Chiropractic/Archive 24

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History improvements

History 2 is a draft replacement for Chiropractic History. Please add comments in Comments on History 2 below. Eubulides17:22, 12 June 2008 (UTC)

History 2

thumb|D.D. Palmer

Chiropractic was founded in the 1890s by Daniel David (D.D.) Palmer in Davenport, Iowa. Palmer, a magnetic healer, hypothesized that manual manipulation of the spine could cure disease. Although initially keeping the theory a family secret, in 1898 he began teaching it to a few students at his new Palmer School of Chiropractic. One student, his son Bartlett Joshua (B.J.) Palmer, became committed to promoting chiropractic, took over the Palmer School in 1906, and rapidly expanded its enrollment.cite journal |journal= Technol Cult |author= Martin SC |date=1993 |volume=34 |issue=4 |pages=808–34 |title= Chiropractic and the social context of medical technology, 1895-1925 |pmid=11623404 Prosecutions of chiropractors for practicing medicine without a license grew common, and to defend against them B.J. argued that chiropractic was separate and distinct from medicine, as chiropractors "analyzed" rather than "diagnosed", and "adjusted" subluxation rather than "treated" disease. Early chiropractors believed that 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, and D.D. and B.J. both seriously considered declaring chiropractic a religion, deciding 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).

thumb|left|141px|B.J. Palmer

Although D.D. and B.J. were "straight" and disdained the use of instruments, some early chiropractors, whom B.J. scornfully called "mixers", advocated their use. In 1910 B.J. changed course and endorsed the use of X-rays for diagnosis; this resulted in a significant exodus from Palmer 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. 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. Until 1983, the AMA labeled chiropractic "an unscientific cult" and held that it was unethical for medical doctors to associate with an "unscientific practitioner".cite journal |journal= Am J Public Health |date=1989 |volume=79 |issue=11 |pages=1569–70 |title= AMA policy on chiropractic |author= Cherkin D |pmid=2817179 |pmc=1349822 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, and was hampered by antiscientific and pseudoscientific ideas that sustained the profession in its long battle with mainstream medicine. 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 spinal manipulation in some cases.cite web |title= Chiropractic history: a primer |author= Keating JC Jr, Cleveland CS III, Menke M |url=http://data.memberclicks.com/site/ahc/ChiroHistoryPrimer.pdf |format=PDF |date=2005 |accessdate=2008-06-16 |publisher= Association for the History of Chiropractic 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. 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.cite journal |journal= Milbank Q |date=2003 |volume=81 |issue=1 |pages=107–38 |title= Chiropractic in the United States: trends and issues |author= Cooper RA, McKee HJ |doi=10.1111/1468-0009.00040 |pmid=12669653

Comments on History improvements

Me thinks these two sections (Medical opposition and Movement toward science) requires further improvements and can be shortened. Feel free to edit both sections. QuackGuru18:55, 11 June 2008 (UTC)

It's not just those two subsections of Chiropractic History. The entire "History" section requires further improvements and should be shortened. The section should be about three paragraphs total, and should use standard SUMMARY style to summarize Chiropractic history. Relatively-minor details should be moved into Chiropractic history (if they're not there already). You can see an example of this in the way that Biology History summarizes History of biology, or in the way that Mathematics History summarizes History of mathematics. Eubulides19:27, 11 June 2008 (UTC)

Chiropractic has a long history. We would loose a lot of interesting facts if we shortened the entire history section. QuackGuru19:37, 11 June 2008 (UTC)

We would not lose any facts, any more than Biology History loses facts with its summary of History of biology, or Mathematics History loses facts with its summary of History of mathematics. All the less-important details would be in Chiropractic history. This is standard Wikipedia style; see SUMMARY. Eubulides19:50, 11 June 2008 (UTC)

Well, some information may be minor while other information may be important. I would like to see BOLD editing on the above sections. QuackGuru21:05, 11 June 2008 (UTC)

Chiropractic history already includes everything that is here. All we have to do is prune this one. -- Dematt Dēmatt 04:13, 12 June 2008 (UTC)

Comments on History 2

OK, I drafted a pruned version above. It still needs work (particularly, it needs coverage of the recent evidence-based and managed-care revolution), but I hope you get the idea of the desirable length anyway. Eubulides17:18, 12 June 2008 (UTC)

I added material about the recent evidenced-based and managed-care changes, and pruned some of the older text. History 2 is now ready to be reviewed with the idea of putting it into the article. Please note that, like Education, licensing, and regulation, this draft contains some material not in its subarticle; the intent is to migrate this new material into the subarticle as well. Eubulides06:36, 13 June 2008 (UTC)

When mentioning the Manga Report, put a footnote to the actual Manga Report, since that's what the reader will want to see. Also, in the text mention the jurisdiction (Ministry of Health of where?).

""its future seemed uncertain"" does not seem NPOV to me. Perhaps the sentence could be re-phrased beginning something like ""In response to pressure from ..."". ☺ Coppertwig13:33, 13 June 2008 (UTC)

Thanks for the comment. To respond to your two points:

"'Manga report"'. The stuff about the Manga report was http://en.wikipedia.org/w/index.php?title=Talk%3AChiropracticdiff=219030228oldid=219027505 inserted without comment by QuackGuru, along with a bunch of other stuff. I disagree that this level of detail belongs in a brief summary of over a century chiropractic history. Certainly citing the Manga report directly would be a mistake: we should be citing secondary sources (high-level summaries of chiropractic history), not primary documents. Also, we should not be citing documents from websites of defunct organizations to highlight their minor contributions to a big field. This detail should be moved to Chiropractic history; it should not be here. I've removed the unnecessary detail, removing any need to cite the Manga report.

"'Future seemed uncertain"'. The cited source (Cooper McKee 2003, PMID|12669653) says this in its introduction, after the first paragraph which talks about its successes:

"Even so, chiropractic's future seems uncertain. Recent expansions of chiropractic colleges are swelling the ranks of practitioners while managed care is restricting payment for what chiropractors do and evidence-based medicine is demanding that what they do must have demonstratable value. At the same time, chiropractors are experiencing greater competition from acupuncturists and massage therapists, whose ranks also are growing."

Several other reliable sources indicate that chiropractic's future seemed uncertain. See, for example, Phillips 2005 (PMC|1840027), Nelson "et al." 2005 (PMID|16000175), the http://www.altfutures.com/pubs/Future%20of%20Chiropractic%20Revisted%20v1.pdf 2005 IAF report, and the debate between DeVocht 2006 (PMID|16523145) and Homola 2006 (PMID|16446588). I don't know of any reliable source saying that chiropractic's future seemed or seems certain.

Eubulides

17:20, 13 June 2008 (UTC)

Me thinks the history rewrite is a bit too short. So I expanded it a bit. QuackGuru17:54, 13 June 2008 (UTC)

That http://en.wikipedia.org/w/index.php?title=Talk%3AChiropracticdiff=219122245oldid=219115987 expansion is more than just "a bit". It grows the length of the summary by about 40%. It adds material that is poorly sourced compared to what's already in there. The new material cites primary sources, which is undesirable. Let's stick with what high-level reviews say rather than telling the history of chiropractic directly from primary sources in in our own idiosyncratic way; that will help us maintain perspective and avoid bias. I am not opposed to a "brief" mention of further conflicts among chiropractic, or a "brief" expansion of evidence-based medicine, so long as they are both supported by reliable general-chiropractic-history sources. But that's not what this "a bit" change does. I am reverting it for now. If, despite these comments, you continue to prefer the much-longer version, I ask that you generate a new one and call it "History 3". Eubulides18:42, 13 June 2008 (UTC)

I agree it's short. I'm not a fan of long and agree it was too long before, but we can't sacrifice content for brevity. Are we wanting to put all of chiropractic into one bucket? If so, that is okay, but we should make sure that we don't put it in one bucket and label it straight or mixer. You almost pull it off, but I see only one source that is probably a good source for the outlook of the straight perspective, but it neglects the other 25000 chiropractors. BJ held the patent on the neurocalimeter and only allowed 5000 sold and only to straight chiropractors. This was a turning point that swelled the number of mixers against him. And remember - it was mixers that made the move against BJ toward science instead of Innate Intelligence. Yes, BJ made an attempt to become scientific with his research in which he used MDs to verify his diagnosis and results, yes he investigated and was responsible for developement of Xray to actually see these spinal distortions, but it was mixers that pushed for the education and reform of the profession. However, BJ and the straight philosophy was the only thing that could keep them out of jail, so everyone rallied behind the 'subluxation' flag. BJ constantly sabotaged mixer attempts to define chiropractic in medical terms. It split the profession. It was the push for education from the mixers starting in the 1930s and again in the 1950s (Homola spoke up during this time) that eventually earned them respect in the late 1970s during a turbulant time in US history. It wasn't until after the Wilk suit that finally ended in the early 1990s that the chiropractic institutions began dropping 'subluxation' and redefining their profession in materialistic terms. Managed care and EBM enter the scene removing any concern for 'philospohy' from both chiropractic and medical equations and only considering results of the particular intervention. Manga was the first report that stated that if chiropractors were gatekeepers, the costs would go down and this boosted chiropractics prestige. Of course there was on outrage from the medical community, but then the The US guidelines put spinal manipulation at the top of the list as alternatives for treating acute low back pain - suggesting that 90% of surgeries were unnecessary. Again chiropractic's prestige was boosted - but this time medicine became interested in performing spinal manipulation. This is why we are seeing a resurgence of the effectiveness of SMT for lbp and other MSK conditions and we are seeing competition for deciding who gets paid to do it. I don't think we have captured these important features quite yet. But don't worry, I don't think the other version did either. -- Dematt Dēmatt 14:32, 14 June 2008 (UTC)

The intent is that Chiropractic History should be a brief summary of Chiropractic history. Obviously any such summary will have to leave things out; but content won't be "sacrificed", it'll be in Chiropractic history.

There are two main sources for History 2: Martin 1993 (PMID|11623404) and Cooper McKee 2003 (PMID|12669653). Both sources talk about both straights and mixers.

I removed the sentence "B.J. helped shift chiropractic from craft to profession, by emphasizing formal education, establishing a professional journal in 1904, and founding a professional organization in 1906." from History 2; I think this fixes several of the problems you mention about the B.J. coverage.

History 2 doesn't cover the history between 1930 and 1983 well. A high-level reliable source on that would help. (The current ChiropracticHistory also neglects this period.)

I don't think Manga was the first to say chiropractors were cheaper. Nor did the Manga report talk about making chiropractors gatekeepers.

The U.S. guidelines do not put spinal manipulation at the top of the list for treating acute low back. The top of the list is advice to stay active, effective self-care, and medications with proven benefits; these are all strong recommendations. Spinal manipulation is suggested only for patients who do not improve with standard treatment; this is a weak recommendation.

Eubulides

19:20, 16 June 2008 (UTC)

::Advice to stay active, and on how to self-care are part of Chiropractic treatment, are they not? DigitalC02:05, 17 June 2008 (UTC)

Sure. They're in the arsenals of chiropractic and of conventional medicine alike. But Dematt's point was that chiropractic's prestige was boosted because U.S. guidelines mentioned spinal manipulation. Had the guidelines stopped after mentioning advice to stay active, and self-care, they would have not had any effect on chiropractic's prestige. Eubulides16:57, 17 June 2008 (UTC)

"The intent is that Chiropractic History should be a brief summary of Chiropractic history. Obviously any such summary will have to leave things out; but content won't be "sacrificed", it'll be in Chiropractic history."

Well, for instance, when we leave out that DD was put in jail in 1906 for practicing medicine without a license and he sells the shop to BJ and leaves the state a beaten man we lose some of the explanation of "why". For instance, it was then that BJ came up with a "vitalistic" approach that "adjusted cause" rather than "treated disease"; Keating and Lerner suggest that this was to protect the profession from organized medicine. There are sources that say he believed that Innate Intelligence was an extension of God (Universal Intelligence) - but this was really DDs invention from his 1914 book that wasn't published until after he died, and apparently nobody bought. It was DD that wanted chiropractic to go the way of Christian Scientists - but that would mean that DD would be the spiritual leader. DD and BJ hated each other - so some sources consider this the reason BJ didn't want to go the Christian Science route. The point is that there are competing views on "who believed what and why".

We should try to write this concise version without any of this, but when we say that "Early chiropractors believed that...", we don't really know what they believed, only what they did. They built a system of healthcare based on vitalistic principles that assumed that all health was directed by a vital force that made it impossible to become part of organized medicine. -- Dematt Dēmatt 04:21, 17 June 2008 (UTC)

We can find DD expressing these religious views in 1911 in http://www.chiro.org/Plus/History/Persons/PalmerDD/PalmerDD's_Religion-of-Chiro.pdf a letter. It also expresses his antagonism to his son, and the competitive nature of their relationship. While DD really did believe these religious views, I believe he (and possibly BJ) also consciously considered using them to protect the profession. -- Fyslee / 06:04, 17 June 2008 (UTC)

The source doesn't talk about B.J.'s or D.D.'s beliefs in particular; it talks about the belief of early chiropractors in general. Let's put it this way: if a reliable source says "Early Christians believed Christ would soon return", should we say, well, that doesn't tell the whole story, and that the belief wasn't shared by "all" early Christians, and there were competing views within early Christianity, and that the belief acted as a mechanism for winning converts more effectively, etc., etc. (all these points are valid ones, by the way); or should we just go with what the reliable source says is a reasonable brief summary of an important early Christian belief? After all, it is a "brief summary" we're talking about here. Eubulides16:57, 17 June 2008 (UTC)

"There are two main sources for History 2: Martin 1993 (PMID|11623404) and Cooper McKee 2003 (PMID|12669653). Both sources talk about both straights and mixers."

