For our protocol, we do just the opposite. In the control group, the examination itself serves as the placebo since it is not used to determine what adjustments are performed. As in a treatment trial, we evaluate clinical outcomes in a diagnostic trial to determine the efficacy of the procedure under study, in this case an adjustive indicator. If the clinical outcome in subjects is no better for the experimental group than for the control group, then there is no clinical impact of the adjustive indicator. We would infer that using the indicator to make decisions on adjustment would serve the patient no better than guessing where to adjust.
Patients improve in spite of the adjustive indicator.
On the other hand, if the clinical outcome is better in the experimental group, then we would conclude that the examination procedure is efficacious. This means that the patient is better off for having the examination, the bottom line for chiropractic care. The study results would indicate that the procedure provides useful information for the clinical decision on where and how to adjust. However, if a procedure is efficacious despite the absence of reliability for indicating specific adjustments, the study results would imply that adjustments and their indicators may work in an entirely different manner from how we think. Adjustive indicators dismissed for lack of reliability might merit reconsideration for further study.