the context of Wikipedia. Since you've cited the opinions of unnamed "top researchers" supporting your side of the question, Fyslee, it's only fair that Levine2112 be able to do the same to support the other side. If Levine2112 has included off-topic information (e.g. about "chiropractic spinal manipulation") in addition to a valid vote, I think it would be counterproductive to discount the entire vote on that basis. What is it about the vote that leads you to state that it's invalid, Fyslee? ☺ Coppertwig (talk) 18:06, 17 October 2008 (UTC)

• He is not answering the question as it is stated, which is the problem. This is a question of logic and knowledge of chiropractic, not just about Wikipedia. It is fundamental knowledge that colors most editors' way of editing, and we need to find out their views on the subject. While there is nothing overtly and openly stated in his statement above that would make it invalid, his motivations for not answering in a clear manner, but in a convoluted manner, are plainly evident from the myriad discussions that have led up to this RfC. He is plainly afraid to answer directly. Your statement indicates that you may not have followed these discussions as closely as the rest of us, which is okay. We happen to have learned his way of thinking quite well now and we don't have to assume bad faith or anything of that kind when we address his way of dealing with this issue. This is simple, very civil plain talk, and a request for straightforward and simple answers. Note that I wrote: "IF other contexts are influencing your decision...", which leaves it up to him to refactor his comments IF other contexts are at work here. I want him to be honest and to refactor, providing a straightforward answer that is not influenced by other factors. I want to find out about his basic knowledge of chiropractic.

• The "unnamed researchers" are known to all the regular editors here. I was just stating my reasons for starting this RfC. The opinions of others isn't the direct issue here, and no rebuttal naming others is necessary to answer the simple question. Naming others would only bring in other issues that are not part of this RfC, as stated above.

• This RfC mustn't get bogged down with the other issues which he has used to keep us going in circles for months, and which his recent comments below are doing. Such comments are specifically not allowed here, as stated above. That's why I have worded this RfC as simply as it's possible to word it. We need honest answers, not politically driven answers. A simple answer to a simple question is what is needed. Leave the qualifiers for other discussions. -- Fyslee / talk 20:11, 17 October 2008 (UTC)

• I don't understand "he is not answering the question as stated". What part of "No" do you not understand? The word "No" seems to me to be a simple, direct answer to the question as stated.^{(01:50, 18 October 2008 (UTC))} ☺ Coppertwig (talk) 01:10, 18 October 2008 (UTC)

• Basically there is only one correct answer, unless one is very ignorant about chiropractic, its writings, research, and history. That is a resounding "yes". A "no" answer indicates that hidden agendas are at play. That's what I should have stated right from the start. Those hidden agendas were mentioned in the "rules of engagement" and were specifically excluded from this RfC. Your answer below is quite enlightening and fair enough. I'll comment there. -- Fyslee / talk 05:55, 18 October 2008 (UTC)

• Maybe I have confused you by too many words regarding esoteric knowledge here among the regular editors. You are excused for not understanding it. The question is not qualified by "In terms of Wikipedia". It is a real, very simple question presented without connection to Wikipedia policies or issues being discussed elsewhere here. It is a question designed to test the basic logic and basic knowledge of chiropractic possessed by anyone who answers the question. Of course this still has relevance to our editing here since the answers provided can used to further our understanding of each other's thinking, which makes it easier to collaborate and avoid misunderstandings. It is thus of direct relevance to our editing here and isn't a waste of time. If the answers here are later used in other connections, so be it, but right now we need to concentrate on the question at hand, without making qualifications, exceptions, etc. -- Fyslee / talk 01:31, 18 October 2008 (UTC)

• I apologize for the tone of my response and have struck out some of my words and replaced them with different ones. ☺ Coppertwig (talk) 01:50, 18 October 2008 (UTC)

• No reliable source has been presented saying that spinal manipulation is not relevant to chiropractic. Apparently this comment is referring to Ernst 2002 (PMID 12379081). However, Ernst doesn't say that SM is irrelevant to chiropractic; he says that some studies of SM (presumably, studies of osteopathic SM, or whatever) are not relevant to chiropractic SM. Nowhere does Ernst say or imply that the topic of SM is irrelevant to chiropractic. The claim that Ernst says SM is irrelevant to chiropractic disagrees with pretty much every paper Ernst has written about chiropractic. Eubulides (talk) 23:18, 9 October 2008 (UTC)

• I am glad that you are finally acknowledging that Ernst did in fact say that some (Ernst says "most") studies of SM are not relevant to chiropractic SM. I think this acknowledgment is a good step in resolving this dispute and if nothing else comes from this rather innocuous RfC, I'm happy with at least getting this much. -- Levine2112 ^discuss 23:26, 9 October 2008 (UTC)

• Ernst did not say that "most" studies of SM are not relevant to chiropractic SM. He merely said that most of the randomized controlled trials of SM for low back pain cited in Meeker & Haldeman 2002 (PMID 11827498) do not relate to chiropractic SM. Chiropractic #Evidence basis does not cite any of those randomized controlled trials; as far as I know, it doesn't cite any RCTs at all. It cites general reviews. Eubulides (talk) 23:52, 9 October 2008 (UTC)

• That's still not entirely accurate. Ernst states that most of the published RCTs of SM for back pain are not related to chiropractic SM. He did not limit it to just those Meeker and Haldeman cited. But again, I am glad you are finally acknowledging at least this much. -- Levine2112 ^discuss 00:44, 10 October 2008 (UTC)

• I think you are really nitpicking on this one, and it's getting us nowhere. This is so trivial, as is all nitpicking. I hope you are satisfied with this supposed "acknowledgment". Can you leave the poor nit alone now so it can sleep a bit? The poor thing is getting tired, and this type of trivial stuff gets very poor mileage and reflects poorly on the one who keeps it going. -- Fyslee / talk 00:55, 10 October 2008 (UTC)

• Not only is it nitpicking, it is incorrect nitpicking. The "them" in the Ernst 2002 (PMID 12379081) comment "most of them do not relate to chiropractic spinal manipulation" clearly refers to the "43 randomized, controlled trials of spinal manipulation for back pain" that were cited by Meeker & Haldeman 2002 (PMID 11827498). Eubulides (talk) 01:27, 10 October 2008 (UTC)

• One man's nitpicking is another man's thorn in his side. I apologize if I keep pointing out Eubulides' errors, but when you keep making them and are editing based on these errors, I feel they should be brought to light for others to consider. For instance, Ernst does not limit RCTs to just the ones cited by Meeker & Haldeman. He says that of the 43 RCTs which M & H claim to exist in publication, most of them do not relate to chiropractic spinal manipulation.SM added later. Eubulides thus is in error when he says that Ernst is limiting to his comment to just those that were "cited" by M & H. -- Levine2112 ^discuss 17:24, 10 October 2008 (UTC)

• The previous comment is incorrect. All 43 RCTs were cited by Meeker & Haldeman 2002 (PMID 11827498). They are the RCTs in citations 48 and 51–94 of their paper; see the first three rows in Table 2, page 221, of Meeker & Haldeman. (I expect that the number of citations slightly exceeds the number of studies because some studies were reported in more than one paper.) Ernst is clearly referring to just the 43 SM RCTs cited by Meeker & Haldeman: he is not referring to any of the sources cited in Chiropractic, and he is not referring to any reviews of SM. Eubulides (talk) 17:44, 10 October 2008 (UTC)

• As you know, I continue to disagree with you on this point. Enough said. -- Levine2112 ^discuss 19:28, 10 October 2008 (UTC)

Levine2112's previous statement repeats, once again, one of his frequent misquotings of Ernst, and attributes a statement to Ernst which he never made:

• "most of them do not relate to chiropractic" - Levine2112
• "most of them do not relate to chiropractic spinal manipulation." - Ernst