Still suggest Keating in those first two paragraphs as some of the "facts" seem skewed in favor of BJs world vision of chiropractic rather than the whole of chiropractic. Keating studied all the schools of chiropractic. -- Dematt Dēmatt 04:21, 17 June 2008 (UTC)

Agreed. Keating was the supreme chiropractic historian, and his work is especially valuable because he maintained a degree of objectivity towards the subject that would be impossible for a chiropractor to achieve. That's just the way it works. He both praised and criticized the profession, and devoted his life to delving into its history, to his teaching as a chiropractic professor, and to his many jobs in valuable positions of trust in the profession, most notably as president of the Association for the History of Chiropractic. We need an article about this remarkable man. -- Fyslee / 06:11, 17 June 2008 (UTC)

I agree that Keating is a good source. But he's cited. The other cited sources are equally reliable. Which "facts" still seem skewed? Without a more specific criticism, I don't see how to improve the draft. Eubulides16:57, 17 June 2008 (UTC)

"I removed the sentence "B.J. helped shift chiropractic from craft to profession, by emphasizing formal education, establishing a professional journal in 1904, and founding a professional organization in 1906." from History 2; I think this fixes several of the problems you mention about the B.J. coverage."

That is an improvement, thanks. There are still more addressed above as well. If the source we are using is verifiable, then it's just a matter of adding another source from a different perspective such as Keating and we should end up with something acceptable to all POVs. -- Dematt Dēmatt 04:21, 17 June 2008 (UTC)

"History 2 doesn't cover the history between 1930 and 1983 well. A high-level reliable source on that would help. (The current ChiropracticHistory also neglects this period.)"

This is the vaccine period ;-) A very turbulent and defining time for the future of chiropractic. -- Dematt Dēmatt 04:21, 17 June 2008 (UTC)

"I don't think Manga was the first to say chiropractors were cheaper. Nor did the Manga report talk about making chiropractors gatekeepers."

Manga was the first Phd at such a high level of government that was seen to validate what chiropractors felt; that being integrated at the same level as medical doctors (without having to go through the medical gatekeeper http://www.silcom.com/~dwsmith/manga.html see R1 and R2 especially) would save the system millions. That was big to chiropractors and chiropractic history. -- Dematt Dēmatt 04:21, 17 June 2008 (UTC)

Manga's recommendations echoed a long list of chiropractor wishes that had been around for decades. For example, R2 talks about insurance covering chiropractic, but that had been true to some extent for decades, and the profession became more broadly eligible for insurance in the 1970s. Manga doesn't represent a revolution in this regard.

Keating "et al." 2005's "Chiropractic History: a Primer" does not mention Manga once. Why should we mention Manga in a 3-paragraph summary when Keating "et al." don't see fit to mention Manga in a 50-page description?

Eubulides

16:57, 17 June 2008 (UTC)

"The U.S. guidelines do not put spinal manipulation at the top of the list for treating acute low back. The top of the list is advice to stay active, effective self-care, and medications with proven benefits; these are all strong recommendations. Spinal manipulation is suggested only for patients who do not improve with standard treatment; this is a weak recommendation."

This is historical: (1994) the AHCPR guideline 14 came out for acute low back pain. http://www.silcom.com/~dwsmith/lbpqtxt.htmlHead17 Check out the Physical Methods section. The only physical method to be considered effective for low back pain was spinal manipulation. And yes, advice to stay active and effective self-care were things that are part of chiropractic care as DigitalC understands. IOWs, this was very supportive of what chiropractors did, but it was also going to be something that everyone was now going to want to do as well. Insurance companies start covering chiropractic care on an equal basis as medical... Chiropractic practices boom... then comes managed care and competition (though we should not be repeating statements about "the future of chiropractic is full of doom" - this may well depend on the social structure of the medical system in each individual country)... -- Dematt Dēmatt 04:21, 17 June 2008 (UTC)

OK, but the current History 2 draft already talks about managed care and competition, and it doesn't say anything about doom, merely about lack of certainty. To summarise the AHCPR stuff I added "guidelines that recommended spinal manipulation in some cases" to History 2. Eubulides16:57, 17 June 2008 (UTC)

cite journal |author= Mirtz TA, Long P, Dinehart A "et al." |title=NACM and its argument with mainstream chiropractic health care |journal=J Controv Med Claims |date=2002 |volume=9 |issue=1 |pages=11–8 |url=http://www.accessmylibrary.com/coms2/summary_0286-25525357_ITM Here is a fun article to read. This reference might be useful for History or even the schools of thought section. QuackGuru06:55, 19 June 2008 (UTC)

I think we can add this to the article now. No specific improvements have been recommended recently. QuackGuru18:37, 21 June 2008 (UTC)

I suggest waiting. I haven't had a chance to look at it yet. Soon History will be the "hot topic". I would appreciate it if you would wait until a consensus version has been agreed on during the time that it's the "hot topic"; I think that's the procedure that's been agreed on.☺ Coppertwig18:54, 21 June 2008 (UTC)

The idea was that we should focus our attention on particular topics and try to achieve consensus on each topic. However, this idea does not preclude people responsibly editing other sections in the meantime, in ways that are not obviously controversial. In our earlier discussion of this idea I wrote "I don't object if others want to work on "Education", but to my mind "History" comes first, and it can be worked on in parallel". Nobody disagreed with working in parallel. Obviously when our focus turns to "History" we can review whatever changes have been added there, but no objections have been made to the draft in History 2 and it's been sitting here for quite some time and has been fixed in response to reviews; so I don't see any objection to installing it now. Naturally it can be edited further later when it comes under focus. Eubulides20:51, 21 June 2008 (UTC)

No way, I haven't even looked at history. I'm still waiting to finish education. I thought that was the idea. If we put History 2 in now, that would be like making a large edit without consensus wouldn't it? -- Dematt Dēmatt 21:50, 21 June 2008 (UTC)

I don't think we agreed to freeze all other work on Chiropractic for what? six months? Currently there are 8 topics listed and up to 3 weeks devoted to each, and that would add up to nearly six months, which is way too long for a freeze. When talking about the proposal I suggested parallel work on other sections and nobody disagreed. I don't recall any consensus for a long freeze.

What I thought was that there was a consensus to focus on one section at a time, and to try to work to achieve consensus on that section. That does not preclude parallel work in other sections.

When you have a chance to look at History 2, please feel free to comment on it. There's no rush, and that remains true regardless of whether it's on the talk page or installed into Chiropractic.

Eubulides

22:51, 21 June 2008 (UTC)

Okay, We probably do need to get science cleaned up pretty quick, too. I'll go ahead and put education 3 in now. -- Dematt Dēmatt 23:06, 21 June 2008 (UTC)

Don't panic about the

fact

tags. I'm using them more as markers while I look for sources so that you can see why I am concerned. -- Dematt Dēmatt 00:53, 22 June 2008 (UTC)

I can understand your concern. For example, DD Palmer did have about eight years of formal education, mixers probably quickly became a majority (but still believed in subluxations, just as most of them do today), etc.. This history section just doesn't jibe with the understanding of chiropractic history I have in my head, and I've read quite a bit. I would prefer we used Keating more, as he is a more reliable historian. Some other chiropractic historians include plain wrong information. -- Fyslee / 05:49, 22 June 2008 (UTC)

(☺ Coppertwig01:35, 22 June 2008 (UTC)

Comments on finished History 2

Please review History 2. If you have concerns please be specific. QuackGuru19:15, 21 June 2008 (UTC)

No specific concerns about history 2 about been raised and it has been about a week. It's time to improve the article. QuackGuru06:56, 27 June 2008 (UTC)

I see you put it in. I can't disagree; History 2 is a huge improvement over what was in Chiropractic History. Eubulides07:53, 27 June 2008 (UTC)

It's pretty obvious that we do not have consensus on putting this in yet. The last edit was yesterday and since then I have been diligently looking into the SM/SMT issue. This violates the spirit of collaboration and our agreement to work according to the hot topic list. Please revert. -- Dematt Dēmatt 12:14, 27 June 2008 (UTC)

I would not have made the change quite just yet, but let's look at it from the other viewpoint: the serious POV problems with the old Chiropractic History have been known for months, and History 2 is a complete proposed fix for the problem that has been sitting in this talk page, with only minor changes, for over two weeks. We should not have to wait for weeks and weeks to fix obvious and undisputed POV issues.

History 2 and History 4? are both vast improvements over what used to be in Chiropractic History. Let's not allow the relatively minor differences between them hold up what's in Chiropractic. How about replacing Chiropractic History's first two paragraphs with what's in History 4?, and then work on improving that during Chiropractic History's "hot topic" period? That should immediately address any concerns you have with what's in Chiropractic History now.

Eubulides

21:53, 27 June 2008 (UTC)

History 3 improvements

I have withdrawn the obsolete History 3 because History 2 has greatly improved. QuackGuru00:28, 17 June 2008 (UTC)

Comments on History 3 improvements

Here is another choice for editors to review. The history of chiropractic should tell a story. For example, the landmark Manga report is part of the story. This draft 3 could be a good replacement for Chiropractic History. Feel free make suggestions and edit the above draft 3. QuackGuru19:50, 13 June 2008 (UTC)

I agree that the history should tell a story. But the Manga report is not nearly so important that it deserves to be mentioned at this level, much less emphasized. The Manga report is just one of dozens of similar reports and is a small part of a long overall debate about the effectiveness and cost-effectiveness of chiropractic. For example, Cooper McKee 2003 (PMID|12669653), a general survey that is of high quality, has about eight pages summarizing the history of evidence-based investigation of chiropractic. It cites the Manga report as one of five citations suppporting the phrase "In the early 1990s, reviews and metanalyses of more than 30 such trials concluded that SMT was safe and effective" and then goes on at "considerable" length (about three pages, with dozens of citations) for what happened after that, with respect to effectiveness and cost-effectiveness. The word "Manga" never appears in the discussion; it appears only in the abovementioned citation to one of 5 sources.

Chiropractic History should be summarizing the likes of Cooper McKee 2003; it should not be reaching down and emphasizing one of Cooper McKee's dozens of citations, far more than Cooper McKee themselves do. I am not saying that we have to follow Cooper McKee weightings slavishly, of course; what I am saying is that Cooper McKee's coverage of Manga suggest that History 3's emphasis of Manga is way out of line compared to the weighting given by reliable sources.

The Manga report is not the only problem with History 3. It also greatly overemphasizes the "objective straight" and "reform" movements, which had a relatively minor effect on the history of chiropractic. This overemphasis, again, is not supported by reliable historical surveys of chiropractic. Cooper McKee, for example, mention neither objective straights nor reforms in their 32-page paper (despite spending about half a page on straights and mixers).

This exhausts the main set of differences between History 2 and History 3; I see no reason, supported by reliable high-level sources, to prefer History 3 to History 2.

Eubulides

20:28, 13 June 2008 (UTC)

""It's future seemed uncertain"" is taken out of context. I suggest restoring the context by including the following words right after it: ""the ranks of practitioners swelled,"".

I think the activator is far more notable than the neurocalometer, and is not mentioned anywhere in the article. (I did a few web searches (e.g. "activator chiropractic" in google scholar) and got many times the hits for activator than for neurocalometer.) I suggest stating somewhere in the article the date of invention of the activator and the name of the inventor. http://www.philosophyofchiropractic.com/primerall72.pdf E.g. this link has that info.

I agree with Eubulides that there's too much material on straights and mixers or whatever. The Wilks thingy works well as the end of the paragraph; the other stuff coming after it seems out of place.

I'd like to see some info on the spread of chiropractic to countries other than the U.S., and the pattern of chiropractic schools, e.g. if there was a particular time period when a lot of new schools opened; the link given above also mentions a lot of schools closing at one point. ☺ Coppertwig00:53, 14 June 2008 (UTC)

Thanks for your comments. Here's what I did:

In History 2 I added "as the number of practitioners grew" after "future seemed uncertain". This is a bit less poetic than "swelled", but I thought the "swelled" would be a bit confusing for non-native English readers.

In History 2 I removed moved the "other stuff coming after it".

and here are some other thoughts:

The activator is more notable in the "current practice" of chiropractic (and this explains your Google Scholar results), but the neurocalometer is far more notable as far as the "history" of chiropractic goes. See, for example, http://www.philosophyofchiropractic.com/primerall72.pdf Chiropractic history: a primer, which gives a couple of sentences to the activator while giving a page and a half to the neurocalometer.

I don't know of any good source (i.e., a high-quality recent review) for the recent (as opposed to pre-1930) history of the education of chiropractic. It's not clear to me that it's worth mentioning at this level. The above-cited chiro history primer doesn't mention it.

Nor do I know of a good source for the expansion of chiropractic to countries other than the U.S. Again, the chiro history primer doesn't mention it.

Eubulides

09:23, 14 June 2008 (UTC)

I like that this version attempts to be more thorough, but reflects some major errors that would require delving deeper into the sources. It also seems to give BJ a lot of credit, for instance - it says he professionalized the profession and adds that because he started a journal - well everyone had a journal. If this source considrs that the reason the profession developed, I would begin to question the source. The whole issue of trying to predict the future is Crystal ball and should be abandoned, even if it said that the future looked bright. Cooper is from 2003 anyway and things are vastly different as research has been added in rapid amounts. I also disagree that we can only use summaries and I'm not aware of anything that states that this needs to be the case for history sections - though it is important not to re-invent history and create a pseudohistory such as both of these versions. Keating is considered the most reliable source for chiropractic history. He worked within it, but was not a chiropractor and is quite often critical of chiropractic. He has several books and papers published in peer reviewed journals. His primary research is available http://www.chiro.org/Plus/History/navigate.html online as well as most of his articles in JMPT, http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmedCmd=SearchTerm=%22Keating%20JC%22%5BAuthor%5Ditool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus PubMed and elsewhere. -- Dematt Dēmatt 14:54, 14 June 2008 (UTC)

Many of these comments apply also to History 2.

I have removed from History 2 some of the credit given to B.J., by removing this sentence: "B.J. helped shift chiropractic from craft to profession, by emphasizing formal education, establishing a professional journal in 1904, and founding a professional organization in 1906." This should address the B.J. part of the comment.

