BMJ 1999;319:57 ( 3 July )

Letters

Patients were more satisfied with chiropractic than other treatments for low back pain

The first 100% of the full text of this article appears below.

EDITOR---Patient satisfaction is increasingly recognised as an important outcome in trials. Whatever interpretation Ernst and Assendelft place on changes in the Oswestry score, they did not mention in their letter1 that significantly more of those patients in our trial who were treated by chiropractic expressed satisfaction with their outcome at three years than those treated in hospital2---84.7% (127/150) v 65.5% (76/116) for those referred by chiropractors (P<0.0001) and 79.2% (103/130) v 60.2% (71/118) for those recruited from hospitals (P=0.001). This aspect was assessed three years after entry to the trial.

The main stimuli to the Medical Research Council's current trial were the suggestive results and further questions raised by our initial observations. Assendelft et al's critique can hardly be considered to have been one of its starting points.3

T W Meade, Professor. 
MRC Epidemiology and Medical Care Unit, Wolfson Institute of Preventive Medicine, London EC1M 6BQ


1. Ernst E, Assendelft WJJ. Chiropractic for low back pain. BMJ 1999; 318: 261[Free Full Text]. (23 January.)
2. Meade TW, Dyer S, Browne W, Frank AO. Randomised comparison of chiropractic and hospital outpatient management for low back pain: results from extended follow up. BMJ 1995; 311: 349-351[Abstract/Free Full Text].
3. Assendelft WJJ, Bouter LM, Kessels AGH. Effectiveness of chiropractic and physiotherapy in the treatment of low back pain: a critical discussion of the British randomized clinical trial. J Manipulative Physiol Ther 1991; 14: 281-286[Medline].

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