This fundamental error has been repeated by him many times now and he's been called on it several times, including here (NORN) and here (misquoting problem). When will this stop? He thinks he's "pointing out Eubulides' errors", but is using fallacious arguments based on misquotings in such attempts. It's getting tiresome. -- Fyslee / talk 19:26, 10 October 2008 (UTC)

• NOTE: Levine2112 has refactored his incorrect statement without comment or edit summary. I have added a link to it in the interest of openness so no one who reads his and my statements will get confused. -- Fyslee / talk 19:49, 10 October 2008 (UTC)

• Fyslee, you know this wasn't intentional. I have explained this to you several times now. Who is the one nitpicking now? -- Levine2112 ^discuss 19:52, 10 October 2008 (UTC)

• Did I say it was intentional? I think not. To make sure readers here understand the background of this, I'll just repeat what I wrote to you at NORN: "I don't want to call this deliberate dissembling on his part because it really is complicated, but the effect on Wikipedia is the same. It games the system and fools people into believing his OR interpretation, and it keeps Talk:Chiropractic hostage to a very long discussion that drags on forever and goes in circles." -- Fyslee / talk 21:13, 10 October 2008 (UTC)

• WP:POT --Surturz (talk) 11:00, 17 October 2008 (UTC)

• Agree. Of course spinal manipulation is relevant to Chiropractic. While it's not the beginning and end of the field, it is their signature treatment. Just imagine this article trying to write this article without mentioning spinal manipulation -- and yes, that's exactly what you'd have to do, if you decided that spinal manipulation was actually irrelevant to Chiropractic. WhatamIdoing (talk) 18:21, 10 October 2008 (UTC)

• Agree. The majority of editors agree there is no OR violation and the editors who claim there is OR are aware top researchers are doing the same thing we are doing. We are following the lead of the top researchers. Chiropractic is strongly associated with spinal manipulation. It can't be original research when we are following the lead of expert reviewers. QuackGuru 17:30, 15 October 2008 (UTC)

• Disagree. While I would agree with the statement stand-alone without any context, I disagree because of previous discussions on this talk page. There is a difference between chiro SM and non-chiro SM and the generalisation "SM is relevant to chiropractic" should not be used to insert material about non-chiro SM into the article. --Surturz (talk) 11:00, 17 October 2008 (UTC)

• Comment about invalid "vote(s)". Well, the question is a stand-alone question. IF other contexts are influencing your decision, then your "vote" doesn't count and is invalid. Either answer the question, or don't vote at all. Deal with the other issues elsewhere or later. This likely applies to the other two dissenting "votes" as well.

• In this case, you are openly stating that your "vote" is influenced by other considerations, so it really is invalid. Please refactor your response and answer the question as is, or remove or strike through your comments.

• As to your personal attack above (WP:POT), I suggest you remove it, as also requested here.. -- Fyslee / talk 13:42, 17 October 2008 (UTC)

• See my comment below to Coppertwig, where I comment on your convoluted reply. -- Fyslee / talk 06:15, 18 October 2008 (UTC)

• My vote above stands. The previous chiro SM vs. non-chiro SM discussions are obviously relevant to this RfC. --Surturz (talk) 01:05, 19 October 2008 (UTC)

• Since that is not the subject of this RfC, and is specifically excluded as a factor in making replies here, your "vote" is off-topic and unhelpful. Your reply is fine outside of this RfC and after it, but not here. Take a look at Coppertwig's method if voting and see if you can give us a clear answer that is on-topic.

• Carefully wording an RfC in an attempt to back-door non-chiro-SM text into the article helps no-one. The issue that has been argued in this talk-page ad infinitum is chiro SM vs. non-chiro SM. To discuss the relevance of SM in general while banning any discussion about the differences between chiro SM and non-chiro SM is inherently biased. --Surturz (talk) 05:19, 20 October 2008 (UTC)

• So now you violate WP:AGF in addition to your violation of WP:NPA. This is really quite simple. Do you understand chiropractic or not? I'm not asking for the Straight chiropractic answer, just the plain common sense version as understood by chiropractors and non-chiropractors alike. Leave all other matters out of it unless and/or until it becomes relevant. It isnt' relevant here at all. Think of this as a closed room, and nothing outside of it matters. Just answer the question and do something about your policy violations. Strikethroughs (it's too late to remove them now) and apologies would be appropriate. They are evidence that will be used against you, but apologies will mitigate the situation. I'm giving you a chance. Please take it. -- Fyslee / talk 06:16, 20 October 2008 (UTC)

• I see you haven't removed your distracting personal attack above. -- Fyslee / talk 04:15, 19 October 2008 (UTC)

• Question and comment. Question: Would someone please cite sources that support the position that spinal manipulation is relevant to chiropractic? Comment: I agree with Surtuz's statement that ""SM is relevant to chiropractic" should not be used to insert material about non-chiro SM into the article." ☺ Coppertwig (talk) 18:06, 17 October 2008 (UTC)

• Lots of reliable sources support the position that spinal manipulation is relevant to chiropractic. (SM is not merely "relevant": it's core to chiropractic and is the reason that chiropractic exists.) Here are a few sources off top of my head (more could easily be cited):

• Principles and Practice of Chiropractic 3rd ed. (ISBN 0-07-137534-1), the leading textbook on chiropractic. For example, see chapters 1, 8, 9, 19, 37, 38, 43, and 57.
• Christensen & Kollasch 2005 (PDF)
• NCCAM 2005 (PDF)
• American Chiropractic Assn 2003 (PDF)
• Cooperstein & Gleberzon 2004 (ISBN 0443074135)
• Villanueva-Russell 2005 (PMID 15550303)
• Meeker & Haldeman 2002 (PMID 11827498) and their 2002 followup letter (PDF)
• Ernst 2008 (PMID 18280103)
• Council on Chiropractic Guidelines and Practice Parameters 2007 (PDF)

• In contrast, no reliable source claims that spinal manipulation is irrelevant to chiropractic.
• In its coverage of effectiveness and safety, Chiropractic neither discusses nor cites research that is specifically about "non-chiro SM". It does discuss and cite research about SM in general, but that's fine: SM is identified with chiropractic, and chiropractors do over 90% of SM.

Eubulides (talk) 19:11, 17 October 2008 (UTC)

Can you help me out here? I just perused Christensen & Kollasch 2005 (PDF) and I can't find where it says that spinal manipulation is relevant to chiropractic. Can you please provide a direct quote?

The same goes for NCCAM 2005 (PDF) where instead of seeing the relevance of one to another, I see the source drawing a clear distinction between chiropractic "adjustments" and spinal manipulation as performed by practitioners other than chiropractors.

Villanueva-Russell 2005 (PMID 15550303) also draws the distinction between chiropractic adjustments and general manipulation: "It should be noted that chiropractors consider the technique of "adjustment" to be exclusive to their profession, and distinguish the clinical procedure as separate from the more general medical term of "manipulation," which is a more generic, often long-lever movement of joints, not restricted to the spinal vertebrae, alone."

