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History

In the early 19th century, chemists and physicians alike shared a common vitalistic belief that, unlike inanimate objects, living objects had a substantial entity (or spirit) controlling their organic processes. Homeopaths and Eclectics had become the majority health care practitioners. Drugs, medicines and patent medicines were becoming more prevalent and were mostly unregulated and laced with compounds such as mercury, alcohol and cocaine. Somewhere around 1895, Davenport, Iowa magnetic healer Daniel David Palmer (D.D. Palmer) developed a theory that manual manipulation, especially of the spine, could cure disease. Although initially keeping the theory a family secret, in 1898 at his new Palmer School of Chiropractic he began teaching it to a few students, one of whom, his son Bartlett Joshua (B.J.) Palmer, became committed to promoting chiropractic, took over the Palmer School in 1906, and rapidly expanded its enrollment. By this time medicine had created the American Medical Association (AMA), absorbed the homeopaths and eclectics and organized into a major political force creating state laws that limited the practice of medicine, but the small chiropractic faction was not included.

Prosecutions and incarcerations of chiropractors for practicing medicine without a license grew common. To defend against medical statutes B.J. argued that chiropractic was separate and distinct from medicine, asserting that chiropractors "analyzed" rather than "diagnosed", and "adjusted" subluxation rather than "treated" disease. The Palmers continued to develop D.D.'s theory along vitalistic lines: all disease was caused by interruptions in the flow of innate intelligence, a vital nervous energy or life force that represented God's presence in man. Chiropractic leaders often invoked religious imagery and moral traditions. D.D. and B.J. both seriously considered declaring chiropractic a religion, which might have provided legal protection under the U.S. constitution, but decided against it partly to avoid confusion with Christian Science. Early chiropractors also tapped into the Populist movement, emphasizing craft, hard work, competition, and advertisement, aligning themselves with the common man against intellectuals and trusts, among which they included the American Medical Association (AMA).

D.D. and B.J. defined chiropractic as "practice by hand" or "straight" and did not use instruments or "mix" chiropractic with other remedies or cures. Chiropractors that did were coined "mixers". Tension soon developed between the two groups as mixers continued to develop new methods and open new schools to teach their proprietory techniques. In 1910 B.J. changed course and endorsed X-rays as necessary for diagnosis; this resulted in a significant exodus from the Palmer School of the more conservative faculty and students. The mixer camp grew until by 1924 B.J. estimated that only 3,000 of the U.S.'s 25,000 chiropractors remained straight. That year, B.J.'s promotion of the neurocalometer, a new temperature-sensing device, was another sign of chiropractic's gradual acceptance of medical technology, although it was highly controversial among B.J.'s fellow straights and ultimately sealed the fragmentation of chiropractic with the development of two professional associations; the mixer American Chiropractic Association(ACA) and straight International Chiropractors Association(ICA).

Despite heavy opposition by organized medicine, by the 1930s chiropractic was the largest alternative healing profession in the U.S. The longstanding feud between chiropractors and medical doctors continued for decades. The AMA labeled chiropractic "an unscientific cult" and held that it was unethical for medical doctors to associate with an "unscientific practitioner". This culminated in a landmark 1987 anti-trust lawsuit, Wilk v. AMA, in which the court found that the the AMA had engaged in unreasonable restraint of trade and conspiracy, and which ended the AMA's de facto boycott of chiropractic.

Serious research to test chiropractic theories did not begin until the 1970s. By the mid 1990s there was a growing scholarly interest in chiropractic, which helped efforts to improve service quality and establish clinical guidelines that recommended manual therapies for acute low back pain. In recent decades chiropractic gained legitimacy and greater acceptance by physicians and health plans, and enjoyed a strong political base and sustained demand for services; like other forms of complementary and alternative medicine, chiropractic became more integrated into mainstream medicine.

History comments

(outdent) I see that further changes have been made to this draft. However, it still has real problems with balanced coverage. Far too much time is spent on topics that are not important for chiropractic (cocaine, for example). And material highly relevant to recent history is still absent (recent competition from other health care professions). Although early chiropractic history is obviously important, the history since 1930 should consume at least a third, and preferably closer to a half of the space. Also, the total length of this section should be cut down so that it's no longer than what's in Chiropractic #History now (which is already too long). Eubulides (talk) 18:06, 25 July 2008 (UTC)

Chiropractic was born and grew as a result of it's non-drug, non-surgery perspective. Are you thinking that cocaine was not used then? I had heroin (from the Still source), but our new source says cocaine. If we aren't specific, people will think we are talking about things like penicillin or antibiotics which of course were not around at the time. Everyone knows that cocaine is not used like it was then. As far as recent competition from other health care professions; is this different? Are you thinking that there was not competition before? Are you aware that chiropractors employ massage therapists? The source that you had was about the present, not the past? How is that history? Those are just a few of the thoughts that went through my head when I read it. I do think that they are appropriate in some section, but not history. -- Dēmatt (chat) 19:11, 27 July 2008 (UTC)

• Sure, cocaine was used back then. It was even part of Coca-Cola. But cocaine is not important enough to mention in a brief summary of chiropractic history. There is no need to mention specific surgical or pharmaceutical techniques used by non-chiropractors back then. This is supposed to be a very brief history of chiropractic, not a long-winded treatment of chiropractic's competition.
• Yes, there has always been competition. But the changes in the past few decades are highly relevant to Chiropractic #History. Certainly the "branching out" of chiropractic into alt-med, natural products is quite relevant. This stuff is sourced to a paper on issues and trends, and the trends compare chiropractic of a few decades back to chiropractic today; this is clearly part of recent history. This stuff is far more important for chiropractic history than mercury in circa-1890s non-chiropractic pharmaceuticals.

Eubulides (talk) 15:00, 28 July 2008 (UTC)

History comments again

This draft is still way too long, and still focuses too much on early history and not enough on more recent history. Some more-detailed comments follow. Eubulides (talk) 15:00, 28 July 2008 (UTC)

There is still waaay too much about the history of chemistry and medicine before chiropractic. It's all vaguely relevant, but it's not nearly important enough to be worth mentioning at this level. There is no need to go back to the early 19th century, or to repeat a discussion and explanation of vitalism (which is already discussed in Chiropractic #Philosophy), or to mention homeopaths or eclectics, or to mention patent medicines, or to mention mercury, alcohol, and cocaine. This stuff should be in History of chiropractic, perhaps. The following text should be trimmed down to one brief sentence or phrase, which talks about vitalism in a historical context: "In the early 19th century, chemists and physicians alike shared a common vitalistic belief that, unlike inanimate objects, living objects had a substantial entity (or spirit) controlling their organic processes. Homeopaths and Eclectics had become the majority health care practitioners. Drugs, medicines and patent medicines were becoming more prevalent and were mostly unregulated and laced with compounds such as mercury, alcohol and cocaine." Eubulides (talk) 15:00, 28 July 2008 (UTC)

Similarly, the following sentence should be eliminated. There is no need to go into the pre-chiropractic history of the AMA. "By this time medicine had created the American Medical Association (AMA), absorbed the homeopaths and eclectics and organized into a major political force creating state laws that limited the practice of medicine, but the small chiropractic faction was not included." Eubulides (talk) 15:00, 28 July 2008 (UTC)

The phrase "Somewhere around 1895" is confusing ("where"?) and should be simplified. Eubulides (talk) 15:00, 28 July 2008 (UTC)

The phrase "magnetic healer" should be wikilinked to Magnetic healing. Most readers won't know what it is. Eubulides (talk) 15:00, 28 July 2008 (UTC)

The wikilink to Populist isn't right, as that is a disambiguation phrase. It should point directly to Populism. Eubulides (talk) 15:00, 28 July 2008 (UTC)

"1987 anti-trust lawsuit" That's not correct. 1987 is the date of the decision, not the date of the lawsuit. It should be "1987 decision". Eubulides (talk) 15:00, 28 July 2008 (UTC)

"the the". Eubulides (talk) 15:00, 28 July 2008 (UTC)

The phrase "and was hampered by the chiropractic philosophy that sustained the profession in its long battle with organized medicine", present in Chiropractic #History is important and should be kept.

The following material on recent history is also important and should be kept (certainly far more important than homeopaths, or the neurocalometer, or vitalism and chemistry, or a bunch of other things like that): "However, its future seemed uncertain: as the number of practitioners grew, evidence-based medicine insisted on treatments with demonstrated value, managed care restricted payment, and competition grew from massage therapists and other health professions. The profession responded by marketing natural products and devices more aggressively, and by reaching deeper into alternative medicine and primary care." Eubulides (talk) 15:00, 28 July 2008 (UTC)

History (another draft)

Chiropractic was founded in the 1890s in Davenport, Iowa by Daniel David (D.D.) Palmer, who had turned from teacher and grocer to the magnetic healing developed by MD Andrew Taylor Still as an alternative to what he saw as the abusive nature of the drugs of that time. After nine successful years as a magnetic healer, Palmer had developed a theory about the cause of all disease, and an encounter with deaf janitor, Harvey Lillard, who reported that after two treatments he could hear quite well, convinced him that manual manipulation to reposition body parts could cure disease. Although initially keeping the theory a family secret, in 1898 at his new Palmer School of Chiropractic he began teaching it to a few students, one of whom, his son Bartlett Joshua (B.J.) Palmer, became committed to promoting chiropractic, took over the Palmer School in 1906, and rapidly expanded its enrollment.

Prosecutions and incarcerations of chiropractors for practicing medicine without a license grew common. To defend against medical statutes B.J. argued that chiropractic was separate and distinct from medicine, asserting that chiropractors "analyzed" rather than "diagnosed", and "adjusted" subluxation rather than "treated" disease. In the early 19th century, chemists and physicians alike shared a common vitalistic belief that, unlike inanimate objects, living objects had a substantial entity (or spirit) controlling their organic processes. The Palmers continued to develop D.D.'s theory along vitalistic lines; all disease was caused by interruptions in the flow of innate intelligence, a vital nervous energy or life force that represented God's presence in man. Chiropractic leaders often invoked religious imagery and moral traditions. D.D. and B.J. both seriously considered declaring chiropractic a religion, which might have provided legal protection under the U.S. constitution, but decided against it partly to avoid confusion with Christian Science.

Tensions developed between "straight" chiropractors such as D.D. and B.J. who disdained the use of instruments, and those, scornfully called "mixers" by B.J., who advocated their use; some opened new schools to teach their proprietary techniques. In 1910 B.J. changed course and endorsed X-rays as necessary for diagnosis; this resulted in a significant exodus from the Palmer School of the more conservative faculty and students. The mixer camp grew until by 1924 B.J. estimated that only 3,000 of the U.S.'s 25,000 chiropractors remained straight. That year, B.J.'s promotion of the neurocalometer, a new temperature-sensing device, was another sign of chiropractic's gradual acceptance of medical technology, although it was highly controversial among B.J.'s fellow straights and ultimately sealed the fragmentation of chiropractic with the development of two professional associations; the mixer ACA and straight ICA.

By the 1930s chiropractic was the largest alternative healing profession in the U.S., but faced heavy opposition by organized medicine. The AMA labeled chiropractic "an unscientific cult" and held that it was unethical for medical doctors to associate with an "unscientific practitioner". This culminated in a landmark 1987 decision, Wilk v. AMA, in which the court found that the the AMA had engaged in unreasonable restraint of trade and conspiracy, and which ended the AMA's de facto boycott of chiropractic.

Serious research to test chiropractic theories did not begin until the 1970s. By the mid 1990s there was a growing scholarly interest in chiropractic, which helped efforts to improve service quality and establish clinical guidelines that recommended manual therapies for acute low back pain. In recent decades chiropractic gained legitimacy and greater acceptance by physicians and health plans, and enjoyed a strong political base and sustained demand for services; like other forms of complementary and alternative medicine, chiropractic became more integrated into mainstream medicine.

Comments on history (another draft)

"Chiropractic was founded in the 1890s in Davenport, Iowa by Daniel David (D.D.) Palmer, who had turned from teacher and grocer to the magnetic healing developed by MD Andrew Taylor Still". The cited source here is the autobiography of Andrew Still, which obviously does not support most of the claims in this part of the sentence. This sentence needs an appropriate source. Furthermore, I don't think Still's autobiography should need to be sourced at all; surely every detail in this sentence can be sourced by a reliable history of chiropractic, and if we really have go to that ancient primary source that is an indication that we are delving into a non-notable area. Also, there's certainly no need to mention that Still was an MD here. I am skeptical that Still needs to be mentioned at all. Eubulides (talk) 21:11, 21 July 2008 (UTC)

"After nine successful years as a magnetic healer" This isn't important enough to appear here. It's enough to say Palmer was a magnetic healer, which has already been said. Eubulides (talk) 21:11, 21 July 2008 (UTC)

"an encounter with deaf janitor, Harvey Lillard, who reported that after two treatments he could hear quite well" There is substantial doubt that this episode ever occurred as recounted by the Palmers. It should not be repeated here without giving the skeptical side. Eubulides (talk) 21:11, 21 July 2008 (UTC)

The citation to DD' Palmer's Lifeline is inappropriate here. These are Keating's notes, which never appeared in a peer-reviewed paper (and he published plenty of papers on this subject). We should not refer to Keating's notes directly; we should refer to his published papers or to other more-reliable sources. Eubulides (talk) 21:11, 21 July 2008 (UTC)

"In the early 19th century, chemists and physicians alike shared a common vitalistic belief that, unlike inanimate objects, living objects had a substantial entity (or spirit) controlling their organic processes." This neglects the important fact that orthodox medicine rejected vitalism even though chiropractic embraced it. Furthemore, it omits several other important ways in which chiropractic departed from mainstream medicine. Also, that source is not that reliable; we should be using a peer-reviewed journal for anything this basic. I suggest basing the discussion of vitalism etc. on far more-reliable and more-relevant sources, e.g., by paraphrasing ideas from the following quote:

"Emphasizing observation rather than experimentation, the ability of the commoner as well as the expert to be a scientist, a vitalist rather than a mechanist philosophy, and a mutually supportive rather than antagonistic relationship between science and religion, chiropractors had created an alternative science. This science justified their approach to healing, attacted supporters, furnished expertise for practitioners, and provided chiropractic at least some of the social and cultural authority derived from the aura surrounding science."

Eubulides (talk) 21:11, 21 July 2008 (UTC)

Of course, our initial sentence is pertinent as it illustrates how some scientists were vitalists at the time. The new quote could be used as well. Some might have to be attributed, like the "alternative science" part. What does that mean? -- Dēmatt (chat) 18:57, 27 July 2008 (UTC)

Vitalism was dying among respectable scientists by then; it is quite misleading to cast chiropractic as state-of-the-art science circa 1895. Eubulides (talk) 15:00, 28 July 2008 (UTC)

The draft removes the following text, which is important, relevant, and well-sourced: "Early chiropractors also tapped into the Populist movement, emphasizing craft, hard work, competition, and advertisement, aligning themselves with the common man against intellectuals and trusts, among which they included the American Medical Association (AMA)." Eubulides (talk) 21:11, 21 July 2008 (UTC)

"some opened new schools to teach their proprietary techniques" This is undoubtedly true, but it needs to be supported by a citation. Eubulides (talk) 21:11, 21 July 2008 (UTC)

"The Palmers continued to develop D.D.'s theory along vitalistic lines" This is not supported by a reliable source, and it's pretty misleading: I don't think "the Palmers" collaborated on the time of day, much less on the development of D.D.'s theory. Eubulides (talk) 21:11, 21 July 2008 (UTC)

The draft replaces "Despite heavy opposition by organized medicine, by the 1930s chiropractic was the largest alternative healing profession in the U.S. The longstanding feud between chiropractors and medical doctors continued for decades." with "By the 1930s chiropractic was the largest alternative healing profession in the U.S., but faced heavy opposition by organized medicine." This misses the important point that the pre-1930s growth was despite opposition, and that the opposition continued for decades more. Eubulides (talk) 21:11, 21 July 2008 (UTC)

The draft removes the important point that evidence-based research "was hampered by antiscientific and pseudoscientific ideas that sustained the profession in its long battle with organized medicine." Eubulides (talk) 21:11, 21 July 2008 (UTC)

The draft removes the even-more important point that "However, its future seemed uncertain: as the number of practitioners grew, evidence-based medicine insisted on treatments with demonstrated value, managed care restricted payment, and competition grew from massage therapists and other health professions. The profession responded by marketing natural products and devices more aggressively, and by reaching deeper into alternative medicine and primary care." These are key issues in the recent history of chiropractic. Eubulides (talk) 21:11, 21 July 2008 (UTC)

OK, you caught me, Eubulides. ☺ I didn't look at the sources much but just rearranged the material from the current article version and the other draft. I may have ended up with footnotes in the wrong place etc. Thanks for agreeing with some of the proposed deletions. I may or may not find time to work on this more. Coppertwig (talk) 12:35, 22 July 2008 (UTC)

I took several of the more constructive criticisms and cut out or cleaned up a lot of the pre-chiropractic info from the first paragraph the first history above just to see what it would look like. -- Dēmatt (chat) 03:19, 25 July 2008 (UTC)

This "another draft" thread (and the subsection immediately above) appear to have gone inactive in favor of the history draft/discussion further up in the thread. Would anyone object if I archived these lower two subsections, #History (another draft) and #Comments on history (another draft)? Thanks, --Elonka 15:51, 1 August 2008 (UTC)

Hi Elonka, sorry we're being such a pain, but thanks for working with us through this! I don't feel comfortable deleting that part without input from Coppertwig as he wrote that. I think some of the older comments were handled, or likely need to be restated anyway so I feel safe in removing them. Just leave the first History as I am slowly working through that when not distracted by other hot topics... Thanks again! -- Dēmatt (chat) 21:03, 1 August 2008 (UTC)

Proposed wording for NOR/N

Following up on Talk:Chiropractic/Archive 24 #Draft questions would not resolve disagreement above, I have drafted below proposed wording for an WP:NOR/N request. Here's how I came up with it. Looking at similar requests already on that page, I don't think generic questions like "Is it possible for an idea which is expressed implicitly but not explicitly in an article to be a SYN violation?" would be that helpful. Once things get too generic, the answer will come back "it depends", which means that a generic question that begins "Is it possible..." will always be answered "Yes, depending on the circumstances" which won't give us much help on this particular question. So we need to be somewhat more specific.

The draft wording is in #SYN and chiropractic's evidence basis below. Eubulides (talk) 21:11, 21 July 2008 (UTC)

SYN and chiropractic's evidence basis

Does Chiropractic #Evidence basis have a significant synthesis problem?

In the opinion of the section's critics, the section is a WP:SYN violation when it presents specific research on spinal manipulation (SM) as evidence of effectiveness of chiropractic care as opposed to the whole range of treatments performed by chiropractors (not just SM), because the reader may confuse the assertions about spinal manipulation specifically as being assertions about chiropractic treatment in general.

In the opinion of the section's proponents, the section clearly distinguishes SM research from other research, every claim in the section is directly supported by a reliable source, standard practice in evidence-based chiropractic relies on SM research, and excluding highly-relevant mainstream research would raise serious WP:WEIGHT problems.

See also Syn tag and SYN and implicit conclusions.

(end of draft wording) Eubulides (talk) 21:11, 21 July 2008 (UTC)

Comments on proposed wording for NOR/N

(Please put comments on draft wording here.) Eubulides (talk) 21:11, 21 July 2008 (UTC)

• When we state, "standard practice in evidence-based chiropractic relies on general-SM studies", we should probably qualify this with a source or suggest that there are sources out there that support this opinion. This is key because this is where the critic's claim of SYN lies. Sources which state that conclusions from general SM research can be applied to make conclusions about chiropractic SM are the "Source B" component of the the critic's claim of SYN. (Whereas, the general SM studies are the "Source A".) Considering that this is a SYN question, I actually think it would be a good idea to clearly illustrate the alleged "A + B and therefore C" scenario. I really think that's all we have to do. Then the respondents on the noticeboard can just examine the formula and determine if it equates to SYN. Sound reasonable? -- Levine2112 non 21:32, 21 July 2008 (UTC)

• I'd rather keep the question short; it's already overlong as it is, compared to the questions already asked at WP:NOR/N. The longer the question is, the less likely it'll get answered.
• I suggest that any lengthy argument about "Source A" and "Clause B" and so forth be put in the talk page, and that the question itself merely contain a wikilink to the lengthy argument.
• I'd rather not have the "Proponents of this section" sentence edited in favor of the critics. That sentence should argue the proponents' side, not the critics' side.
• Do you have any specific wording-change proposals? They could include wikilinks to the talk page or the talk page archives.

