Archived Comments for:
How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years
Comment on: How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years
Username: Richard Southam, Disqus ID: richardsoutham
16 March 2018
What a sad piece of research. Limiting the beliefs of students before they get to practice and start seeing patients health improve (despite being no evidence for it). Just because there is no evidence out there now does not preclude the possibility that there will be some in the future. If the researchers start looking for it...... But they are too busy trying to narrow the scope of Chiropractic.
Competing interests
Unknown
Comment on: How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years
Username: Nantahalla, Disqus ID: Nantahalla
16 March 2018
I'll agree Richard. While evidence-based 'anything' should earn a higher order of acceptance, years of success with 'anything' should not be dismissed. Moreover, reasonable thought preceding a trial period of 'anything' is critical to advancement. Where would we be if Palmer, Still, and so many others sat around waiting for accumulation of evidence?
Competing interests
Unknown
Comment on: How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years
Username: Peter Robb, Disqus ID: disqus_y3ZAhIBBzh
16 March 2018
I see that a lot of effort went into the analysis of these questions. However if we are talking of "evidence based" opinion, what a pity the same effort did not go in a to meaningful presentation of "evidence" for the things we see in practice. Evidence is NOT about those things that we know that are 100% going to happen every time we see a patient. If that were the case we would never see another flu shot since the CDC's latest opinion of last years effectiveness was that 77 needed to get the shots for 1 to get a benefit. I would like to see these authors and especially Dr Charlotte and Dr Bruce put more of their efforts into developing the evidence and the NNT of response to various conditions that we all see change as a result of chiropractic intervention. Same effort, but a better result for humanity would result. At present I see some papers being presented more as a political tool rather than furthering the profession. Sorry if that hurts but it is my growing opinion.
Competing interests
Unknown
Comment on: How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years
Username: Chiro John, Disqus ID: chirojohn
16 March 2018
The term 'musculo-skeletal' was invented to assist with the study of the human organism and to categorise its' various maladies. However, in reality, there is no such thing as a strictly musculo-skeletal condition. Most have associated pain ... woops - it's now a neuro-musculo-skeletal condition. Pain affects thought process and behavious - now a neuro-psych-musculo-skeletal condition. I think the drive to put chiropractic into a musculo-skeletal 'box' is an academic obscenity that does the profession and society a great disservice. From time to time, and with no predictability, spinal manipulation does appear to influence conditions not in the musculo-skeletal box. Now retired, in the last 35 years of my professional life I would not have used the term subluxation once to a patient. I was forever wary of good clinical reasoning before referring for xrays. I did not ever sell 'wellness' as a reason for patients to attend. I ran, in essence, a crisis care spinal pain clinic. But, on occasion, patients did report unexpected and positive changes in 'medical' conditions (another misuse of language) which had not responded well to traditional care. I do not suggest that subluxation theory be part of current curricula, (other than perhaps as a historic concept) because it has no evidence base to support it. However, to strictly confine our thoughts to musculo-skeletal, throws the baby with the bath water. Respectfully JD
Competing interests
Unknown
Comment on: How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years
Username: Chiro John, Disqus ID: chirojohn
19 March 2018
Strange? Unusual? No response to comments. What does that tell you?
Competing interests
Unknown
Comment on: How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years
Username: Jonathan Field DC PhD FRCC(pai, Disqus ID: jonathanfielddcphdfrccpain
22 March 2018
I thank the authors for this interesting paper but would ask for clarification of their interpretation of the results. Whilst it is not desirable for chiropractors or other clinicians to work outside their scope of practice or engage with non sensical care, it would presumably be seen as a good thing for them to be engaging with wider public health initiatives. The responses of the chiropractic students here regarding giving advice on non-musculoskeletal health conditions is interpreted by the authors as indicating a belief that their future scope of practice will extend beyond musculoskeletal conditions. Questions asked in the study included those on giving advice on stress, cardiovascular disease, diabetes and wellness in general. These might be interpreted as providing evidence supported advice. The UKs Making Every Contact Count and similar initiatives elsewhere would support giving information on appropriate activity, nutrition, avoiding prolonged sitting, smoking etc to support a healthy lifestyle and reduce the increasing burden of preventable disease (1). The authors go some way to acknowledging this in their limitations when they call for future studies to clarify what is meant by ‘providing advice’ and I hope they will confirm that their intention was not for chiropractors to abstain from wider public health initiatives.