I am of the belief that spinal manipulation is somewhat relevant to chiropractic in the same way that X-rays are somewhat relevant to chiropractic. However, just as a general X-ray study which makes no conclusions about chiropractors use of X-rays (termed here as a nonchiropractic x-ray study) is irrelevant to the Wikiepdia chiropractic article, so irrelevant is a general spinal manipulation study which makes no conclusions about chiropractors use of spinal manipulation (termed here as a non-chiropractic spinal manipulation study). Just as the non-chiropractic X-ray study would be more appropriate at the X-ray article, so would the non-chiropractic spinal manipulation study be more appropriate at the Spinal manipulation study. -- Levine2112 ^discuss 19:28, 17 October 2008 (UTC)

• The first source you mention, Christensen & Kollasch 2005 (PDF), says in Table 10.12 (page 135) that 96% of chiropractors use the Diversified technique, and that most chiropractors use other spinal-manipulation techniques such as Gonstead.
• The second source you mention, NCCAM 2005 (PDF), leads its section 2 (page 2) with the sentence "Chiropractic is a form of spinal manipulation, which is one of the oldest healing practices."
• That quote from Villanueva-Russell 2005 (PMID 15550303) makes it clear that chiropractic adjustment is an important special case of manipulation. This supports the position that manipulation is relevant to chiropractic. Other parts of the same source (e.g., page 553) talk at length about the turf war over SM between chiropractic and other professions. For example, page 553 quotes Sportelli 1995 as saying "Chiropractic must lay claim and full ownership to what the general public already associates with chiropractors—spinal manipulation." This also supports the position that SM is relevant to chiropractic.
• The other 6 sources, which you didn't mention, also clearly support the position that SM is relevant.
• The claim that spinal manipulation is merely "somewhat relevant" to Chiropractic is incorrect, just as a claim that X-rays are "somewhat relevant" to Radiography would be incorrect. X-rays are core to radiography and are the reason for radiography's existence. It's perfectly reasonable for Radiography to cite sources about X-rays. Likewise for spinal manipulation and Chiropractic.
• Clearly SM is directly related to Chiropractic. No credible argument to the contrary has been presented here. Let's move on.

Eubulides (talk) 20:31, 17 October 2008 (UTC)

Christensen & Kollasch 2005 (PDF) never mentions the word "manipulation". So I don't see how we can infer it is drawing the conclusion that spinal manipulation is relevant to chiropractic. Again, I am not sure what "relevance" is going to give us. IF this is a discussion about WP:OR violation, then the standard is "directly related". NCCAM 2005 (PDF) certainly tells us that chiropractic is a form of spinal manipulation. Form is the operative word. Chiropractic is not spinal manipulation, but rather employs some form of spinal manipulation which differs from other forms. And yes Villanueva-Russell 2005 (PMID 15550303) makes it clear that the chiropractic adjustment is a special case of manipulation; "special case" because it is different from other forms of spinal manipulation. So from just those sources, we know that there are sources which positively identify "chiropractic spinal manipulation" (spinal adjustments) as different from "non-chiropractic spinal manipulation". I stopped there and didn't go into the other sources as I felt that enough has been presented for us to make this conclusion. But if you want to look into Ernst 2008, for instance, he too differentiate chiropractic spinal manipulation from other forms of spinal manipulation: Numerous forms of spinal manipulation exist but "the short-lever technique-touchingthe vertebrae directly at high velocity and low amplitude, i.e., by moving a small distance-with the spinal or transverse process as a fulcrum, is considered the typical chiropractic manoeuver. "Somewhat relevant" is a realistic claim; whereas "directly related" is the burden needed to satisfy WP:OR and thus far, that burden has not been upheld by those supporting inclusion of non-chiropractic specific spinal manipulation research. You say that "SM is directly related to Chiropractic". Show us that in terms of sources. Remember, "relevant to" and "direct related to" are not equivilent. Beyond that, the OR discussion goes to more detail and you must show that non-chiropractic-specific spinal manipulation research is directly related to chiropractic (the topic of this article). Thus far, just the opposite has been shown (with quotes from leading researchers such as Ernst stating that the majority of spinal manipulation RCTs for LBP are not related to chiropractic SM. And if something isn't related, then it certainly is not directly related. -- Levine2112 ^discuss 22:18, 17 October 2008 (UTC)

• Levine2112, you write: "If this is a discussion about WP:OR violation..." No, it isn't, as clearly stated above, and your comments are dragging this RfC back into your endless discussions of matters not related to this RfC. Please stop or your comments will be moved to a different thread. This is an off-topic discussion.

• Other editors, please do not participate in this type of off-topic diversion. -- Fyslee / talk 01:39, 18 October 2008 (UTC)

• Diversified is the most widely used form of SM. As Christensen & Kollasch state, 96% of chiropractors use Diversified; most of them also use other SM techniques. Clearly SM is directly related to chiropractic.
• If chiropractic is a form of SM, then SM is directly related to chiropractic.
• Whether chiropractic SM differs from non-chiropractic SM is irrelevant to this topic.
• The topic is whether SM is directly related to chiropractic. Which it clearly is. The Ernst 2008 quote is another quote supporting this position.
• Our last few comments in this subthread have not made any progress. Please feel free to have WP:THELASTWORD.

Eubulides (talk) 23:49, 17 October 2008 (UTC)

I appreciate that. All I ask is that you look at your use of the word "form" in your last response and realize that if chiropractic is just a form of SM then it is to that form of SM which chiropractic is DIRECTLY related. The other forms of SM may possibly be somewhat related to chiropractic, but they certainly aren't directly related. For instance, the form of use of a hypodermic needle which medical doctors employ is directly related to Medical doctors. However, a heroin addict's form of use of a hypodermic needle is plausibly somewhat related to Medical doctors, but it certaily isn't directly related. Therefore the topic "Hypodermic needles" is somewhat related to Medical doctors, but certainly not directly related. After all, if there was a study documenting the dangers of heroin addicts' use of hypodermic needles, you would expect to find that study on the Medical doctor article in the context of "Medical doctors use hypodermic needles a great deal. According to research studying heroin addicts, hypodermic needles are dangerous." Take some time. Step back. Think about it. I promise I'll do the same. -- Levine2112 ^discuss 00:35, 18 October 2008 (UTC)

Please stop this off-topic discussion. -- Fyslee / talk 01:39, 18 October 2008 (UTC)

I'd say that a discussion of "knowledge and logic" outside of the realms of a Wikipedia application of such knowledge and logic is a discussion which is off-topic. From WP:Talk#How_to_use_article_talk_pages: Talk pages are for discussing the article, not for general conversation about the article's subject... Keep discussions on the topic of how to improve the associated article. Irrelevant discussions are subject to removal. -- Levine2112 ^discuss 02:02, 18 October 2008 (UTC)

No one forced you to participate in this RfC. If information that can help us understand each other and help us to collaborate better doesn't interest you, you can (continue) to stand outside that collaboration. Your continued stonewalling and gaming the system is not welcome anyway and it's very disruptive and tiring. Please stop dragging us around in circles and admit that you have not gathered a consensus behind your OR POV, a POV not supported by views in the profession. OTOH, you are welcome to strike through your comments, but please leave them in place, since many other comments only make sense because of them.

There is another option, and that is to strike through your previous comments and then answer the question honestly and simply as Coppertwig has done below. That way you can at least make some semblance of attempting to stay within sight of collaboration, instead of disrupting this RfC. -- Fyslee / talk 06:05, 18 October 2008 (UTC)

• Agree, qualified by Surtuz' comment that ""SM is relevant to chiropractic" should not be used to insert material about non-chiro SM into the article." (Apologies for the repetition.) A narrow question has been asked and my answer pertains only to that, not to other questions.
  Thank you very much for the list of references, Eubulides. Based on those references, I found the following some of which in my opinion support the RfC question:

  • Principles and Practice: I'm not sure if I have easy access to this book.
  • Christensen & Kollasch 2005: does not contain the string "spinal m"
  • NCCAM: "Chiropractic is a form of spinal manipulation".
  • American Chiropractic Association: The mere fact that they published a document entitled "Spinal Manipulation Policy Statement"; also the section heading "Spinal Manipulation Therapy is a Chiropractic Science"; also the quote "The general description, spinal manipulative therapy, has long been used to broadly describe theprimary manual techniques utilized by a doctor of chiropractic (chiropractic physician)." and the quote "This supports the premise that by far the providers currently best qualified by education and practical skill and testing to perform spinal manipulation are doctors of chiropractic (chiropractic physicians)."; incidentally, the phrase "chiropractic spinal manipulation" also appears several times.
  • Villanueva-Russell: (This quote tends to contradict the RfC question) "The existing scientific research refers to spinal manipulation generally and without reference to specific technique or practitioner."
  • Villanueva-Russell quotes Sportelli: "Chiropractic must lay claim and full ownership to what the general public already associates with chiropractors-spinal manipulation. (1995, p. 39; emphasis added)"
  • Meeker and Haldeman: "Much of the positive evolution of chiropractic can be ascribed to a quarter century-long research effort focused on the core chiropractic procedure of spinal manipulation."
  • Ernst 2008: "This article attempts to critically evaluate chiropractic. The specific topics include ... the concepts of chiropractic, particularly those of subluxation and spinal manipulation;..."; and also "The core concepts of chiropractic, subluxation and spinal manipulation," and "Recent definitions of chiropractic:" of 12 definitions, 3 mention "spinal manipulation"; the phrase also appears in a summary of the "The three main hypotheses of modern chiropractic"; there's also this quote: "Chiropractors therefore developed spinal manipulations to correct such subluxations,... "
  • Council on Chiropractic Guidelines...: Inconclusive; I didn't find "chiropractic" and "spinal manipulation" in the same sentence.