Eubulides (talk) 05:45, 22 July 2008 (UTC)

I am not suggesting that we put in "any lengthy argument"; however, this is a question for the NOR/N specifically about SYN. Therefore, we must illustrate what the critic's perceive as "A + B so therefore C". If you think the question is overlong now, then I would suggest cutting something out. But clearly the perceived "A + B so therefore C" formula must be illustrated for the NOR/N as this formula is at the heart of any SYN discussion. Let's make it extremely clear what Source A states, what Source B states and what the perceived Conclusion C is, because this is core to the SYN charge and we must provide any noticeboard respondents with complete clarity. Once we get that wording in there, then we can talk about including "wikilinks to the talk page" or "any specific word-change proposals". Please take a crack at inserting the perceived "A + B so therefore C" formula into the question as I think it would be a good-faith exercise in "writing for the enemy", so to speak. Thanks for your efforts to resolve this dispute in good faith, Eubulides! -- Levine2112 06:22, 22 July 2008 (UTC)

I don't think this would be a good idea, as I think it will make the question way too long. Obviously you disagree, though. I doubt whether I can do full justice for text I disagree with, so can you please propose a specific wording change? Thanks. Eubulides (talk) 06:33, 22 July 2008 (UTC)

Sure, here it goes:

::::Critics of the section say the section employs SYN when it cites sources on SM in general (as opposed to studies specifically on chiropractic SM), because these citations imply to the reader that general-SM studies are relevant to chiropractic, a conclusion that these studies themselves do not make. Whereas there exists some Source A which applies conclusions from some non-chiropractic SM research to make conclusions about chiropractic SM, and whereas there exists some Research B which studies non-chiropractic SM as performed by non-chiropractic practitioners and makes no conclusions about chiropractic SM specifically whatsoever. Thus, there is a rationale that since there exists some Source A which applies non-chiropractic research to make conclusions about chiropractic, therefore it is okay for our article to use non-chiropractic Research B to make or imply some Conclusion C about chiropractic SM. Hence, "A and B, so therefore C."

I think that is pretty clear. It's pretty much my position here in this dispute, though I don't know how well it represents the positions of Dematt, DigitalC, TheDoctorIsIn, GlenG, and several other editors on the critical side here. I'd love input from them here, as well as from the supporting side (just Eubulides and QuackGuru, I believe). -- Levine2112 07:02, 22 July 2008 (UTC)

OK, I agree with the general idea being discussed here of the question to be asked focussing directly on the reason for this particular SYN tag, noting though that the more general question I suggested will probably not be answered and may need to be addressed later when some other issue arises. Here's an attempt at a short version of the question:

::::::Does the evidence basis section of Chiropractic contain a SYN violation because it discusses the effectiveness of spinal manipulation (SM) baseed on studies of SM performed by various professionals, not just chiropractors, studies which made no conclusions about the effectiveness of chiropractic? Does this mislead the reader about the effectiveness of chiropractic? Another study states that research on SM in general is relevant to studies of chiropractic effectiveness (make sure this wording agrees with the source); does citing this study fix the SYH violation or make it worse?

If this is too long, perhaps only the first sentence could be used. ☺ Coppertwig (talk) 12:35, 22 July 2008 (UTC)

I think this is really good, Coppertwig, as it really implies the A, B, C without spelling it out. Here is a slightly revised version:

::::::Does the evidence basis section of Chiropractic contain a SYN violation because it discusses the effectiveness of spinal manipulation (SM) based on studies of SM in general (SM as performed by various professionals, not just chiropractors) studies which made no conclusions about the effectiveness of chiropractic SM specifically? Does this mislead the reader about the effectiveness of chiropractic SM? Another study states that research on SM in general is relevant to studies of chiropractic SM effectiveness (make sure this wording agrees with the source); does citing this study fix the SYN violation or make it worse? Essentially, if one source says that it is okay to apply general SM research to make conclusions about chiropractic SM, does that give us license to draw the same conclusions about other sources?

I feel that my last question/sentence above really distills this to the core issue. Thoughts? -- Levine2112 20:05, 22 July 2008 (UTC)

A few statistics. The wording in #SYN and chiropractic's evidence basis devotes (by my count) 48 words to critics of the section and 39 words to supporters. Levine2112 originally proposed adding 143 words to the critical side. Coppertwig proposes adding (by my count) 64 words to the critical side and 17 words to the supportive. Levine2112 responded by proposing (by my count) 103 critical and 17 supportive words. Adding any of these three changes hardly sounds fair, as more weight was already being given to the critical side. What to do? Eubulides (talk) 23:19, 22 July 2008 (UTC)

Let's not get bogged down in word count stats just yet. Let's first seek writing for clarity of the issue at hand. That said, I don't think that Coppertwig nor my responding version is intended to be wording for the supporters or the critics. The intent (at least my intent) was to combine rather than divide the points of view here. After all, doesn't my last question alone summarize the core of the dispute without being worded for the supporters nor the critics?

::::::::If one source says that it is okay to apply general SM research to make conclusions about chiropractic SM, does that give us license to draw the same conclusions about other sources?

If you feel that this isn't a neutral question, perhaps you could suggest a revision and/or explain why you feel it isn't neutral. -- Levine2112 00:18, 23 July 2008 (UTC)

Levine2112 listed me as being on the "critical" side, but I thought I was neutral/undecided on this SYN issue. Also, I thought we were going to try to straighten it out by clarifying the various definitions of SM and SMT in various contexts; some work was done on that but I'm still confused about it.

Suggestion: Use Eubulides' draft wording, but if it's desired to shorten it, then delete the "Here's the background" paragraph (and spell out SM the first time it appears). Also reduce the number of words when giving the additional links at the end, by saying simply "See also (link) and (link)."

Re Levine2112's last suggested wording: I would append "about other sources".☺ Coppertwig (talk) 02:14, 23 July 2008 (UTC)

Thanks for the suggestions. I deleted the "Here's some background" paragraph, spelled out SM, and reduced the words at the end, as you suggested. Eubulides (talk) 05:17, 23 July 2008 (UTC)

I would be reluctant to use Eubulides version. Let's examine the sentences in his/her proponents section:

::::::::::: Proponents of the section say that every claim in the section is directly supported by a reliable source, that standard practice in evidence-based chiropractic relies on general-SM studies, and that excluding highly-relevant mainstream research would raise serious WP:WEIGHT problems.

First, "standard practice in evidence-based chiropractic relies on general-SM studies". This should be clarified. Eubulides says that this is standard practice and bases his opinion off of a couple of sources. However, I and others have shown him/her sources where this is refuted; where either chiropractors or non-chiropractors have stated that general SM studies should not be used to draw conclusions about chiropractic SM.

Second, "excluding highly-relevant mainstream research" is an opinion. Especially the "highly relevant" portion. It is Eubulides' contention that this research is "highly-relevant". Also, no one is talking about excluding mainstream research in general, yet this is what is insinuated here. I welcome mainstream research. What's more I welcome highly-relevant mainstream research. And by highly-relevant, I mean mainstream research which is specifically about chiropractic. If it isn't about chiropractic, it isn't highly-relevant. -- Levine2112 02:34, 23 July 2008 (UTC)

Suggestion: re-write the "critics say" section the way you like it, but in the same number of words. Insert "what they consider to be" before "highly-relevant mainstream research". ☺ Coppertwig (talk) 03:03, 23 July 2008 (UTC)

• I like that suggestion as well; we should let the critics write the section describing the critical viewpoint. I disagree with Levine2112's criticism of the proponents' section, naturally; the proponents should be allowed to make their case as well.
• As for the proponent viewpoint, I don't think "what they consider to be" is necessary there. It's quite clear from the context that the text in question is being written from the proponents' viewpoint.
• Similarly, it isn't necessary to insert a "what they consider to be"-like qualifier before the phrase "these citations imply to the reader" in the critical section. Obviously, it's the critics who are asserting that these citations imply something to the reader, and we don't have to repeat that here.

Eubulides (talk) 05:17, 23 July 2008 (UTC)

If we are each going to be making our cases, we should at least be doing that honestly and clearly. If something is an opinion, it should be made clear as Coppertwig suggests (i.e. "what they consider to be"-like qualifier). I don't want to move forward on this until we all can at least agree to this basic principle in fairness. -- Levine2112 22:49, 23 July 2008 (UTC)

It shouldn't be necessary to add "proponents of the section say" in front of every clause in that sentence. That will make the sentence longer and harder to read. If its leading "Proponents of the section say that" isn't clear enough, how about replacing the phrase with "In the opinion of the section's proponents," and making the obvious grammatical changes to the rest of the sentence? Similarly for the critical section, of course. Eubulides (talk) 23:04, 23 July 2008 (UTC)

Give it a whirl and I will try and base the critic's section on your lead. Let's not worry about word count yet. Let's focus on making this clear. Perhaps we should start off with an agreed statement of fact. Thoughts? -- Levine2112 23:08, 23 July 2008 (UTC)

OK, I reworded it as I suggested above. Originally I drafted what I assumed was an agreed statement of fact, but removed that "Here's some background" paragraph after Coppertwig suggested removing it. We could resurrect it, I suppose; but all other things being equal, shorter is better. Eubulides (talk) 23:49, 23 July 2008 (UTC)

• "Chiropractic #Evidence basis discusses the evidence basis for chiropractic treatment" - This is part of the problem. Chiropractic #Evidence basis doesn't discuss the evidence basis for chiropractic treatment, it discusses the evidence basis of various conservative treatment procedures, that may be employed by Chiropractors or other health care practitioners. The implication that this is disussing effectiveness of chiropractic treatment IS the SYN violation. - DigitalC (talk) 23:22, 21 July 2008 (UTC)

• Please see the above comments about keeping the question itself short, the above suggestion for doing this by wilinking into the talk page, and the above request for specific wording-change proposals. Eubulides (talk) 05:45, 22 July 2008 (UTC)

• I would suggest changing "Chiropractic #Evidence basis discusses the evidence basis for chiropractic treatment" to "Chiropractic #Evidence basis discusses the evidence basis for various treatment methods, focusing on spinal manipulation (SM)..." - DigitalC (talk) 05:54, 22 July 2008 (UTC)

• OK, thanks, done, except "various" sounded a bit discursive; I used "several" instead. Eubulides (talk) 06:33, 22 July 2008 (UTC)

I agree with DigitalC here; that the SYN violation is that we are placing evaluations of specific conservative treatments (like spinal manipulation) and passing them off as evaluations of chiropractic care. I don't even think we should be discussing evaluations of spinal adjustments in this article because there are so many different types they shoud be handled in their own articles. But, I don't see where this is reflected in anything that has been changed or written so far. I admit though that I may be missing something. -- Dēmatt (chat) 03:07, 24 July 2008 (UTC)

Nothing is being passed off. Every statement in Chiropractic #Evidence basis accurately describes its source. If the source talks about SM, the statement talks about SM. Eubulides (talk) 05:06, 24 July 2008 (UTC)

Dematt, could you suggest a specific change in wording of the question? How about this: "In the opinion of the section's critics, the section is a WP:SYN violation when it cites sources on spinal manipulation (SM) in general (as opposed to SM performed by chiropractors specifically or, more to the point, the full range of chiropractic treatment, not just SM), because the reader may think the assertions apply to chiropractic treatment."

There was nothing wrong with the "here's some background" part; it's just that the suggestion had been made to make the question shorter; I agree that shorter tends to be better.☺ Coppertwig (talk) 13:31, 24 July 2008 (UTC)

Well, my contention has been that discussing the good information in the wrong article is a form of synthesis because it implies to the reader that conclusions about one leads to conclusions about the other. So mine would look something like this:

• In the opinion of the section's critics, the section is a WP:SYN violation when it presents specific research on spinal manipulation as evidence of effectiveness of chiropractic care as opposed to the whole range of treatments performed by chiropractors (not just SM), because the reader may confuse the assertions about spinal manipulation specifically as being assertions about chiropractic treatment in general.

I might be missing part of other's issues as well, so it probably still needs tweaking. -- Dēmatt (chat) 03:06, 26 July 2008 (UTC)

OK, thanks, I switched to that wording, and to balance added "the section clearly distinguishes SM research from other research" to the wording on the other side. Can anybody suggest further tweaking? Eubulides (talk) 08:31, 26 July 2008 (UTC)

I'm OK with the current wording, but here's an attempt to insert the concern that some of the SM research involved SM by some non-chiropractors; I don't know if this lengthens it too much and makes it too confusing:

"In the opinion of the section's critics, the section is a WP:SYN violation when it presents research on spinal manipulation (SM), some of which was performed by non-chiropractors, as evidence of effectiveness of chiropractic care as opposed to the whole range of treatments performed by chiropractors (not just SM), because the reader may confuse the assertions about spinal manipulation specifically as being assertions about chiropractic treatment in general." — Preceding unsigned comment added by Coppertwig (talk • contribs) 00:31 28 July 2008 (UTC)

Sorry, I don't know who made the above unsigned comment, but if it's all the same to you I'd rather just keep the question shorter. It's already too long, I think. It's been a week now doing ever more minor and minor edits; I'm inclined to ask the question at the appropriate administrator's noticeboard, unless there's some objection. Eubulides (talk) 15:00, 28 July 2008 (UTC)

No further comment so I put up the NOR/N question at Misplaced Pages:No original research/noticeboard #Chiropractic section on evidence basis. Eubulides (talk) 19:04, 29 July 2008 (UTC)

I am a little disappointed that Eubulides posted this to NOR/N without gaining a consensus. I thought discussions may have stalled but I don't think they were over. We have two options, I think: take down the post or edit the post. I chose the latter for now and expanding it to better represent the situation, I feel. -- Levine2112 19:22, 29 July 2008 (UTC)

• Sorry, I did not realize that consensus was lacking. All specific objections to the wording were accepted. As far as I know the last comment you made was 23:08, 23 July 2008 (UTC), and you did not object to any of the proposals or changes in wording after that. The last objection was by Dematt at 03:06, 26 July 2008 (UTC), with a relatively minor wording change which was accepted as-is. The previous change was also a minor wording change. That sounded like consensus (even boredom) to me.
• We have a third option, which I prefer: just go ahead with the query as written. You are of course free to open a new query of your own, or to append your own commentary to the query. I disagreed with the rewrite you made; it's obviously unfair to give one side significantly more discussion than the other. I took the liberty of undoing the rewrite at WP:NOR/N #Chiropractic section on evidence basis and moving the easily-separable addition in that rewrite to a later paragraph, signed by you.

Eubulides (talk) 21:31, 29 July 2008 (UTC)

Okay, well I understand your mistake in thinking that there was a consensus. I guess it would have been better to ask us first before posting. Anyhow, what's done is done and I have taken your advice and appended my own commentary to the query. I don't think it is unfair to give more discussion because the discussion your version made was insufficient and incorrect in its coverage of the opinions of the section's critics. I hope my attempts have rectified that. -- Levine2112 21:37, 29 July 2008 (UTC)

Antiscientific three times

Do we realize that we state Keating's opinion about "antiscientific reasoning" three-times in this article?! Talk about a WP:WEIGHT violation. We should attribute and mention it maybe once and then be done with it. -- Levine2112 17:22, 25 July 2008 (UTC)

It is an important point and is well worth summarizing in the lead, as well as in the body. The two places where it is mentioned in the body are both important: one is with respect to the evidence basis (or scientific research). The other is in discussing the history of chiropractic and why serious research did not begin until the 1970s and was hampered by antiscientific and pseudoscientific attitudes. Eubulides (talk) 18:06, 25 July 2008 (UTC)

Is this one of the sources to verify the antiscience text? See ref 74. We should not attribute source after source. I see no reason for that. QuackGuru 17:27, 25 July 2008 (UTC)

Those sources source Keating's opinion in that regard. It's actually page 64 (not 74) of Principles and Practice of Chiropractic where the word "antiscience" appears in a chapter of the book written by Keating and it is merely in a footnote reference back to the source of Keating's opinion already cited here. -- Levine2112 17:29, 25 July 2008 (UTC)

Where the word "antiscience" appears is merely in a footnote reference back to the source of Keating. That's WP:V.

No reason has been given to attribute every source. Do you have any references that differ from the current sources. QuackGuru 17:40, 25 July 2008 (UTC)

But it is still Keating's opinion. He is merely citing himself in a chapter of a book which he wrote. He doesn't even support the claim we are stating in this article. It is just a reference which happens to have the word "antiscience" in it. That's all. Several references have been supplies which differ from Keating opinion. And at the very least, we should not be restating Keating's opinion three times in our article! -- Levine2112 17:46, 25 July 2008 (UTC)

There seems to be some confusion here. The citation in Chiropractic #Evidence basis to Principles and Practice of Chiropractic is not to Keating. It is to Phillips, which is a different chapter. This is not the case of Keating merely citing himself. Eubulides (talk) 18:06, 25 July 2008 (UTC)

The bullet points still haven't been addressed by the above comments. I took the initiative to start working on the most urgent bullet point, namely that the current edit mischaracterizes "antiscientific" by implying that only Keating makes this claim. I did this by adding three citations to other mainstream sources that make similar claims on this topic. These sources are Nelson, Lawrence, Triano, Bronfort, Perle, Metz, Hegetschweiler & LaBrot 2005 (PMID 16000175), Keating, Charlton, Grod, Perle, Sikorski & Winterstein (PMID 16092955), and Phillips 2005 (in Principles and Practice of Chiropractic, 3rd ed.). The first two of these sources are peer-reviewed; the last one is a chapter in the leading current textbook on chiropractic. I hope this lays to rest any concerns that editors have that the opinion in question is merely that of the leading chiropractic historian of the last 15 years.

This doesn't fix that bullet point, though, as the text still says this:

'the other end employs what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims"'

This text no longer accurately summarizes what the cited sources say, since the cited sources now include 15 mainstream chiropractic researchers who agree on this topic. It's no longer appropriate to use Keating's name (unless we also use 14 other names, which is unrealistically awkward). Nor is it appropriate to use quote marks, since the various sources uses different words (e.g., "antiintellectual", "pseudoscientific") to make similar points. So I suggest that we replace the text with this:

'the other end employs what chiropractic researchers call antiintellectual, antiscientific or pseudoscientific reasoning'

Eubulides (talk) 18:06, 25 July 2008 (UTC)

In response to Eubulides' points: (Edit conflict. This was in response to the bulleted points at the top of the "Inserting "Keating says"" section, and to a comment by QuackGuru. I had originally intended to say here but forgot: Thank you, Eubulides, for clearly organizing and restating your points, and I'm sorry if I hadn't read the previous discussion thoroughly enough.) _{(13:20, 26 July 2008 (UTC))}

• If "is a CAM profession" is pejorative, then it violates WP:NPOV, which states "The tone of Misplaced Pages articles should be impartial, neither endorsing nor rejecting a particular point of view." The existence of one part of the article which violates NPOV is not an excuse for another article to also violate NPOV in order to match it.
• "multiple reliable sources, not just Keating": Others have stated in the discussion above that all of the other sources are either citing Keating, or are not talking about chiropractic.
• Balance: if there are any statements from another viewpoint which are also mere opinions, are also ultimately traceable to one relevant reliable source, and are stated in the article as if they are fact, then please point them out; probably they need to have prose attributions attached, too. Or, undue weight could be addressed in some other way. Again, the existence of some NPOV violations doesn't justify other NPOV violations.
• Re "antiscientific" not being controversial: as I pointed out earlier, it's fallacious reasoning to assert that we must take something as universally agreed merely because no one has negated it using precisely that word. (see my comment re purple aliens.)
• Re "Simon says": I think it would be good to go through the article and make sure all opinions have prose attributions attached. Only uncontroversial, verifiable facts should be stated as if they are facts.

QuackGuru said, "Sources indicate antiscience and it is not necessary to apply attribute." Actually, those sources are expressing an opinion, not a fact. The word "antiscience" is a pejorative label with more than one possible meaning; applying it to a group is not asserting a fact. If we find out what Keating meant, perhaps a verifiable statement in other words could be based on it and asserted as fact, if it really is verifiable as fact from reliable sources. If it's a fact, it's something about the real world which can be expressed in different words so as to avoid a non-NPOV pejorative tone.\

I agree with Levine2112's edit which re-instated the prose attribution of "antiscientific" to Keating and caught two more uses of this word. Please don't repeatedly delete this prose attribution which is supported by many editors of this page and required by the NPOV policy. I agree with Levine2112 that per WP:UNDUE, the use of this word should be reduced to once in the article. Coppertwig (talk) 18:19, 25 July 2008 (UTC)

• In some circles "is a chiropractor" "chiropractic" is pejorative: does this mean that Chiropractor Chiropractic must quote every use of the term "chiropractic", and attribute the quote in the text? Surely not.
• I don't recall the claim "all of the other sources are either citing Keating, or are not talking about chiropractic". In any event, the claim is incorrect. The Phillips source (which Levine2112 deleted without discussion!) is about chiropractic, and does not cite Keating. Here's the citation:
• So this opinion is not "ultimately traceable to one relevant reliable source", and it should not be treated specially in Chiropractic.
• Furthermore, it is misleading for the text to imply that only Keating holds this opinion, or that the opinion is controversial among reliable sources. It is not controversial among reliable sources. Many sources agree with it. Despite considerable search, zero reliable sources have been found that disagree with it.
• I don't understand the significance of the "purple aliens" remark. No reliable sources have been been proffered that dispute the claim of antiscientific reasoning using any terminology. If you look for "pseudoscience" or "antiintellectual" or any roughly-equivalent term, reliable sources all use words like these to describe the sort of ideas or thinking used in straight chiropractic. No reliable sources disagree on this point.
• This antiscientific reasoning is a significant problem in chiropractic. It is a primary reason that chiropractic has not been accepted within mainstream medicine. Downplaying this significant problem is an important WP:WEIGHT problem of its own.