Cooper McKee 2003 (PMID|12669653) is being cited about history in the past few decades. That history has not changed.

In a controversial area like this, we are much better off using historical summaries from reliable sources. It's far too easy to pick and choose our own historical tidbits and give a misleading picture. This is supposed to be a summary section, after all: it's better to rely on a reliable source to give us that summary, instead of using our own opinion to decide what's important enough to summarize and what isn't.

I agree Keating is a reliable source on chiropractic history, and he'd be a fine source for Chiropractic History. I suggest his Chiropractic History: a Primer.

Eubulides

19:20, 16 June 2008 (UTC)

I have included information using Keating as a source. At this point, which version do editors prefer. The current mainspace version, history 2, or history 3. QuackGuru20:00, 14 June 2008 (UTC)

I merged some of the suggestions (including using Keating as a source) into History 2. History 2 now covers the same general material as History 2, in what I hope is a more concise and encyclopedic way. History 2 cites the Keating "et al." history primer rather than Keating's individual articles, as I think the primer provides a better overall summary of history. Eubulides19:20, 16 June 2008 (UTC)

History 2 has been improved and now is better than History 3. QuackGuru19:38, 16 June 2008 (UTC)

History 4?

Moving History 2 here with my concerns marked for now.

Chiropractic was founded in the 1890s by Daniel David (D.D.) Palmer in Davenport, Iowa. Palmer, a magnetic healer, hypothesized that manual manipulation of the spine could cure disease. He began teaching it to a few students at his new Palmer School of Chiropractic before being incarcerated for practicing medicine without a license in 1906. His son, Bartlett Joshua (B.J.) Palmer, took over the school, became committed to promoting chiropractic, and rapidly expanded its enrollment.cite journal |journal= Technol Cult |author= Martin SC |date=1993 |volume=34 |issue=4 |pages=808–34 |title= Chiropractic and the social context of medical technology, 1895-1925 |pmid=11623404To survive accusations of practicing medicine without a license, B.J. argued that chiropractic was separate and distinct from medicine, as chiropractors "analyzed" rather than "diagnosed", and "adjusted subluxation" rather than "treated disease". Early chiropractors believed that all disease was caused by interruptions in the flow of an innate intelligence, a vital nervous energy or life force; chiropractic leaders often invoked religious imagery and moral traditions. They also tapped into the Populist movement, emphasizing craft, hard work, competition, and advertisement, aligning themselves with the common man against intellectuals and trusts, including the American Medical Association (AMA).

thumb|left|141px|B.J. Palmer

With the advent of electrotherapeutical equipment, chiropractors began to include other forms of treatment in their practices. Most early influential chiropractors were "straight" and considered the practice of chiropractic as being a "hands only" practice. However, in 1910 B.J. changed course and endorsed the use of X-rays as a necessary tool for diagnosis; this resulted in a significant exodus from Palmer of the more conservative faculty and students as B.J. was called a "mixer". 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, another sign of chiropractic's gradual acceptance of medical technology, yet again helped swell the mixer ranks. 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. Until 1983, the AMA labeled chiropractic "an unscientific cult" and held that it was unethical for medical doctors to associate with an "unscientific practitioner".cite journal |journal= Am J Public Health |date=1989 |volume=79 |issue=11 |pages=1569–70 |title= AMA policy on chiropractic |author= Cherkin D |pmid=2817179 |pmc=1349822 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.

History 4 is a work in progress

Made a start and feel good about first paragraph... Taking a break for the night. -- Dematt Dēmatt 02:39, 22 June 2008 (UTC)

Okay

This is not a good start or a proposal. QuackGuru18:46, 22 June 2008 (UTC)

Thanks for the vote of confidence :-) I'll keep working on it. Do you have any specific suggestions for improvements? -- Dematt Dēmatt 02:49, 23 June 2008 (UTC)

There already is a finished History draft. Please review the completed History 2 and provide specific suggestions for improvements. That's my specific suggestion. QuackGuru06:22, 23 June 2008 (UTC)

History 4? omits the last paragraph of History 2; I assume that is inadvertent.

Not inadvertant. Didn't want to bite off more than I could chew. -- Dematt Dēmatt 03:52, 24 June 2008 (UTC)

Ah, then I take it that there's no huge objection to the last paragraph (i.e., huge enough to delete it without any comment....). Eubulides07:02, 24 June 2008 (UTC)

Oh,no, sorry.. I didn't consider that it would look that way. I'm sure we can work with that paragraph, too. -- Dematt Dēmatt 15:23, 24 June 2008 (UTC)

I agree with removing the "no formal education" from History 2; it's not important enough to be worth emphasizing here.

Agree. -- Dematt Dēmatt 03:52, 24 June 2008 (UTC)

I agree with removing "21-year-old", for similar reasons.

Good news. -- Dematt Dēmatt 03:52, 24 June 2008 (UTC)

I disagree with removing the point that B.J. was D.D.'s student.

I'm okay with that. -- Dematt Dēmatt 03:52, 24 June 2008 (UTC)

I agree with replacing "gained control of" with "took over".

We're on the same page so far. -- Dematt Dēmatt 03:52, 24 June 2008 (UTC)

I agree with moving the "To survive accusations" sentence up to just after the "took over" sentence.

Makes more sense there. -- Dematt Dēmatt 03:52, 24 June 2008 (UTC)

I disagree with removing the trade-secret issue; that's more important.

You might be right. It's the word 'trade secret' that sticks out at me considering that there really wasn't a trade. Keep an open mind on this and see if there is another source that uses something similar? Otherwise, I'll agree to stick with 'trade'. -- Dematt Dēmatt 03:52, 24 June 2008 (UTC)

Good catch. The source says "Initially, D. D. Palmer was reluctant to publicize his discovery, hoping to keep it a 'family secret.'". I have changed "trade secret" to "family secret" to match the source better. Eubulides07:02, 24 June 2008 (UTC)

That feels better ;-) -- Dematt Dēmatt 15:23, 24 June 2008 (UTC)

I disagree with ending D.D.'s career at the Palmer School with "before being incarcerated for practicing medicine without a license in 1906". This gives a misleading impression that D.D. had to give up control of Palmer because he was jailed. That's not what happened: he got into a fight with B.J. I don't think the incarceration is that important (it would be more relevant to cite the fight between D.D. and B.J., but I don't think that's so important either, in the big scheme of things we're reporting here).

Hmmm. You're interpretation is unusual. We might have some sources that disagree, likely because only DD and BJ know for sure. No doubt there was bad blood, but I've never read that it was the reason BJ's wife bought the college for $2000. Let's keep looking. -- Dematt Dēmatt 03:52, 24 June 2008 (UTC)

Keating "et al." 2005, the cited source, says (on page 11), "B.J. featured his father as a “Martyr to His Science” in the pages of "The Chiropractor", but when the elder Palmer finally paid the fine and was released after several weeks behind bars, the friction between father and son reached a pinnacle. They negotiated a settlement of their shared property, and the elder headed for Medford, Oklahoma, where his brother Thomas was in business. For a while, the father of chiropractic once again operated a grocery store, but by 1907 had established yet another school, this time in partnership with Alva Gregory, M.D., D.C. The school survived for several years, but D.D. Palmer again found it difficult to share leadership, and left the Palmer-Gregory College of Chiropractic for greener pastures." Eubulides07:02, 24 June 2008 (UTC)

But we still make a jump to assume either one, right. Maybe there is a way we can state both NPOV and let the reader decide. Realistically, the times were tough and things were stressful. I imagine both did play a role. Incarcerations were a very important part of chiropractic history and DD was one of the first making a statement by going to jail. He ended up paying the bail and getting out early. BJ was charged but never tried, but he never practiced again - only taught (no law against teaching) according to Lerner. Once DD saw how BJ was able to make it work, he wanted back in, but that wasn't going to happen. Instead DD opened many schools across the midwest, California, and Oregon - some of the biggest mixer schools in the country. BJ, along with Tom Morris successfully developed the straight philosophy defense that arguably "saved" the profession. This is what perpetuated the "vitalistic approach" and even considering "religion" as a protection from persecution. We can't mention religion without presenting these factors if we want to give the reader the whole story. You can't separate the two, because it is likely that one would not have happened without the other. -- Dematt Dēmatt 15:23, 24 June 2008 (UTC)

BTW, "The Chiropractor" was the periodical that BJ and DD created. BJ had publicly called his father a Martyr because the profession was being persecuted, they were losing the battle. When DD couldn't do the whole jail sentence, he was a beaten man. We will never know what happened between BJ and his father, but BJ's wife bought DD out. The school that BJ was left with was broke and had very few students. The profession was almost defunct. -- Dematt Dēmatt 15:52, 24 June 2008 (UTC)

History 2 does not assume either one. It does say that B.J. made the school grow. Is any specific improvement being proposed here? Eubulides21:18, 24 June 2008 (UTC)

The incarcerations are integrally entwined in the religious aspect. We shouldn't mention one without mentioning the other. If we want to keep it short and sweet it works without either, but if we want to mention one, we have to mention both. Also, I agree that DD's career did not end there, but that is where he lost control of the school. Everything else he did was an effort to regain control of the profession, but he was not as influential as others from that point on. I'm not sure that we need to meniton him from that point on in the short and sweet version. -- Dematt Dēmatt 12:45, 25 June 2008 (UTC)

OK, I added a brief discussion to History 2 of the prosecutions for practicing medicine without a license. Eubulides23:38, 25 June 2008 (UTC)

I disagree with removing "that represented God's presence in man". Both D.D. and B.J. believed that innate intelligence was a fraction of the Almighty.

I'm not sure we can be sure what DD or BJ believed. One thing for sure, they both wanted control of the profession and making it vitalistic would keep it in their hands. DDs ultimate life force was Universal Intelligence which is not really a God per se. Though, no doubt some interpreted it this way. Again, we might have to compare some sources. -- Dematt Dēmatt 03:52, 24 June 2008 (UTC)

The cited source (Martin 1993, PMID|11623404) says (p. 812), "At its inception chiropractic explicitly addressed considerably broader issues than etiology, diagnosis, and therapeutics. For chiropractors innate intelligence was more than a mysterious life force, it represented God's presence in man." This is a reasonable summary of D.D.'s theory that Innate Intelligence was a fraction of Universal Intelligence; the difference between "Universal Intelligence" and "God" is not a great one, and they are often equated. See, for example, http://www.jcca-online.org/client/cca/JCCA.nsf/objects/Commentary+The+meanings+of+Innate/$file/3-Commentary%20Keating.pdf Keating 2002 which simply says "II was proposed as a fraction of Universal Intelligence (God)". Eubulides07:02, 24 June 2008 (UTC)

I'm not sure where Martin is getting his information so I can't speak to that, but Keating discussed DD Theories in detail, considering the concepts that I stated above. From his http://www.chiro.org/Plus/History/navigate.html "DD Palmer's Forgotten Theories of Chiropracic":

"Despite the vital-magnetic background which led him to chiropractic, Palmer's first theory of chiropractic offered mechanical rather than spiritual metaphors; the human was construed as a machine that would operate smoothly, without friction, if all parts were in their proper place. Not until 1904 do distinctions between "innate" vs. "educated" nerves appear in his publications, and not until 1906 does "innate" become a distinct personality, Innate Intelligence. Old Dad Chiro may not have equated Innate Intelligence with Universal Intelligence (God) "'until after his conviction and incarceration in Scott County Jail in 1906"'(emphasis mine). Eventually, his religious platform was offered to provide legal protection to chiropractors under the religious exemption clauses in many medical practice acts."

I think it important that we capture this concept in anything that we write as well. -- Dematt Dēmatt 15:23, 24 June 2008 (UTC)

Martin is talking about early chiropractors in the 1900s range; your source is distinguishing them from the much smaller set of "earliest" chiropractors in the 1890s range. I don't object to a brief summary of the very-earliest theory, but the more-influential 1900s theory should be emphasized. Eubulides21:18, 24 June 2008 (UTC)

They also are entwined in the prosecutions - 15,000 in 20 years from 1904 to 1924. What period is your source talking about? -- Dematt Dēmatt 13:17, 25 June 2008 (UTC)

Approximately 1900 to 1910. I added something about prosecutions to History 2. Eubulides23:38, 25 June 2008 (UTC)

I disagree with removing "and B.J. seriously considered declaring chiropractic a religion, deciding against it partly to avoid confusion with Christian Science". It's worth emphasizing the importance of religion of early chiropractic (as this is quite different from the role of religion in chiropractic now, and is not discussed elsewhere in the article).

They were accused of being a religion, but never saw anyone saying they were. During the years of trying to keep chiros out of jail, DDs letter suggests he was wanting to go the way of Christian Science so that they could be protected from Medicine and of course he could be the leader (and get the school from BJ), but obviously BJ wouldn't go for that. Of course, I'll give way to reliable sources. -- Dematt Dēmatt 03:52, 24 June 2008 (UTC)

The text does not say chiropractic was a religion; it merely said that B.J. considered making it one. The source here is Martin 1993, which says "One important rival was Christian Science, which had successfully established itself as a religion. Establishing chiropractic as a religion had the potential advantage of providing legal protection under the Constitution. It would also underscore the philosophical and spiritual underpinnings of chiropractic, and both D.D. and B.J. Palmer seriously considered declaring chiropractic a religion before deciding against it, in part to avoid confusion with Christian Science." This in turn cites Catherine Albanese, "Nature Religion in America" (1991), chapter 4; and B.J. Palmer, Lecture Notes, October 21, 1908, page 4. I see now that both D.D. and B.J. considered making chiropractic a religion (not just B.J.), so I added D.D. to History 2 here. Eubulides07:02, 24 June 2008 (UTC)

same argument as above. These can all probably be worked together. -- Dematt Dēmatt 15:23, 24 June 2008 (UTC)

I disagree with removing "a minority," from the 2nd paragraph. Mixers did start out being a minority. Also, removing the phrase makes the sentence ungrammatical.