Chiropractic & Manual Therapies
Comment on: How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years
16 March 2018
What a sad piece of research. Limiting the beliefs of students before they get to practice and start seeing patients health improve (despite being no evidence for it).
Just because there is no evidence out there now does not preclude the possibility that there will be some in the future. If the researchers start looking for it......
But they are too busy trying to narrow the scope of Chiropractic.
Competing interests
Unknown
Comment on: How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years
16 March 2018
I'll agree Richard. While evidence-based 'anything' should earn a higher order of acceptance, years of success with 'anything' should not be dismissed. Moreover, reasonable thought preceding a trial period of 'anything' is critical to advancement. Where would we be if Palmer, Still, and so many others sat around waiting for accumulation of evidence?
Competing interests
Unknown
Comment on: How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years
16 March 2018
I see that a lot of effort went into the analysis of these questions. However if we are talking of "evidence based" opinion, what a pity the same effort did not go in a to meaningful presentation of "evidence" for the things we see in practice. Evidence is NOT about those things that we know that are 100% going to happen every time we see a patient. If that were the case we would never see another flu shot since the CDC's latest opinion of last years effectiveness was that 77 needed to get the shots for 1 to get a benefit. I would like to see these authors and especially Dr Charlotte and Dr Bruce put more of their efforts into developing the evidence and the NNT of response to various conditions that we all see change as a result of chiropractic intervention. Same effort, but a better result for humanity would result. At present I see some papers being presented more as a political tool rather than furthering the profession. Sorry if that hurts but it is my growing opinion.
Competing interests
Unknown
Comment on: How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years
16 March 2018
The term 'musculo-skeletal' was invented to assist with the study of the human organism and to categorise its' various maladies. However, in reality, there is no such thing as a strictly musculo-skeletal condition. Most have associated pain ... woops - it's now a neuro-musculo-skeletal condition. Pain affects thought process and behavious - now a neuro-psych-musculo-skeletal condition. I think the drive to put chiropractic into a musculo-skeletal 'box' is an academic obscenity that does the profession and society a great disservice. From time to time, and with no predictability, spinal manipulation does appear to influence conditions not in the musculo-skeletal box. Now retired, in the last 35 years of my professional life I would not have used the term subluxation once to a patient. I was forever wary of good clinical reasoning before referring for xrays. I did not ever sell 'wellness' as a reason for patients to attend. I ran, in essence, a crisis care spinal pain clinic. But, on occasion, patients did report unexpected and positive changes in 'medical' conditions (another misuse of language) which had not responded well to traditional care. I do not suggest that subluxation theory be part of current curricula, (other than perhaps as a historic concept) because it has no evidence base to support it. However, to strictly confine our thoughts to musculo-skeletal, throws the baby with the bath water. Respectfully JD
Competing interests
Unknown
Comment on: How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years
19 March 2018
Strange? Unusual? No response to comments. What does that tell you?
Competing interests
Unknown
Comment on: How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years
22 March 2018
I thank the authors for this interesting paper but would ask for clarification of their interpretation of the results.
Whilst it is not desirable for chiropractors or other clinicians to work outside their scope of practice or engage with non sensical care, it would presumably be seen as a good thing for them to be engaging with wider public health initiatives.
The responses of the chiropractic students here regarding giving advice on non-musculoskeletal health conditions is interpreted by the authors as indicating a belief that their future scope of practice will extend beyond musculoskeletal conditions. Questions asked in the study included those on giving advice on stress, cardiovascular disease, diabetes and wellness in general. These might be interpreted as providing evidence supported advice. The UKs Making Every Contact Count and similar initiatives elsewhere would support giving information on appropriate activity, nutrition, avoiding prolonged sitting, smoking etc to support a healthy lifestyle and reduce the increasing burden of preventable disease (1).
The authors go some way to acknowledging this in their limitations when they call for future studies to clarify what is meant by ‘providing advice’ and I hope they will confirm that their intention was not for chiropractors to abstain from wider public health initiatives.
1 https://www.england.nhs.uk/...
Competing interests
Unknown