Eubulides (talk) 19:36, 25 July 2008 (UTC)

and here we're getting to the root of the issue; antiscientific is not being used for any philosophical or objectively coherent meaning, but as a surrogate for "pseudoscientific" that somehow sounds more serious, somehow worse that unscientific and much worse than mistaken. Antiscience or antiscientific is virtually absent from the entire PubMed literature base, and pseudoscience and pseudoscientific are rare, in both cases almost vanishingly rare in connection with chiropractic. This is not a sign of endorsement of chiropractic, it is a sign of objective treatment of controversial issues avoiding offensive terms that have no coherent meaning. If something is wrong, it's enough to say its wrong, and if chiropractic's theories are not accepted more widely maybe its because they are unconvincing or unneccessary. Hyperbole or rhetoric makes the objectivity of the case look suspect. Avoidable pejoratives simply antagonise the neutral reader. Gleng (talk) 20:30, 25 July 2008 (UTC)

These terms are used in the standard primer on chiropractic history, and in the most-popular textbook on chiropractic. They are used by chiropractic researchers, not by mainstream medical researchers (which may help to explain why they're so rarely mentioned in Pubmed), but that doesn't mean that they are not notable terms within the context of Chiropractic. Again, zero reliable sources disagree with the point that antiintellectural/antiscientific/pseudoscientific/whatever-you-want-to-call-it is a significant and continuing problem within chiropractic. It would be a violation of WP:WEIGHT not to mention this significant problem.

Well that explains why a joint search for chiropractic and antiscience produses no hits at all, though PubMed carries some chiropractic journals. But I'm not sure here of the logic - mainstream medicine and science doesn't use it, but one end of the chiropractic continuuum does occasionally uses it about the other, so it would be right to use it here?Gleng (talk) 21:21, 25 July 2008 (UTC)

"in some circles "is a chiropractor" is pejorative: does this mean that Chiropractor must quote every use of the term "chiropractic", and attribute the quote in the text? Surely not." Whether or not someone is a chiropractor is a fact, not an opinion. This fact can be verified by determining if the person has a license to practice chiropractic. DigitalC (talk) 23:30, 25 July 2008 (UTC)

Ouch, my comment was not coherent; it mixed "chiropractic" and "chiropractor". I have corrected it. Sorry about the confusion. The point about "chiropractic" being pejorative to some people remains. In controversial areas, lots of words can become pejoratives, I'm afraid. Eubulides (talk) 23:48, 25 July 2008 (UTC)

I'm sorry, I don't see how "chiropractic" can be used in a perjorative sense. DigitalC (talk) 22:53, 27 July 2008 (UTC)

Antiscience and ahistorical syntheses

From the outset I objected that "antiscientific" was a pejorative masquerading as objective; that it had rhetorical force, that it expressed distaste, but was an opinion and because its nature might be confused should be flagged as that. It is a catch-all descriptor of diverse groups antagonistic to science, lacking a coherent operational definition. Eubolides countered by saying that antiscience had a philosophical pedigree, and its origins in the 18th century attack on scientific materialism by Thomas Hobbes captured the essence of the vitalistic theories held by straight chiropractors. This is a comprehensive misunderstanding. Thomas Hobbes was vehemently opposed to vitalism, and was an arch reductionist; his views read as almost a manifesto of modern scientific method "Everything is best understood by its constitutive causes. For, as in a watch or some such small engine, the matter, figure and motion of the wheels cannot be well known except it be taken asunder and viewed in parts." Hobbes was attacking the materialism of the empiricists, who believed that understanding could be gained by speculative theory and experiment; he argued for close observation and rigorous reason. "Antiscientific" as used by Keating is not congruent with this position. It may be possible to trace some connection; indeed it may be possible to change "husband" to "cuckold" in ten moves, but not I think without cheating.

What is left is evidence of misunderstanding of what "antiscientific" might mean, and evidence that the opinions it gives voice to are confusable with fact. Now is its use controversial? Must we annotate every opinion? Well chiropractic as a CAM is not controversial as it is a view held by chiropractors themselves. If straight chiropractors describe their position as antiscientific then I will happily accept it is not controversial, but I don't think that they do. Perhaps they are so small a minority that they can be disregarded, the 3% of Reed Phillips: but if this is true then are their views worthy even of mention?

Thus it seems that the philosophical attribution of a meaning to antiscientific is unfounded here; what remains is its opinionated nature, that expression of perhaps merited distaste. Let it be said, but let it not be confusable with fact; in kind it is no different from other pejorative expressions, and that it is used by a few authors repeatedly does not make it more objective. Hitler is almost universally regarded as evil, but it is still a subjective judgement. Hitler wisely refrains from using it or any equivalent judgemental statement.Gleng (talk) 09:43, 24 July 2008 (UTC)

WP:TL;DR and Godwin's law. Rewordings or attribution could probably help in this case. Do you have a proposed rewording to correct what you see as the PoV nature of current references to "antiscience" in the article? Jefffire (talk) 10:21, 24 July 2008 (UTC)

Coppertwig's suggestion above was to rephrase the disputed text as "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims"". Seemed fine to me.Gleng (talk) 10:51, 24 July 2008 (UTC)

Sound as a pound to my eyes. Jefffire (talk) 10:55, 24 July 2008 (UTC)

Sorry, I had to look that up! Apparently "Sound as a pound" indicates agreement. I haven't been paying attention to exchange rates, so I have no idea whether the pound is sounder than other currencies at the moment. ☺ Coppertwig (talk) 14:16, 24 July 2008 (UTC)

Thanks. OK, I put in the wording attributing "antiscientific" to Keating. I count four editors supporting this edit (Jefffire, Gleng, Coppertwig and Dematt) versus two opposing (Eubulides and QuackGuru). Also, I don't see positive reasons given for opposing the edit: only that it's "unnecessary". (Unless, as I said, there are other sources specifically mentioning chiropractic, in which case the attribution can be modified.) Eubulides may not see a distinction between attributing "antiscientific" and attributing statements like "is a complementary and alternative medicine health care profession". but don't worry: I do see a distinction, so the article won't turn into a pincushion of prose-attributions. As Gleng pointed out, chiropractors themselves consider themselves to be in "complementary and alternative medicine"; but _{(18:19, 25 July 2008 (UTC))} I think it would be difficult to find chiropractors referring to themselves as "antiscientific". ☺ Coppertwig (talk) 14:30, 24 July 2008 (UTC)

The only objection I have heard to CAM is that it is an oxymoron. How can something be complementary (used with) as well as alternative (used instead of) - its like new & improved. I see no problem with attribution here, and perhaps we will need to attribute more in the article (Eubulides suggested we would need to attribute DeVocht). However, I disagree that statements of fact need to be attributed. - DigitalC (talk) 23:59, 24 July 2008 (UTC)

Perhaps you missed the discussion in #Inserting "Keating says" on this subject? Coppertwig (who cited Gleng, but I don't see Gleng making this claim) was incorrect to claim that "chiropractors themselves consider themselves to be in 'complementary and alternative medicine'". Redwood et al. 2008 (PMID 18435599) says that by a wide margin, chiropractors themselves reject the claim that they are CAM practitioners. Eubulides (talk) 18:06, 25 July 2008 (UTC)

An interesting point Eubulides. If the majority of Chiropractors consider Chiropractic to be a part of integrated medicine, why isn't THAT in the article? DigitalC (talk) 23:43, 28 July 2008 (UTC)

No, the study said only 27% of surveyed chiropractors considered chiropractic to be part of integrated medicine. Eubulides (talk) 00:15, 29 July 2008 (UTC)

Archiving

This talkpage has again ballooned to a size which limits participation: Over 220K (and some editors have browsers that cannot easily handle anything over 32K). I don't think we need to pare back to a 32K size, but getting back to under 100K would be good. There is an archive bot trying to manage this page, but it is being blocked because of the way that section headers are being used. In other words, it archives sections that start with level 2 headers (==title==). However, if there is a single message within any of the level 3 headers (===subtitle===) of that section that is recent, the bot assumes that the entire level 2 section is recent, and won't archive any of it.

To address this problem, I recommend more frequent use of level 2 headers, or perhaps "downgrading" a subsection when it appears that it has gone inactive. For example, if there is a section "==Stuff==", and there is a level 3 subsection within it, "===Painting===", and the subsection is no longer active, but other subsections within "Stuff" are active, then we could change the subsection's header to "==Stuff: Painting==", and then the bot would recognize and archive it. Or, at that point the subsection could simply be archived manually. Another option is to move lengthy subsection discussions off to a subpage. Whichever way it is handled, I recommend that something be done, otherwise this page is going to continue to grow to even more unmanageable levels. --Elonka 17:54, 24 July 2008 (UTC)

Would collapsing templates address this problem? I came across a talk page the other day (unfortunately I can't recall which one), which had sections that were collapsed. So, given that something in a level 3 subsection is quite related to the other subsections under that level 2 heading, we might not want them sent to the archive yet. However, if we could collapse the previous level 3 subsections until we are ready to archive the whole section, that might be an improvement? Another example would be the proposed History section. The proposed text could be collapsed, with the comments about it uncollapsed. - DigitalC (talk) 00:46, 25 July 2008 (UTC)

(page currently at 300K and growing). Collapsed sections help with the scroll, but unfortunately not with the download. The entire (uncollapsed) page is still downloaded by the browser, it's just displayed as though it's smaller than it actually is. My recommendation at this point is to do partial archives of "inactive" sections of certain large threads, and just link to the archives via a {{sidebox}}. --Elonka 04:08, 27 July 2008 (UTC)

(317K) Another reason that the page seems to grow so large, is the practice of incorporating large quantities of page content here. A better practice might be maintaining a "mirror" page, such as at Talk:Chiropractic/draft. Then discussions and consensus-building could proceed on that page, with constructive changes periodically moved over to the live article. --Elonka 03:54, 28 July 2008 (UTC)

(362K) Okay, unless anyone has another idea, I'm going to start with archiving, per above suggestions. --Elonka 21:45, 29 July 2008 (UTC)

Archiving seems like a good idea to me. -- Levine2112 21:47, 29 July 2008 (UTC)

The idea of archiving is fine, but it has to be done with care. Currently we have Misplaced Pages:No original research/noticeboard #Chiropractic section on evidence basis with several wikilinks into this talk page; I don't want those links to stop working, nor do I want them to point into a newly created archive, as the SYN discussion is still very much active. Eubulides (talk) 22:08, 29 July 2008 (UTC)

Good point, and if someone who is familiar with that situation wants to handle the archiving, that's fine. But the situation is currently at a critical level, as this page is over triple the "maximum" size, and is continuing to grow at a rapid rate. --Elonka 22:19, 29 July 2008 (UTC)

I archived the page with this edit to the talk page and this edit to the archive, but my edit to the talk page got reverted by Dematt. For now I have reverted the edit to the archive to avoid duplicate archiving in the future. I guess I'll retire from the archiving business for now (to be honest, my heart wasn't in it). Eubulides (talk) 01:56, 30 July 2008 (UTC)

It looks as though you tried to archive the very much active "History" section toward the top of this page. That conversation is still going so it would be inappropriate to archive it just yet. -- Levine2112 02:01, 30 July 2008 (UTC)

If you, Levine2112, think it is inappropriate to archive when a conversation is still going then wait for the discussion to finish.

I think the archive is appropriate as along as links to the archives are given. Maybe an admin needs to do the archiving. This page is way too long. QuackGuru 02:12, 30 July 2008 (UTC)

Sorry for the confusion! I just did not want to lose that history again. The last time it wouldn't let me copy and paste from the archive and I didn't want to lose too many subsequent edits so I tried to act fast. The effect was lots of edit conflicts! Sorry. The next archive, please leave the history part, we can archives the comments though. -- Dēmatt (chat) 02:22, 30 July 2008 (UTC)

Evidence basis rewrite

The practice of evidence based medicine involves integrating the doctor's clinical judgement, based on his experience and expertise, with the best available external clinical evidence. Such evidence includes evidence from randomized trials and meta-analyses, and evidence from more specific studies relevant to particular cases. Chiropractors have access to several databases of information to foster good patient care practice including DCConsult and the Index of Chiropractic Literature. Chiropractors also use consensus guidelines developed by experts in the field.

Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors while the other end tends to use consensus guidelines that rely on postulates that are not part of mainstream science and medicine, and which, according to critics within the chiropractic profession, reveal dogmatic attitudes and uncritical thinking.

EBM alternative

"The practice of evidence based medicine involves integrating the doctor's clinical judgement, based on his experience and expertise, with the best available external clinical evidence. Such evidence includes evidence from randomized trials and meta-analyses, and evidence from more specific studies relevant to particular cases. Chiropractors have access to several databases of information to foster good patient care practice including DCConsult and the Index of Chiropractic Literature. Chiropractors also use consensus guidelines developed by experts in the field."Gleng (talk) 12:12, 27 July 2008 (UTC)

Excellent, I used that! I think we can use this as the intro for this section and now start building on what we want next. What do we want next? -- Dēmatt (chat) 14:30, 27 July 2008 (UTC)

• This new discussion of evidence-based medicine is misleading. It promotes the notion that evidence-based medicine is individual chiropractors using whatever clinical trial results they want to, in order to justify their own preconceptions about the best treatment. That is not what EBM is about.
• This new discussion is derived from a source that is quoted in Evidence-based medicine #Criticism of evidence-based medicine, a source that is covering only one part of EBM. The discussion does not adequately cover the point that EBM, although obviously not the last word in every medical decision, "seeks to clarify those parts of medical practice that are in principle subject to scientific methods and to apply these methods to ensure the best prediction of outcomes in medical treatment" (quoting Evidence-based medicine lead).
• This article does not need a lengthy summary of evidence-based medicine that (in effect) argues against applying evidence-based guidelines. We can just use the phrase in context, wikilink to Evidence-based medicine, and be done with it. Which is what Chiropractic already does.

Eubulides (talk) 16:32, 27 July 2008 (UTC)

Evidence basis rewrite comments

I have started by taking some of the sentences that concerned evidence based guidelines from different subsections of Chiropractic#Evidence basis and brought them into the initial paragraph where they help to explain the reasons that physicians are concerned about the abuse of evidence based guidelines. I believe it is NPOV and accurate. I have not thoroughly checked the references yet. -- Dēmatt (chat) 02:00, 25 July 2008 (UTC)

Suggestion: drop "anyway" from "validity of these guidelines anyway." and instead use "validity of these practice guidelines." -- Fyslee / talk 05:03, 25 July 2008 (UTC)

Done. -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

Overall, this version seems extremely solid. Nice work! -- Levine2112 17:12, 25 July 2008 (UTC)

Thanks! Still more work to do though! -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

This version has problems. For example, the part that says Those that are opposed are concerned is not NPOV. The current version without attribution is best. QuackGuru 17:17, 25 July 2008 (UTC)

Please describe why you feel that sentence is not NPOV? Please refer to the source when possible. -- Levine2112 17:43, 25 July 2008 (UTC)

Yep, hard to fix something that doesn't look broken. Any suggestions? -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

I suggest that you can just say "some are concerned..." it may also be a concern amogst supporters of EBM that the research base is not always specifically about chiropractic. But generally think you've done a good job. I think it is helpful to start by explaining what EBM is as it is so often misunderstoodGleng (talk) 11:11, 26 July 2008 (UTC)

• If the idea is to take text away from some other section and put it here, then we also need to see what the other section will look after the text is removed from there. Can you please show the entire proposed change, rather than just this part of it? (I did take the opportunity of migrating the recent change to Chiropractic into this part of the proposal]].)

No preconceived intentions other than to follow the sources and fix synthesis problems so that we can remove the tag. So far just some re-arranging. Not sure I see where you've migrated anything? -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

• I haven't migrated the text in question. As I understand it, this draft proposes migrating text (like "Many controlled clinical studies of SM are available, but their results disagree") from other paragraphs into the first paragraph of Chiropractic #Evidence basis. If so, then we need to see what the other changed paragraphs will look like as well, in order to see what the entire proposal is. Eubulides (talk) 02:40, 26 July 2008 (UTC)

• The new phrase "Those that are opposed are concerned that" is not supported by a reliable source. QuackGuru also objected to this phrase on NPOV grounds, but the lack of a source is even more worrisome to me.

You really think it needs one? -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

Yes; that phrase is a claim that the chiropractors who employ antiscientific reasoning etc. are are concerned that research has focused on SM in general. But we don't have a reliable source saying that. And in fact, I expect that the actual concern is also shared by many chiropractors who stick to scientific reasoning, so I am concerned that the phrase may in fact be misleading. Finding and citing reliable sources on this topic will help to dispel this concern. Eubulides (talk) 02:40, 26 July 2008 (UTC)

There is a continuum; I assume that includes those that object for reasons that are not antiscientific. But I did make some changes try and clarify this. -- Dēmatt (chat) 05:30, 26 July 2008 (UTC)

• The "These" in the new phrase "These chiropractors" is not supported by a reliable source.

You really think it needs one?-- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

Yes, for the same reason as before. We don't have a reliable source equating the set of chiropractors who employ antiscientific reasoning etc. with the chiropractors who voice concerns about stealing SM procedures, and in fact I am concerned that these sets of chiropractors are substantially different. Eubulides (talk) 02:40, 26 July 2008 (UTC)

• The phrase "and they are typically of low quality" (referring to clinical studies on SM), which was present in the source, is absent here. It seems important; why omit it?

It seemed POV and unnecessary as everyone knows that clinical studies are not as good quality as RCTs. I think that is the point that was made by the source as well. -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

I doubt that the typical Misplaced Pages reader will know this. For one thing, the text doesn't even say that the studies are typically clinical studies rather than RCTs. The low quality of studies is an important point, and should be summarized in this section, rather than expecting the reader to follow the citation in order to see the point. Perhaps you meant to leave the low-quality sentence in the source paragraph? This is why we need to see the edited source paragraphs as well as the edited destination paragraph. Eubulides (talk) 02:40, 26 July 2008 (UTC)

Just a query. If the source criticises the low technical quality of the clinical trials then I'd support Eubolides here, if the source is referring to low quality in the EBM context (i.e. possibly well conducted but of low weight as far as systematic assessment is concerned because of small numbers/single centre etc) then a different wording might be better. Gleng (talk) 11:11, 26 July 2008 (UTC)

• The phrase "leaving questions about the validity of these guidelines anyway" which Coppertwig spotted as a grammar problem, is not supported by the source. The source talks only about guidelines for low back pain, not about guidelines for chiropractic care in general.

Good point. It doesn't belong in the effectiveness for low back pain section either then. -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

Sure it does. It's about low back pain. Eubulides (talk) 02:40, 26 July 2008 (UTC)

• As mentioned above, I suggest replacing this:

the other end employs what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims".

with this:

the other end employs what chiropractic researchers call antiintellectual, antiscientific or pseudoscientific reasoning, stratagems that are ethically suspect when they let practitioners maintain their beliefs to patients' detriment.