• ☺ Coppertwig (talk) 02:08, 18 October 2008 (UTC)

• Thank you Coppertwig for a straightforward answer. Your qualification afterwards doesn't disturb me, since it reveals that you do have other thoughts, and that's quite legitimate. At least you don't launch into more discussion of that particular subject, which is good since we are discussing that elsewhere. You know how to keep things separate, an admirable quality.
• Interestingly enough Surturz does what you do, except he (contrary to the rules of engagement) allows those other agendas to affect his answer. If he had done as you have done, then we'd have had fewer problems here. -- Fyslee / talk 06:15, 18 October 2008 (UTC)

• My answer is affected by the totality of my life experience; that's why not everyone's answer is the same. I don't understand why you think I'm allowed to also have other thoughts while you've marked some other editors' votes as invalid. Given the way you marked others' votes, to be consistent I think you should mark mine as invalid, too. I said "Agree, qualified..."; Levine2112 said "No." with a period after it. How can you call my answer "straightforward" and Levine2112's "invalid"? ☺ Coppertwig (talk) 15:30, 18 October 2008 (UTC)

• Just to please you, I have stricken two spots above. To explain esoteric discussions isn't worth the grief. -- Fyslee / talk 15:51, 18 October 2008 (UTC)

• DISAGREE Chiropractic is a profession. . . which uses a specific kind of spinal manipulation called the "adjustment". The adjustment is relevant to chiropractic.TheDoctorIsIn (talk) 20:32, 18 October 2008 (UTC)

• Comment Request for comment is about requesting comments. It is not about voting. No votes are valid as no vote is taking place.--ZayZayEM (talk) 09:58, 21 October 2008 (UTC)
• Comment This RfC has clearly been loaded in an attempt to push through information clearly not entailed in the request for comment. Full context should be provided with any RfC. Do not abuse editors good faith.--ZayZayEM (talk) 09:58, 21 October 2008 (UTC)
• Quibble per other editors statements above. Not all spinal manipulation is relevant to Chiropractic. Spinal manipulation may be a core concept of chiropractic, and be directly associated with a chiropractor - however only chiropractic spinal manipulation is relevant to this article. It is kind of obvious. To use a illustrative concept: movement through water is clearly directly related and central to swimming - however not all in-water motion is directly related to swimming, and would therefore be irrelevant to that article. Any mention of boat motion through water, or fish motion through water, or a quad-amputee's body sinking downwards in a lake (live human motion in water) would need to be in direct relation to the concept of swimming - or would be not relevant (and unencyclopedic) on the topic.--ZayZayEM (talk) 09:58, 21 October 2008 (UTC)

  Comment: No offense to any quad-amputees, but I concur with ZayZayEM's comments and quibble above. Fyslee, thank you very much for striking out some of your comments. ☺ Coppertwig (talk) 14:03, 21 October 2008 (UTC)

  Comment It would help if you provided evidence if you are insinuating that general spinal manipulation research is not relevant. BTY, editors have provided evidence that it is directly related. QuackGuru 22:23, 21 October 2008 (UTC)

• Obvously no "voting" is taking place, which is indicated in my frequent use of quotation marks when using the word. An RfC is more of a straw poll with no real consequences, in contrast to a AfD, where articles actually get deleted. You aren't dealing with newbies here. After giving a short and clear "vote", your comments (including quibbles not already covered in the discussions outside this RfC) are welcome. This RfC generally functions like most others, but it can be seen as more focused, getting to the core of the subject by excluding distractions included in other RfCs. Those "contexts" aren't part of this one. This one is pretty much "contextless" by excluding them.
• As a non-regular here I'll excuse you to some degree, but you are still obviously assuming bad faith in your "loaded" accusation and will give you a chance to refactor, now that you have been warned. The context you mention is all around you here, and this RfC is "un"loaded specifically to exclude those discussions. There would be no point in another RfC on the same subject. This one is designed for a specific purpose, which is clearly stated. That's it. -- Fyslee / talk 14:01, 21 October 2008 (UTC)

As perhaps only an outsider can do, ZayZayEm has analyzed this without passion or prejudice and has stated that not all spinal manipulation is relevant to chiropractic. ZZM's swimming analogy is spot on. It's simple logic, easy to follow and I thank this editor for their outside perspective. -- Levine2112 ^discuss 02:52, 22 October 2008 (UTC)

Review of RFC

It's time to move on and remove the OR tag when no evidence of WP:OR has been presented.

In order to stop the continued OR discussion we may need a specific topic ban on editors who never stop claiming there is OR when we are doing exactly what researchers outside of Wikipedia are doing. The topic ban would be anything directly related to the original research discussion. This would not be an article ban but only a ban on this specific topic. We could have an article ban on any editor who continues the original research discussion if editors believe it to be necessary. Note. Consensus can easily be gamed when editors attempt to block consensus and improvements without a valid reason. WP:IDONTLIKEIT or misunderstanding policy is not a reason to exclude neutrally written information using highly reliable references.

DigitalC has not provided a reason to disagree other than DigitalC thinks the question is too vague but wrote Overall, the answer is "not necessarily". Not neceessarily is trying to have it both ways.

Surturz wrote: While I would agree with the statement stand-alone without any context, I disagree because of previous discussions on this talk page. There is a difference between chiro SM and non-chiro SM and the generalisation "SM is relevant to chiropractic" should not be used to insert material about non-chiro SM into the article. Surturz agrees but then asserts there is a difference between chiro SM and non-chiro SM but that is not a reason to exclude directly related research. We should stick to Wikipedia policy and not decide on personal wishes not based on anything at Wikipedia.

Levine2112 wrote: No. In terms of Wikipedia, spinal manipulation is not "relevant" to chiropractic. Chiropractic spinal manipulation is relevant to chiropractic. Disagree. The profession and its top researchers don't necessarily agree either. In fact, we have highlighted reliable sources demonstrating such disagreement in the professional and research worlds. According to Levine2112, top researchers don't necessarily agree either but no evidence by Levine2112 has been presented. Levine2112 has read comments indictating chiropractic is directly related or is relevant to chiropractic. Levine2112 has been informed that chiropractic is strongly associated with spinal manipulation according to the reliable references presented.

ZayZayEM wrote in part: Spinal manipulation may be a core concept of chiropractic, and be directly associated with a chiropractor - however only chiropractic spinal manipulation is relevant to this article.

The comments by ZayZayEM is good a reason to include SM research because we using references that are directly related to chiropractic. ZayZayEM is aware that spinal manipulation may be a core concept of chiropractic. Coppertwig agrees with ZayZayEM about quibbling. Coppertwig has been informed it is not productive to continue to support there is original research when no evidence of OR has been presented.

Per WP:OR:

Wikipedia does not publish original research or original thought. This includes unpublished facts, arguments, speculation, and ideas; and any unpublished analysis or synthesis of published material that serves to advance a position. This means that Wikipedia is not the place to publish your own opinions, experiences, or arguments. Citing sources and avoiding original research are inextricably linked: to demonstrate that you are not presenting original research, you must cite reliable sources that are directly related to the topic of the article, and that directly support the information as it is presented.