How do you know mixers were a minority... ever? Most of DDs first students went on to start mixer chiropractic colleges. Solon Langsworthy started the mixer school right after he graduated... It was only after 1902 that DD even coined the phrase mixer to describe those like Solon. I'm not sure we can reliably say there was ever a minority of mixers. -- Dematt Dēmatt 03:52, 24 June 2008 (UTC)

The cited source (Martin 1993) says (p. 821), "Prior to the introduction of spinography, a minority of chiropractors had already advocated broader use of technology. Scornfully dubbed 'mixers' by B. J. Palmer, these chiropractors accepted machines as valuable adjuncts to chiropractic diagnosis and treatment." Spinography was introduced in 1910, so mixers as a minority must predate 1910. Eubulides07:02, 24 June 2008 (UTC)

You are assuming that the "minority of chiropractors" is used to refer to only mixers. It could have been a minority of all chiropractors. It really says nothing as to whether mixers were either a minority or a majority. -- Dematt Dēmatt 15:23, 24 June 2008 (UTC)

When the cited source talks about "these chiropractors" who were "scornfully dubbed 'mixers'", it is clearly referring to the "minority of chiropractors" it mentions in the previous sentence. Eubulides21:18, 24 June 2008 (UTC)

It is saying a "minority of chiropractors", not "the minority mixers"; not clearly saying mixers were the minority. Keating 2005 even says http://data.memberclicks.com/site/ahc/ChiroHistoryPrimer.pdf BJ was dubbed a mixer (on page 26) after suggesting spinography. Mixer was an obscenity to straights, that didn't say anything about how many there were. -- Dematt Dēmatt 13:17, 25 June 2008 (UTC)

It is saying that the "minority of chiropractors" were called "mixers". But to forestall future discussion I removed the "minority" from History 2; it's not that big a deal. Eubulides23:38, 25 June 2008 (UTC)

The ((really)) and :Template:fact in the 2nd paragraph aren't needed; the source (Martin) makes the point explicitly.

Again, those were notes for me to verify, I also thought they were interesting.

I changed History 2 to incorporate the above bullet points.

It's much better. -- Dematt Dēmatt 03:52, 24 June 2008 (UTC)

These are all the points I see in History 4? so far; if I missed any, please let me know.

Eubulides

08:18, 23 June 2008 (UTC)

That's it so far. I didn't get to work on it today, but I still have concerns about paragraph two that I'll work with and we can work it this way. I don't feel comfortable changing your work directly as we tend to lose what was there and we may want to go back to it. -- Dematt Dēmatt 03:52, 24 June 2008 (UTC)

I've responded to your more-recently elucidated concerns above, and as mentioned have in some cases edited History 2 accordingly. Hope this helps. Eubulides07:02, 24 June 2008 (UTC)

Thanks, hope my responses help as well. -- Dematt Dēmatt 15:23, 24 June 2008 (UTC)

Thanks, I modified History 2 further after reviewing your more recent tweaks. Eubulides23:38, 25 June 2008 (UTC)

These http://en.wikipedia.org/w/index.php?title=Talk:Chiropracticdiff=nextoldid=221647891 tweaks makes the sentences vague. This is exactly what we should avoid doing. This reminds me of the problems with the philosophy section. Vagueness is not good. There is a story to tell and the readers should be able to understand the story. Vagueness will cause a lack of understanding for the reader. QuackGuru16:33, 25 June 2008 (UTC)

I'm sorry: if I'd known I would take so long and have so few comments, I wouldn't have asked people to wait. I've made a couple of little changes (punctuation etc.) in History 2 and History 4; I changed "hailed" in History 4 because "hailed" has very positive connotations but the context seems to call for a negative word such as "derided"; I put the neutral "called".

Good point. The source does say hailed, but the positive was definitely not what was meant. ur problem with either version is that we have not introduced mixer or straight before we made this statement. BJ was the leader of the straights since his father was ousted. Of course there were straights who didn't liked DD better, so when BJ made the move toward instruments, this was there chance to deride him and call him a "mixer", which was a bad word to straights. BJ managed to convince them that it was okay to use instruments for "diagnosis" as long as they didn't for "treatment". This value still holds today and is probably important. Can you make the sentences portray that? Go for it. -- Dematt Dēmatt 02:25, 29 June 2008 (UTC)

We'd need a source for all that. I don't think B.J. managed to convince all the straights in 1910 re X-rays; there were significant defections even then. 1924 and the neurocalometer was worse in that regard, of course. Eubulides02:40, 29 June 2008 (UTC)

I don't think all that is needed in the article, that was just history for Coppertwig so he can see if he could come up with something compatible. Of course, I wouldn't be able to repeat it if I hadn't read it somewhere, but more importantly, I've never seen Coppertwig write anything he didn't have a reference for anyway. ;-) -- Dematt Dēmatt 04:21, 29 June 2008 (UTC)

I think it's significant that there were multiple incarcerations of chiropractors and that this should be mentioned: e.g. "Prosecutions and incarcerations" or "Incarcerations" rather than just "Prosecutions". However, "Prosecutions" as in History 2 is better than just "accusations" as in History 4. ""before being incarcerated"" in History 4 makes it sound (to me) as if D.D. was incarcerated for much longer than 23 days: it makes it sound as if the incarceration itself directly caused the end of his teaching career. I think it's more important to mention multiple incarcerations than to mention the incarceration of D.D.

I agree this important and would be interested to see how you would incorporate this. Go for it in History 4 and if Eubulides likes it, he will put it in History 2. -- Dematt Dēmatt 02:25, 29 June 2008 (UTC)

We have a source for "prosecutions" (lots of 'em) but not "incarcerations". I think "prosecutions" suffices. Eubulides02:40, 29 June 2008 (UTC)

Oh, there are sources for incarcerations! Pictures even - of chiros standing at the jailhttp://chiro.org/Plus/History/Persons/Jail/Reaver_behind-bars.pdf , Reaver was jailed the most (13 arrests, 12 convictions, 4 terms in jail in Cincinnati” (Dzaman et al., 1980, p. 203)) and http://chiro.org/Plus/History/Persons/Jail/Reaver_jail-protesters.pdf patients picketing the jails to release their doctor. Yeah, there are references for that one. -- Dematt Dēmatt 04:30, 29 June 2008 (UTC)

I agree with Dematt that apparently the religious aspects may not have been present from the beginning and may have been introduced in order to protect against accusations of practicing medicine without a license. I disagree with the phrase "Early chiropractors believed ..." in History 2: I think we don't know what they actually believed. It could be changed perhaps to "Early chiropractors talked of..." except that according to the source Dematt quotes, they may not have talked in this religious way from the very beginning, so that could still be misleading. Something could be added along the lines of ""which would have added the potential advantage of providing legal protection under the U.S. constitution"" to show that this may have been their motivation. I think it's more significant to mention this motivation for considering making it a religion, than to mention Christian Science, which seems to me relatively unimportant in this context.

I felt the same way and did make a change to the article version almost the same way you describe. Eubulides made an acceptible change to it as well. If you can improve, feel free to give it a try. -- Dematt Dēmatt 02:25, 29 June 2008 (UTC)

In some places, there are unnecessary ref tags: if consecutive sentences are all based on the same source, the ref tag is needed only at the end of the last sentence.

The first two sentences of paragraph 2 in History 4 don't seem to me to add any significant information in comparison to the shorter version of this passage in History 2. ☺ Coppertwig22:44, 28 June 2008 (UTC)

Yes, I wasn't finished there and had to return to the SYN discussion for awhile. My intention there was to try to follow the source that was showing how medical technology was an important feature that applied pressure to straights and helped to create a large mixer group - though I hadn't figured the best way to introduce the mixers yet ;-) Feel free to help me think it through. -- Dematt Dēmatt 02:25, 29 June 2008 (UTC)

I suspect part of the reason Coppertwig has seen so few comments is that I mostly commented by putting the good stuff into History 2 and QuackGuru move it to Chiropractic History.

The prosecution point is a good one, and I moved it into Chiropractic History which says "Prosecutions of chiropractors for practicing medicine without a license grew common, and to defend against them...". This detail is absent from History 4? and should suffice to motivate why chiropractors needed a legal defense.

The text does not say that chiropractors promoted a religious view from the beginning; it says only "early chiropractors", and 1910 qualifies as early.

If we can find a reliable source saying that the religious views were present for legal protection, I suppose we could make that point. It sounds like a tough point to prove, though. D.D.'s 1911 doesn't prove it.

I don't agree that we should put in weasel words to the effect that early chiropractors "said" they were religious but they may not been telling the truth, for the same reason that similar weasel words are not necessary when describing the belief of early Christians (see Comments on History 2), or early Communists for that matter.

Wording along the lines of "providing legal protection" has been added to Chiropractic History.

As the new citation to D.D.'s 1911 letter demonstrates, the mention of Christian Science is entirely apropos here.

I agree with you about consecutive ref tags, and feel free to remove the duplicates; but from past experience I expect to see "fact" tags added later.

Some nice things in History 4?:

X-rays "as a necessary tool" for diagnosis; good point, and I've merged that into ChiropracticHistory using more-concise wording "necessary for diagnosis", so I hope this point is moot now.

Some things missing from History 4?:

D.D. initially kept chiropractic a secret.

B.J. was D.D.'s student.

Innate intellegence was thought to be God's presence in man.

D.D. and B.J. seriously considered declaring chiropractic a religion.

D.D. called early chiropractors who advocated use of instruments "mixers".

Explanation that a neurocalometer is a temperature-sensing device. We can't expect the reader to know what a neurocalometer is.

Mentioning that neurocalometers were highly controversial.

Some questionable things in History 4?, for which no source is cited:

"With the advent of electrotherapeutical equipment, chiropractors began to include other forms of treatment in their practices."

"considered the practice of chiropractic as being a 'hands only' practice"

"B.J. was called a 'mixer'"

"yet again helped swell the mixer ranks". Not only is this unsourced, it's not a sentence.

Eubulides

02:40, 29 June 2008 (UTC)

Comments on moving information

"Objective Straight" chiropractors, who were an off-shoot of straights, only focused on the correction of chiropractic vertebral subluxations while traditional straights claimed that chiropractic adjustments are a plausible treatment for a wide range of diseases.cite web |url=http://www.f-a-c-e.com/positionpaper1.htm |title=Position Paper One — What is Objective Straight Chiropractic? |accessdate=2008-03-24 |publisher=Foundation for the Advancement of Chiropractic Education (F.A.C.E.) "Reform" chiropractors were an evidence-based off-shoot of mixers who rejected traditional Palmer philosophy and tended not to use alternative medicine methods.cite journal |author= Mirtz TA, Long P, Dinehart A "et al." |title=NACM and its argument with mainstream chiropractic health care |journal=J Controv Med Claims |date=2002 |volume=9 |issue=1 |pages=11–8 |url=http://www.accessmylibrary.com/coms2/summary_0286-25525357_ITM

I suggest we move this information back to the Schools of thought and practice styles section. QuackGuru18:23, 14 June 2008 (UTC)

This material doesn't belong under Chiropractic Schools of thought and practice styles, as those groups are no longer active. A good place for this material is Chiropractic history. Eubulides19:20, 16 June 2008 (UTC)

I think this material is interesting information for ChiropracticSchools of thought and practice styles, as this is part of the schools of thought. QuackGuru00:33, 17 June 2008 (UTC)

Do we have any sources that shows that these groups still exist (by name)? DigitalC03:38, 17 June 2008 (UTC)

The section is about Schools of thought and practice styles. This is part of the schools of thought. I used the correct tense in the sentences. For example, who "were" an off-shoot of straights... The word were makes it clear to the reader. QuackGuru08:03, 17 June 2008 (UTC)

It is very strange to be citing the web sites of seemingly-nonexistent organizations to demonstrate the current importance of their philosophies. This material is not that relevant to the "current" state of chiropractic. It is of relatively minor historical interest at this point. It belongs in Chiropractic history, not in the current section. Eubulides16:57, 17 June 2008 (UTC)

article improvements

ref improvement

cite journal |author= Keating JC Jr |journal= Skept Inq |volume=21 |issue=4 |pages=37–43 |url=http://www.encyclopedia.com/doc/1G1-19727577.html |title= Chiropractic: science and antiscience and pseudoscience side by side |date=1997 |accessdate=nbsp;• cite paper |author= Keating JC Jr |url=http://www.sherman.edu/research/rsch510/FaultyLogic-in-Chiro.pdf |format=PDF |title= Faulty logic non-skeptical arguments in chiropractic |date=1997 |accessdate=

The Keating 1997 ref has the final version of the article but the orginal version is readable and requires no signup. I suggest we combine both refs together. QuackGuru19:16, 14 June 2008 (UTC)

I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=219749806oldid=219613588 changed the URL to a different one that requires no signup. Odd; the old one didn't require me to sign up; I guess it depends on the IP address of the reader or something. Thanks for pointing out the problem. Eubulides19:20, 16 June 2008 (UTC)

long run on sentence

"...but retains a holistic approach and an emphasis on manual therapy." I suggest we remove the last part of the long run on sentence in the ChiropracticVertebral subluxation section. QuackGuru19:16, 14 June 2008 (UTC)

Is est a expertus intended parumper imprimis user. Is rudimentum impetro a panis of three reverto sceptrum. EGO puto user sentio proprietas of page. "'Commodo"' operor non take esca. --Samuel Pepys20:40, 14 June 2008 (UTC)

Gratias ago vos. EGO diligo vestri changes. Vestri consultum est bonus quoque. EGO mos operor meus optimus sumo vestri consultum. -- Dematt Dēmatt 00:45, 15 June 2008 (UTC)

unreferenced sentence

Chiropractors are also generally permitted to use adjunctive therapeutic modalities such as acupuncture and manipulation under anesthesia with additional training from accredited universities/colleges.citation needed

This unreferenced sentence requires a reference or it could be deleted soon. QuackGuru07:41, 16 June 2008 (UTC)