Eubulides (talk) 18:06, 25 July 2008 (UTC)

Still an ongoing discussion on that one. See below. -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

I certainly agree that its right to mention ethical issues somewhere. All professions have theirs - academic medicine with conflict of interest, medical practice with overprescribing, science with fraud etc.; I'd have thought that the major ethical concern with chiropractic has been over advertising. Obviously it must be a concern if patients are deflected from effective care, but is there evidence of much actual harm arising from straight chiropractic, or is this mainly fear that it might? Gleng (talk) 22:43, 25 July 2008 (UTC)

I don't know of any scientific evidence about actual harm arising from chiropractic (either straight or mixer) due to deflection. Certainly there is anecdotal evidence of deflection, as well as a few (quite rare) documented cases of harm due to treatment, but that is not scientific evidence. Eubulides (talk) 23:48, 25 July 2008 (UTC)

I agree that we should mention ethical issues NPOV. Of course, these get complicated too ;-) Do appreciate all the help we can get! -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

I see that further edits have been made but it seems to be a work-in-progress; some lengthy quotes about EBM have been added, which aren't that relevant here, and there's still material (e.g., "'steal' SM procedures) taken from other paragraphs but it's not clear how the other paragraphs will be altered. So I'll hold off further comments for now. Eubulides (talk) 08:31, 26 July 2008 (UTC)

Yes, still a work in progress and I simply had to get some sleep :-) Re: EBM stuff added; I am waiting to see how the SM decision works out. After Coppertwig seemed to think that we can use good information even if it is not specific to one article, I think it is perfectly reasonable to explain EBHC so that the reader can understand the various POVs concerning it. BTW, I just quoted straight from Sackett for now, but will paraphrase soon (though I think Coppertwig and Gleng are good at this, too). Notice that Sackett explains that EBM is not restricted to RCTs. I was considering that we can include other types of research that help a doctor evaluate patients. Ie., in the absense of RCTs, we might be able to find sources that make some EBM choices based on the latest expert consensus type guidelines. Of course, we would have to explain that as well. -- Dēmatt (chat) 15:28, 26 July 2008 (UTC)

I've rewritten my rewrite in a totally different direction. It seemed that the information that I had was going nowhere so I followed what I thought the reader would want to know. It's just a start again, and needs some balance, so feel free to give some advice. -- Dēmatt (chat) 04:07, 27 July 2008 (UTC)

Please see #EBM alternative above. Eubulides (talk) 16:32, 27 July 2008 (UTC)

Thanks Eubulides. I hear what you are saying. I added the second paragraph which adds our infamous sentence. I'll let us digest that one for awhile. Any input? -- Dēmatt (chat) 18:15, 27 July 2008 (UTC)

"the other end tends to use consensus guidelines that rely on postulates that are not part of mainstream science and medicine, and which, according to critics within the chiropractic profession, reveal dogmatic attitudes and uncritical thinking" As far as I can see the source doesn't say "the other end" (i.e., straights) uses "consensus guidelines". Also, this is watering down what the source says: it says that "the other end" uses antiscientific and pseudoscientific reasoning, a much stronger charge than mere dogmatic attitudes and uncritical thinking. Eubulides (talk) 15:00, 28 July 2008 (UTC)

Inaccurate insertion of "Simon says" phrases

I see now that what I predicted earlier would happen, is indeed starting to happen: this edit inserted two more "Simon says" remarks, and inserted quotation marks, in order to weaken the discussion. In these cases, the "Simon says" remarks were not accurate, as the source in question is by Keating and two other authors, not by Keating alone. Also, the newly-inserted quotation marks are not strictly accurate. Furthemore, the edit made the controversial change of removing "pseudoscientific" (a point that is made by the source). It also unnecessarily removed wikilinks. I'll sew what I can do to fix all this now, but I wish controversial changes like this were discussed first, before being made. Eubulides (talk) 18:06, 25 July 2008 (UTC)

Actually, my edits were discussed above first. My issue is that we are stating Keating's "antiscience" opinion three times in this article. That is most certainly a WP:WEIGHT violation. I have reduced it to one time. -- Levine2112 18:14, 25 July 2008 (UTC)

• No, all that was said above was "we should not be restating Keating's opinion three times in our article". That is not a discussion of specific edits; it is a statement of a problem.
• The changes introduced errors, as discussed above, and I will try to repair them on short notice. It would have been more helpful to discuss the specific edits first.
• It is not a WP:WEIGHT violation to mention an important topic once in the body and to summarize it in the lead. The straights's dogma/pseudoscience/antiscience/antiintellectual/whatever-you-want-to-call-it is an important reason chiropractic continues to have problems with mainstream medicine, and this problem needs to appear in the lead. In an attempt to reach a compromise I will attempt to reword it without the word "antiscience", which appears to be a hot-button among sveral editors.
• I continue to disagree with the idea of making controversial changes like this without specific discussion of the edits first. This is not a good way to move forward in this controversial article.

Eubulides (talk) 19:36, 25 July 2008 (UTC)

I have attempted a quick workaround of the problem with this edit, which does the following:

• Restore the discussion of the issue to the lead, without using the hot-button word "antiscientific". This discussion uses terminology that comes from "Chiropractic History: a Primer", while avoiding the hot-button word.
• Move the single use of the word "antiscientific" from Chiropractic #History to Chiropractic #Evidence basis. The problem of antiscientific/pseudoscientific/antiintellectual/whatever-you-want-to-call-it is a continuing one, so if it's going to be mentioned in one place, it's better not to imply that the problem has gone away by putting it into the History section.
• Restore the point that evidence-based guidelines are supported by some chiropractors. Removing this point was not discussed, and I assume it was inadvertent.
• Restore the citations to Phillips in PPC; this is an independent source (which does not cite Keating) about the issue.
• Restore the citation to the "subluxation or dogma" paper, as it is a relevant source here (as elsewhere in the article).
• Add a phrase talking about ethical issues; this was suggested in Talk:Chiropractic/Archive 25 #Antiscientific reasoning above, and nobody has objected to this particular phrase.

Eubulides (talk) 21:09, 25 July 2008 (UTC)

• "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs what chiropractic researchers call antiintellectual, antiscientific or pseudoscientific reasoning, stratagems that are ethically suspect when they let practitioners maintain their beliefs to patients' detriment."

This sentence gives the impression that all chiropractic researchers call some undescribed set of chiropractors antiintellectuals, antiscientific or pseudoscientific. I think what other editors are suggesting is that, rather than using the words antiscience, ps.... that we use the reasons that these particular researchers call them that instead. That way we avoid the pejorative sensations that the words themselves present without explanation.

BTW, is it okay if I make changes to the article without first getting consensus here, too. I'm okay with that if you are. -- Dēmatt (chat) 00:26, 26 July 2008 (UTC)

• It doesn't call the undescribed set antiscientific; it merely says that they employ antiscientific reasoning, which is a different thing.
• I don't think the other editors were saying that the word "antiscientific" be removed; only that it not be mentioned more than once and that it be attributed in the text; the current version does that.
• I'd rather that we stick to the advice "Please read this page and discuss substantial changes here before making them." which has long been at the top of this talk page. I wish we had followed that advice in this instance.

Eubulides (talk) 00:41, 26 July 2008 (UTC)

• The references that we have sourced do not say anything about a continuum that I can see. They all do seem to be opinion pieces; in fact as Coppertwig enlightened us, they are part of a debate within chiropractic. Why don't we consider phrasing it in the context of a chiropractic debate such as, "The debate within chiropractic circles is whether resistance to evidence based guidelines is justifed or is based on anti-scientific reasoning and unquestioning adherence to dogmatic beliefs." This way, we as wikipedians avoid taking sides. I'm not sure that it fits in the evidence based section though, unless we lost a link somehwere.

• I'm not sure what you mean by "opinion pieces"; by the "Simon says" standard being proposed, I'd guess that all the sources currently cited by Chiropractic are opinion pieces, so in that sense, yes, they are opinion pieces. But this particular point is not controversial among reliable sources, and it's not being debated as far as I can see. The paraphrase you suggest is about evidenced-based guidelines and would clearly fall within the subject of Chiropractic #Evidence basis; however, I don't know of any reliable source that would support that paraphrase. Eubulides (talk) 02:40, 26 July 2008 (UTC)

• I wish we had followed that advice in this instance. I think Coppertwig did. I wish we had followed it in every instance. That is the only fair way and it actually encourages collaboration, rather than destroys trust. -- Dēmatt (chat) 01:15, 26 July 2008 (UTC)

• Yes, Coppertwig did, but this section (#Inaccurate insertion of "Simon says" phrases) was not prompted by Coppertwig's edits. It was prompted by later edits that were not discussed before being installed.

Eubulides (talk) 02:40, 26 July 2008 (UTC)

Oh, I returned it to the consensus version that Coppertwig made. I still don't see the continuum part. I really thought we had something that said that. -- Dēmatt (chat) 04:46, 26 July 2008 (UTC)

I see, but this version still has a problem. The text says:

'what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims"'

but the citations are not just to Keating 1997; they are also to Phillips 2005 (an independent source: he doesn't cite Keating) and to Keating, Charlton, Grod, Perle, Sikorksi, and Winterstein 2005. We need to fix the text to match the sources, which are not just Keating. The quote-marks are no longer appropriate, since we're citing some non-Keating sources, and they don't all use those exact words. To fix this I propose changing the abovementioned text to look like the following instead:

'what chiropractic researchers call antiscientific reasoning and unsubstantiated claims'

Eubulides (talk) 08:31, 26 July 2008 (UTC)

Thank you, Eubulides, for your effort in working towards a consensus version. The reference Keating, Charlton, Grod, etc. 2005 apparently does not contain the word "antiscientific". I'm not sure if I can access Phillips 2005: does it use that word?

Re "the other end employs what chiropractic researchers call antiintellectual, antiscientific or pseudoscientific reasoning": The phrase "chiropractic researchers" could easily be misinterpreted to mean researchers who are chiropractors, leading to an erroneous impression that we're saying that chiropractors are calling themselves antiscientific etc. A list of several pejorative terms seems unnecessary and leads to a non-neutral tone even if it's in a quote or indirect quote.

Re "'what chiropractic researchers call antiscientific reasoning and unsubstantiated claims'" OK except for my concerns about the phrase "chiropractic researchers". How about "commentators" or "commentators about chiropractic" or "researchers about chiropractic" or "commentators such as chiropractic historian Keating" or possibly just "researchers"?

You said that the prose attributions had been added for the purpose of weakening the phrase. That isn't my purpose. The purpose is to satisfy NPOV. The statement can be very clear and strong, as long as it's neutrally worded. How about something like "...the other end relies on postulates which are not scientifically established"? Does that express the concept sufficiently? If not, can you find a way to explain it in a phrase like that, rather than relying on individual words such as "antiscientific" which may mean different things to different people? Such a phrase may not need prose attribution, if we can agree that it's a verifiable fact expressed in neutral terms. ☺ Coppertwig (talk) 18:37, 26 July 2008 (UTC)

• I realize it wasn't your purpose to make the text NPOV POV. But that is the effect of these changes. And it is this effect that we must deal with and fix.

I think you meant POV here. In which case I disagree.Gleng (talk) 17:53, 27 July 2008 (UTC)

I did mean "POV". Sorry about that. I corrected it. Eubulides (talk) 15:00, 28 July 2008 (UTC)

• Keating, Charlton, Grod, etc. 2005 don't use the specific word "antiscientific", but they do make the point, and they do use the word "unsubstantiated" several times. Here's a brief sample: they say that the "preeminent theoretical construct" of "many chiropractors" (i.e., straights) "remains unsubstantiated". They also say that the ACC's subluxation claims are "exemplary of scientifically unjustified assertions" and that they "can only bring scorn and continued alienation from the wider health care community and the public"; this point is summarized in the abstract, using the word "ridicule" rather than "scorn". Their summary says "The dogma of subluxation is perhaps the greatest single barrier to professional development for chiropractors.... Commitment to this dogma undermines the motivation for scientific investigation of subluxation as hypothesis, and so perpetuates the cycle."

No dispute. Why not give as a quote that last sentence as you've put it, which makes their point admirably?Gleng (talk) 17:53, 27 July 2008 (UTC)

The last quote wouldn't make sense by itself. ("the cycle"? what cycle). Also, it's too long. The main point here is that straights make unsubstantiated claims, and that this sort of behavior brings ridicule/scorn from the mainstream. Eubulides (talk) 15:00, 28 July 2008 (UTC)

I meant the whole of your last sentece beginning "the dogma...", but better ended after "hypothesis". 79.68.13.143 (talk) 20:38, 28 July 2008 (UTC)

Ah, I see, but there's two problems with that. First, that's about subluxation, not evidence basis, so it would belong in Chiropractic #Vertebral subluxation, not in Chiropractic #Evidence basis. Second, that's really long: "The dogma of subluxation is perhaps the greatest single barrier to professional development for chiropractors; commitment to this dogma undermines the motivation for scientific investigation of subluxation as hypothesis." is much longer than "the other end employs antiscientific reasoning and makes unsubstantiated claims". Eubulides (talk) 22:05, 28 July 2008 (UTC)

That's about dogma and unsubstantiated claims.. Let's use those words. -- Dēmatt (chat) 16:13, 29 July 2008 (UTC)

I don't object to mentioning dogma and unsubstantiated claims in addition to antiscience, pseudoscience, and antiintellectualism. I do object to watering down the stronger terms and substituting the weaker ones, when no reliable source opposes the stronger terms. Eubulides (talk) 19:04, 29 July 2008 (UTC)

• Phillips 2005 uses "antiscientific" (along with "antimedicine" and "antiintellectual"). I've already quoted this above. Look for "antimedicine" in #Evidence basis rewording proposal. Phillips makes the explicit point that this antiscientific/antimedicine/antiintellectual persists today.

again, these are words that express an opinionated judgement but which have in themselves no clear objective meaning. Alone, they are the sauce without the beef.Gleng (talk) 17:53, 27 July 2008 (UTC)

These are the words that the source uses. This is a reliable source published in a refereed journal. No reliable source has been found that disagrees with this point. It is not our place to water down the points that reliable sources are making because, in our opinion, the words have "no clear objective meaning". That is simply arguing against reliable sources, something we are not supposed to do. Eubulides (talk) 15:00, 28 July 2008 (UTC)

Not arguing against sources, that this is their opinion is not in dispute. Representing their expression of distaste (which Fyslee clearly argues that it is) as though its an editorial judgement of fact is POV, to my mind at least. I don't think you'll find such expressions used much (if at all) in serious encyclopedias, or serious reviews in mainstream scientific/medical journals (though occasionally in opinion pieces maybe), or on NHS sites, NIH sites, AMA sites, etc etc. But we're going round in circles; it's an honest disagreement; I wouldn't give the word houseroom myself except in a context where it had an operational definition, I think it's just a small step up from playground insults. It's fine in forums for expressing gut feelings, should be absent from reasoned, objective discourse. But that'll be my last word on it and here.79.68.13.143 (talk) 20:38, 28 July 2008 (UTC)

I agree that words like "pseudoscientific" and "antiscience" are not commonly used in serious reviews, because most serious reviews don't waste their time on pseudoscientific and antiscientific views. But they are used on occasion, when fringe theories gain enough popularity to be a significant issue. For example, Weiss et al. 2008, a source on autism treatments (an area where many parents desperately choose treatments that have no scientific support), have a section entitled "Science, pseudoscience, and antiscience", which goes on for multiple pages, as this is a serious problem in autism treatments. See: Weise MJ, Fiske K, Ferraioli S (2008). "Evidence-based practice for autism spectrum disorders". In Matson JL (ed.) (ed.). Clinical Assessment and Intervention for Autism Spectrum Disorders. Academic Press. pp. 33–64. ISBN 0123736064. {{cite book}}: |editor= has generic name (help)CS1 maint: multiple names: authors list (link) Eubulides (talk) 22:05, 28 July 2008 (UTC)

• I disagree that the supposed "list of pejorative terms" is unnecessary. It's important to make the point that the mainstream, and this includes the chiropractic mainstream, strongly repudiates the antiscientific attitude of the straights. We should not be bowdlerizing what reliable sources say on this matter. The terms being used may be strong but they are important.
• I suggest just plain "researchers"; there's little point giving more details about their identities in the text.

• No further comment on this, so I changed it to use the wording you suggested, choosing "researchers" among the alternatives you listed. Eubulides (talk) 15:00, 28 July 2008 (UTC)

• I see now that Levine2112 reverted the change with the log entry "no consensus to change this yet". I don't see any disagreement about this on the talk page: Coppertwig proposed the change and I agreed. If there is some disagreement, please discuss it here, rather than reverting without comment here. Thanks Eubulides (talk) 15:19, 29 July 2008 (UTC)

I don't see where Coppertwig agrees and I don't agree that all chiropractic researchers think straights are antiscientific. Ceratinly some researchers think they are totally scientific. You've gone too far the other way. -- Dēmatt (chat) 16:13, 29 July 2008 (UTC)

• Coppertwig actually proposed the wording in question, in his comment 'Re "what chiropractic researchers call antiscientific reasoning and unsubstantiated claims" OK except for my concerns about the phrase "chiropractic researchers". How about "commentators" or "commentators about chiropractic" or "researchers about chiropractic" or "commentators such as chiropractic historian Keating" or possibly just "researchers"?'. I took the last alternative, "researchers".
• The proposed text does not say "all researchers", it just says "researchers". Of all the reliable sources we've found, all agree on this subject; there's no reason to water it down by giving the implication that it's just Keating's opinion.

Eubulides (talk) 19:04, 29 July 2008 (UTC)

(outdent) From edits like this one it appears that QuackGuru as well would prefer the wording that Coppertwig proposed to the wording that's in Chiropractic now. Do any other editors have an opinion on this topic? Eubulides (talk) 02:08, 30 July 2008 (UTC)

I prefer what's in there now. It's not misleading. Or perhaps we should just remove the phrase for the time being until we can agree on something. Further, I think Keating was referring to a group now all but expired. This would be better suited for the history section. -- Levine2112 02:14, 30 July 2008 (UTC)

I prefer we just remove the Keating phrase for now and perhaps we can replace it with researchers. Dematt agrees the current text is misleading. QuackGuru 02:28, 30 July 2008 (UTC)

I prefer to leave the text attributed to Keating until we find a different configuration. Changing it to researchers goes too far the other way. I will not argue with its temporary removal if others are not happy with it as is. -- Dēmatt (chat) 02:33, 30 July 2008 (UTC)

So far we have three editors (Coppertwig, QuackGuru, and myself) preferring the Coppertwig-suggested wording with "researchers", Dematt preferring the existing text until we think of something better, and Levine2112 preferring either the existing text or nothing. The existing text is highly misleading, though, so we really do have to improve it it one way or another. Removing it is not a reasonable alternative, as antiscience is a significant problem in any profession that uses evidence-based principles. This is not as good a consensus as I'd like, but so far the "researchers" variant seems to be ahead of the known alternatives. Any other suggestions? Dematt? Eubulides (talk) 07:16, 30 July 2008 (UTC)

(<<outdent) I did suggest the individual word "researchers". But we have to make sure the article accurately reflects the sources. In this version, as Dematt points out, it seems to imply that all researchers use the phrase "antiscientific", yet the first footnote goes to a source that doesn't use that word. (How many sources actually say "antiscientific"?) Inserting "some" before "researchers" would go too far the other way, though, if Eubulides is right that there are no dissenting views. How about this wording, based partly on Gleng's: "...the other end rely on postulates that are not part of mainstream science and medicine, and which have been called "antiscientific" and "unsubstantiated claims" by critics within the chiropractic profession." (and putting the footnotes in order: those containing "antiscientific" first if that word is quoted first in the sentence.) Coppertwig (talk) 13:29, 30 July 2008 (UTC)

Oops, I made a mistake; but– wait a minute! This source does contain the word "anti-scientific" after all; I had searched using control-F in my browser for "antiscientific" without the hyphen only. Sorry about that. However, it appears to be saying more-or-less that chiropractic is not anti-scientific, so it's the source Eubulides was asking for that refutes the "anti-scientific" claim. It says "There is nothing inherently dogmatic or anti-scientific in the notion that an articular lesion may have health consequences, or that correction of joint dysfunction may relieve symptoms and/or improve health." (I suggest reading this whole paragraph in the source: Keating Charlton Grod etc.). ☺ Coppertwig (talk) 16:29, 30 July 2008 (UTC)

• I was not asking for a source refuting the claim that chiropractic is antiscientific. Nobody has made that claim, and Chiropractic did not make that claim. I was asking for a source that refutes the claim that a segment within chiropractic use antiscientific reasoning, which is the claim that Chiropractic actually makes, and which the source you mention confirms. The rest of the paragraph you quote goes on to warn us against "the unreasonable extrapolation of current knowledge into speculation and presentation of theory as fact", which is exactly what this segment of chiropractic does, and which corresponds to the "unsubstantiated claims" and "pseudoscience" that several reliable sources attest to.
• I have several times read the sources in question. Before this current editing ruckus started, Chiropractic summarized them accurately, and gave the accurate impression that there is an antiscientific component of the chiropractic community that uses antiscientific and pseudoscientific reasoning which is a barrier to evidence-based medicine. There is no controversy about this among reliable sources.