When spinal manipulation research is directly related to chiropractic there can't be any original research and the editors who claim there is original research should read policy again. No evidence of orginal research has been presented but editors continue to claim there is OR. Please show and not assert your view based on policy. These comments provided additional context for uninvolved editors and uninvolved admins. QuackGuru 18:50, 21 October 2008 (UTC)

X-rays

Chiropractors use them (some critics say "too often"). Historically, the profession is credited with much of the advances in the field of Radiology.

• Could we use a study about chiropractor's use of X-rays in this article? (i.e. to support a statement such as "According to study A, chiropractic use of X-ray is regarded as safe/dangerous"?
• Could we use a study about X-ray use in general (not necessarily performed by chiropractors) in this article? (i.e. to support a statement such as "According to study A, the use of X-rays is safe/dangerous")?

I am thinking about this in terms of WP:NOR, but I am interested in any input about any policies as well regarding this. -- Levine2112 ^discuss 19:24, 10 October 2008 (UTC)

I think it'd be helpful to put in a brief discussion of chiropractic and X-rays. The topic is already discussed in Chiropractic #History but only from a historical viewpoint, and it'd be helpful to cover it from today's. Sources that we might want to take a look at include French et al. 2003 (PMID 17987210) and Ernst 2002 (PMID 9616232).

I am a bit leery about using Ernst so much. His bias is of concern and with so much from him already going into this article, there is a legitimate WP:WEIGHT concern. Anyhow, while I want to pursue this conversation, I would really like to use this space to discuss my two hypothetical scenarios above. It seems like you would say "Yes" to scenario 1, given your post; but what about scenario 2. Could we put the conclusions of a general (non-chiropractic) X-ray study here and discuss the relative safety of X-rays based on that study? For instance, let's say we found a review of literature which says X-rays are completely safe. Could we include that conclusion in this article where we are talking about chiropractors use of X-rays? -- Levine2112 ^discuss 07:49, 11 October 2008 (UTC)

Lets stay on topic. The Ernst ref is relevant and freely readable too. Click on Begin manual download if it does not go straight to the PDF file. QuackGuru 18:14, 11 October 2008 (UTC)

As a matter of fact,t he topic of this thread is what I defined it to be when I started it. Could you answer it please? -- Levine2112 ^discuss 18:29, 11 October 2008 (UTC)

I will answer your question the the form of a question. Do you think X-rays are strongly associated with chiropractic to the same degree as spinal manipulation according to the expert reviewers? QuackGuru 17:35, 15 October 2008 (UTC)

I don't know. I have not looked at the expert reviewers take on X-rays and chiropractic. Does that really matter in the case of my hypothetical question above? -- Levine2112 ^discuss 17:43, 15 October 2008 (UTC)

It may be best for you to strike your questions. You don't know what experts think about this and you claim: Does that really matter in the case of my hypothetical question above? At this point, I don't see any reason to continue a discussion on this hypothetical question. Time to move on. QuackGuru 17:57, 15 October 2008 (UTC)

I suggest you strike out your repeated hypothetical question too. It serves no purpose to the OR discussion here. The noticeboard is not a policy page or for general discussion. QuackGuru 18:06, 15 October 2008 (UTC)

This is an attempt to discuss policy and people's understanding of such policy. NORN is the perfect place to do that, I think. -- Levine2112 ^discuss 19:16, 15 October 2008 (UTC)

Scope of practice 4

The following proposal builds on the wording proposed in #"Limited scope of practice" (version 3), and also the wording proposed in #Fixing first paragraph under EFFICACY. In #Comments on "Limited scope of practice" (version 3) it was suggested to "Please tweak it and let's see what your version looks like". As I mentioned toward the end of that section, more surgery than a "tweak" is needed. The current proposal (below) make several changes to Chiropractic #Scope of practice, instead of merely appending text to it. Here is the proposal:

• Move the following sentence from Chiropractic #Effectiveness, to Chiropractic #Scope of practice as shown in the proposed (modified) wording below:

No single profession "owns" spinal manipulation and there is little consensus as to which profession should administer SM, raising concerns by chiropractors that orthodox medical physicians could "steal" SM procedures from chiropractors; the focus on SM has also raised concerns that the resulting practice guidelines could limit the scope of chiropractic practice to treating backs and necks.

• Move the following (modified) text from Chiropractic #Scope of practice to the end of 2nd paragraph of Chiropractic#Education, licensing, and regulation, as it talks about education rather than scope-of-practice:

Specialty training is available through part-time postgraduate education programs such as chiropractic orthopedics and sports chiropractic, and through full-time residency programs such as radiology or orthopedics.

• Move the following (modified) text from Chiropractic #Scope of practice to the beginning of 3rd paragraph of Chiropractic#Education, licensing, and regulation, as it is more relevant to accreditation than to scope of practice, and it will then immediately precede text that talks about the U.S., etc.

Chiropractic is established in the U.S., Canada, and Australia, and is present to a lesser extent in many other countries.

• Replace Chiropractic #Scope of practice with the following:

Scope of practice

Chiropractors, also known as doctors of chiropractic or chiropractic physicians in many jurisdictions, emphasize the conservative management of the neuromusculoskeletal system without the use of medicines or surgery, with special emphasis on the spine. Chiropractic combines aspects from mainstream and alternative medicine: although chiropractors have many attributes of primary care providers, chiropractic has more of the attributes of a medical specialty like dentistry or podiatry. It has been proposed that chiropractors specialize on nonsurgical spine care, instead of attempting to also treat other problems; but the more-expansive view of chiropractic is still widespread. Mainstream health care and governmental organizations such as the World Health Organization consider chiropractic to be complementary and alternative medicine (CAM); however, a 2008 study reported that 31% of surveyed chiropractors categorized chiropractic as CAM, 27% as integrated medicine, and 12% as mainstream medicine.

The practice of chiropractic medicine involves a range of diagnostic methods including skeletal imaging, observational and tactile assessments, and orthopedic and neurological evaluation. A chiropractor may also refer a patient to an appropriate specialist, or co-manage with another health care provider. Common patient management involves spinal manipulation (SM) and other manual therapies to the joints and soft tissues, rehabilitative exercises, health promotion, electrical modalities, complementary procedures, and lifestyle counselling.

Chiropractors cannot write medical prescriptions or perform major surgery. In the U.S. their scope of practice varies by state in areas such as conducting laboratory tests or diagnostic procedures, dispensing dietary supplements, and using other therapies such as homeopathy and acupuncture; in the state of Oregon they can become certified to perform minor surgery and to deliver children via natural childbirth. A 2003 survey of North American chiropractors found that a slight majority favored allowing them to write prescriptions for over-the-counter drugs. A related field, veterinary chiropractic, applies manual therapies to animals and is recognized in a few U.S. states, but is not recognized by the American Chiropractic Association as being chiropractic.

Spine care is offered by several other professions, including massage therapists, osteopaths, and physical therapists. No single profession "owns" spinal manipulation and there is little consensus as to which profession should administer SM, raising concerns by chiropractors that orthodox medical physicians could "steal" SM procedures from chiropractors. A focus on evidence-based SM research has also raised concerns that the resulting practice guidelines could limit the scope of chiropractic practice to treating backs and necks. Some U.S. states prohibit physical therapists from performing SM, some states allow them to do it only if they have completed chiropractic training, and some states allow only chiropractors to perform SM, or only chiropractors and physicians. Bills to further prohibit non-chiropractors from performing SM are regularly introduced into state legislatures and are opposed by physical therapist organizations.

