It is easy for Godlee and Ernst to deride the 'evidence' provided by
the chiropractors. By current standards it doesn't stand up to scrutiny as
ably illustrated by Ernst. But what conclusions should we draw from this?
Does it mean that chiropractic is base quackery out to dupe a
gullible public and use legal muscle to avert dissent? Personally I think
not.
Ernst has for a long time gunned for chiropractic, over-stating the
dangers and understating the benefits.
Should treatment be allowed only if it satisfies an RCT, the gold
standard, and all other evidence be ignored, as seems to be Ernst's
approach?
If not, then perhaps clinicians need "to withstand the domination of
authority" from non-clinicians and assert what is obvious daily, namely
that, while research evidence is essential and helps inform clinical
practice, individual patients require an individual approach, and that
most treatments are unsuitable for assessment by RCT.
Where is the evidence that a treatment approach based purely on RCTs
results in better patient outcomes?
It seems that we all are required to believe in science as we once
believed in religion and to see science as the source of wisdom rather
than the tool it is and should be.
Beware, as Hannah Arendt remarked in "The Origins of Totalitarianism
": 'Ideological thinking becomes emancipated from the reality that we
perceive with our five senses, and insists on a "truer" reality concealed
behind all perceptible things, dominating them from this place of
concealment'.
Clearly chiropractors find in their clinical practice that some
paediatric conditions can be helped safely and we must assume that they go
about this in a professional manner. The truly scientific approach would
be to try and find out more rather than take an arbitrary standard and
then seek to denigrate them.
Rapid Response:
Real Science?
It is easy for Godlee and Ernst to deride the 'evidence' provided by
the chiropractors. By current standards it doesn't stand up to scrutiny as
ably illustrated by Ernst. But what conclusions should we draw from this?
Does it mean that chiropractic is base quackery out to dupe a
gullible public and use legal muscle to avert dissent? Personally I think
not.
Ernst has for a long time gunned for chiropractic, over-stating the
dangers and understating the benefits.
Should treatment be allowed only if it satisfies an RCT, the gold
standard, and all other evidence be ignored, as seems to be Ernst's
approach?
If so, then outlaw the 87% of common medical treatments that are
unproven as beneficial
(http://clinicalevidence.bmj.com/ceweb/about/knowledge.jsp). Would this be
in patients best interest?
If not, then perhaps clinicians need "to withstand the domination of
authority" from non-clinicians and assert what is obvious daily, namely
that, while research evidence is essential and helps inform clinical
practice, individual patients require an individual approach, and that
most treatments are unsuitable for assessment by RCT.
Where is the evidence that a treatment approach based purely on RCTs
results in better patient outcomes?
It seems that we all are required to believe in science as we once
believed in religion and to see science as the source of wisdom rather
than the tool it is and should be.
Beware, as Hannah Arendt remarked in "The Origins of Totalitarianism
": 'Ideological thinking becomes emancipated from the reality that we
perceive with our five senses, and insists on a "truer" reality concealed
behind all perceptible things, dominating them from this place of
concealment'.
Clearly chiropractors find in their clinical practice that some
paediatric conditions can be helped safely and we must assume that they go
about this in a professional manner. The truly scientific approach would
be to try and find out more rather than take an arbitrary standard and
then seek to denigrate them.
Competing interests:
None declared
Competing interests: No competing interests