Eubulides (talk) 18:50, 30 July 2008 (UTC)

Regardless if that is what you were asking for, you got it. Keating is saying that there is nothing inherently antiscientific about dogma or subluxation, just the dogmatic reliance on unsubstantiated claims. Also, that makes the group that he is referencing a much smaller group - super straight or objective straight is his target, but even they don't make claims that they cure any disease... in fact, they have a healthy respect for science, they just don't "waste their time" making a diagnosis. (Notice the judicious use of the quotes so as to show it is their opinion). That leaves us with one source of Keating using the word to slap the other side. So we should either attribute it with quotes because of its questionable definition or describe the opinion NPOV with less POV wording. Either way, we probably need to give the other side.. -- Dēmatt (chat) 13:54, 31 July 2008 (UTC)

Obviously Keating is not saying that all chiropractic is antiscientific. But Chiropractic is not saying that either. It is merely saying that one end of a continuum is antiscientific. There is not "one source" using the word: we have several sources, including Principles and Practice of Chiropractic (in a chapter that Keating did not write, and which does not cite Keating). Eubulides (talk) 14:22, 31 July 2008 (UTC)

One editor claims or is implying the text may not be verfied. QuackGuru 01:20, 1 August 2008 (UTC)

The diff in question is fairly cryptic; I can see several ways to interpret it. I wouldn't worry about it too much (it's just a user talk page comment) unless the topic is brought up on this page. Eubulides (talk) 08:08, 1 August 2008 (UTC)

That was me. I was not claiming or implying that the text may not be verified. I was simply expressing an intention to examine the sources before proposing another suggested version of the text. I see no need to bring that comment into this discussion. ☺ Coppertwig (talk) 12:40, 1 August 2008 (UTC)

It's been a day and a half since I noted the impasse in the discussion, with the current wording clearly having a problem (it misleadingly suggests that only Keating holds the opinion), and with a proposal on the table that seems to be favored by three editors, disliked by one, and keep-until-we-think-of-something-better by a fifth. If nobody can think of something better, we should switch to the Coppertwig-suggested wording with "researchers", as it's clearly an improvement over the misleading text currently in use. We can substitute the something-better later, once we think of it. Eubulides (talk) 14:30, 1 August 2008 (UTC)

I don't think we should have to keep commenting in order to "keep" a consensus version. Which three editors? -- Dēmatt (chat) 03:09, 2 August 2008 (UTC)

Coppertwig (who proposed the wording in question), QuackGuru, and myself. The version in Chiropractic is not really a consensus version; on the contrary, there is considerable sentiment that it is misleading in its current form (as it talks only about Keating saying "antiscientific", when "antiscientific" is actually the consensus among several reliable sources). Eubulides (talk) 06:14, 2 August 2008 (UTC)

Read the last part of the edit summary: Don't assert non-NPOV statements without quotes.

It is misleading to claim it was only Keating. If it was non-POV then quotes would not help. Based on the edit summary the editor thinks it is not NPOV. I thought we have been through this before. The text is verified by more than one reseacher. If this continues then the neutrality noticeboard is one of the options we can choose. QuackGuru 17:15, 1 August 2008 (UTC)

• I take the last part of that edit summary to be referring to "pseudoscientific", which is not the wording being discussed here.
• I think there's consensus that it's misleading to give the impression that it's only Keating. Where there's less agreement is how to fix the problem. The Coppertwig-suggested wording with "researchers" has the most consensus of any proposed replacement. I hope the neutrality noticeboard isn't needed for this relatively-minor issue.

Eubulides (talk) 17:50, 1 August 2008 (UTC)

"researchers" goes too far the other way. I'm also thinking the use of "antiscientific" can be used in the history with both Keating and Phillips 2005 and "unsubstantiated claims" in Evidence base. -- Dēmatt (chat) 03:09, 2 August 2008 (UTC)

"Antiscientific" belongs better under Evidence basis (formerly Scientific investigation) because it is about an obstacle to evidence-based medicine. The antiscientific component of chiropractic is not merely a historical issue; it doesn't belong only, or even primarily, under History, although I suppose it could be mentioned there as well. Do you have any specific wording to propose other than the wording Coppertwig proposed, with "researchers"? Eubulides (talk) 06:14, 2 August 2008 (UTC)

Speaking as a historian

He's speaking as a historian, talking about how history has forged contemporary attitudes. He's notable as a historian, almost uniquely well qualified to talk about this. He's not a scientist, which is maybe why he uses terms scientists generally avoid (in public, in private hey use them all the time - about each other).Gleng (talk) 17:53, 27 July 2008 (UTC)

Again, this is not just Keating; lots of other chiropractic researchers agree with him and so far we've found no reliable sources disagreeing. The chiropractic researchers have D.C.s and are publishing in peer-reviewed journals or in popular chiropractic textbooks. This is all in public. Eubulides (talk) 15:00, 28 July 2008 (UTC)

• "the other end relies on postulates which are not scientifically established" isn't right, as it waters down what the mainstream chiropractors are saying. They are not saying merely that straights are speculating. They are saying straights are antiscientific and pseudoscientific. Real scientists speculate; but they don't continue to speculate, indefinitely, when evidence can be found, and is found.

No, afraid that's not true. Scientists hang on to theories long after they've been superceded - see "The Structure of Scientific Revolutions" by Thomas Kuhn (actually I don't recommend the WP articles unless you want a headache). They are dogmatic too; conservatism is I'm afraid a neccessary part of science. The point at which such adherence becomes unreasonable is hard to judge, at some point it does - but it's a judgement call, not black and white.Gleng (talk) 17:53, 27 July 2008 (UTC)

Kuhn's thesis does not affect the point that real scientists do not continue to speculate, indefinitely, when evidence can be found, and is found. Eubulides (talk) 15:00, 28 July 2008 (UTC)

Merely on a point of accuracy, Kuhn said very clearly that older, more experienced scientists did usually adhere dogmatically to older theories indefinately. He quote Max Planck:"A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grow up that is familiar with it."Gleng (talk) 09:04, 29 July 2008 (UTC).

Even if Planck's quip were largely true, which it is not, that would still not explain the straights' dogmatic and antiscientific position, which has held sway for a century. B.J. died long ago, no? And Planck is a counterexample to his own quip (and to Kuhn's thesis as well, of course): his own doctoral thesis of 1879 specifically opposed Boltzmann's constant and Boltzmann's statistical interpretation of the 2nd law of thermodynamics, but obviously he changed his mind in his quantum theory. For more, please see: Blackmore JT (1978). "Is Planck's 'principle' true?". Br J Phil Sci. 29 (4): 347–9. doi:10.1093/bjps/29.4.347. I realize that postmodernists love Kuhn because it allows them to say science is all relative, but encyclopedia articles should stick with the common interpretation of words like "science" and "antiscience". Eubulides (talk) 15:19, 29 July 2008 (UTC)

Well, what Kuhn actually said was "every individual choice between competing theories depends on a mixture of objective and subjective factors." While both he and Popper are postmodernists, they certainly did not say that science was all relative - and Kuhn regarded science as the "most rational" of all human activities. But defining science is the job of Philosophy of Science, and his book is the most cited book in the category of Philosophy and History of Science (and indeed one of the most cited academic books of all time, with more than a million copies sold).</ref>

I agree that what Kuhn said differs from what other postmodernists say about science and relativism. But we are straying from the discussion's point. The popularity of Kuhn's book, and even Kuhn's book itself (assuming one agrees with it), do not affect the point that some chiropractors are antiscientific. Eubulides (talk) 19:04, 29 July 2008 (UTC)

So what does Kuhn think is antiscientific. Let's compare it to Keating's and Eubulide's. Maybe we are talking about two different things. -- Dēmatt (chat) 20:45, 29 July 2008 (UTC)

Quite possibly we are. The "antiscientific" I'm talking about is the "antiscientfic" of chiropractic historians and researchers like Keating, Phillips, etc. Eubulides (talk) 21:31, 29 July 2008 (UTC)

Kuhn's approach was empirical: you can define scientists by their communities, professional affiliations journals etc, and then science is what scientists do. Unscientific things are things they don't allow, and different communities allow different things, so it's not a universal. Antiscientific I think he reserved for things in clear opposition to science (with the primary meaning of anti as hostile to) - he certainly used it to describe the book burning by the Church in the 16th century.Gleng (talk) 09:00, 30 July 2008 (UTC)

Ah, so what we are talking about here are two distinct groups of chiropractors that have their own ideas of science; one that uses vitalistic constructs like Innate Intelligence and Universal Intelligence as metaphors to explain what they think happens and the other side uses evidence based best practice procedures based on results no matter what the cause. It seems that Kuhn would think that each had their own science then. In that case, using the word antiscience from Keating and his friends is just an attack on the other side's science. Is that your impression? -- Dēmatt (chat) 15:50, 30 July 2008 (UTC)

I disagree completely with this speculation about what "Kuhn would think". But it doesn't matter what I, or any other Misplaced Pages editor, speculates in this area. What matters is what reliable sources say, and on this point there is no disagreement among reliable sources. Eubulides (talk) 18:50, 30 July 2008 (UTC)

• Asking me to "find a way to explain it in a phrase like that", without using the word "antiscientific", sounds an awfully lot like a request to depart from what reliable sources say, in order to spare the sensibilities of... who? Misplaced Pages readers? They won't care. There are no four-letter words here. Of chiropractors? But the sources were edited by mainstream chiropractors: they won't care either. Of fringe chiropractors? No, they won't care either, they're used to words like that. Or are we sparing the sensibilities of some Misplaced Pages editors? But that shouldn't matter: what should matter here is what reliable sources say. On this subject there is zero disagreement among reliable sources. We should not be searching for toned-down language to weaken what reliable sources say, in order to avoid upsetting some editors. We should be summarizing what sources say, as best we can.

Well not really; I have a lot of respect for Keating because he goes on to say exactly what he means, and he did not mean "antiscience" in the sense of being anatagonistic to science, which is the most common contemporary understanding, and certainly not "antiscience" in the philosophical postmodernist sense, but dogmatic attitudes about unneccessary postulates. So why not say that? If you want to express not merely his argument but also his emotional distaste, by all means use the words he used in quotes and attributed specifically. Gleng (talk) 17:20, 27 July 2008 (UTC)

Actually we would be doing OR by not accepting his word "antiscience", although I certainly understand that we should follow the author's obviously real meaning, rather than the exact text if it is obviously misleading. Why do I say that? Because I think Keating actually meant the true revulsion and distrust of science, of the scientific method, and of scientists, when he wrote "antiscience". You see, the people he wrote about had/have their own "science", the "science of chiropractic", which is pseudoscience at best, and antiscience at worst. I've read a number of statements from very notable chiros like Sid Williams (Life College founder) and Fred Barge that express such sentiments. I think the reason is just what you have expressed - their defenses of and "dogmatic attitudes about unneccessary postulates." Keating wrote this about Barge: "... by this time we had already established some degree of mutual understanding of our frequently opposing views about chiropractic, about science, about vitalism, and about health care in general. We are opponents, not enemies." Keating understood science better than Barge did, but they were both gentlemen and friends. As to Williams, he was a football player turned practice builder, who started the largest chiropratic school. The depth of his intellectual understanding of the true workings of science are about as thick as a byte on cyberpaper, but his influence was huge. As to the Palmers themselves, their antiscientific and antiintellectual attitudes are legendary. Keating really did mean "antiscience", because he was likely referring to such prominent chiros who often spewed very antiscientific sentiments, and those sentiments were picked up by their followers. -- Fyslee / talk 14:13, 28 July 2008 (UTC)

Barge is dead. And so are the rest of them. Sid Williams was basically kicked out of Life College for causing them to lose their accreditation. I suppose that is what Kuhn meant. IOWs, that's history now, lest we want to continue to talk about leeching in the medical articles. -- Dēmatt (chat) 13:30, 29 July 2008 (UTC)

Is this an assertion that straight chiropractic is dead? If so, I disagree: it's still very much alive. Keating is dead too, alas, but that doesn't mean his opinions are dead; others still share them. Eubulides (talk) 15:19, 29 July 2008 (UTC)

What are you calling straight chiropractic, the one that doesn't mix with other things; the one that holds that the body i smore than the sum of its parts; or the one that believes that scientists are idiots. I think the one that thinks scientists are idiots is dead, though there is still a significant group of straights and mixers that think that medicine is pseudoscience and makes unsubstantiated claims, but that's not using antiscientific reasoning. -- Dēmatt (chat) 16:13, 29 July 2008 (UTC)

If you can come up with reliable sources saying that the antiscientific component is dead, then fine, let's cite and use them. However, we have multiple reliable sources, three dated 2005, that agree that the antiscientific component is signficant; and we have no reliable sources disagreeing. We can't go against reliable sources just on our say-so, or by conducting our own original research. Eubulides (talk) 19:04, 29 July 2008 (UTC)

I agree with Fyslee here. The criticism of Keating (and others) is not strictly limited to dogmatic attitudes; it also refers to the antiintellectual/antiscience attitudes of the straights, and to the pseudoscience that they use. Making it sound like dogmatism is the only criticism, waters down that criticism greatly. Eubulides (talk) 15:00, 28 July 2008 (UTC)

This may well be what he thought - although to be fair, that needs reading into his words, because these are not things he goes on to say in the articles concerned. In those articles he talks about dogmatic attitudes and untested assumptions at great and careful length. So I think it is probably OR (if correct OR) to say that he also meant these other things; whereas its not OR to say he meant to say the things he went on to specify. Again, I don't object to using his words, if it's made clear that they are his words and not necessarily the words that would have been chosen by Misplaced Pages editors. As for the Palmers' attitudes to science I am much less sure; that is a tricky historical call; William Cullen wrote -the major medical textbook of the late 18th/early 19th century, and he held that almost all diseases had a major nervous system component, and proposed the vague concept of "sympathy" to explain nervous influences on disease processes. Sounds so like innate intelligence that I wonder if Palmer didn't simply lift it and re-express it.Gleng (talk) 17:33, 28 July 2008 (UTC)

• The current situation, in which the ideas have been watered down and then surrounded with quote marks and then (incorrectly) attributed in the text only to Keating, is the worst of both worlds. If we're going to use quote marks, we should let these reliable sources have their say, without removing words like "antiscientific" and "pseudoscientific" that some editors think are pejorative. Both antiscience and pseudoscience are real problems in a segment of chiropractic, a problem that reliable sources agree on, and Chiropractic should not attempt to sweep this issue under the rug.

Eubulides (talk) 16:32, 27 July 2008 (UTC)

I think that criticisms are stronger when they are expressed rigorously and objectively. Again, using these words risks alienating the neutral reader, and risks making the sophisticated reader contemptuous of the lack of rigor and clarity. It seems that you're trying to make the conclusion for the reader, rather than explaining the arguments and letting him or her draw a conclusion themselves. Gleng (talk) 17:20, 27 July 2008 (UTC)

These sorts of words are used by reliable mainstream chiropractic sources published in refereed journals. It is not our place to second-guess and water them down out of fearing of "alienating the neutral reader". If we water them down, then it is we who are trying to make the conclusion; that's not our job. It's our the job of our sources' to make the conclusions, and it is our job to summarize these conclusions as accurately and concisely as we can. Eubulides (talk) 15:00, 28 July 2008 (UTC)?

Thanks for thoroughly stating the arguments here. I still don't see enough reason to think that we have enough not to attribute the statement to Keating and am thinking that the word should be used in the scope of practice section under the straights - properly attributed and defended. Now that Eubulides points out the fact that subluxation vs evidence based medicine objection, I am wondering if Keating was talking about evidence based medicine when he wrote that. We might consider just deleting it as being in the wrong section. -- Dēmatt (chat) 13:30, 29 July 2008 (UTC)

It's not a question of attribution. Of course we must attribute the claim to Keating, as well as to Bronfort, Charlton, Grod, Hegetschweiler, LaBrot, Lawrence, Metz, Nelson, Perle, Phillips, Sikorski, Triano, and Winterstein. It's a question of whether the attribution must give the reader the incorrect impression that Keating is the only person to share this opinion, which is obviously not the case. The point about antiscience is crucial to evidence basis, as the antiscientific attitudes of some chiropractors have hampered the job of coming up with practice guidelines. It's not so clearly relevant to scope of practice: after all, it's not as if legislators are putting the word "antiscience" in the laws regulating chiropractic! Eubulides (talk) 15:19, 29 July 2008 (UTC)

You said Pillips 2005 didn't use antiscience. It's not antiscience that is hampering the guidelines, it is genuine concern that guidelines will limit what they can do for their patients.. that is not disbelief in science; they believe science will validate what they do. It is distrust of the insurance system that they see as dominated by medicine. -- Dēmatt (chat) 16:13, 29 July 2008 (UTC)

• I didn't say that Phillips 2005 didn't use antiscience. On the contrary, I quoted Phillips 2005 as using words like "antimedicine", "antiscientific", and "antiintellectual".
• Genuine concern hampering the guidelines does not contradict the claim, made by a reliable source, that antiscience hampers the guidelines as well.

Eubulides (talk) 19:04, 29 July 2008 (UTC)

Re "...the other end relies on postulates which are not scientifically established". That's going to be hard to reference. Maybe this is where we can bring in the "low quality research" somehow. Though realistically, according to Murphy, they are all citing the same research but ending up with different consensus versions of guidelines. IOWs, mixers and straights have different guidelines that were consensus guidelines. The first were the Mercy Guidelines by Haldeman in the 1990s that got a lot of flack from the straights so they made their own, which included the same research but must have allowed more visits or something. Since then, I think the CCPG? guidelines were developed and again the straights have developed their own, only this time I think it is just the WCA straights(minority). My question would be, whose EBM guidelines are we talking about? -- Dēmatt (chat) 00:47, 27 July 2008 (UTC)

There is no need for the attribution. We have more than Keating saying this. It is misleading to say it is just Keating. QuackGuru 06:30, 27 July 2008 (UTC)

I think Coppertwig and Dematt are in agreement that the criticisms should be expressed clearly and objectively, and Coppertwig's suggestion "...the other end relies on postulates which are not scientifically established" is a reasonable suggestion that expresses the criticism in a way that I think is fair, and the existing references for that are good explanations of that. I'd support this, but it might be better to express things robustly but making it clear that the views are the opinions of an identifiable group e.g. "...the other end rely on postulates that are not part of mainstream science and medicine, and which, according to critics within the chiropractic profession, reveal dogmatic attitudes and uncritical thinking." The first part is a statement of fact, and I think uncontroversial in that (I think) chiropractors declare these postulates as unique and distinctive features of chiropractic; the second is a judgement declared as an opinion and attributed. Gleng (talk) 11:43, 27 July 2008 (UTC)

Your solution sounds excellent to me, Gleng. I was thinking that my "not scientifically established" sounded a bit weak. "dogmatic" etc. gets the message across. What do others think?

Meanwhile, though, this end of the sentence has somehow gotten into the article, without consensus I think: "stratagems that are ethically suspect when they let practitioners maintain their beliefs to patients' detriment". This would certainly need prose attribution if it's kept. Also, the word "stratagems" seems non-NPOV to me: it seems to imply that people have some ulterior motive. (Why can't they just believe something because it seems true to them?) This addition was discussed, and the point was made that prose attribution would be needed for it, but it's been added to the article as a Wikipedian assertion. I would prefer simply deleting this part, but I might accept a NPOV version of it if one is suggested, i.e. with prose attribution and removing "stratagems". Also, it seems unclear who is being talked about: the educators at chiropractic schools perhaps? ☺ Coppertwig (talk) 14:35, 27 July 2008 (UTC)

• "Who is being talked about" is chiropractors in general (this is true for both Chiropractic and for the source).
• I don't recall the point being made that prose attribution would be needed for it, but obviously we can discuss it here.
• I don't see the pejorative connotatation behind "stratagems", but we could use some similar word. How about "tactics"? It's shorter, which is better.

Eubulides (talk) 15:00, 28 July 2008 (UTC)

"...the other end rely on postulates that are not part of mainstream science and medicine, and which, according to critics within the chiropractic profession, reveal dogmatic attitudes and uncritical thinking." Dogma is definitely the word we should use. I think the atrribution is reasonable as well.

For those who forgot, these are the postulates that we are talking about. Are we trying to say that[REDACTED] is saying that all of these are not part of mainstream science and medicine or should we attribute this same group of people? I'll go with whatever you decide as it is 50/50 for me.

• 1. There is a fundamental and important relationship (mediated through the nervous system) between the spine and health.
• 2. Mechanical and functional disorders of the spine (subluxation) can degrade health.
• 3. Correction of the spinal disorders (adjustments) may bring about a restoration of health.

-- Dēmatt (chat) 17:55, 27 July 2008 (UTC)

I had thrown in the word "postulates" and was vaguely alluding to something like that, but I realize we had better not use that word unless we're clear about which postulates it means. I think Gleng's suggested edit is better; it doesn't use that word, so we're not implying that any specific statement is or is not accepted by mainstream science. Thanks for bringing up that point to clarify things, Dematt. ☺ Coppertwig (talk) 00:00, 28 July 2008 (UTC)

So where are we? I still haven't seen anything that uses the continuum example. How many chiropractors do you think actually use antiscientific reasoning. Do you think it is more than a fringe? If is isn't, then we don't have to explain their POV, but if it is more then we do, right. -- Dēmatt (chat) 13:44, 29 July 2008 (UTC)

I don't know what percentage of chiropractors use antiscientific reasoning; from reliable sources it seems to clearly be a minority, but a significant one. Eubulides (talk) 15:19, 29 July 2008 (UTC)

Eureka, I found it! The continuum statement is on page 3. Let me just go ahead and put the referenced text here:

Chiropractic colleges vary considerably in terms of the commitment their faculties and administrators make to critical reasoning, skepticism, science, and scholarship. At one end of the spectrum lies Life College (situated outside Atlanta), whose founding president, Sid Williams, D.C., is also a former president and former chairman of the board of the International Chiropractors' Association. With a student body in excess of four thousand, Williams is proud of having built the world's largest chiropractic institution. Although he speaks of the "science of chiropractic," he is notorious for his antiscientific attitudes and unsubstantiated claims; examples of his rhetoric include (American Chiropractic Association 1994):

God spoke to me in very clear language on three different occasions during a five-month period telling me to commence this work.