Eubulides (talk) 07:38, 11 October 2008 (UTC)

That sounds pretty good to me. There is one point at which I hesitate, and that is where the word "steal" could be understood to mean that chiropractic already owns SM, which is not the case. They are seeking to own it by preventing other professions from using it. It's a Liebensraum political move. One cannot steal something from someone who doesn't own it. SM predates chiropractic and has been used by other professions for a long time, in some cases before chiropractic came into existence. The Villanueva cite should include a URL to the whole article, if possible. -- Fyslee / talk 00:14, 12 October 2008 (UTC)

Thanks for catching that. The proposal doesn't talk about stealing SM, it talks about stealing SM procedures. To make this point clearer I replaced "There is little consensus as to which profession should administer spinal manipulation," with "No single profession "owns" spinal manipulation," in the proposal. The cited source supports both wordings, but the latter is clearer on this point (and is much easier to read to boot). Eubulides (talk) 06:28, 12 October 2008 (UTC)

The wording change is confusing. It sounds as if there is a concern over who owns SM. QuackGuru 06:55, 12 October 2008 (UTC)

Sorry, I don't see the confusion. There is a concern over who "owns" SM. Some chiropractic groups do want to "own" it; after all, SM is chiropractic's core treatment form, and it's the reason chiropractic exists. Conversely, PTs, MDs, DOs, etc. dispute the "ownership", and say they can do SM as well. The mainstream consensus is that no group "owns" SM, which is what the new text says. However, if the new text is confusing to you, perhaps we should go back into the old text. It's been that way in the article for months, and I'd rather not have this overall edit be sidetracked by a question over whether this particular change is confusing. Eubulides (talk) 13:31, 12 October 2008 (UTC)

I think we should keep the updated version. The attempts to gain "ownership" by chiropractic goes against the grain of how medicine historically works. Mainstream, authorized professions have always reserved the right to use or adopt any method that is effective or has some legitimacy, or even if not totally proven yet, using it as an experimental treatment, with MDs having absolute rights in this regard, and subordinate professions like PTs choosing to concentrate on methods within their scope of practice, which is why SM is a logical part of their armamentarium of treatment techniques. Any method, including currently alternative medicine methods, ceases to be "alternative" and becomes mainstream if proven effective, and thus becomes legitimate game for mainstream professions. If I had access to the full text version I'd be able to contribute more effectively here. -- Fyslee / talk 18:35, 12 October 2008 (UTC)

Me thinks we should keep the original version and if editors agree we can add the new material No single profession "owns" spinal manipulation. right before the old material for context. QuackGuru 02:30, 13 October 2008 (UTC)

OK, thanks for the suggestion, I did that. Eubulides (talk) 07:06, 15 October 2008 (UTC)

Time to remove tags

Discussion seems to have died down about the two maintenance tags in Chiropractic. It's time to fix this as discussed.

First, Chiropractic #Effectiveness has a {{Mergeto}} tag that has been discussed in great detail in #Relevancy and in #Scope of practice 4 above. It can be removed by applying the change discussed in #Scope of practice 4.

Second, Chiropractic #Evidence basis has a {{SectOR}} tag that has been discussed in enormous detail, in several places, including:

• RfC: Effectiveness of chiropractic care (April 24)
• RfC: Effectiveness of chiropractic care (May 12)
• Its followup Improved version RfC (May 14)
• Chiropractic section on evidence basis (July 29)
• Request for Comment, Possible OR violation at Chiropractic Effectiveness (September 10)
• Request for Comment: Excluding treatment reviews (September 16)
• Outside view believes spinal manipulation is relevant (September 30)
• RfC: Is the "subject" of spinal manipulation relevant to chiropractic? (October 9)

While there is not universal agreement in the above threads, there is a consensus that the text in question is not original research. Further reopening of RfCs and NORN issues is likely to be not useful, as we've reached the point of RfC exhaustion. It's time that we brought this discussion to a close, removed the tag, and moved on to further improving the article. Eubulides (talk) 07:06, 15 October 2008 (UTC)

There is no consensus that the text in question is not a violation of WP:OR. Saying so is a gross distortion of the truth. I'd say that it is time to remove the text in question and move on to further improving the article. However, I am not going to suggest that until this conversation is truly over. As of now, the conversation is hardly over. I still plan on opening the new RfC and continuing with WP:DR. How come you never answered my X-ray questions above? -- Levine2112 ^discuss 17:21, 15 October 2008 (UTC)

We are doing the same thing experts outside of Wikipedia are doing and you know this. I'm sure of it. On Wikipedia we do not lead but follow the latest references carefully. That's exactly what we are doing. QuackGuru 17:51, 15 October 2008 (UTC)

Actually, Levine, consensus is relatively clear in the RFC. Further discussion there may yet be useful to come up with suggestions on how to minimize perceived WP:OR violations, but I highly doubt that consensus will change due to it. Cheers. lifebaka++ 19:02, 15 October 2008 (UTC)

Which RfC are you referring to? We've had several. Some editors who responded in earlier ones did not respond in newer ones. And some of the newer RfC don't really discuss whether or not the OR tag is appropriate. -- Levine2112 ^discuss 19:07, 15 October 2008 (UTC)

The one above at #RfC: Is the "subject" of spinal manipulation relevant to chiropractic? was what I was referring to specifically. If you have links to older RfCs on the topic, I'll be happy to look over them. It is true that this specific RfC does not directly address the issue of OR, and perhaps another RfC based on its outcome would be appropriate. Cheers. lifebaka++ 19:12, 15 October 2008 (UTC)

Thanks for the response. Yes, that RfC does not address the possible OR violation directly. Whereas, this one does. You will note that the majority (if not all) of the outside respondents agreed that there was an OR violation. -- Levine2112 ^discuss 19:14, 15 October 2008 (UTC)

Editors claimed there was OR but specific exmples are needed. See Talk:Chiropractic/Archive 27#Examples needed. The OR concerns are only concerns. No evidence of OR has been presented. For this article, Wikipedians are doing the same thing top researchers are doing. Time to move on. QuackGuru 20:06, 15 October 2008 (UTC)

Interesting, but I don't see consensus either way in that one. Outside participation in the linked RfC was very low, though you are correct that it favored the position that an OR violation had been committed. Cheers. lifebaka++ 22:36, 15 October 2008 (UTC)

What is more interesting is that the editors who claim OR are unable to produce any evidence of OR. Outside participation was very low. Some of the editors are involved editors and not outside observers. Hmm. QuackGuru 04:39, 16 October 2008 (UTC)

Indeed, Lifebaka. I'd say there was a very clear consensus that no OR is involved in following the literature and using these references in the same way as other publications on the topic. Tim Vickers (talk) 19:10, 15 October 2008 (UTC)

And I would disagree. When one looks at the totality of the discussion (including here), no clear consensus exists. DigitalC (talk) 08:07, 16 October 2008 (UTC)

• The totality of the discussion includes all 8 threads I listed at the start of this section. The thread that you and Levine2112 cite is the one most-favorable to the contention that OR exists. And that particular thread is a slender reed indeed: the RfC itself is vaguely worded and contains no specific examples, outside respondents' opinions contain statements like "I have not digested the section in question" which make it clear that their opinions are uninformed, and the resulting comments don't establish consensus either way. And that's the thread most-favorable to the contention that OR exists; the other 7 threads listed above are unfavorable to the contention.
• Levine2112 has stated multiple times an intent to continue this months-long campaign of opening RfCs and other dispute-resolution options, with comments like "The conversation is hardly over" (e.g., [1], [2]). As part of this campaign, for example, there's a currently-open thread at WP:NOR/N #A hypothetical which raises a hypothetical question about X-rays within chiropractic. The questions in this campaign are vague or hypothetical questions, sometimes contain inaccurate summaries of what is actually in Chiropractic, and do not propose specific changes to the wording in the article. Such questions are unlikely to result in any improvements to Chiropractic. Much better would be specific wording proposals, such as the one in #Proposed addition re X-ray safety below.