It's been tagged for weeks, with no progress on finding a source. For now I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=219753445oldid=219749806 removed it. It can be re-added later if someone finds a good source. Eubulides19:20, 16 June 2008 (UTC)

I think it would be hard to find a good source that chiropractors are "Generally permitted" to do anything. However, if we think that acupuncture is worth adding to the article, we could add that "As a result of the professional and public demand for acupuncture by doctors of chiropractic, 37 states have enacted legislation or regulated the practice through their respective state boards of chiropractic examiners. Acupuncture is clearly a vital part of the chiropractic profession."

cite web |url=http://www.chiroweb.com/archives/22/18/01.html |title=Why Every Full-Scope DC Should Practice Acupuncture/Meridian Therapy |publisher=www.chiroweb.com |accessdate=2008-06-17 . Or that, "About 10 percent of chiropractic clinicians perform acupuncture, and approximately 66 percent perform acupressure or meridian therapy" cite web |url=http://www.chiroweb.com/archives/19/11/01.html |title=CHIROWEB | DC Archives - (DCs Who Perform Acupuncture -Turf War, or Question of Training?) |publisher=www.chiroweb.com |accessdate=2008-06-17 . DigitalC07:20, 17 June 2008 (UTC)

The first is way too promotional. The second is not really a scope-of-practice statement or source; it's more suitable for Chiropractic Treatment procedures. Also, that source simply cites another source for the information in question; we should simply cite the original source. Eubulides08:29, 18 June 2008 (UTC)

Good idea, perhaps we should have in SOP that "37 states have regulated the practice of acupuncture by Chiropractor", while in Treatment procedures, we include the information about percentage using acupuncture or acupressure. DigitalC01:16, 23 June 2008 (UTC)

duplication in Scope of practice

"Chiropractors may further specialize in fields such as Chiropractic Orthopedics (DABCO), Chiropractic Radiology (DABCR), and Chiropractic Sports Physician (DABCSP) by completing additional study and passing the specified boards that are separate and distinctly different than medical boards."cite web |url=http://www.amerchiro.org/pdf/ApprovedChiropracticSpecialtyPrograms.pdf |format=PDF |title=Approved Chiropractic Specialty Programs |accessdate= |date= |publisher=American Chiropractic Association

The above has some duplication with regard to chiropractors can further specialize in fields such as orthopedics and radiology. QuackGuru19:14, 16 June 2008 (UTC)

It would be helpful if you would propose specific wording changes, briefly, so that other editors can easily understand the proposal. It's less helpful to merely copy big chunks of text into the talk page along with brief critical comments. For more on this topic, please see Comments on Philosophy rewrite below. Eubulides19:20, 16 June 2008 (UTC)

I think the entire above sentence (beginning with "Chiropractors may further specialize...") is duplication. It is the same information as the previous sentence only reworded. I suggest deleting it. QuackGuru06:34, 27 June 2008 (UTC)

I agree that it is duplication and should be removed. Hmm, I see you already removed it; that was a bit hasty. Eubulides07:53, 27 June 2008 (UTC)

Syn tag

In response to this http://en.wikipedia.org/w/index.php?title=User_talk:Demattcurid=4817601diff=220349971oldid=220285802 comment: SMT is the centerpiece of chiropractic. If there is other information missing from the effectiveness section then bring on the appropriate references or remove the http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=218378837oldid=218251415 Syn tag. QuackGuru16:20, 19 June 2008 (UTC)

Is there any statements in there drawing from conclusions made from research about Spinal Manipulation in general or as performed by practitioners other than just chiropractors? If so, usage of such statements present a clear SYN violation and thus should be removed (even if we express that this is about SMT in general). Until then, removing the SYN tag would be - IMHO - wholly unjustified. -- Levine211219:56, 19 June 2008 (UTC)

This argument has come up several times before, e.g., Talk:Chiropractic/Archive 18 Specific to chiropractic?. The objection is that Chiropractic should cite only studies derived entirely from chiropractic data. However, this objection disagrees what reliable sources say and do. Here are two examples:

http://annals.org/cgi/reprint/137/8/701.pdf Haldeman Meeker 2002 write, "We agree that many of the randomized trials we described were on spinal manipulation rather than specifically on chiropractic manipulation itself, but we believe that this is not a significant point. Chiropractors use all forms of manipulation. In the United States, more than 90% of all spinal manipulation services are provided by chiropractors, and research on spinal manipulation, like that on any other treatment method, is equally of value regardless of the practitioner providing it."

The http://ccgpp.org/lowbackliterature.pdf 2007 CCGPP literature synthesis of chiropractic management of low back pain, a document written by and for chiropractors, cites sources derived from non-chiropractic data. For example, it cites Aure "et al." 2003 (PMID|12642755) to support manual therapy for low back pain, even though Aure "et al." specifically disallowed chiropractic manipulation.

No recent reliable sources have been found that criticize the practice of using data derived partly from non-chiropractic sources to assess the effectiveness or safety of chiropractic treatments. In short, I don't know why that SYN tag is present, and its presence needs to be justified better. Eubulides20:28, 19 June 2008 (UTC)

It's quite simple really. If we have a source doing the synthesizing for us - such as Haldeman Meeker - then by all means, we can cite Haldeman's analysis of those general, non-chiropractic-specific SMT studies. However, to go ahead and apply Haldeman et al's rationale to all non-chiropractic-specific SMT studies constitutes a SYN violation. Think of it this way: Haldeman says that the randomized trials "'he"' described were on spinal manipulation rather than specifically on chiropractic manipulation itself but he believes that this is not a significant point. Let's call Haldeman's conclusion "Statement A". Then let's take another independent reviewer of SMT (as performed by osteopaths and PTs) who found that SMT is beneficial with treating lower back pain. Let's call this conclusion "Statement B". Now then, by using only Statements A and B in our article to claim that chiropractic adjustments are beneficial with treating lower back pain absolutely creates a SYN violation. Because the only way we can derive such a conclusion is through combining two bits of separate information (since "B" shows that SMT is effective for such-and-such and since "A" says that there is no significant difference between chiropractic adjustments specifically and SMT in general; therefore chiropractic adjustments must be effective for such-and-such). That's textbook synthesis. With this in mind, I encourage you all to re-read SYN. The Smith and Jones/Chicago Manual of Style example given there is nearly identical to the situation we have here.

Okay. What about the argument that I've read that says, "But we aren't saying that Chiropractic is effective or not effective based on these studies. We are only talking about SMT in general"? My response is that if you are not talking about chiropractic specifically, then it shouldn't be in this article. If it is about SMT in general, then it can go in the spinal manipulation article. Putting conclusions here about SMT in general will lead readers to associate those conclusions with chiropractic specifically. And hence, once again, a SYN violation. -- Levine211222:13, 19 June 2008 (UTC)

This argument would make sense if there were a "Statement B" in Chiropractic. But I don't know of any "Statement B". Chiropractic's sources for statements about SMT are backed by studies that include chiropractic data. For example, consider Ernst Canter 2006 (PMID|16574972), a controversial and critical review of SMT. Its sources are derived from chiropractic data as well as from non-chiropractic. Its results are highly relevant to chiropractic, as can be seen (for example) in comments about it in Bronfort "et al." 2008 (PMID|18164469), a source which is written by chiropractors and from the chiropractic point of view. It would not be right for us to cite Bronfort "et al." and not Ernst Canter, as that would introduce POV by citing only the supportive-of-chiropractic side. It would be equally wrong to cite neither source: both sources are of high quality and are highly relevant to the topic of the effectiveness of chiropractic care. Eubulides23:22, 19 June 2008 (UTC)

Does Ernst and Canter draw any conclusions specifically about chiropractic? Are the statements which we are sourcing from Ernst specifically about chiropractic? If the answer is no, then we cannot use the source to make any conclusions about chiropractic. At the same time, if Bronfort is using Ernst to draw conclusions about chiropractic, then Bronfort can arguably be used. Still, Ernst cannot be used. It's not a matter of POV being unbalanced. And to "balance" what you deem an inequity would not require us to cite Ernst because that would introduce a SYN violation. Of course, if we were to cite some source which uses Ernst to draw negative conclusions about chiropractic specifically, then that can arguably be used. However, be aware that this line of thinking of yours confuses NPOV. NPOV is not a matter of balancing every positive statement with a negative one. Rather it is a matter of representing all significant viewpoints fairly, proportionately and without bias. If there is no viewpoint (from an RS of course) which uses Ernst to highlight something negative about chiropractic, then we are in no way required to omit or balance a viewpoint which uses Ernst to highlight something positive. -- Levine211223:33, 19 June 2008 (UTC)

Oh, and as for a Statement B being used to draw a conclusion C about chiropractic specifically even though the source behind Statement B is not specifically about chiropractic but rather SMT in general - Hmm, let's just pick one at random. Okay, how's this one from "Low Back Pain": "A 2007 U.S. guideline weakly recommended SMT as one alternative therapy for spinal low back pain in nonpregnant adults when ordinary treatments fail..." Okay this one isn't even about chiropractic. It's about SMT in general. So what is it doing in this article? Let's look at http://annals.org/cgi/content/full/147/7/478 the source. The only mention of chiropractic there is this: "The evidence is insufficient to conclude that benefits of manipulation vary according to the profession of the manipulator (chiropractor vs. other clinician trained in manipulation) or according to presence or absence of radiating pain." That's it! There's no other mention of chiropractic in the entire research and recommendations. So again, why are we using this material here in this article? The only basis which you have provided for using non-chiropractic specific sources such as this has been based on what Haldeman and others say - that there is no significant difference in SMT as performed by chiropractors and other practitioners. That's SYN. And, funny enough, this randomly selected low back pain research even says that the evidence is insufficient to conclude that benefits vary from one practitioner to another. So even if we could ignore SYN to justify inclusion of general SMT studies, well here's an opinion which says that there is not enough evidence to make such synthesis. -- Levine211223:49, 19 June 2008 (UTC)

Eubulides wrote - "The 2007 CCGPP literature synthesis of chiropractic management of low back pain, a document written by and for chiropractors, cites sources derived from non-chiropractic data. For example, it cites Aure et al. 2003 (PMID|12642755) to support manual therapy for low back pain, even though Aure et al. specifically disallowed chiropractic manipulation.". Authors elsewhere are not bound by SYN. However, editors here are. Just because synthesis occurs in the literature, doesn't mean it can be done here. SYN is a type of OR, and OR is obviously acceptable in the literature - however, that wouldn't make it ok for us to start using OR. I absolutely agree with Levine2112 that this is a violation of SYN. That was my whole reason for supporting Effectiveness 3C - it was free of SYN violations. Again, I support the creation of an effectiveness section over at Spinal manipulation (and hopefully other articles, for effectiveness of LLLT and US etc), and having that wikilinked from the effectiveness section of Chiropractic. For clarification, from SYN "...if the sources cited are not directly related to the subject of the article, then the editor is engaged in original research." - The sources here are not directly related to Chiropratic, they are directly related to Spinal manipulation, as such it is a SYN violation. DigitalC00:49, 20 June 2008 (UTC)

For clarity, from SYN "if the sources cited are not directly related to the subject of the article, then the editor is engaged in original research." The reliable sources we are citing are "directly" related to chiropractic. Spinal manipulation is the centerpiece of chiropractic, as such it is NPOV. We are following the lead of the expert reviewers. QuackGuru01:30, 20 June 2008 (UTC)

Incorrect. Using general SMT studies to tell about the effectiveness of chiropractic specifically is - in essence - saying that the two are one in the same. Now some expert reviewers say this is true. But if we were to follow their lead - as you say - and apply their opinion here to all SMT studies to draw a conclusion in this article about chiropractic, then we would clearly be in violation of SYN, in that we are taking what some researchers say to do with their research (Source A) and then we are using this advice to analyze wholly different pieces of research (Source B) and synthesizing the two together to make an original statement in our article (Conclusion C) - it's textbook SYN. QED. -- Levine211201:41, 20 June 2008 (UTC)

I'm moving to history, but, yes, Levine and DigC described the reason I put the tag on pretty well. I don't see any reason to waste too much energy here, yet. I'll take a look at history tomorrow. -- Dematt Dēmatt 03:24, 20 June 2008 (UTC)

For outside observers, spinal manipulation is related to chiropractic.

For clarity, from SYN "if the sources cited are not directly related to the subject of the article, then the editor is engaged in original research." The reliable sources we are citing are "directly" related to chiropractic. Spinal manipulation is the centerpiece of chiropractic, as such it is NPOV. We are following the lead of the expert reviewers.

http://en.wikipedia.org/w/index.php?title=Talk%3AChiropracticdiff=220478573oldid=220477209 Incorrect? How is the above comment incorrect? No specific explanation has been given. How is it clearly a violation of SYN?

I know spinal manipulation is related to chiropractic. What is source A and what is source B and where is conclusion C? Vague comments makes no sense.

What are the original statements? Everything is verified and accurate.

Dematt wrote in part: http://en.wikipedia.org/w/index.php?title=User_talk:Demattcurid=4817601diff=220349971oldid=220285802 There are too many factors to leave it to one drug that they use to treat one condition. That is what we are doing with chiropractic. Chiropractic care is not SMT. We are synthesizing sentences together to make it look that way.

What are the too many factors? How are we synthesizing sentences together to make it look that way?

Please explain specifically or remove the Syn tag. Which specific sentences are synthesis.

