Ernst Slams Chiropractic for Children
I've been sounding the alarm about the need for chiropractic research for about 20 years now. Over that timeframe the situation has become more and more serious. An increasingly skeptical public, the shift to accountability in health care and the understanding that the consumer should not pay for what does not work are some of the reasons why things have become so serious.
Organized medicine, while certainly behind along with everyone else in the era of evidence, for the most part embraces such a shift and has already geared up and gotten underway to engage in the process. For the most part they do not have a cultural problem when it comes to research.
The chiropractic profession on the other hand is a different story. Our profession, for the most part, does not embrace research. In fact the culture in our profession is one of disdain when it comes to the topic. We do not value it and therefore we do not engage in the enterprise.
One of the only pieces of evidence on research infrastructure within chiropractic revealed that the profession has less than 70 full time researchers. We know that the chiropractic profession has received less than $50 million from the NIH in the entire 100+ years of its existence and we also know that less than 7% of the profession subscibes to a peer reviewed research journal.
Some say we don't need research. That the public wants us and that's all we should care about. Well setting aside for a moment the very small number of chiropractors seeing over 100 visits a week and understanding that the profession's market share has not grown in at least 40 years one has to conclude that the profession as a whole has a serious problem.
A recent paper on systematic reviews of the literature by Ernst had the following conclusions regarding the literature supporting chiropractic care for children:
- Results were mixed and unconvincing.
- Studies were methodologically poor
- Those that had good methodology did not suggest chiropractic was effective
- None used validated outcome measures
- There are no RCTs of chiropractic for otitis media, despite the claims made by chiropractors that it is an effective treatment for that condition.
- Insufficient data to recommend chiropractic as an effective treatment for nocturnal enuresis in children.
- Conflicting results for the treatment of asthma
The authors made this final point about chiropractic for children:
Moreover, adverse events of CAM extend beyond the actual treatments themselves. It hasbeen shown that children who consult naturopathy and chiropractic practitioners are signifi cantly less likely to receive the recommended vaccinations and were significantly more likely to be diagnosed with a vaccine-preventable disease.
Over the past 20 years that I've been advocating an intense focus on chiropractic research those admonitions were focused heavily on subluxation based research. Several years ago as the dire nature of the situation became clear to me I further focused my exhortations towards the need for chiropractic research that focuses on health outcomes related to subluxation in pregnant women and children. My reasoning is that given the short amount of time we have to provide the level of evidence that is needed this is the population we should focus on.
So, what can you do to help? Remember what I said earlier about less than 7% of the profession subscibing to a peer reviewed research journal? Here is what you need to do:
1. Join the ICPA and get involved in their research efforts
2. Subscribe to a peer reviewed chiropractic research journal
In order to make your decision about supporting this journal easier please take advantage of this special Mid-summer offer to become a subscriber. If you subscribe to the journal now I will send you, absolutely free, 2 PowerPoint presentations titled:
CLICK HERE TO SUBSCRIBE!
The crucial need for chiropractic research alone should compel you to subscribe and support the efforts of those in the profession trying to gather the data to support what you do day in and day out but hopefully this added special offer will make it a no brainer. Your actions today help support needed research for the future.
And while you're at it please forward this e-mail to a colleague so they can benefit from this special offer.
As always I look forward to your feedback, comments and suggestions.
Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net
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