Eubulides (talk) 17:02, 16 October 2008 (UTC)

This comment seems irrelevant IMHO. This is how consensus policy can easily be gaming the system. The editors who claim OR have not presented any evidence of OR. Should we respect the opinion of editors who make a claim of OR when they refuse to demonstrate any evidence of OR exists or should we move on to other parts of the article? This is when admins may want to step in an make an executive decision. Should editors continue to argue (continue to recycle old arguments) or move on to bigger and better things (possibility of WP:GA)? QuackGuru 18:08, 16 October 2008 (UTC)

Proposed addition re X-ray safety

There's been some discussion on procedural grounds about a hypothetical example involving chiropractors and X-rays. That topic is clearly relevant and notable to Chiropractic, so I propose to append the following text to Chiropractic #Safety, as a new paragraph. This is not intended to be a hypothetical example: this is a real proposal to improve the article.

Chiropractors sometimes employ diagnostic imaging techniques such as X-rays and CT scans that rely on ionizing radiation; practice guidelines aim to reduce unnecessary radiation exposure, which causes cancer in proportion to the amount of radiation received.

Eubulides (talk) 20:45, 15 October 2008 (UTC)

Is general spinal manipulation (GSM) technically different than chiropractic spinal manipulation (CSM)?

There has been a lot of discussion about original research but what is the difference? Is there any significant difference? According to what source there is any specific difference between GSM and CSM. QuackGuru 05:20, 16 October 2008 (UTC)

To get useful answers you'll need to use standard terminology. Please explain more specifically what you are referring to. Is GSM the same as HVLA spinal manipulation, and is CSM the same, but performed by a chiropractor, and thus if it is a straight chiropractor, will be termed a spinal adjustment? If so, the only difference is the performer and the intention. A chiropractor (especially a straight one) manipulates/adjusts with the intention of "correcting" vertebral subluxations (VS). Regardless of intent, both practitioners are causing the same effect on the structures being manipulated, but will be causing different beliefs about what is happening in the minds of their patients. Physically equal, but mentally different.

If by CSM you are allowing the myriad techniques that are also (in addition to HVLA spinal manipulation) included under the umbrella term spinal adjustment, then the sky's the limit, as techniques vary quite a bit, including mechanical and electrical devices, and including techniques that don't have an earthly chance of having any real effect on a spinal motion segment.

Basically, "adjustment" is a code word for the claimed "correction" of anything any chiropractor claims is a VS, and thus is the manipulation of an imaginary lesion. There is often no known objective method of identifying them. When the original Medicare requirements for objective proof (x-rays) were made, it turned out that such proof was not forthcoming, and finally the requirement was dropped in 2000. Now there is no requirement for proof. Medicare just accepts the subjective word of any chiropractor that they have corrected a VS. -- Fyslee / talk 05:58, 16 October 2008 (UTC)

Yes Chiropractic adjustments are different than other doctors or nondoctors application of spinal manipulative therapies. . . Chiropractors use different technique favoring short lever, high velocity, low amplitude where osteopaths tend to do long lever movements. . . chiropractic adjustments are much more specific than any other kind of smt.TheDoctorIsIn (talk) 20:39, 18 October 2008 (UTC)

Please provided a reference to support your view. Do you have and specific recommendation to improve the article with a reference that supports your position. Without a reference your position is speculation. QuackGuru 23:14, 18 October 2008 (UTC)

I too would like to see proof for that straight chiropractic claim. The claim can be documented from straight chiro literature, but that is not evidence that the claim is true. Apparently User:TheDoctorIsIn/User:DoctorIsOut is not aware that DOs, PTs, and some MDs learn these same techniques, with equal specificity. The one thing that remains different is the intention. Only DCs, especially straight ones, claim to "correct vertebral subluxations". Otherwise the HVLA manipulations/adjustments are physically/biomechanically the same. Keep in mind that Palmer learned from osteopaths, and that spinal manipulation predates both professions, having been used by medical physicians and bonesetters for ages. Both osteopaths and chiropractors have shared their techniques for years with MDs and PTs. Of course the term "chiropractic adjustment" can also include chiropractor-performed long lever movements, and also includes myriad non-HVLA techniques which are performed using instrumentation and electric devices, and some of which don't even touch the body, yet the DC doing it claims to be "correcting subluxations". Go figure....

Yes, I would like to see real published evidence that this claim is true. -- Fyslee / talk 03:29, 19 October 2008 (UTC)

Are you insinuating that TDII is a sockpuppet of the banned user DoctorIsOut? This isn't the proper venue, if so. If not, you should strike that from your comments.

Practitioners rely on "chiropractic adjustments" comprised of quick, forceful thrusts by hand to the spinal vertebrae in order to release an impinged nerve, thus removing a subluxation. It should be noted that chiropractors consider the technique of "adjustment" to be exclusive to their profession, and distinguish the clinical procedure as separate from the more general medical term of "manipulation," which is a more generic, often long-lever movement of joints, not restricted to the spinal vertebrae, alone. Villanueva-Russell 2004

Manipulation, as an abstract concept, was interchangeably used by some researchers and practitioners affiliated with osteopathy, chiropractic, physical therapy and orthodox medicine; whereas chiropractic "adjustments" were more specifically applied using "the spinous and transverse process as levers to restore the misaligned [spinal] vertebra into normal position" Williams 1994

That standard, written in the Mercy report, has reduced the profession of chiropractic to a modality of manipulation. A manipulation technique that is to be prescribed in a limited way for a limited kind of musculoskeltal condition. ACA Journal of Chiropractic 1992

These systematic reviews usually include trials of spinal manipulation regardless of who administered it. Thus, they are not exclusively an evaluation of chiropractic. Ernst 2008

-- Levine2112 ^discuss 02:30, 22 October 2008 (UTC)

Possibly misleading text or a weight violation from a source was added without discussion or consensus

Please revert and discuss major changes to the text. Or are we back to being WP:BOLD for this article. We can remove the controversy template that is towards the top of the talk page if editors agree. QuackGuru 01:53, 18 October 2008 (UTC)

• No, the usual style for Chiropractic is that we discuss possibly-controversial changes on the talk page, giving other editors adequate time to think and comment about the changes, before installing them. That was done for the previous version of the text in question: in Talk:Chiropractic/Archive 28 #Misleading sentence, four editors discussed an older version, proposed and refined the previous version over a period of eight days, achieved consensus, and eventually installed the change.
• In contrast, the edit you refer to simply installed a controversial change without discussion. This isn't a good way to proceed, for obvious reasons. I reverted the edit and am copying it here for further discussion (inserted text in italics):

A 2002 review of randomized clinical trials of SM was criticized for not distinguishing between studies of SM in general, and studies on chiropractic SM in particular chiropractic SM in particular and studies of SM in general - most of which do not relate to chiropractic SM;

• The inserted text incorrectly summarizes Ernst 2002 (PMID 12379081), the cited source, for two reasons:

• Ernst 2002 nowhere says that these 43 trials are "studies of SM in general".
• As was explained repeatedly[3][4][5][6] in #RfC comments, Ernst 2002 is not referring to "most" of the "studies of SM in general"; it is clearly referring to just the 43 SM randomized controlled trials cited by Meeker & Haldeman (PMID 11827498).

• Levine2112 originally claimed Ernst wrote that most studies of SM are not relevant to chiropractic SM,[7] and responded to the explanations to the contrary (documented in the previous bullet) at first by disputing them[8][9] and then by saying "As you know, I continue to disagree with you on this point. Enough said."[10]
• Given that Levine2112 knew that the edit was controversial, it is disappointing to see that the edit was installed anyway, despite consensus on the talk pages that potentially-controversial changes should be discussed here first. I urge that we stick with that consensus; otherwise, editing on Chiropractic will degenerate back to the revert-war-happy state that it had not so long ago.
• I don't see an easy way to repair the edit above, other than by reverting. Perhaps another editor can come up with better wording. But please propose it here first, rather than installing it; this is a controversial area.