Spinal manipulation is the most common modality in chiropractic care. No? QuackGuru06:28, 20 June 2008 (UTC)

We are not talking about NPOV here QG, we are talking about SYN. A source that is discussing SMT, and not mentioning Chiropractic is NOT directly related to Chiropractic, it is directly related to Spinal Manipulation. Whether or not SMT is the most common modality in chiropractic care is a strawman argument. DigitalC07:54, 20 June 2008 (UTC)

How is it a strawman argument when chiropractors perform spinal manipulation on their patients. This is easy to understand spinal manipulation is related. QuackGuru08:08, 20 June 2008 (UTC)

(I think an argument can be made that SMT is not only the thing most frequently done by chiropractors, but also that it is a fundamental, defining characteristic of chiropractors."(Unverified; don't have clear definition of SMT or fraction of chiros who use it 04:40, 26 June 2008 (UTC))" (Are there chiropractors who do not do SMT?) Even if we decide that SMT and chiropractic cannot be considered essentially synonymous, nevertheless they are clearly closely related subjects, as QuackGuru points out, and it may be perfectly valid to collect information about them both within the same article. Perhaps it might help if the SMT effectiveness studies were mentioned under a subheading such as "Effectiveness of SMT" rather than just "Effectiveness", which implies that they're stating a conclusion about effectiveness of chiropractic. I think the SYN argument has considerable validity but am undecided as to what we should do. ☺ Coppertwig 10:57, 20 June 2008 (UTC)

Chiropractors are known for spinal manipulation. Therefore, this is part of writing an encyclopedia. QuackGuru17:02, 20 June 2008 (UTC)

From SYN:

Material published by reliable sources can inadvertently be put together in a way that constitutes original research. Synthesizing material occurs when an editor comes to a conclusion by putting together different sources. If the sources cited "do not" explicitly reach the same conclusion, or if the sources cited are not directly related to the subject of the article, then the editor is engaged in original research. Summarizing source material without changing its meaning is not synthesis; it is good editing. Best practice is to write Wikipedia articles by taking claims made by different reliable sources about a subject and putting those claims in our own words on an article page, with each claim attributable to a source that makes that claim explicitly.

Editors should not make the mistake of thinking that if A is published by a reliable source, and B is published by a reliable source, then A and B can be joined together in an article to come to the conclusion C. This would be synthesis of published material which advances a position, which constitutes original research.Mr. Wales disapproves of synthesized historical theories and states: "Some who completely understand why Wikipedia ought not create novel theories of physics by citing the results of experiments and so on and synthesizing them into something new, may fail to see how the same thing applies to history." (Wales, Jimmy. http://mail.wikipedia.org/pipermail/wikien-l/2004-December/017591.html "Original research", December 6, 2004) "A and B, therefore C" is acceptable only if a reliable source has published this argument in relation to the topic of the article.

A sentence states in SYN: If the sources cited do not explicitly reach the same conclusion, "or if the sources cited are not directly related to the subject of the article", then the editor is engaged in original research.

The last part of the above sentence states: "or if the sources cited are not directly related to the subject of the article" Spinal manipulation is related to chiropractic because it is a commonly performed modality.

The article states: Research has focused on spinal manipulation therapy (SMT) in general,cite journal |journal= Ann Intern Med |date=2002 |volume=137 |issue=8 |pages=702 |title= Chiropractic: in response |author= Meeker WC, Haldeman S |url=http://annals.org/cgi/reprint/137/8/701.pdf |format=PDF rather than specifically on chiropractic SMT.cite journal |journal= Soc Sci Med |date=2005 |volume=60 |issue=3 |pages=545–61 |title= Evidence-based medicine and its implications for the profession of chiropractic |author= Villanueva-Russell Y |doi=10.1016/j.socscimed.2004.05.017 |pmid=15550303

We are following the lead of the expert reviewers and the research we are using has a close relationship to the topic of this article.

Spinal manipulation research is related to chiropractic because chiropractors perform spinal manipulation. Spinal manipulation is related to the subject of the article. It's time to remove the synthesis tag. QuackGuru17:02, 20 June 2008 (UTC)

Incorrect. By "following the lead" of the researchers - as you are saying - and applying their reasoning in their research to other research we find, we are committing a clearcut SYN violation. Some researchers say that the difference between SMT and chiropractic adjustments are negligible. Some say that there is a significant difference. Some say that is unclear whether there is a difference. Who are we to choose which researchers are right? This is an article about chiropractic; not about spinal manipulation and not even about spinal adjustment. The research we use in this article, therefore, should be directly about chiropractic specifically and not about research which may be round-about related to chiropractic according to some researchers who have not specifically commented about said research. Again, if a researcher is specifically drawing conclusions about chiropractic from SMT general research, then fine; use that researcher's conclusions. However, we cannot and will not draw our own conclusions about chiropractic from research not specifically about chiropractic. To do so would be a clear violation of SYN. -- Levine211217:41, 20 June 2008 (UTC)

Spinal manipulation is closely related to chiropractic because chiropractors perform spinal manipulation. We are using research that is related to chiropractic. QuackGuru18:13, 20 June 2008 (UTC)

Bottom line, we would be coming to a conclusion about chiropractic by putting together different sources. Don't forget about the first part of that sentence you keep mentioning in the SYN policy: "If the sources cited "do not" explicitly reach the same conclusion... then the editor is engaged in original research." Behind Door A, we have some researchers saying that it is okay for them to use general SMT research to reach their own conclusions about chiropractic. And behind Door B, we have some general SMT research reaching some conclusions about SMT in general. Now you want to "follow the lead" of the researchers from behind Door A by applying the conclusions about general SMT from behind Door B to chiropractic and thus form an original piece of Research C here a Wikipedia? A SYN violation doesn't get more clearcut than that. "A and B, therefore C" is acceptable only if a reliable source has published this argument in relation to the topic of the article. The topic of this article is Chiropractic, not SMT. Chiropractic does not equal SMT. If it did, we would have cause to merge the articles. -- Levine211223:50, 20 June 2008 (UTC)

Please provided specific examples for "A and B, therefore C" based on the current text in the article. For example, which text is SYN? The conclusions of the sentences are verified using spinal manipulation research that is closley related to chiropractic. I don't see any multiple doors in the information we are using. When spinal manipulation is related to chiropractor we can use spinal manipulation research. QuackGuru00:21, 21 June 2008 (UTC)

Please refer to my sixth and seventh entry to this thread for a specific example of "A and B, therefore C" currently employed in the article. It deals with this statement in the article: "A 2007 U.S. guideline weakly recommended SMT as one alternative therapy for spinal low back pain in nonpregnant adults when ordinary treatments fail..."

BTW, even if there is just the implication of a conclusion "C" without actually some sentence "C", we've committed a SYN. Meaning that by merely including the result of general SMT (non-chiropractic) research in the article based on the borrowed rationale from Haldeman et al. (that in terms of analysis, the difference between chiropractic adjustment research and SMT are not significant), we are implying that these results apply specifically to chiropractic (even though the research was not about chiropractic). That the SYNful conclusion "C". By implying or stating these conclusions are about chiropractic based on non-chiropractic research, we have created original research over and over again and hence we are guilty of original SYN and must be banished from the Garden of WikEdenPedia. ;-) -- Levine211201:36, 21 June 2008 (UTC)

Levine2112 wrote in part: It deals with this statement in the article: "A 2007 U.S. guideline weakly recommended SMT as one alternative therapy for spinal low back pain in nonpregnant adults when ordinary treatments fail..."

The above sentence is statement A. Where is statement B? QuackGuru06:44, 21 June 2008 (UTC)

"Research has focused on spinal manipulation therapy (SMT) in general, rather than specifically on chiropractic SMT." Really look at this statement and the sources from which it is derived. -- Levine211206:50, 21 June 2008 (UTC)

The above sentence is verified and makes it more clear for the reader. QuackGuru07:00, 21 June 2008 (UTC)

Arbitrary section break (SYN cont'd)

(outdent)

I see no clear example of an "A and B, therefore C" in Chiropractic Scientific research. The abovementioned text "A 2007 U.S. guideline weakly recommended SMT as one alternative therapy for spinal low back pain in nonpregnant adults when ordinary treatments fail" is not a "therefore" statement and is not an example.

I just now checked, and the pattern "A with citation and B with citation, therefore C without citation" doesn't occur anywhere in Chiropractic Scientific research that I can see. With one minor exception, every statement in Chiropractic Scientific research is supported by a specific citation. (The minor exception is the linking text "Available evidence covers the following conditions:", which is not controversial.)

"even if there is just the implication of a conclusion "C" without actually some sentence "C", we've committed a SYN". I strongly disagree. Every well-written Wikipedia article has countless implications that a reader can draw, implications that are not explicitly in the text. Often the authors are not even aware of those implications. Let's take today's featured article Phishing, for example. Its section PhishingFilter evasion says "Phishers have used images instead of text to make it harder for anti-phishing filters to detect text commonly used in phishing e-mails." An obvious implication is that filters can work around this problem by altering or deleting messages containing images. But it is not a SYN violation that this implication is neither written down nor sourced in Phishing. There's no way in the world that an author can source every implication of every statement he makes. More generally, it is not a SYN violation to write an encyclopedia article that readers can make inferences from.

"There's no other mention of chiropractic in the entire research and recommendations. So again, why are we using this material here in this article?" Again, I strongly disagree. Encyclopedia articles about topic X are allowed to, and even encouraged to, cite sources that do not mention X. Again, let's look at today's featured article Phishing. It cites many sources that do not mention phishing. For example, it discusses the homograph attack, one technique for doing phishing, and cites http://www.cs.technion.ac.il/~gabr/papers/homograph_full.pdf Gabrilovich Gontmakher 2002, a source about homograph attacks that never mentions phishing. And yet this is not SYN, not at all: homograph attacks are obviously relevant to phishing and citing a source on homograph attacks is precisely what an encyclopedic article on phishing "should" do.

The biggest problem I see with the proposed overly-strict interpretation of 18164469) are publishing high-quality reviews of treatments for conditions like low back pain in non-chiropractic-only journals, without putting the word "chiropractic" in their title or abstract. That is how mainstream chiropractic works, and Chiropractic should respect this rather than attempt to impose its own idiosyncratic view of what counts as a proper "chiropractic" paper and what doesn't.

Eubulides

07:51, 21 June 2008 (UTC)

If the source says "chiropractic" and the conclusions which we are using are specifically about "chiropractic" then by all means use the source. However, once we start using the conclusions of Haldeman or others (Source A) to dictate how we treat studies about general SMT (those which make no mention of chiropractic or don't distinguish between chiropractic and SMT... Source B) then we are guilty of SYN in the placement of Source B in our article to imply that Source B's conclusions are relevant to some conclusion about chiropractic (Conclusion C). That is where the A and B, therefore C has been done over and over again through this section. Dump those references (whether they are positive or negative about SMT) and maybe move them to the apropriate location: the spinal manipulation article. But they serve no purpose here other than to create original research by violating SYN. -- Levine211203:34, 22 June 2008 (UTC)

Source a and b are different. Source a is being used to make it clearly for the reader. Source b is related to chiropractic. There is not a conclusion C written in the article. There never was any OR or SYN. QuackGuru15:55, 22 June 2008 (UTC)

Yes! Thank you. Source A and B are different. And how you say Source A is being used to make it clear for the reader, is actually Source A being used to make a certain unsourced POV clear for the user - that all of the Source B's should be interpreted in a way which none of the Source B's explicitly state. Thus, Conclusion C is that based on Source A, all of the Source B's are actually about to chiropractic; even though the sources don't say so. Hence, OR and specifically SYN. Now then, I think by now you understand my point, and Digital C's point, and Dematt's point, and CorticoSpinal's point, etc. Finally. -- Levine211217:17, 22 June 2008 (UTC)

Source a and b be are different. Each source has its own sentence and ref. They are not explicitly joined together. Source A is not being misused to make certain sourced NPOVs clearer for the user. I don't see any unsourced POV. I understand your point has an implied conclusion C that is not written in the article. Hence, the argument of OR or SYN is incorrect. QuackGuru18:27, 22 June 2008 (UTC)

Source A is being used to justify the inclusion of Source B, despite Source B having nothing to do with chiropractic directly. The synthesized conclusion which any reader would come to is that the claims of Source B are relevant to Chiropractic based on what Source A says. A + B = C. Hence, SYN. The solution is to remove all of the "Source Bs" (i.e. any source which we are attempting to use to make so conclusion about chiropractic despite the source itself not mention such a conclusion. -- Levine211219:00, 22 June 2008 (UTC)

I do not see how source a is being used to justify the inclusion of source b. Source a is being used to make it clearer for the reader. Source b is related to chiropractic. The non-existent conclusion c is not written in the article. Where is conclusion c written in the article? QuackGuru19:19, 22 June 2008 (UTC)

Let's put it this way: How do you know that Source B is related to Chiropractic when Source B doesn't mention Chiropractic? How does the casual reader know this? -- Levine211219:23, 22 June 2008 (UTC)

I will answer your question in the form of a question. Where does it say it in SYN that the reader must know that source b is related?

We are using related references which is okay. According to which policy we must explain to the reader which ref is related.

The casual reader understands that chiropractors perform spinal manipulation and spinal manipulation is related. QuackGuru19:41, 22 June 2008 (UTC)

Just let me know how you know that Source B's research conclusions can be used to make conclusions about chiropractic when Source B itself was not expressly studying chiropractic nor does it make any make any direct correlation to chiropractic nor does it make any reference whatsoever to chiropractic. So how do you know that Source B's conclusions can be applied to chiropractic? -- Levine211219:49, 22 June 2008 (UTC)

Because source b is related to chiropractic. QuackGuru19:57, 22 June 2008 (UTC)

And what are you basing this opinion of yours on? I mean, Source B does not outright say nor imply that it is related to chiropractic. You are saying it is. Is this just your opinion that the conclusions of general SMT research which makes no claims about chiropractic can be used at Wikipedia to infer claims about chiropractic? Or is there something I am missing in Source B which actually does say that the conclusions of Source B can be applied to Chiropractic? Or is there something else? Please be explicit. -- Levine211221:39, 22 June 2008 (UTC)

Source b is related to chiropractic because...

...spinal manipulation is commonly performed by chiropractors.

Where is conclusion c written in the article?

There never was a conclusion c.