These conspirators would convince us that the "scientific approach" to chiropractic is the only approach acceptable to the public community, the professionals, the legislatures.

To hell with the scientists. They haven't proven a bumble bee can fly.

If you got an improved homeostasis, what damn difference does it make what diseases you're gonna be encountering. The whole germ theory comes crashing down from its tower.

Rigor mortis is the only thing that we can't help!

At the other end of the ideological continuum one finds schools such as the National College of Chiropractic (situated outside Chicago), the Los Angeles College of Chiropractic (LACC), and several others. Now celebrating its ninetieth year, the National College has been a leader in scientific and scholarly development within the profession. This commitment is particularly apparent in its founding of the JMPT, and more recently of the Journal of Chiropractic Humanities. Members of the LACC's faculty and administration have been frequent contributors to the scientific literature and collaborators with the RAND Corporation in developing systematic, evidence-based guidelines for the practice of spinal manipulation for specific health problems (e.g., Shekelle et al. 1991). The above-average commitment to scholarship and critical thinking of the LACC and the National College are further reflected in each school's initiative in developing problem-based learning for chiropractic students. Skeptical eyebrows may be raised by some of the hypotheses entertained at these schools, but a closer examination will reveal that a healthy skepticism is also present.

So, I think it is important to note that that was 1997. Keating took aim at Sid Williams at Life College, who was subsequently kicked out of Life College as the the CCE pulled it's accreditation. I don't think we are talking about the same profession now that Keating was then. Does the Phillips 2005 source mention antiscience in relation to evidence based medicine? I do agree with Eubulides that mainstream chiropractic and mainstream medicine consider Sid Williams antiscientific and antimedicine, though I think antiintellectual would be hard to prove. He was certainly a theologin, but some of our best intellectuals are theologins. But he is gone now. Since then, I think we have evidence that chiropractic schools are all working along education that is along the evidence base and guidelines are in place and all tend to follow some sort of guidelines that are based on evidence. If we need to say anything it would be about the quality of that evidence and how it is interpreted. Thoughts? -- Dēmatt (chat) 14:23, 29 July 2008 (UTC)

• Straight chiropractic is not dead. It is still a signficant component of chiropractic. It did not die with Williams, any more than scientific chiropractic died with Keating.
• We cannot do our own research from third-party sources ("evidence that chiropractic schools are all working along education") to come to the conclusion that straight chiropractic is dead. That would be a clear case of WP:OR. We cannot go through random course catalogs and say "look, there's all this evidence-based stuff! the straights are dead!".
• If we really want to make the claim that the straights are no longer significant, we have to find a reliable source that says so. But we won't be able to find one, I'm afraid.

Eubulides (talk) 15:19, 29 July 2008 (UTC)

Lord no, straight chiropractic is not dead; just that portion that feels and talks like Sid is much smaller. The question is whether it is small enough to not have to worry about their expalining their POV. But then if it is that fringe, then why are we mentioning it. It is such a conundrum. -- Dēmatt (chat) 16:13, 29 July 2008 (UTC)

If the antiscientific component is now so small as to not be significant, then we obviously can decrease the amount of space we devote to its views. (We shouldn't eliminate it, obviously; it will continue to be important, at least in the History section.) However, reliable sources, including the most-recently published edition of the leading textbook on chiropractic, continue to agree that the antiscientific component is still an issue and is still worth mentioning. We have found no reliable sources disagreeing with this, or saying that the antiscientific proportion of chiropractic has shrunk, much less shrunk to insignificance. Eubulides (talk) 19:04, 29 July 2008 (UTC)

Here is an interesting piece from the Foundation of Chiropractic Education (the superstraights!) It helps explain a lot. So we have mixers and straights, but the (now super-) straights think the straights sold out to medicine so they tried to rename as Objective straight in the late 1970s and 1980s, but have gotten really small. This is the group that all those researchers are talking about.. we should also check the WCA website. We might be able to isolate this group. Notice though that Sherman is included in this - but Sherman does have a science department as well. -- Dēmatt (chat) 01:09, 30 July 2008 (UTC)

Again, this removal of all terms like "pseudoscientific", "antiscientific", and "antiintellectual", is watering down the sources. We have multiple reliable sources agreeing, and no reliable source disagreeing, that a segment of chiropractic uses this sort of reasoning. This is a far more serious charge than merely "reveal dogmatic attitudes and uncritical thinking". It is not our place to seriously water down what reliable sources are saying, merely because we dislike the terms that they are using. Eubulides (talk) 15:00, 28 July 2008 (UTC)

Nonsense. It's not like we aren't either describing the same thing in NPOV format or attributing them to the proper sources. Using them just for the sake of throwing spitballs is something that chiropractors can do amongst themselves, but WP doesn't take sides. That would be embarrassing if there were such a thing as a self correcting inborn intelligence. -- Dēmatt (chat) 13:40, 29 July 2008 (UTC)

Chiropractic is not using critical words like "antiscientific" for the sake of throwing spitballs, just as it is not using supportive words like "important" and "fundamental" for the sake of throwing rose petals. It is using words supplied by reliable sources to describe important aspects of chiropractic. If the style is to put critical words like "antiscientific" in explicit quotes because they are critical, then for consistency we must put supportive words like "important" and "fundamental" in explicit quotes as well. As there are many, many more supportive than critical words in Chiropractic, this will be a big job, and will result in an article that is much harder to read. I don't favor such changes. However, it should be inarguable that if such changes are made to weaken the critical side of the article, it would be clear NPOV not to make a similar, consistent change to weaken the supportive side. Eubulides (talk) 15:19, 29 July 2008 (UTC)

We should remove words like important or fundamental or attribute them to their sources. -- Dēmatt (chat) 16:13, 29 July 2008 (UTC)

I wonder about phrasing like this as well: "Although vaccination is one of the most cost-effective forms of prevention against infectious disease,.." -- Dēmatt (chat) 17:13, 29 July 2008 (UTC)

There is no controversy among reliable sources on that point either; vaccination is right up there, along with potable water, as the main contributors to public health of the last two centuries. If we need to put quote marks and in-text attribution on this sentence, then for consistency we'll need quote marks and in-text attribution for almost all the sentences in Chiropractic; lots of them make far-more controversial points than this one. Eubulides (talk) 19:04, 29 July 2008 (UTC)

Oh no, I was just talking about getting rid of "although". You're right though, do we have a source for that? -- Dēmatt (chat) 20:45, 29 July 2008 (UTC)

• The cited source does indeed say "Although" on exactly this point.
• That being said, I doubt that we need to cite linking words like "and", "but" and "although". What's next, citing each comma and semicolon? Do we need to cite the white space too?

Eubulides (talk) 21:31, 29 July 2008 (UTC)

This is the source says:

• Although most public health authorities would agree that vaccination constitutes one of the most cost-effective infectious disease control measures of the last century, few, if any, would argue that there are no problems associated with their use.23

We have:

• Although vaccination is one of the most cost-effective forms of prevention against infectious disease, it remains controversial within the chiropractic community.

Even they attribute that to "most public health authorities" and add the disclaimer at the end.. we should, too. That way we wouldn't have to add the other POV.

-- Dēmatt (chat) 02:42, 30 July 2008 (UTC)

The source is reliable for the controversy within chiropractic, but it is not particularly reliable for the cost-effectiveness of vaccination. Is there a serious dispute about the cost-effectiveness? If so, we can easily supply several more reliable sources confirming that it is cost-effective; that's not a controversial point. Eubulides (talk) 07:16, 30 July 2008 (UTC)

Well, "few, if any, would argue that there are no problems associated with their use.23", hints at the other side of the story. IOWs, it seems to contend that a few do argue there are some problems, and chiropractors tend to side with them. Is ther esomething wrong with giving that impression. Is it not real? -- Dēmatt (chat) 03:19, 2 August 2008 (UTC)

That is a misleading summary of what public-health officials say. They all acknowledge that there are adverse effects of vaccines, but the effects are much, much smaller than the positive effects. Chiropractors who argue against vaccination do so by magnifying the adverse effects, and minimizing the positive effects, creating in the public's mind the false impression that the positive and negative effects are roughly of the same magnitude, or even that the negative effects are greater. Eubulides (talk) 06:14, 2 August 2008 (UTC)

Phillips 2005 speaking as a historian in PPC Haldeman

I've had a chance to pick up a copy of PPC Haldeman that has the Phillips 2005 use of antiscience and antiintellectual. It's on google books page 71. It is in chapter 3 called "The Evolution of Vitalism and Materialism and its Impact on Philosophy in Chiropractic" in the section labeled "vitalism in chiropractic and the twentieth century". The quote concerning antiscience and antiintellectualism seems to be referring to a period about 1920-1930. The entire chapter is interesting and most is online in the googlebooks. Unfortunately the good stuff is not, but the conclusion that Reed Phillips goes something like this:

• "Allopathic hegemny attempted to eliminate the budding profession using legal means. Unable to withstand the frontal assault, chiropractic leadership sought refuge under the shield of an alternative vernacular... This protective shield prompted a segment of the profession to extend its comfort zone by adopting not only an antimedicine position but an antiscience stand... Although this antiintellectual position persists in a small percentage of chiropractors in the twenty-first century, the profession never developed a broad-based consensus around Stephenson's 33 principles. The current spectrum of thought ranges from these tradition concepts espoused by B.J, Stephenson, and their adherents to an equally dogmatic and complete denial of vitalistic concepts at the other end of the spectrum... Fortunately, the spectrum contains a great deal of space between the two anchoring ends, a space wherein may be found many types of principles, such as vitalism, holism, naturalism, therapeutic conservatism, critical rationalism, and thoughts from the phenominological and humanistic paradigms.... "

Stephenson's 33 principles is definitely objective or super straight - Sherman style chiropractic which, as we saw earlier, has a healthy respect for science now as well. The other end is likely the group that we would equate with the NACM, super science oriented. We have already noted that both are fringes, but they both still exist. That leaves the middle ground. I would be satisfied with anything that mentions these two extremes but keeps it in context as to the vast majority of weight that should be somewhere in the middle. Thoughts. -- Dēmatt (chat) 01:30, 2 August 2008 (UTC)

OK, how about replacing this:

"Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs what chiropractic historian Joseph C. Keating, Jr. calls "antiscientific" reasoning and unsubstantiated claims,"

with this:

"Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the middle of the spectrum contains many types of principles, such as holism and naturalism; the other end employs antiscientific reasoning and unsubstantiated claims,"

with the same citations as now (one of these citations is Phillips 2005 of course). Eubulides (talk) 06:14, 2 August 2008 (UTC)

Hmm, it seems to give the impression that only the one extreme group supports Evidence based guidelines. -- Dēmatt (chat) 21:56, 2 August 2008 (UTC)

You know, there are two sets of guidelines, one from the "left" and one from the "right". The first guidelines were the Mercy guidelines and were consensus guidelines that were considered too restrictive so the straights created another set of consensus guidelines that allowed for more leeway from doctor's experience. Recently new guidelines were created from each side. Maybe the way to handle it is that if we make a comment about one, we need to make a comment about the other. I'm sure we can find something on the WCA website or even in the FSCO website. -- Dēmatt (chat) 00:33, 4 August 2008 (UTC)

i read thru the archives of these talks and it seems like all we got is one source. . . Keating. . . saying that "anti-science" is still employed by any group of chiros... and today that is only a very small minority group. We need to say "Keating says..." if we say anything at all. . . but i question if the mention is even necessary. . . anti-science is a loaded term with a mixed-bag of meanings. . . and at the end of the day, this is just one guy's opinion.TheDoctorIsIn (talk) 17:24, 3 August 2008 (UTC)

Yeah, no matter what, it needs to be attributed to whoever said it. -- Dēmatt (chat) 00:33, 4 August 2008 (UTC)

Complementary and alternative

I take back the pincushion remark. Eubulides has stated that "The very first claim in Chiropractic is an opinion, not a fact." I now realize that Eubulides is right about this. However, NPOV requires that Misplaced Pages articles not present opinions as if they are facts, so we need to change this. I suggest deleting "complementary and alternative" from the first sentence, making it "Chiropractic is a health care profession..." Later in the article, the phrase "complementary and alternative" can be used with appropriate prose attribution.
If the article becomes peppered with prose attributions, so be it. It must conform to the WP:NPOV policy, which states "Assert facts, including facts about opinions—but do not assert the opinions themselves." (emphasis in the original.) We can take as a model the Circumcision article, which has many prose attributions, largely due to the careful, precise work of Jakew who worked hard to ensure that the article conforms to NPOV. It's hard to find any statement in the Circumcision article about which anyone is likely to say "But that's not true!" This article needs to be elevated to that standard. ☺ Coppertwig (talk) 18:19, 25 July 2008 (UTC)

This sounds to be entirely reasonable. I would support such an edit. -- Levine2112 18:22, 25 July 2008 (UTC)

• The Circumcision article is not a model of text attribution for every opinion. Let's take the very first claim in the body of Circumcision:

"For infant circumcision, clamps, such as the Gomco clamp, Plastibell, and Mogen are often used."

This is an opinion, not a fact, because the word "often" is a judgment call made by the cited source (Holman et al. 1995, PMID 7625325). Were the "Simon says" style actually used, this sentence would have to be worded like this:

"According to the physicians John R. Holman, Evelyn L. Lewis, and Robert L. Ringler, for infant circumcision, clamps, such as the Gomco clamp, Plastibell, and Mogen are often used."

(As it happens, this wording is also incorrect, because "often used" is not what the cited source actually says; but that is a problem for Circumcision, not for Chiropractic.)

• This is just one example, the first thing I looked at in Circumcision; I'm sure there are many others.
• What this illustrates, is that WP:NPOV does not require the proposed style, even in controversial articles such as Chiropractic or Circumcision. It is common and entirely appropriate to state and source mainstream opinions, where no reliable sources disagree with the opinions, without putting "Simon says" in front of each sentence.
• For this reason, I disagree with adding "Simon says" to "complementary and alternative". It suffices to cite reliable sources on the topic; we shouldn't add "Simon says" all over the place.

Eubulides (talk) 19:36, 25 July 2008 (UTC)

One more point. The proposed replacement '"Chiropractic is a health care profession..."' also fails the proposed "Simon says" rule, since it is merely an opinion (not a fact) that chiropractic is health care. See, for example, Chiropractic and its Role in the Health-Care Profession, which says "I would suggest that chiropractic is not health care, but neither is it more than health care. It is something different altogether, so different that it defies description and comparison to health care." This source is not a reliable mainstream source (it is the FACE, a straight-chiropractic website), but if the rule is that we have to put "Simon says" in front of every opinion expressed in Chiropractic, then we cannot simply say "Chiropractic is a health care profession" in the lead. Eubulides (talk) 21:24, 25 July 2008 (UTC)

I think that you are over-reacting. I and others objected to expressing judgemental opinion in a way that seemed to allow those opinions to be understood as fact. We also objected because the word antiscientific has no consistent objective meaning, and didn't endorse its use in this way in a serious encyclopedia. You might say, with postmodernists, that all language is value laden and everything is opinion - that is indeed a philosophically anti-science position. That's not our position. Scientists don't generally see a real problem is distinguishing facts from interpretion, and interpretation from opinion. Who objected to the lead sentence? Is it a real objection, or was it just to make a point?

"Chiopratctic is a health care profession is a factual statement. It may be wrong, in which case put it right, but "health care profession" is an objective descriptor with an operational definition. "X is antiscientific reasoning" is a judgemental opinion, unless it is used in a contect where there is a relevant operational definition of "antiscientific reasoning". You pointed to Antiscience for this, which, as I detailed above, led to Hobbes ....] (talk) 18:19, 26 July 2008 (UTC)

• My comments have nothing to do with postmodernist theory; they use terms like "antiscientific", "pseudoscientfic", "antiintellectual", "health care", "profession", etc., in their usual senses, the sense used by chiropractic researchers. These researchers are published in peer-reviewed journals, which are more-serious sources than Misplaced Pages itself. No reliable sources are disagreeing with them, and it is not our place to second-guess reliable sources.
• My objection to the lead sentence is a real objection. The lead sentence is directly contradicted by a reliable source that says that, by a landslide, chiropractors reject the CAM label. This is a far more serious problem than the "antiscientific" one. First, because it's the lead sentence. Second, because (unlike "antiscientific") we have reliable sources directly disagreeing with the opinion expressed in Chiropractic. Eubulides (talk) 15:00, 28 July 2008 (UTC)
• This is not the only such opinion in the lead, or in Chiropractic. Chirorpactic #Philosophy, for example, is almost 100% opinion, from beginning to end. And yet the "Simon says" style is not used in that section, which is entirely supportive of chiropractic. It is a clear violation of NPOV to insist on the "Simon says" style for critical opinions, while using ordinary style for supportive opinions.
• "Chiropractic is a health care profession" (which is not the lead sentence, but has been proposed as the lead) is clearly an opinion. Some people don't think chiropractic contributes to health care; others think that it is a way of life and is not health care. Some people don't think chiropractic is a profession. Their opinions, even if we disagree with them, are opinions that reasonable people can hold, just as the opinion that "chiropractic is a health care profession" is an opinion that reasonable people can hold. "Chiropractic is a health care profession" is just as much an opinion as "X is antiscientific reasoning" is, and if our style rules are such that we must use "Simon says" and quotation marks for the latter, then for consistency and fairness we must do something similar for the former.

Eubulides (talk) 15:00, 28 July 2008 (UTC)

Education etc

Since UK chiropractors are mentioned in this section, may be appropriate to cite The GCC, the statutory body analagous to the General Medical Council in the UK.Gleng (talk) 14:52, 26 July 2008 (UTC)

I put it in, make sure I got it right! -- Dēmatt (chat) 04:52, 27 July 2008 (UTC)

Treatment procedures diagram

In this section there is a nice diagram of various treatment procedures. Unfortunately it looks like crap there. Wouldn't it be better to move it to the Chiropractic treatment techniques article? -- Fyslee / talk 06:52, 27 July 2008 (UTC)

Looks pretty good to me, but maybe that's just because of my screen resolution or choice of browsers. However, if it isn't already on Chiropractic treatment techniques, it should be there as well - and perhaps in lieu of it being here. -- Levine2112 07:22, 27 July 2008 (UTC)

I use a 24" screen with 1920 x 1200 screen resolution. It's sharp as can be, but the diagram is cramped and pushes the other text around. We shouldn't lose it, but the other article might be the place for such detail. -- Fyslee / talk 07:54, 27 July 2008 (UTC)

I agree that Fyslee the diagram (table) looks a bit ugly and cramps the text. On the other hand I did find it very interesting. If you decide to keep it here, it might be worth experimenting with smaller fonts within the table and giving it a bit of a margin?79.68.13.143 Gleng (talk) 10:06, 27 July 2008 (UTC)

I was bold and set column widths in the table, to make the whole table narrower. Feel free to ask me to self-revert. ☺ Coppertwig (talk) 14:06, 27 July 2008 (UTC)

I think that's better, but the real problem is it also need a small margin to stop the adjacent text bumping into it. I don't know how to do that.Gleng (talk) 12:40, 28 July 2008 (UTC)

I liked the old way but it's not a big deal either way. Eubulides (talk) 15:00, 28 July 2008 (UTC)

Currently, the diagram is too narrow. A small adjustment can fix it. QuackGuru 19:37, 31 July 2008 (UTC)

QuackGuru, are you advocating for adjustments now? ;) DigitalC (talk) 05:09, 1 August 2008 (UTC)

I think it would be best to make more adjustments to the Chiropractic#Treatment procedures section. I think the readers would want to know more about the different procedures and treatments chiropractors offer. QuackGuru 07:55, 1 August 2008 (UTC)

(<<outdent) Eubulides said, "Don't specify table widths, as that works poorly with large or small fonts." and changed it to have <br>. In my opinion, (mild preference), it works better with the width specified. With the width specified: if I keep the width of my window constant but change the font size, it changes from one line per item (with small font) to three lines per item (with big font), which I think is good, whereas with the line breaks hard-coded: it always has two lines for some items and with big font the table is too wide and pushes the rest of the text to below the table. However, I don't feel strongly about this. ☺ Coppertwig (talk) 13:09, 1 August 2008 (UTC)

I still think it's totally unnecessary here. It can be used in the actual Chiropractic treatment techniques article, which is linked here. If any listing is needed, it can be done in sentence form. BTW, that article still needs a cleanup. -- Fyslee / talk 14:20, 1 August 2008 (UTC)

• We certainly need some content here; even with the table, Chiropractic is woefully inadequate in its coverage of what chiropractors actually do. I would favor a longer description in the text, but until that's present we can't just remove the table.
• As for the appearance with large fonts, I suppose it depends on the browser. With mine (Firefox 3) if the table column width is specified in pixels, and you use a large font, the browser breaks up the text in bizarre ways in order to shoehorn the text into the column, e.g., by puting "Ice" on one line and "packs/cryotherapy" on another. Conversely, if the table uses line breaks rather than pixels, and you use a large font, once the table fills the screen the browser does start to insert more line breaks to get the line to fit. Inserting line breaks is bad, but specifying column width is also bad; to some extent one chooses one's poison. For what it's worth, with a normal font size the table is narrower on my browser with the line breaks than with the table width specified explicitly, and I thought the complaint was the table was too wide?