Eubulides (talk) 05:59, 18 October 2008 (UTC)

I read the source and what Levine wrote is documented in the source. . . may be we should just quote the source. . . that way there is no room for interpretation.TheDoctorIsIn (talk) 20:35, 18 October 2008 (UTC)

This edit is very misleading. The source does not support the change. Please specify where in the source documented this or revert your edit. QuackGuru 23:11, 18 October 2008 (UTC)

The way to settle this needs to start with an analysis of the source and the two conflicting edits. See below and comment there. -- Fyslee / talk 04:01, 19 October 2008 (UTC)

Analysis of the source and other versions

• "... The authors also claim that 43 randomized, controlled trials of spinal manipulation for back pain have been published, but they fail to mention that most of them do not relate to chiropractic spinal manipulation." - Original Annals of Internal Medicine source

Various versions:

• "... has been criticized as being misleading for failing to mention incorporation of data derived from studies of SM that do not relate to chiropractic SM;..." - Previous version
• "... was criticized for not distinguishing between studies of SM in general, and studies on chiropractic SM in particular;..." - Consensus version
• "... was criticized for not distinguishing between studies of chiropractic SM in particular and studies of SM in general - most of which do not relate to chiropractic SM;..." - version proposed by TheDoctorIsIn and Levine2112

Analysis comments

• Again, the source is not referring to "most" of the "studies of SM in general"; it is clearly referring to just the 43 SM randomized controlled trials cited by Meeker & Haldeman (PMID 11827498). This has been explained several times.[11][12][13][14] in #RfC comments. No explanation to the contrary has been presented.
• I see that the incorrect version has again been installed, again without discussion here in advance, with the only comment being that the claim is "documented in the source". This claim is clearly not at all documented in the source; the source does not at all say that "most" "studies of SM in general" "do not relate to chiropractic SM".
• Again, the usual style for Chiropractic is that we discuss possibly-controversial changes on the talk page, giving other editors adequate time to think and comment about the changes, before installing them. Please do that here. It is not helpful to repeatedly apply this incorrect change.
• By the way, it's not correct to call the first version "Eubulides' version". That text was originally proposed by TimVickers here, and was the product of a consensus of four editors arrived at during a discussion over a period of several days (see Talk:Chiropractic/Archive 28 #Misleading sentence). More accurate would be "consensus version".
• For reference, here's the version that was in place before the consensus version was installed. Perhaps it can be used to come up with a compromise version.

"... has been criticized as being misleading for failing to mention incorporation of data derived from studies of SM that do not relate to chiropractic SM;..."

Eubulides (talk) 07:21, 19 October 2008 (UTC)

Noted and changed. -- Fyslee / talk 16:23, 19 October 2008 (UTC)

Sorry if my edit seemed WP:BOLD, but I figured that we had discussed Ernst's quote ad nauseum, so making the tweak to reflect what I feel he is saying was no more controversial than what leaving what another editor interprets Ernst to mean. I saw it suggested - I believe in TDII's edit summary - that we simply quote Ernst rather than interpret what he is saying in his criticism. Clearly we disagree with what he is saying and we may never agree. Perhaps quoting is the best solution. How about this?

A 2002 review of SM was criticized because it claimed "that 43 randomized, controlled trials of spinal manipulation for back pain have been published," but failed "to mention that most of them do not relate to chiropractic spinal manipulation"; however the review's authors stated that they did not consider this difference to be a significant point as research on SM is equally useful regardless of which practitioner provides it.

Reasonable? -- Levine2112 ^discuss 02:08, 22 October 2008 (UTC)

At first glance this seems like a good solution. What say others? -- Fyslee / talk 04:38, 22 October 2008 (UTC)

The current writing style for this article is it to avoid quotes. Stating it claimed is not the way I would write the sentence. What is the point to say "most of them do not relate to chiropractic spinal manipulation"? That point can easily be misleading if the reader reads it wrong. The reader could think it means that most SM research does not relate to chiropractic spinal manipulation when we know that is false. The neutrally written and consensus version is: A 2002 review of randomized clinical trials of SM[35] was criticized for not distinguishing between studies of SM in general... QuackGuru 04:55, 22 October 2008 (UTC)

More potentially controversial edits

Here is the next possibly controversial edit for today. This changed or added text without a reliable reference. However, that section of the article has always been difficult to find highly reliable references. QuackGuru 23:22, 18 October 2008 (UTC)

Here are the conflicting edits:

• "Straight chiropractors believe that vertebral subluxation leads to interference with an "Innate Intelligence" within the human nervous system and is a primary underlying risk factor for almost any disease. Straights view the medical diagnosis of patient complaints (which they consider to be the "secondary effects" of subluxations) to be unnecessary for treatment." - Original

• "Straight chiropractors believe that vertebral subluxation leads to interference with an "Innate Intelligence" normally communicated through the human nervous system. This interference creates a state of dis-ease (loss of homeostasis) within the body and is a primary underlying risk factor for almost any disease. Straights view the medical diagnosis of patient complaints (which they consider to be the "secondary effects" of subluxations) to be unnecessary in providing chiropractic care." - New version by anon IP

Let's analyze these and figure out which is closer to the truth of the straight position, and if it is justified by the source that has been used (). I have emphasized the changes in bold letters. -- Fyslee / talk 04:10, 19 October 2008 (UTC)

• The first change, '"Innate Intelligence" within normally communicated through the human nervous system', has some justification but is not quite right. The source says "Innate, he [D.D. Palmer] believed, was an intelligent entity which directed all the functions of the body, and used the nervous system to exert its influence." A better change would be 'Innate Intelligence" within exerted via the human nervous system'.
• The second change, "This interference creates a state of dis-ease (loss of homeostasis) within the body and is a primary underlying risk factor for almost any disease." is not supported by the cited source: it mentions "dis-ease" as the result of inflammations, but does not connect it to homeostasis. Also, the second change would modify Wikipedia so as to appear to endorse the theory of the straights, which we can't do.
• The third change, "unnecessary for treatment in providing chiropractic care" is I guess distinguishing chiropractic treatment from medical treatment, which has some justification. However, here's a shorter and better change: "unnecessary for chiropractic treatment".

Eubulides (talk) 06:30, 20 October 2008 (UTC)

Network Chiropractic

Is network chiropractic sufficiently noteworthy to be mentioned?

http://www.associationfornetworkcare.com/whatisnsa.shtml Campingcar (talk) 13:12, 19 October 2008 (UTC)

Currently Chiropractic #Treatment techniques lists only adjustive procedures received by more than 20% of patients of licensed U.S. chiropractors in the survey reported in Christensen & Kollasch 2005 (PDF), and neither Network Chiropractic Technique nor Network Spinal Analysis make that cut. There are a whole bunch of chiropractic techniques and we don't have room here to list them all. According to Table 10.12 of that source, Pierce-Stillwagon and Meric (which also didn't make the cut) are more popular than NCT or NSA (which I assume are are lumped into "other"). Eubulides (talk) 06:30, 20 October 2008 (UTC)

Thanks for the explanation.Campingcar (talk) 14:26, 20 October 2008 (UTC)

You might consider starting a separate article just for Network chiropractic. See if you can find third-party sources (not just ones promoting Network chiropractic) which discuss the topic. If you are able to find some good ones, then it might pass the WP:N threshold for article creation. -- Levine2112 ^discuss 02:12, 22 October 2008 (UTC)

Sounds like a good idea. There might be enough V & RS, so give it a try Campingcar. You could start it in a sandbox in your userspace and seek help and comments there. Then when it seems good enough to pass muster without immediately getting nominated for deletion, you can "go public" with it. Here's a sandbox for you to start with, if you wish:

• Network Spinal Analysis

Just start adding what you find there and format it like any other decent article. Good luck. -- Fyslee / talk 04:48, 22 October 2008 (UTC)

References

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