Conclusion d: It's time to remove the tag. QuackGuru23:39, 22 June 2008 (UTC)

You're creating a logical fallacy by evading the question. How do we know that research about SMT in general is directly applicable to chiropractic specifically? -- Levine211200:33, 23 June 2008 (UTC)

Further, please note that a few moons ago, there was a RAND study on the appropriateness of spinal manipulation which came out quite favorable for SMT. When chiropractors jumped on that research to proclaim things such as "Chiropractic works!", the chiropractors were in turn jumped on by the researchers who said that these studies were not about chiropractic specifically, but rather SMT and that chiropractors were in effect misusing these studies. So you see, it is a double-edge sword. RAND spokesperson Dr. Paul Shekelle, released this statement in 1993:

""...we have become aware of numerous instances where our results have been seriously misrepresented by chiropractors writing for their local paper or writing letters to the editor....RAND's studies were about spinal manipulation, not chiropractic... Comparative efficacy of chiropractic and other treatments was not explicitly dealt with.""

Now I may not be recounting this totally correct. If Fyslee is around, he knows this tidbit better than I do. But the point still goes to show that some researchers say that confounding SMT with chiropractic is a no-no. Thus, "Conclusion D" (as you put it) would actually be to excise all general SMT studies/reviews from this section regardless of whether they are supportive of spinal manipulation or not. And if you still don't agree, I ask you once again and urge you not to evade: How do we know that the conclusions of research about SMT in general may be directly applied as conclusions about chiropractic specifically? -- Levine211200:41, 23 June 2008 (UTC)

I will answer your question in the form a question. Do the majority of chiropractors perform spinal manipulation? If yes, then spinal manipulation is related. QuackGuru06:00, 23 June 2008 (UTC)

The above discussion does not cast much light on the issue, I'm afraid. None of the bullet points in my previous comment were addressed. Eubulides08:18, 23 June 2008 (UTC)

"For example, it discusses the homograph attack, one technique for doing phishing" - forgive me for my ignorance of phishing. Can a homograph attack be used outside of phishing? Wouldn't the effectiveness of a homographic attack be better addressed at Homograph attack rather than at phishing? I'm not sure this is a clear analogy.

As far as I can tell, the purpose for including the sentence "Research has focused on spinal manipulation therapy (SMT) in general,112 rather than specifically on chiropractic SMT." is to ALLOW the synthesis that is being performed.

"Its section PhishingFilter evasion says "Phishers have used images instead of text to make it harder for anti-phishing filters to detect text commonly used in phishing e-mails." An obvious implication is that filters can work around this problem by altering or deleting messages containing images. But it is not a SYN violation that this implication is neither written down nor sourced in Phishing." I don't see this as an obvious implication. However, it is obvious that we are implying that research that doesn't explicitly mention chiropractic when discussing smt is the same as research that does mention chiropractic.

"* The biggest problem I see with the proposed overly-strict interpretation of SYN is that it disagrees with how the relevant research is being reviewed by high-quality sources." - Again, high-quality sources are not restricted by SYN, as they are outside the world of wikipedia. In other sources, saying "A is true, and B is true. C." is not a problem. However, it is against wikipedia policy. It is 100% original research for us to conclude that general SMT is valid when discussing chiropractic SMT, when those sources have NOT been discussed in such a manner elsewhere. DigitalC01:13, 24 June 2008 (UTC)

Yes, a homograph attack can be used outside of phishing. But it's highly relevant to phishing, and it's quite reasonable to discuss it in Phishing. I disagree that it would be better to remove the discussion of homograph attacks from Phishing. There are lots of similar examples, e.g., Phishing cites http://support.microsoft.com/kb/834489 this Microsoft support page which does not mention phishing. There is nothing at all wrong with this sort of citation.

I would prefer omitting the sentence ""Research has focused on spinal manipulation therapy (SMT) in general, rather than specifically on chiropractic SMT." I think it's too much detail for Chiropractic. This is not to say that I would support removing discussion of SMT, which is quite relevant; only that this sentence is overkill. The sentence is not there to allow synthesis.

Chiropractic does not say or imply that "research that doesn't explicitly mention chiropractic when discussing smt is the same as research that does mention chiropractic."

I think the "obvious implication" in Phishing is obvious to anyone who is at least moderately expert in that area.

I should mention that I chose Phishing only because it happened to be the Featured Article when I wrote that comment. I expect similar sorts of citations will occur in many high-quality articles in Wikipedia.

Again, there is no statement of the form "A is true, and B is true. C." in Chiropractic Scientific investigation. Every sentence in that section is directly supported by a citation to a relevant source. I'm not sure what the phrase "general SMT is valid when discussing chiropractic SMT" refers to; it doesn't correspond closely to anything in Chiropractic Scientific investigation.

Eubulides

07:02, 24 June 2008 (UTC)

Coppertwig wrote - "Perhaps it might help if the SMT effectiveness studies were mentioned under a subheading such as "Effectiveness of SMT" rather than just "Effectiveness", which implies that they're stating a conclusion about effectiveness of chiropractic. I think the SYN argument has considerable validity but am undecided as to what we should do.". This is basically what I have proposed, except that it would be located on Spinal manipulation, with a wikilink from the Effectiveness section at Chiropractic. Obviously, the effectiveness section over at Spinal manipulation would not include other treatment modalities such as LLLT, Ultrasound, IFC, acupuncture, etc. No one has stated a valid reason for NOT doing it this way. DigitalC01:13, 23 June 2008 (UTC)

However, spinal manipulation is related to chiropractic. QuackGuru06:00, 23 June 2008 (UTC)

It would be reasonable to have a more-extensive discussion of SMT effectiveness at Spinal manipulation. (By "more-extensive", I mean, more extensive than what is in Chiropractic now.) However, a summary is still in order here. Chiropractic is strongly associated with spinal manipulation, and vice versa. It would make little sense for a discussion of effectiveness of chiropractic treatments to not focus on the effectiveness of SMT. Eubulides08:18, 23 June 2008 (UTC)

Chiropractic is closely associated with spinal manipulation. Information on the effectiveness of SMT is relevant. QuackGuru18:14, 23 June 2008 (UTC)

You are still evading my question: How do we know that it is okay to directly attribute conclusions about general SMT with that of chiropractic? -- Levine211219:25, 23 June 2008 (UTC)

I did not evade your question. Again: Chiropractic is closely associated with spinal manipulation. Therefore, information on the effectiveness of SMT is relevant. QuackGuru06:26, 24 June 2008 (UTC)

Could this be presented in more mainstream terms? Wouldn't an article about medicine discuss prescription drugs? This could avoid SYN issues, if the two weren't so tightly connected as they are now. Xavexgoem01:28, 24 June 2008 (UTC)

Medicine is too broad an article to compare to Chiropractic. Perhaps Internal medicine may equate, but that may not even be specific enough. However for the sake of comparison, at Internal medicine, would you expect to find conclusions about the efficacy of drugs sourced to a review of literature concerning itself with drugs as administered by non-internists? What if the reason for the editor's applying such reviews to Internal medicine was based on another piece of research which in fact said it was okay to confound research about the efficacy of non-internists' use of drugs with the efficacy of Internists' use of drugs (at least in terms of their research)? So we have a review about the efficacy of drugs as administered by non-internists (Source A) and we have a piece of research which confounds a different study about the efficacy of drugs as administered by non-internists with the efficacy of drugs as administered by internists (Source B). So, by the rationale of Source B, the editor says it's okay to apply the research of Source A to internists by placing it in the Internal medicine article (Conclusion C). Would that not be a textbook SYN violation? And what if the only other argument presented by the editor in favor of violating SYN with such an inclusion is that Internists prescribe the most drugs, therefore we should just disregard that the non-internists might not be diagnosing their patients or prescribing drugs in the same manner as actual internists would diagnose and prescribe? Forgive my run-ons galore. :-) -- Levine211201:58, 24 June 2008 (UTC)

What I suggest is separating source A so far from source B that no conclusion C can be reached :-) Xavexgoem02:02, 24 June 2008 (UTC)

The separation would have to be the distance of two separate articles. Whereas, Source A is only expressly about SMT in general and therefore can be placed at Spinal manipulation. The whole justification of using Source A here at chiropractic is inextricably entangled with the rationale given in Source B. So no matter the distance of separation within this article, including Source A is always a SYN violation. -- Levine211202:07, 24 June 2008 (UTC)

It's only a suggestion, at any rate; maybe Source A could have another justification, though, if all goes wrong :-p Xavexgoem02:17, 24 June 2008 (UTC)

I am always open to suggestions. I appreciate it. And I am always willing and ready to change my mind - do a complete 180 - if the right suggestion/explanation is given. And yes, Source A (research about SMT in general with no expressed implications about chiropractic) does certainly need another justification other than the tired ones already debunked here if we are going to use the likes of Source A at all in article space. I have yet to read such a justification. Therefore I continue to voice my support of the shared proposal of the majority of editors here - to remove any such "Source A's" from the article and rather rely on research/reviews which explicitly makes conclusions about the particular subject at hand: Chiropractic. -- Levine211202:42, 24 June 2008 (UTC)

I think we have to consider this; researchers do not use the words 'chiropractic care' and 'spinal manipulative therapy'(SMT) interchangeably because chiropractic care includes multitudes of variables that cannot be isolated. However, they can make statements about spinal manipulation because they can isolate that procedure and study it. The purpose of that research is to inform everyone in the field of the effectiveness of that specific treatment under those specific conditions. There are some studies that specifically evaluate 'chiropractic care'. Most of those are surveys. Those would certainly be appropriate here because they do consider the entire chiropractic encounter, but they cannot say anything specific about SMT, because they are not synonymous. Our hearts and minds really want to assimilate this information into a simple package for our readers, but Wikipedia makes rules about this so that we don't make this mistake. They are part of NOR and SYN. We are working too hard here. Let's just look for sources that use 'chiropractic care' and let's see what we come up with. Menawhile, we know that the information that we have can at least be used in the spinal manipulation article. -- Dematt Dēmatt 03:24, 24 June 2008 (UTC)

Maybe we should consider this. No evidence of OR or SYN has been presented.

We can cite sources that use chiropractic research as well as spinal manipulation research.

How do we know that it is okay to attribute general SMT with that of chiropractic?

Because spinal manipulation is related to chiropractic and using related references is okay.

It was suggested that we separate source A so far from source B. Source A is to make it clearer for the reader. A little context helps. Source B is related to chiropractic. We can't remove a non-existant conclusion C when there never was a conclusion C. QuackGuru06:26, 24 June 2008 (UTC)

"No evidence of OR or SYN has been presented." Really? Come on. There is megabytes of discussion about said evidence here. Sorry, spinal manipulation may be related to chiropractic, but not enough to overcome the clear SYN violation. If they truly were the same in terms of research, then chiropractors wouldn't have come under fire for using RAND's "The Appropriateness of Spinal Manipulation for Low-Back Pain" to declare "Chiropractic works!" Suffice it to say that there is no agreement in the scientific community that general SMT studies can be used to make conclusions about chiropractic specifically. Therefore we can not include general SMT studies here. I echo Dematt's sentiments above: "We are working too hard here. Let's just look for sources that use 'chiropractic care' and let's see what we come up with. Menawhile, we know that the information that we have can at least be used in the spinal manipulation article." -- Levine211206:38, 24 June 2008 (UTC)

No evidence of OR or SYN has been presented and Levine2112 has clearly stated "spinal manipulation may be related to chiropractic..." That did it for me. Related research is allowed. Where is conclusion C? Nowhere! QuackGuru06:45, 24 June 2008 (UTC)

Baseball is related to cricket, but you wouldn't see Barry Bonds listed as a slugger on the cricket page. Nuff said. -- Levine211207:34, 24 June 2008 (UTC)

(outdent)

No specific evidence of a SYN violation has been presented. Only vague claims about implications have been made, implications that do not appear in the text. These claims have been made several times (and have generated much discussion), but they have not specifically described anything like what SYN describes as a SYN violation.

Chiropractic Scientific investigation does not use the phrases "chiropractic care" and "spinal manipulation therapy" interchangeably.

The studies that evaluate "chiropractic care" tend to be of lower quality (e.g., surveys), tend to be written by chiropractors, and tend to be more supportive of chiropractic. Requiring Chiropractic to depend exclusively on such sources is a recipe for lower quality and a recipe for more problems with POV.

Chiropractic Scientific investigation currently refers to the best and most-reliable sources available on the effectiveness of SMT for back pain, a core area for chiropractic. Arbitrarily excluding these best sources, simply because they don't say the magic words "chiropractic" in their title, will cause this part of the article to revert to lower-quality sources that often contain little more than unsubstantiated claims.

Wikipedia is supposed to give the most space to mainstream sources that rely on the scientific method to evaluate claims. In this area the best-quality sources do their job in a certain way. We shouldn't exclude them arbitrarily in favor of lower-quality and more-biased sources.

Eubulides

07:02, 24 June 2008 (UTC)

Only vague claims? I don't know how much more explicit we can be. Truly! -- Levine211207:34, 24 June 2008 (UTC)

If the most explicit claim of SYN that can be made is something like "The synthesized conclusion which any reader would come to is that the claims of Source B are relevant to Chiropractic based on what Source A says." then there is no SYN violation. SYN does not say anything about implied conclusions, or conclusions "which any reader would come to". It says something only about explicit conclusions made in the text. Claims about implied conclusions are vague, because one can infer lots of implied conclusions from any well-written article.

It is obvious that the effectiveness of spinal manipulation is central to the question of whether chiropractic care is effective. SMT is core to chiropractic, and chiropractic's characteristic treatment is SMT.

As the Phishing example suggests, it is routine for a high-quality Wikipedia article to rely on a source that does not mention the article's title, so long as the source is on a relevant topic. Saying that such citations are SYN violations is stretching the notion of SYN far away from what SYN is intended for.

