As already mentioned, Terrett  has carried out a study with the objective of determining how the words chiropractic and chiropractor have been used in publications reporting complications from cervical SMT. Furthermore, he pointed out that in countries without chiropractic registration it can be difficult to determine the educational and professional background of the provider of care that has been associated with harm. Terrett revealed that errors regarding terminology and professional identity have been documented, in one or more cases, in India, Ireland, Italy, Taiwan, France, and Germany. The results of the present study suggest that errors regarding terminology and professional identity are still taking place in Germany [9, 13], and that Spain  and England  can now also be added to that list.
Terrett's review  revealed that many cases of complication after manipulation described in the medical literature as "chiropractic complications" are found to be, on closer inspection, either
(a) medical misrepresentation of the literature;
(b) inaccurate reporting by medical authors; or
(c) inaccurate reporting by medico-legal journalists.
Reflecting upon the present study in light of Terrett's classification, we find that two case studies [9, 12], and one case series  are examples of inaccurate reporting by medical authors and that the secondary report, published in an English medical journal , that briefly summarised the findings from one of the above mentioned case reports , was in part the result of inaccurate reporting by the involved BMJ editor, and is therefore an example of medical misrepresentation of the literature.
It is important for research attempting to document associations between the care provided by chiropractors and harm, and/or benefits, to realize that chiropractic is a profession and not just a procedure. That such is the case is reflected in WHO Guidelines on Basic Training and Safety in Chiropractic ;
'Chiropractic– A health profession concerned with the diagnosis, treatment and prevention of disorders of the musculoskeletal system, and the effects of these disorders on the nervous system and general health.'
Furthermore, membership in the chiropractic profession is predicated on detailed globally agreed upon educational standards. The European Council on Chiropractic Education (ECCE) is an international autonomous organization established by the chiropractic profession in Europe to accredit and re-accredit institutions providing undergraduate chiropractic education and training. The principal goal of the ECCE is to assure the quality of chiropractic undergraduate education and training against a set of educational Standards. It is the only chiropractic educational accreditation agency serving Europe that is a member of the Council on Chiropractic Education International (CCEI), and that is recognized by the profession and the other Councils on Chiropractic Education around the world. Through its membership with CCEI, the ECCE adheres to the CCEI Model Standards that include educational criteria and accreditation procedures. Such adherence indicates essential equivalence of the educational standards of all CCEI member agencies and, thereby, the competency of individuals graduating from institutions accredited by ECCE and all member Councils on Chiropractic Education .
ECCE Standards specify that the duration of a chiropractic programme last for at least five full-time academic years and are based on the following definition and description of a chiropractor:
'The chiropractor is concerned with the health needs of the public as a member of the healing arts. He/she gives particular attention to the relationship of the structural and neurological aspects of the body in health and disease. He/she is educated in the basic and clinical sciences as well as in related health subjects. The purpose of his/her professional education is to prepare for practice as a primary care provider. As a portal of entry to the healthcare system, the chiropractor must be well educated to diagnose, to care for the human body in health and disease, and to consult with, or refer to, other healthcare providers'. 
To describe someone as a chiropractor simply because that person performs SMT, but without knowing that person's educational background or professional affiliations, is clearly inappropriate. However, that seems to be the basis upon which the authors of the six articles of this review proceeded.
Chiropractors who feel an injustice has been committed when case reports inappropriately link their profession with some form of harm might consider the following. The scientific process is not over with the publication of an article; it's up to the scientist's or clinician's peers to review works in journals and critique them with letters to the editor. If a publication's errors go unchallenged, they are the fault of the reader as much as the person who submitted the paper for publication.
The researchers who have published these cases probably did not have malicious intentions towards chiropractic. I believe that case studies of 'manipulation induced injury' readily catch the eye of readers and journal editors alike so that such papers make for an easy publication. Furthermore, I get the impression, from my communications with the principal researchers involved, that they are using the title 'chiropractor' as if it is synonymous with 'spinal manipulator' and the term 'chiropractic manipulation' as if it is synonymous with 'spinal manipulation'.
Unfortunately, the case series by Dziewas et al. , which incorrectly suggested that twenty cases of carotid artery dissection (CAD) were caused by qualified chiropractors has been quoted by at least four subsequent publications [24–27]. This is another form of what Terrett  termed "inaccurate reporting", wherein the original publication, by Dziewas et al. , does attribute the injuries to chiropractors, but personal communication with the author, and subsequent letters to the editor [16, 20], revealed a different scenario. This form of inaccurate reporting likely adds significantly to the over-reporting of chiropractic-related injury. In support of the authors of those four subsequent publications it should be noted that all three of the reviews [24–26], and the one commentary  were submitted for publication subsequent to the date when my letter to the editor of the Journal of Neurology , and the reply by Dziewas , made public the fact that the care providers of the 20 relevant cases they reported on were not qualified chiropractors.
It is noted with dismay that despite all the discussion, via letters to editors, in relation to the inappropriate use of the title chiropractor and term chiropractic manipulation, that a more recently published retrospective survey from Germany  used the title, Vertebral artery dissections after chiropractic neck manipulation, despite the fact that only 4/36 (11%) of the cases reportedly involved a care provider identified as a chiropractor. The largest group of providers, 18/36 (50%), linked to injury through their use of SMT, were orthopaedic surgeons. Surely if the title of that paper was going to be associated with one particular profession, or specialty, it should have been orthopaedic surgeons rather than chiropractors. Furthermore, given the propensity for publications from Germany to inappropriately use the title 'chiropractor', it may yet prove to be the case that none of the four chiropractic-related injuries identified by that retrospective review were the result of care provided by qualified chiropractors.
This prospective review suffers from a number of limitations;
• Only one electronic data base (PubMed) was monitored across the 12 month. Had more data bases been included more relevant studies may have been detected,
• The search strategy used for this review was very basic and included only three search terms. A more detailed search strategy and the inclusion of more search terms may have resulted in the detection of more relevant studies,
• The means by which authors of relevant papers were contacted was limited to e-mail. Authors of two of the six relevant papers detected via this review's search strategy did not respond to this author's e-mails. The professional identity of the care providers in those two case studies therefore remains unknown. A more thorough attempt to communicate with authors of relevant papers, beyond e-mail, may have been more successful in eliciting responses.
The true incidence of this form of over-reporting, wherein a care provider, whose application of SMT is associated with an injury, is inappropriately identified as a chiropractor, has not been documented. However, based on the preliminary findings provided by Terrett's previous work  and the present prospective review, further investigation, aimed towards determining the extent to which the inappropriate use of terminology contributes to the over-reporting of chiropractic induced injury, seems warranted. Further research in this area might also explore whether the title 'chiropractor' and term 'chiropractic manipulation' are being misused only in relation to harm caused by non-chiropractors, or if the same misuse is taking place in relation to descriptive studies documenting benefits. That is to say it might also be informative, in determining whether any bias exists, to look at whether the term and title are also being inappropriately used in studies documenting some patient benefit due to this type of care when provided by non-chiropractors.
Moreover it is recommended that authors of future publications, aimed at exploring the link between SMT and injury, should very clearly define the terminology used and clearly delineate the training and professional identification of those care providers whose care is subsequently deemed to be in some way associated with injury.