Eubulides (talk) 14:30, 1 August 2008 (UTC)

We definitely need some text, but we have a whole article for all the details. That's the way the article size can be controlled. Just take the contents of that list and make a long sentence. Simple as that. It can also be formatted in this manner. -- Fyslee / talk 14:38, 1 August 2008 (UTC)

• Is it really that simple? Would you drop all the percentages from the discussion? What would the long sentence look like? The "% of DCs using it" column can be removed (its info is not that useful, as all the figures are above 90%) but is the "% of patients getting it" info useless?
• Since the 2nd column was useless, I went bold and removed it. This should make it a bit easier to convert to text, at any rate.

Eubulides (talk) 17:50, 1 August 2008 (UTC)

I'm sorry, I put the second column back in because I think with all the misconceptions that all chiropractors do is use spinal manipulation, I think it is important that others see how often other techniques are used in their spinal adjustments. This is certainly not a complete list, but it's a start. -- Dēmatt (chat) 01:40, 2 August 2008 (UTC)

How about if we omit the 2nd column but put in some text saying that every technique in the table is used by more than 90% of chiropractors? Eubulides (talk) 06:14, 2 August 2008 (UTC)

Treatment procedures

I have added hidden content that can be used immediately, if we can agree on it. It is a reasonable practice to use the lead in fork articles as the content in sections of major articles. Those articles were created because the original article was too large, and this article is no exception. Here is the proposed content (the final form will be without the explanations):

SUGGEST USING THIS LEAD FROM THE "Chiropractic treatment techniques" ARTICLE AS THE SOLE CONTENT OF THIS SECTION, ALONG WITH THE "MAIN" ARTICLE LINKS.

Many chiropractic treatment techniques/modalities are available for use by chiropractors. Although the chiropractic profession is primarily based on the use of the spinal adjustment, many other techniques exist for treating the spine, as well as other joints and tissues. A modern chiropractor may specialize in spinal adjustments only, or may use a wide range of methods intended to address an array of neuromusculoskeletal and general health issues. Examples include soft tissue therapy, strength training, dry needling (similar to acupuncture), functional electrical stimulation, traction, and nutritional recommendations. Chiropractors may also use other complementary alternative methods as part of a holistic treatment approach.

WE CAN ALSO ADD THE CONTENTS OF THE TREATMENT PROCEDURES DIAGRAM IN SENTENCE FORM, AND THEN MOVE THE ACTUAL DIAGRAM WITH PERCENTAGES TO THE PROPER ARTICLE:

Diversified (full-spine manipulation), Physical fitness/exercise promotion, Corrective or therapeutic exercise, Ergonomic/postural advice, Self-care strategies, Activities of daily living, Changing risky/unhealthy behaviors, Nutritional/dietary recommendations, Relaxation/stress reduction recommendations,Ice pack/cryotherapy, Extremity adjusting, Trigger point therapy, Disease prevention/early screening advice

This can of course be tweaked to make it flow better, but basically we don't need more content in this section. All details should be in the other article. There is absolutely no excuse for too much detail here. -- Fyslee / talk 06:44, 2 August 2008 (UTC)

There are some good suggestions here, but some problems too that need to be addressed.

• I agree with replacing the current text with a summary of Chiropractic treatment techniques, but that article is currently woefully limited; we shouldn't simply summarize it. We should summarize it the way it should be, not the way it currently is.
• It is important in Treatment procedures to define spinal manipulation (SM) and spinal manipulation therapy (SMT), and to distinguish between the two. The rest of the article refers to both, and Treatment procedures are where they are defined.
• The proposed summary uses wording (leading with "many treatments", using "although" etc.) that focuses too much on treatments other than SMT. It should say SM is the most common modality without saying "although" and without emphasizing the other treatments.
• The proposed summary, if adding the contents of the diagram, includes a lot of duplication. The diagram contents list the most commonly-used procedures, so I propose using its list (which is sourced as being the most popular among patients) rather than rolling our own.
• With all that in mind, I propose the summary in #Treatment procedures 2 instead.

Eubulides (talk) 14:38, 2 August 2008 (UTC)

When and if we use all this as a replacement for the existing content, we need to make sure that nothing gets deleted from here before ensuring it is already in the "...techniques" article. -- Fyslee / talk 16:53, 2 August 2008 (UTC)

Treatment procedures 2

Spinal manipulation, which chiropractors call "spinal adjustment" or "chiropractic adjustment", is the most common treatment used in chiropractic care; in the U.S., chiropractors perform over 90% of all manipulative treatments. Many other treatment forms are used by chiropractors for treating the spine, other joints and tissues, and general health issues. The following procedures were received by more than 1/3 of patients of licensed U.S. chiropractors in a 2003 survey: diversified (full-spine manipulation), physical fitness/exercise promotion, corrective or therapeutic exercise, ergonomic/postural advice, self-care strategies, activities of daily living, changing risky/unhealthy behaviors, nutritional/dietary recommendations, relaxation/stress reduction recommendations,ice pack/cryotherapy, extremity adjusting, trigger point therapy, and disease prevention/early screening advice.

Spinal manipulation is a passive manual maneuver during which a three-joint complex is taken past the normal physiological range of movement without exceeding the anatomical boundary limit; its defining factor is a dynamic thrust, a sudden force that causes an audible release and attempts to increase a joint's range of motion. More generally, spinal manipulative therapy (SMT) describes techniques where the hands are used to manipulate, massage, mobilize, adjust, stimulate, apply traction to, or otherwise influence the spine and related tissues; in chiropractic care SMT most commonly takes the form of spinal manipulation.

Treatment procedures 2 comments

(Please put comments about #Treatment procedures 2 here.) Eubulides (talk) 14:38, 2 August 2008 (UTC)

I took the liberty of installing #Treatment procedure 2's first sentence into Chiropractic #Treatment procedures. This edit has the following properties:

• It removes some duplication about how chiropractors do most SM.
• It removes the incorrect implication that only in the U.S. do chiropractors "consider themselves to be expertly qualified providers of spinal adjustment, manipulation and other manual treatments" (that is the position of the World Federation of Chiropractic).
• It avoids duplicate wikilinks to Spinal adjustment, one in the Main articles: leader, and one in the text.
• It leads with the mainstream term "spinal manipulation" for the treatment in question, mentioning "spinal adjustment" and "chiropractic adjustment" as terms used by chiropractors. The recent edit to lead with "spinal adjustment" was made without discussion, so this is simply going back more to the longstanding use here.
• It's shorter. It avoids longwinded phrases like "are terms used by", "to describe their approaches to", and "is most frequently employed by".

Eubulides (talk) 14:55, 2 August 2008 (UTC)

Good work! This will summarize the whole subject, leaving all the details for the specific "... techniques" article. That's the proper way for article forks to supplement the main subject.

I think an improvement in flow could be made by moving everything about spinal manipulation/adjustment together, IOW move the second short paragraph up. Here is the proposed revision: -- Fyslee / talk 16:49, 2 August 2008 (UTC)

Treatment procedures 3

Spinal manipulation, which chiropractors call "spinal adjustment" or "chiropractic adjustment", is the most common treatment used in chiropractic care; in the U.S., chiropractors perform over 90% of all manipulative treatments. Spinal manipulation is a passive manual maneuver during which a three-joint complex is taken past the normal physiological range of movement without exceeding the anatomical boundary limit; its defining factor is a dynamic thrust, a sudden force that causes an audible release and attempts to increase a joint's range of motion. More generally, spinal manipulative therapy (SMT) describes techniques where the hands are used to manipulate, massage, mobilize, adjust, stimulate, apply traction to, or otherwise influence the spine and related tissues; in chiropractic care SMT most commonly takes the form of spinal manipulation.

Many other treatment forms are used by chiropractors for treating the spine, other joints and tissues, and general health issues. The following procedures were received by more than 1/3 of patients of licensed U.S. chiropractors in a 2003 survey: diversified (full-spine manipulation), physical fitness/exercise promotion, corrective or therapeutic exercise, ergonomic/postural advice, self-care strategies, activities of daily living, changing risky/unhealthy behaviors, nutritional/dietary recommendations, relaxation/stress reduction recommendations,ice pack/cryotherapy, extremity adjusting, trigger point therapy, and disease prevention/early screening advice.

Treatment procedures 3 comments

(Please put comments about #Treatment procedures 3 here.) -- Fyslee / talk 16:49, 2 August 2008 (UTC)

Fix for CAM claim

Regardless of one's opinion of the "Simon says" style, which would require quote marks and explicit text attribution for most of the sentences in Chiropractic, it's clear that something needs to be done about the very first claim in chiropractic (the claim that chiropractic is CAM), as this claim is disputed by most chiropractors in a recent survey described by Redwood et al. 2008 (PMID 18435599). The problem occurs in several places in Chiropractic, and here are proposed changes to fix it. These changes do not use the "Simon says" style; obviously further changes would be needed to conform to it. Italics are used for proposed insertions, strikeouts for deletions, and roman text for unchanged parts of the text.

• Chiropractic (from Greek chiro- χειρο- "hand-" + praktikós πρακτικός "concerned with action") is a complementary and alternative medicine health care profession that focuses on diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system and their effects on the nervous system and general health, with special emphasis on the spine. Chiropractic is generally considered to be complementary and alternative medicine, a characterization most chiropractors dispute.
• Complementary and alternative medicine (CAM) pPractitioners such as chiropractors are often used as a complementary form of care to primary medical intervention.
• like acupuncture, herbal medicine, and other forms of complementary and alternative medicine, chiropractic became more integrated into mainstream medicine

Also, move the following sentence from the end of Chiropractic #Utilization and satisfaction rates, where it does not really belong, to the beginning of Chiropractic #Scope of practice:

• Mainstream health care and governmental organizations such as the World Health Organization consider chiropractic to be complementary and alternative medicine (CAM). However, a A 2008 survey stated that 69% of DC chiropractors disagree with the categorization of chiropractic as CAM, with 27% having some preference for the term "integrated medicine".

Eubulides (talk) 19:04, 29 July 2008 (UTC)

I don't think that chiropractic being a "health care profession" is disputed. -- Levine2112 21:40, 29 July 2008 (UTC)

Good point. "Health care profession" is an opinion that is not disputed by reliable sources. Since this proposal is not using the "Simon says" style, there is no need to remove the "health care profession" phrase from the lead. I restored it. Thanks for catching that. Eubulides (talk) 22:02, 29 July 2008 (UTC)

Why the deletion of "CAM" and "alternative" when most altmed, chiropractic, and official government sources use those categorizations? This (study) particular example of the opinions of some chiropractors about themselves is irrelevant in this regard, especially when it's based on only one study. Even if it were based on thousands of such studies, it would only serve as documentation for some chiropractors' self-opinion, in contrast to the rest of published sources. Many chiropractors maintain their aversion to being identified with mainstream medicine and they are proud of being an alternative to the big, bad, pharma controlled, drug using, MD cartel. This article is not to be written exclusively from the chiropractic perspective, since that would be an NPOV violation. This study is the only place where the identification of chiropractic as CAM and altmed is disputed, including here among editors, so why change this longstanding consensus version? If it's not broken, don't fix it. -- Fyslee / talk 04:05, 30 July 2008 (UTC)

• I agree that the article should not be written exclusively from the chiropractic perspective. But we can't ignore the chiropractic perspective either.
• I also agree that from the mainstream viewpoint, chiropractic is CAM. However, it's indisputable that "chiropractic is CAM" is controversial among chiropractors themselves. We can easily find other reliable-among-chiropractic sources to confirm this point. Here's one: "Is Chiropractic Part of CAM? The answer to this question depends on one's perspective. Chiropractic opinion is divided. Most others in the health care system, as evidenced by current policies of the US National Institutes of Health, the European Parliament in its adoption of the 1997 Lannoye Report, and the World Health Organization in its current strategies on traditional medicine and CAM, clearly see chiropractic as part of CAM." Chapman-Smith DA, Cleveland CS III (2005). "International status, standards, and education of the chiropractic profession". In Haldeman S, Dagenais S, Budgell B et al. (eds.) (ed.). Principles and Practice of Chiropractic (3rd ed. ed.). McGraw-Hill. pp. 111–134. ISBN 0-07-137534-1. {{cite book}}: |edition= has extra text (help); |editor= has generic name (help)CS1 maint: multiple names: editors list (link)
• How about if we simply mention this dispute in the lead, emphasizing the mainstream view? I've changed the draft change to the lead, to do that.

Eubulides (talk) 07:16, 30 July 2008 (UTC)

That change looks good. The dispute is about the current classifications of the profession as a form of CAM (both within and outside the profession), and the wish by many DCs to be accepted as mainstream, but even that survey showed that more of them would prefer to be classified as IM, IOW as that part of CAM that is working with the mainstream without actually being mainstream. They wish to maintain a "separate but equal" status. -- Fyslee / talk 17:30, 2 August 2008 (UTC)

Removing vague tag

This change, which removed the {{vague}} tag with changes not previously discussed, had some problems:

• It created a sentence with confusing mixed tense "has gained"/"enjoyed"/"is gradually becoming".
• The newly-introduced "gradually" is not supported by the source.
• The introduction of "certain" and "methods" is not supported by the source. That wording was the result of a long discussion in Talk:Chiropractic/Archive 22 #"Rigorously proven"; you might want to read that discussion before proposing further changes.
• The newly-inserted quote marks are not clearly connected to any source, and are confusing to boot. I was at a loss to understand why "subluxation" was quoted, just by itself. The quote marks are not necessary and can be removed.

I attempted to fix these problems with this change. It's better to discuss changes like these first, I expect. Eubulides (talk) 07:16, 30 July 2008 (UTC)

Maybe the tenses did get mixed, but I attempted to correct misleading language. "ecame more integrated into mainstream medicine" is misleading as it can lead readers to think that chiropractic has become integrated, but it is still far from integrated. Only in certain areas is that the case, but it is gradually becoming so. Does the added qualifier violate the source, or do we just need another source for what should be an uncontroversial qualifier? (see below about the lack of need for sourcing of uncontroversial wordings)

Adding "certain" and "methods" doesn't violate the source, does it? It's at least closer to the truth, because the previous wording is misleading. It is only certain methods that are questioned, not chiropractic as a whole. The existing wording was very vague and misleading. If the addition of qualifiers doesn't violate the source, and is closer to the truth, then we should just provide a better source, IF that is really needed, which I don't think is necessary in the lead. We deal with the topic later. Uncontroversial true statements don't usually need special sourcing, so I didn't consider it an issue to introduce such modifying terms.

The quotation marks in this phrase "sustained by "anti-scientific and pseudo-scientific ideas" like "subluxation" that are significant barriers to scientific progress within chiropractic." are precise quotes from the source. I followed it very closely, so I don't understand your objection. If you don't want quote marks, fine, but those words are exact and supported by the source. -- Fyslee / talk 14:44, 30 July 2008 (UTC)

• As far as I can see, the cited source (Cooper & McKee 2003, PMID 12669653) does not say or imply that the integration is "gradual". It does uses the phrase "increasingly integrated", which Chiropractic summarizes (accurately, I think) as "more integrated". Here's the sentence containing that phrase; the context is a discussion of chiropractic: "Moreover, it is at the vanguard of complementary and alternative medicine (CAM), which receives ever greater proportions of health expenditures and which is being increasingly integrated into conventional medicine."
• As for "certain" and "methods", the cited source (DeVocht 2006, PMID 16523145) does not have these qualifiers. It says "Nevertheless, there are different views concerning the efficacy of chiropractic treatment, which is not surprising." Inserting these qualifiers weakens what the source says. The claim "It is only certain methods that are questioned, not chiropractic as a whole." is not correct: a significant number of critics question chiropractic as a whole.
• It is not necessary or desirable to quote every word that is shared by Chiropractic and a source. If that were done, more than half of Chiropractic would be surrounded by quote marks, and the article would be weird and harder to read. Quote marks should be used only on special occasions, e.g., when the quotes are long or are opinions that are controversial among reliable sources.
• For an example of the use of quote marks in a high-quality article, please see the most-recent Featured Article on a biomedical topic, namely Genetics. Genetics uses quote marks when defining terms like "Mendel's second law", but it never uses quote marks in the proposed "Simon-says" style, despite the fact that genetics is even more controversial than chiropractic is. Here's the very first claim in the body of Genetics:

'Although the science of genetics began with the applied and theoretical work of Gregor Mendel in the mid-1800s, other theories of inheritance preceded Mendel.'

If the "Simon says" style were used, I suppose that would have to be something like this:

'According to historian of science James P. Dooley, Jr., although the "science of genetics" began with the "applied and theoretical" work of Gregor Mendel in the mid-1800s, other "theories" of inheritance preceded Mendel.'

(I am inventing Dooley's name, if that's not clear. :-) After all, it is only an opinion that genetics was a science in Mendel's time, and it is only an opinion that the speculation about inheritance that preceded Mendel amounted to "theories".

Eubulides (talk)

I am okay with most of those changes other than the antiscience and pseudoscience one only because it is being discussed above now and consensus has not been reached. I agree they seem to reflect an accurate assessment (as much as one can be made) and are reasonable tweaks that as long as they are still supported by the references, why not? The issue with anti and ps is attribution and your fix was certainly according to the source, though I see that Keating has more to say about it in Keating 2005, so I guess we still have some work to do. -- Dēmatt (chat) 17:43, 30 July 2008 (UTC)

As discussed in my previous comment above, the changes are nto supported by the sources. I agree we have more work to do. Eubulides (talk) 18:50, 30 July 2008 (UTC)

Eubulides, I don't know what you mean by "the proposed "Simon-says" style": I thought you had been the one to introduce the term "Simon-says". The existence of another article which never quotes short phrases is not a reason that we can't do so here. Quotes need to be used when the word or phrase has a significantly non-NPOV tone (if the phrase is appropriate to include in the article at all) or when a word has multiple meanings so it isn't sufficiently clear what is meant, or when the statement is opposed by more than a tiny minority of reliable sources. See WP:NPOV. The examples you gave for the purpose of reductio ad absurdum do not seem to me to fall into any of these categories. ☺ Coppertwig (talk) 02:28, 31 July 2008 (UTC)

For a reply, please see #Simon-says in 1st paragraph below. Eubulides (talk) 14:22, 31 July 2008 (UTC)

(outdent) Eubulides, from the cited source -- (Cooper & McKee 2003, PMID 12669653): "Moreover, it is at the vanguard of complementary and alternative medicine (CAM), which receives ever greater proportions of health expenditures and which is being increasingly integrated into conventional medicine." -- you have chosen a phrase. The part of that source you have chosen to use doesn't seem to even refer to chiropractic, but to alternative medicine in general. That sentence needs to be parsed very carefully. I have underlined and bolded the key words. "It" refers to chiropractic, while both "which" seem to refer to alternative medicine in general, not specifically to chiropractic. This source provides context. The article has some positive words, but it actually paints a dismal picture for the future of the profession, it's current lack of growth, the much faster growth of other competing professions, its poor evidence base for spinal manipulation, its lack of worth for viscerosomatic disorders, and other concerns that are commented on in this chiropractic article:

• A Policy View of Chiropractic. Meeker is wisely concerned by some of these criticisms, which he sees as serious and even legitimate.

The PubMed synopsis also raises concerns:

• Chiropractic in the United States: trends and issues

Out of curiosity, I would like to read your source, as it obviously contains more than I have found, but the context of your quote indicates that it is "complementary and alternative medicine (CAM)" that "is being increasingly integrated into conventional medicine," not specifically chiropractic.

This leaves us without any backing for our wording at all! Even the profession's growth has stagnated and other competing professions are growing much faster.

You make this comment about my talk page quote above:

• The claim "It is only certain methods that are questioned, not chiropractic as a whole." is not correct: a significant number of critics question chiropractic as a whole.

I fully agree that many critics question chiropractic as a whole, which proves that integration into the mainstream is far from complete, but that wasn't my point. I was referring specifically to methods, and it is certain methods that are criticized more than others. I think we actually agree about the realities of the situation, but may need to tweak the edit in order to cover all the bases and see eye to eye.

As to my use of quote marks, I understand your concerns about overuse of the Simon says format, but I agree with Coppertwig. We are sometimes required to use it in our attempts to provide proper attribution and maintain NPOV. By doing that we avoid anyone getting confused about whether a source says it, or Misplaced Pages says it. I'm not saying my edit was perfect, but it was at least true to the source. I'm certain it can be improved, but the objection about it not being sourced isn't correct. FA articles can and do contain specific quotes. That is no hindrance to becoming an FA. It just shouldn't be overdone. -- Fyslee / talk 03:57, 31 July 2008 (UTC)

• I don't recall an objection about your edit not being sourced. My objection was more about the "Simon-says" style.
• Of course featured articles sometimes contain specific quotes, but I don't know of any featured article that contains nearly as many quotes as what is being proposed here. Can you cite some examples?
• I remain skeptical that the "Simon-says" style is advisable here. Certainly it is not required.
• I agree that Cooper & McKee 2003 (PMID 12669653) talks about integration of CAM in general (in which it includes chiropractic), not about chiropractic in particular. As a quick fix to this problem I removed the claim.

Eubulides (talk) 14:22, 31 July 2008 (UTC)

• I agree that Cooper & McKee 2003 (PMID 12669653) talks about integration of CAM in general (in which it includes chiropractic), not about chiropractic in particular. As a quick fix to this problem I removed the claim. Am I missing something. Are you saying you are looking at something that is not in the abstract? I don't see anything but chiropractic - and it is saying chiropractic "... has entered the mainstream of health care, gaining both legitimacy and access to third-party payers." -- Dēmatt (chat) 01:50, 2 August 2008 (UTC)

Oh, I see it in Fyslee's source of the first page of the actual paper. I agree he was talking about CAM. -- Dēmatt (chat) 02:10, 2 August 2008 (UTC)

Your "source" objection is found at the start of this section: "The newly-inserted quote marks are not clearly connected to any source, and are confusing to boot. I was at a loss to understand why "subluxation" was quoted, just by itself. The quote marks are not necessary and can be removed."

I then documented that I had followed the source very closely, and by using quote marks I made sure that readers would be clear it was a quoted source, and not editorial opinion. Subluxation was quoted by itself because it was the only example named in the quote. -- Fyslee / talk 14:45, 31 July 2008 (UTC)

• Thanks for clarifying about the "source" objection. Sorry I wasn't clear earlier: that objection was primarily about the style being used (in that the connection between the quotes and the source wasn't entirely clear), not that the statements were not sourced at all. Eubulides (talk) 22:20, 31 July 2008 (UTC)

I think you're right Fyslee. I don't think that you can make an article NPOV by somehow balancing POV statements that are favorable with POV statements that are critical. To make all statements NPOV, you must be clear about which statements are statements of fact, and which report an opinion; there is a middle ground of interpretation, but the first step is to be clear about the extremes. Of course you report opinions, without dilution, but as opinions. You might try to strip the text of editorial value judgements. Some phrasings could be made more objective include:

• has enjoyed a strong political base: received considerable political support
• related in an important and fundamental way, drop ""important and"
• Chiropractors pay careful attention, drop "careful"
• beyond simply manipulating the spine, drop "simply"
• Conservativism carefully considers, drop "carefully"
• accept the value that the scientific method has to offer, change to "accept the importance of scientific research into chiropractic"
• primary underlying risk factor, drop primary
• lack rigorous proof of effectiveness, drop rigorous.
• unreasonable restraint of trade and conspiracy, needs quote marks. This is the converse to the "antiscientific" dispute above; the word unreasonable is a value judgement, in this case it's a legal judgement, but it's still a judgement of value not of fact. I'd quote it as the actual words of the Judge.Gleng (talk) 09:27, 31 July 2008 (UTC)

Wow, those are some good choices, Gleng. I don't know about anyone else, but I am willing to let Gleng go through and make those changes and any other ones that he sees. He has proven himself a valuable NPOV editor on[REDACTED] in the past and am sure that we will all be satisfied with his work. I know that it is his style to make several screening passes through an article and clean up things like that. I would really appreciate his skill in that regard. -- Dēmatt (chat) 13:17, 31 July 2008 (UTC)

It's worth a try. Just do a few at a time, save, and then go on. Go for it. -- Fyslee / talk 14:10, 31 July 2008 (UTC)

I agree with many of Gleng's proposed changes. Here are the ones I have qualms about:

• "received considerable political support". The source says "Chiropractic's political base is strong", and Gleng's rewording is much weaker than this. How about if we instead use "has had a strong political base".

Fine by meGleng (talk) 18:31, 31 July 2008 (UTC)

• "primary underyling risk factor". Why drop "primary"? Saying just "a risk factor" is too weak, surely.

Primary has a technical meaning. Fine if that is true, not fine if it's just a reinfocing adjectiveGleng (talk) 18:11, 31 July 2008 (UTC)

I just now checked the source, and it doesn't talk about risk factors at all. I propose that we fix this problem by replacing 'an "Innate Intelligence" within the human nervous system and is a primary underlying risk factor for almost any disease' with 'an "Innate Intelligence" which directs all the functions of the body via the human nervous system', as the "directs all the functions of the body" is supported by the cited source. Eubulides (talk) 22:20, 31 July 2008 (UTC)

• "lack rigorous proof of effectiveness". Let's keep the "rigorous". The source says "rigorous" and this is an important part of the qualification of that statement. Here's the quote from the source. "Unfortunately, it is difficult to establish definitive, unarguable, and conclusive findings regarding much in the healing arts despite the millions of papers that have been written about presumably scientifically sound studies. Because of this difficulty, numerous medical procedures have not been rigorously proven to be effective either." (DeVocht 2006, PMID 16523145)

proof is a technical statement; something is either proved or not. A proof that isn't rigorous is not a proof. Just because a source uses a word redundantly or imprecisely, we don't have to follow it.Gleng (talk) 18:11, 31 July 2008 (UTC)

DeVocht is not talking about mathematical proof; he's talking about empirical tests; the kind of proof one sees at automobile proving grounds. This sort of proof can be more or less rigorous. Eubulides (talk) 22:20, 31 July 2008 (UTC)

Then don't use the word proven; it has no scientific meaning except as conclusive demonstration. Use shown instead.79.68.13.143 (talk) 08:40, 1 August 2008 (UTC)

As Coppertwig notes below, this isn't math. If you look at biomedical uses of the word "proven" (e.g., here) you'll see that we are using the commonplace meaning here. "Shown" is considerably weaker than "proven" and to some extent "rigorously shown" is self-contradictory: merely "showing" something is less-rigorous than "proving" it. Eubulides (talk) 14:30, 1 August 2008 (UTC)

I din't mention math. Proof is "

The evidence or argument that compels the mind to accept an assertion as true.". Rigorously is a redundant reinforcer, a rhetorical device. If the evidence isn't compelling, it's not proof. If it's not rigorous, it can hardly be compelling.Gleng (talk) 20:51, 2 August 2008 (UTC)

• There is no need to quote "unreasonable". The "unreasonable" is in the context of the phrase "the court found that", so it's already quite clear to the reader that "unreasonable" is the opinion of the court, not the opinion of Misplaced Pages.

Eubulides (talk) 14:22, 31 July 2008 (UTC)

Wouldn't wish that a reader might be mistakenly think that this word is editorial POV.Gleng (talk) 18:11, 31 July 2008 (UTC)

I like Gleng's changes because they excise a lot of the flowery and loaded descriptors which are inherently POV and unnecessary. Go for it, Gleng. -- Levine2112 17:00, 31 July 2008 (UTC)

I'm going to leave it to you good people, I really don't have the time these days to get into a line by line fight. Sorry, but you have my best wishes.Gleng (talk) 18:11, 31 July 2008 (UTC)

"Can't says that I blames ya." -- Dēmatt (chat) 18:33, 31 July 2008 (UTC)

I went for it, for the changes that were not controversial in the above discussion. We can discuss other changes as needed. Thanks, Gleng, for coming up with that helpful list. Alas, as discussed in #Simon-says in 1st paragraph below, I fear that the list is only a partial one. Eubulides (talk) 22:20, 31 July 2008 (UTC)

I also agree with most of Gleng's proposed changes. Re underlying risk factor: I suggest just dropping "primary" for now. The source (the primer) doesn't talk about primary underlying risk factor, but it also doesn't say (from what I was able to find) that straight chiropractors currently believe that an innate intelligence directs all functions of the body.

re "rigourous": I agree with Eubulides that it's better to keep this word. There may be proof of a sort, enough to convince some people, even if there isn't rigorous proof. This isn't math.

If we can verify that "unreasonable restraint" is the actual words of the court decision, I think it's useful to put it in quotes so the reader knows it isn't a Wikipedian paraphrase. ☺ Coppertwig (talk) 02:03, 1 August 2008 (UTC)

• The source doesn't talk about risk factors at all, whether "primary" or not; so it cannot be used to justify any claim about risk factors. If you don't agree with that paraphrase of the source and innate intelligence, I suggest that we rely instead on Kaptchuk & Eisenberg 1998 (PMID 9818801), a more-reliable source anyway, which talks about straights and innate intelligence. Shall I draft something along those lines?
• "Unreasonable restraint" is a generic term of antitrust law, and is not a specific or unusual conclusion made by this particular judge. It would be misleading to quote it, as it would suggest to the inexpert reader that the word "unreasonable" was a notable, particular opinion of that judge. Suppose we altered Timothy McVeigh to read 'McVeigh was found "guilty"'; such a quote would be literally repeating the words in the court's decision, but it would mislead the reader into thinking that there was something unusual about that decision. We shouldn't change Timothy McVeigh in that way; nor should we change Chiropractic in a similar way.

Eubulides (talk) 08:08, 1 August 2008 (UTC)

LOL! OK, "guilty" is usually not put in quotes, and although "unreasonable restraint" is not as frequently-used a term and in my opinion therefore needs quotes more than "guilty" does, and I still prefer it quoted, you've convinced me that it's OK to leave it unquoted. This article puts "not guilty", and some other short phrases, in quotes, and it doesn't look at all odd to me: it's giving the information that those are the exact words of the source. ☺ Coppertwig (talk) 12:54, 1 August 2008 (UTC)

LOL!! Yep, the important one is that they put "Yale Sluts" in quotes! How would you like to be the poor sweet girls being called antiscientific Yale sluts. :-D -- Dēmatt (chat) 22:17, 2 August 2008 (UTC)

Simon-says in 1st paragraph

• By "'Simon-says' style" I meant the style used in changes like this. I coined the term in #Inaccurate insertion of "Simon says" phrases.
• The existence of featured articles on controversial subjects like Evolution, articles that do not use the "Simon-says" style, shows that we need not use the "Simon-says" style here. The "Simon-says" style is certainly not required for NPOV. It is merely a style; other, better styles are available.
• The proposed style guideline, which is to insert quotes "when the word or phrase has a significantly non-NPOV tone", raises the question of how one determines whether a word or phrase has a significantly non-NPOV tone. Some editors think "antiscientific" doesn't have such a tone; others do. How can this be resolved?

It's not about tone of words at all, it's about wording things in a way that the editorial opinion doesn't intrude, one way or the other. It's about reporting facts, coolly and objectivelyGleng (talk) 09:17, 1 August 2008 (UTC)

• The best and most-reliable way to resolve it is to see whether reliable sources use the term in high-quality publications, without quote marks, and without any significant disagreement within reliable sources.

This opens terrible doors. Can I see someone stating that 'generally scientists despise doctors', on the authority of Steve Jones (see above) and challenging others to find any dissension in the peer reviewed literature? Pfff. The original source if it is any good, will have a whole context to qualify and explain the exact meaning and as importantly the status of words used. As we have seen here, a common problem is that different sources use the same words in very different ways to mean different things. Here you must think of the reader and of internal coherence of the article. So don't get hung up on the exact words; understand the factual content, and express that so that it can be understood.Gleng (talk) 09:39, 1 August 2008 (UTC)

I'm not familiar with the claim "scientists despise doctors"; I couldn't find it with a Google search. However, assuming Jones actually said that, it is easy to dispute such a claim with reliable sources saying that more physicians should be scientists and so forth, e.g., see Rosenberg 1999 (PMID 9925491). I suppose there might be some obscure topic where a reliable source makes an controversial claim and nobody else bothers to counter it, but the antiscience claim is hardly obscure: we have several sources, including the leading chiropractic textbook, making the claim. If this well-established claim were really controversial (which it's not), I would expect to see some dispute about it among reliable sources. Eubulides (talk) 14:30, 1 August 2008 (UTC)

It's in his most fanous book. But I see you are happy to counter this with references that rebut this indirectly, so you'd be happy to accept references asserting that straight chiropractic endorses the value of scientific research, as a rebuttal of the "antiscientific" opinion, right? I really think we must avoid double standards at all costs.Gleng (talk) 16:46, 2 August 2008 (UTC)

Either way, I'm game. -- Dēmatt (chat) 17:18, 2 August 2008 (UTC)

To quote Gleng from above "This opens terrible doors." When any wording is controversial, it needs to be clear it's a citation. It is the sources that say it, not Misplaced Pages. That's why any specific wording, no matter how controversial, opinionated, offensive, or whatever, is legitimate content in any article, as long as it is from a RS and complies with other editorial guidelines and policies. If we don't do this, we will constantly be getting edit wars over the phrasing from newbie editors who come along and discover it, as well as risking that readers think it is Misplaced Pages's "opinion", when it's not supposed to have an opinion. I can think of situations where attribution is so clear that such quote marks won't be necessary, but it must be very clear to all readers and newbie editors. -- Fyslee / talk 18:04, 2 August 2008 (UTC)

• Another way to determine whether a word or phrase has "a significantly non-NPOV tone" is to let Misplaced Pages editors decide, as a matter of their own personal preference, regardless of what reliable sources say. That is what has been done here. But it should be obvious that this is a recipe for Misplaced Pages editors, no matter how well-meaning, to introduce their own biases into the article.

• I disagree with Coppertwig's characterization of the "James P. Dooley" example in #Removing vague tag; that example is not just reductio ad absurdum. But rather than waste time talking about some other article, let's talk about Chiropractic, as that's more useful here.
• Let's start with the very first paragraph of Chiropractic's body.

• This paragraph has several non-POV terms, including (obviously) "important" and "fundamental", but also including more-subtle opinions in phrases like "a wide diversity of belief" (why not just "many opinions"?), "share the principle that" (why not just "agree"?), "pay careful attention to" (why not just "study"?), and "preventing and restoring health" (why not just "disease prevention and treatment"?). Obviously this paragraph is reeking with puff-piece phrases, all supported by a reliable source; if the Simon-says style must be use whenever a POV phrase is used, then this paragraph has at least a dozen words that need quoting and text attribution.

Agree with these examples. Prefer "believe" to "agree". "Fundamental" though is harder to remove, I read it as not really a reinforcing term but a qualifying term.Gleng (talk) 09:17, 1 August 2008 (UTC)

• But the POV in this 1st paragraph is much deeper and more fundamental than its puff-piece words. This paragraph passes off as undisputed the chiropractic dogma that the structure and function of the spine play an important fundamental role in preventing disease and restoring health, a dogma that is at the heart of chiropractic and that lacks good scientific evidence and is disputed by many in the scientific and medical mainstream.

This paragraph is about the Philosophy of chiropractic, i.e. stating the mere facts of what they believe. It's not stating either the basis for those beliefs or the reasons why others don't hold them. If it is clear that this paragraph is simply summarising what chiropractors believe, without endorsing or denigrating those beliefs, then it will be NPOVGleng (talk) 09:17, 1 August 2008 (UTC)

The problem is that the current wording doesn't make it clear that the paragraph is simply summarizing what chiropractors believe. It appears to be endorsing the chiropractor's opinion that the spine is central to overall health. Eubulides (talk) 14:30, 1 August 2008 (UTC)

• It doesn't matter whether one counts single words, or looks more deeply at what is being said. Either way, the 1st paragraph of the body of Chiropractic has much more POV than the "antiscientific" sentence. And this is not an isolated example: I chose it merely because it happened to be the 1st paragraph in the body.
• I haven't objected to the 1st paragraph before now, because my understanding was that opinions that are sufficiently supported by reliable sources can be written down and cited, and that's enough. If we are changing the rules, it's obviously completely POV to change the rules only for critical comments of chiropractic, which is what's been done so far. We need to be consistent for the whole article.
• With that in mind, here is a proposed rewrite for the first paragraph of Chiropractic #Philosophy, which uses what I understand to be the Simon-says style. If my understanding of the style is incorrect, please let me know

Although chiropractors disagree about many things, they agree that the spine "occupies a unique and privileged position" in affecting health via the nervous system. Chiropractors study what the American Chiropractic Association says are "the biomechanics, structure and function of the spine, its effects on the musculoskeletal and neurological systems, and the role played by the proper function of these systems in the preservation and restoration of health".

Eubulides (talk) 14:22, 31 July 2008 (UTC)

I would say that the quotes here are neccessary in the first use if you use those exact words, and the second half could be rephrased as a factual statement.Chiropractors study the biomechanics, structure and function of the spine, its effects on the musculoskeletal and neurological systems, and its role in health and disease. It's a factual statement. Is it true? if so fine, if not, put it right Gleng (talk) 09:17, 1 August 2008 (UTC)

That second-half rewording still appears to endorse chiropractors' opinion that the spine is central to overall health. How about the following rewording instead? It omits quote marks but adds a qualifier to avoid the appearance of endorsement: "Chiropractors study the biomechanics, structure and function of the spine, along with what they say are its effects on the musculoskeletal and neurological systems and its role in health and disease." Eubulides (talk) 14:30, 1 August 2008 (UTC)

I see how you might think this could be a problem, though to scientists, when you study the effects of something, say when you study the effects of a treatment on a health outcome, you are not implying that the treatment is effective merely by the fact of studying it. Your alternative is I think wrong; chiropractors do not study "what they say" are its effects and its role, they study its effects and its role - even if others may disagree that these are in fact its effects and its role. I am not sure if it can disputed that the biomechanics, structure and function of the spine have an impact on muscoskeletal and neurological systems, nor that this has some role in health and disease. The legitimate dispute is only about the extent of that impact. This study is the particular focus of chiropractic. Others might feel that chiropractors attach more importance to spinal malfunction than it merits; but I suspect that every speciality ever conceived attaches much much importance to its own areas of interest than others do.Gleng (talk) 20:18, 1 August 2008 (UTC)

Why not just change "agree" to "the beliefs"

Although a wide diversity of ideologies exist among chiropractors, they share the belief that the spine and health are related in a fundamental way, and this relationship is mediated through the nervous system. Chiropractors pay attention to the biomechanics, structure and function of the spine, its effects on the nervous and musculoskeletal systems, and the role these systems play in preventing disease and restoring health.

But this is different than the "antiscience" situation. More like a strawman. -- Dēmatt (chat) 03:31, 2 August 2008 (UTC)

Think your text is a good suggestion Dematt; you've proposed a way of declaring what chiropractors assert without implying that what they assert is generally accepted. I agree with you that here we are simply discussing the most accurate expression of a factual statement (about what chiropractors believe), the statement expresses facts not opinions (though there may be different opinions about whether the facts about their beliefs are true; whether their beliefs are true is not relevant here)Gleng (talk) 16:35, 2 August 2008 (UTC)

• It is different from the "antiscience" situation, but only because it is worse than the "antiscience" situation. With the "antiscience" situation we had multiple reliable sources agreeing, with none disagreeing, that antiscience is an issue in a segment of chiropractic. In contrast, the first paragraph in Chiropractic #Philosophy contains multiple opinions for which it is easy to find reliable sources that disagree. And yet the Misplaced Pages article presents these controversial, pro-chiropractic opinions as its own.
• I don't understand the 'Why not just change "agree" to "the beliefs"' comment, nor the duplication of a paragraph from Chiropractic immediately after that comment. That stuff looks like stray discussion text to me; I can't make heads or tails of it.

Eubulides (talk) 06:14, 2 August 2008 (UTC)

• Which POV word are you objecting to. I don't have any problem with creating a prose attribution for whatever it might be.
• Take another look, it was subtle, but accurate and succinct.

-- Dēmatt (chat) 17:18, 2 August 2008 (UTC)

References

(The following resolve otherwise-dangling references: )

• Misplaced Pages controversial topics
• All unassessed articles
• A-Class Alternative medicine articles
• A-Class Skepticism articles
• High-importance Skepticism articles
• WikiProject Skepticism articles