Eubulides

08:46, 24 June 2008 (UTC)

The issue is fundamental. SYN is part of the three WP Policies, NPOV,RS and V, and NOR for a reason. SYN states n the first paragraph:

Material published by reliable sources can inadvertently be put together in a way that constitutes original research. Synthesizing material occurs when an editor comes to a conclusion by putting together different sources. If the sources cited "do not" explicitly reach the same conclusion, "or if the sources cited are "'not directly related to the subject of the article""', then the editor is engaged in original research. Summarizing source material without changing its meaning is not synthesis; it is good editing. Best practice is to write Wikipedia articles by taking claims made by different reliable sources about a subject and putting those claims in our own words on an article page, ""'with each claim attributable to a source that makes that claim explicitly"'." (emphasis mine)

The remainder of the conversations have been an attempt to explain the reason for the policy. The bottom line is that chiropractic and SMT are not synonymous, interchangeable, or in any way the same thing any more than medicine is vioxx. Vioxx is one treatment medicine uses; SMT is one treatment chiropractic uses. We wouldn't put information about the effectiveness/research of/cost benefit of vioxx on the medicine page and we can't put information about the effectiveness/research of/cost of SMT on the chiropractic page. It's really pretty simple. There is research about the effectiveness/cost of chiropractic care and that is what can be on this page. ""'IF""' chiropractic = SMT then the research will support this as well and Chiropractic will reflect this, so the end result is the same, but we have not created SYN. That is the only thing that will get us to FA status. Anything that looks contrived will not cut the mustard. -- Dematt Dēmatt 14:40, 24 June 2008 (UTC)

There's no disagreement that SYN is part of a core Wikipedia policy. And we all agree that chiropractic and SMT are not synonymous. However, the fact that they are not synonymous does not establish a SYN violation here. Chiropractic does not say or imply or assume that they are synonymous. We've already seen, from the Phishing example, that a featured article can cite sources that do not mention the article's topic. What matters is whether the sources' topics ares relevant; and clearly the effectiveness and safety of SMT are highly relevant to the effectiveness and safety of chiropractic care. Eubulides21:18, 24 June 2008 (UTC)

Sure Chiropractic implies that chiropractic and SMT are synonymous by presenting general SMT studies under the guise of Chiropractic's effectiveness. You say, "clearly the effectiveness and safety of SMT are highly relevant to the effectiveness and safety of chiropractic care." How do you know that they are highly relevant? -- Levine211221:49, 24 June 2008 (UTC)

There is no misrepresentation in ChiropracticEffectiveness. All studies about SMT are described accurately as being about SMT. It is self-evident that the effectiveness and safety of SMT are highly relevant. We've seen reliable sources saying they're relevant, and we don't know of any recent reliable source that seriously disputes the point. Eubulides23:36, 24 June 2008 (UTC)

SMT is a common treatment chiropractic uses. When SMT is related to chiropractic then the research is relevant. Vague comments confirm there is no SYN. No evidence has been presented. There never was a conclusion C. If anyone believes there is a conclusion C then present your evidence. Which specific sentence is conclusion C? QuackGuru18:34, 24 June 2008 (UTC)

By including the conclusions of general SMT research in an article about chiropractic, we are leading the reader to assume that these conclusions are somehow relevant to chiropractic. That is Conclusion C. However, as we know, various sources disagree on the relevance of general SMT research to chiropractic specifically. There is nothing vague about this. And regardless if you disagree with the fact that this is a clearcut SYN violation, you simply must agree that this text is contentious at best. It is misplaced in this article, making about as much sense as placing Barry Bonds' home run stats in the cricket article to describe the abilities of a batsman. -- Levine211220:51, 24 June 2008 (UTC)

"Various sources disagree on the relevance of general SMT research"? Which ones? None have been cited in this thread.

Obviously there is disagreement here, but that does not mean the article should not cover the topic. If it was our policy to remove all controversial topics, the article would rapidly become empty.

Chiropractors regularly refer to articles like Bronfort "et al." 2008 (PMID|18164469), a high-quality recent source which is written by chiropractors and from the chiropractic point of view. Bronfort "et al." resolutely take the general-SMT viewpoint; they do not restrict themselves to data derived solely from chiropractic adjustments. And Bronfort "et al." are not unusual in this respect; they represent the typical case among high-quality research on chiropractic these days.

If cricket experts regularly cited data derived from baseball in their best-quality analyses of batting, it would indeed be appropriate to use those analyses in CricketBatting. But they don't do that. So the analogy to Barry Bonds does not hold up.

A better analogy would be AutomobileSafety. Its first citation is to "http://who.int/violence_injury_prevention/publications/road_traffic/world_report/en/ World report on road traffic injury prevention", a WHO report on road traffic injuries. This report summarizes data not only from cars, but from all motor vehicles. The same section also cites the http://www.iihs.org/ The Insurance Institute for Highway Safety's home page; again, this is a source that focuses on highway safety for all vehicles, not just automobiles. This is not a SYN violation either; clearly road safety is an important aspect of automobiles, and clearly the WHO and IIHS sources are good sources that are relevant to automobile safety.

Eubulides

21:18, 24 June 2008 (UTC)

I am confused. Aren't cars a type of automobile? And aren't motor vehicles and automobiles synonymous terms? Please explain. I mean, it would be more relevant if the article on Cars had a safety section which confounded car safety statistics with truck safety statistics. But that would be weird, right? What if a couple of car experts said that in their research, there is no reason to distinguish car safety from truck safety and what if there were experts who disagreed. Would that mean that we have the go-ahead at Wikipedia to find other studies on truck safety and put those conclusions under CarsSafety?

Anyhow, I think you have missed my reference to the RAND study on general SMT. Chiropractors came under heavy fire for using those conclusions to declare that "Chiropractic works!" The response from RAND was that chiropractors should not be misusing their study because their study was about SMT as performed by a host of practitioners and not just chiropractors. RAND spokesperson Dr. Paul Shekelle: "...we have become aware of numerous instances where our results have been seriously misrepresented by chiropractors writing for their local paper or writing letters to the editor....RAND's studies were about spinal manipulation, not chiropractic... Comparative efficacy of chiropractic and other treatments was not explicitly dealt with." And a http://annals.org/cgi/content/full/147/7/478 source we are already using in the article says "The evidence is insufficient to conclude that benefits of manipulation vary according to the profession of the manipulator (chiropractor vs. other clinician trained in manipulation)...". So there are at least two nonchiropractic sources out there saying either that there is insufficient evidence to make such a comparison or that such a comparison is straight out wrong. -- Levine211221:37, 24 June 2008 (UTC)

Automobile safety (the topic of the article section AutomobileSafety) and road safety (the topic of the abovementioned sources of AutomobileSafety) are not synonymous. Many motor vehicles are not automobiles; they are freight trucks, for example. And road safety also includes issues like the design of roads or intersections, which are not automobile safety topics per se.

The 1993 Shekelle letter rightly warns us about the danger of misrepresenting SMT studies as chiropractic-care studies. But ChiropracticScientific research does not do that. It clearly marks whether a study is about SMT, or about chiropractic care.

The Chou "et al." 2007 quote ("The evidence is insufficient to conclude that benefits of manipulation vary") you mention is citing http://www.annals.org/cgi/reprint/138/11/871 Assendelft "et al." 2003, which found no evidence that SMT is better (or worse) for low back pain than standard treatment, and found no evidence that chiropractic SMT is better (or worse) for low back pain than non-chiropractic SMT. This quote actually underlines the point that there's no good reason to exclude non-chiropractic data when studying effectiveness of SMT (whether chiropractic or non-chiropractic SMT).

As it happens, Shekelle is a coauthor of Assendelft "et al." 2003, suggesting that any doubts he had back in 1993 about mixing chiropractic with non-chiropractic data have long since gone by the wayside.

Eubulides

23:36, 24 June 2008 (UTC)

By including SMT research in an article about chiropractic, we are including related information to chiropractic. Therefore, conclusion C does not exist. No specific sentence is conclusion C. QuackGuru00:48, 25 June 2008 (UTC)

SYN, SMT, presentation, and evidence

Please note that according to SYN, it's not necessary for statement C to actually be stated in the article for a SYN violation to occur. In the example at SYN, it says that the paragraph expresses the idea that Jones did not commit plagiarism; but the paragraph does not state that Jones did not commit plagiarism: it only implies it by juxtaposing some ideas. Similarly, placing a verifiable statement under the heading "Effectiveness" in an article titled "Chiropractic" could be seen as expressing an idea which is not stated in the source. Not all implications, not even obvious implications, are SYN violations, as Eubulides points out; however, if it appears that the whole point of including the information is to lead to a certain conclusion, then it's a SYN violation unless we have a source that expresses that conclusion.

I think it's important to check that we're all using the same definition of "spinal manipulation". The Wikipedia article is pretty vague on its definition and needs to be fixed up, I think. I would like to see the various articles clarify the relationship among these terms: "spinal manipulation", "spinal adjustment", "manual adjustment", "activator technique", mobilization", etc. Are any of these terms subsets of other terms? Does the term "spinal manipulation" cover every mechanical thing chiropractors do to spines? For example, is the activator technique considered to be a form of spinal manipulation? I don't know if this Google Scholar snippet is off-base: ""Spinal manipulation is defined by chiropractors as "a specific form of direct articular manipulation utilizing a short lever and characterized by a dynamic..."" http://www.springerlink.com/content/q043129r2t274852/

Sources do not have to be limited to those that contain the word "chiropractic". Actually, looking over this article, I see that almost every single sentence in this article contains the word "chiropractic" or "chiropractor". I think it may be less boring for the reader if we open up a bit and talk a little about things that are related to chiropractic without always repeating the word. For example, here's one sentence which does not contain the word "chiropractic" as such (though it does have an abbreviation for it!): ""Chester A. Wilk, DC from Chicago initiated an antitrust suit against the AMA and other medical associations in 1976 - Wilk "et al." vs AMA "et al.""" This sentence talks about one particular chiropractor, not about all chiropractors; and it talks about one particular thing that chiropractor did, not about everything that chiropractor does; and it also mentions a non-chiropractic organization. Yet it's quite appropriate for this article. Similarly, perhaps information about SMT may be appropriate for this article: simply not including everything chiropractors do, or not containing the word "chiropractor" in the source, or being something people other than chiropractors also do (non-chiropractors have also sued people) are not in themselves reasons to exclude the information.

Per IAR and WIARM, we don't just blindly apply rules, and therefore I would like to ask Levine2112 (and/or Dematt etc.) to explain what is the reason for applying the SYN rule in this particular case: what harm exactly do you think the SYN violation might do the reader in this particular case?

I don't think separating something off into another article is the only way to avoid SYN. The key is to present the information in such a way that it appears that the reason for presenting it is something other than to imply statement C. A reader who visits a particular chiropractor and receives SMT might reasonably be interested to know whether SMT is effective, regardless of whether the study was about that particular chiropractor, that particular kind of chiropractor, or about chiropractors as opposed to a more general category of people who do SMT, and regardless of whether the person also received other therapy from the chiropractor in addition to SMT. It seems to me that the topic of SMT is closely related to the topic of chiropractic, though clarification of the definition of SMT is needed to know how closely related it is.

Re this sentence: ""Research has focused on spinal manipulation therapy (SMT) in general, rather than specifically on chiropractic SMT."" I think it may help reduce the SYN concerns if we append to that sentence, ""or on the totality of chiropractic treatment including non-SMT chiropractic treatment or treatment in addition to SMT."" or a shorter version ""or on the totality of chiropractic treatment.""

Re finding no evidence that chiropractic SMT is better or worse: finding no evidence can just mean there weren't many subjects included in the study, or something. Statistical data cannot be used to prove that two groups are equal. A study which simply says it found no evidence is not saying much. If it had a lot of statistical power it might draw a conclusion such as "this supports the hypothesis that if there is a difference, then it's less than 20%"; statistical studies rarely have enough data to be able to draw this type of conclusion. ☺ Coppertwig01:42, 25 June 2008 (UTC)

Wow, that's a lot of good comments! Let me try to address them.

The example text at SYN illustrates SYN not because it implies (without explicitly stating) that Jones did not commit plagiarism. It illustrates SYN because it says that if Jones's claim is false then that would be contrary to the Chicago Manual of Style. That is an explicit conclusion in the example text, a conclusion that is supported by none of its sources; this is obviously SYN. I therefore disagree that SYN says that it's not necessary for statement C to actually be stated in the article for a SYN violation to occur.

I suppose it is possible that one could write an article that is a SYN violation without explicitly stating the synthesized conclusion, but so far I haven't seen an example of one.

Chiropractic Treatment procedures defines spinal manipulation to be "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" and cites the ACA. I don't see much vagueness there, but if you can say what the vagueness is, perhaps we can improve the definition.

I agree that Chiropractic Treatment procedures is an extremely weak section, technically speaking. It says almost nothing about treatment procedures. It should discuss spinal manipulation vs spinal adjustment, mobilization, etc. This point has been made before on this talk page, but nobody has made the time to improve it.

I agree that the words "chiropractor" and "chiropractic" are used too often. (The Wilk sentence you mention ought to be removed, though; please see History 2.)

Re the proposed addition of "'"or on the totality of chiropractic treatment including non-SMT chiropractic treatment or treatment in addition to SMT."" or a shorter version ""or on the totality of chiropractic treatment."" What's the source for this addition? I don't see where the cited sources say anything like that.

http://www.annals.org/cgi/reprint/138/11/871 Assendelft "et al." 2003 found no evidence not because their study was small (they were doing a review, not a single study). They found no evidence because although they looked at more than 1000 studies, almost all of them were of such low quality that they could be ignored, and the results of the few high-quality studies were not statistically significant when aggregated, when SMT was compared with other therapies for low back pain.

Eubulides

02:43, 25 June 2008 (UTC)

The ChiropracticTreatment procedures section is the place to explain more about spinal manipulation in chiropractic care and to include more details about other treatment modalities. That would make it more clear for the reader. QuackGuru03:22, 25 June 2008 (UTC)

Thanks for your extensive reply, Eubulides; I hope to find time later to reply more fully. Another suggestion is to insert a sentence, immediately before the first statement about SMT effectiveness, such as ""SMT is one part of the overall treatment provided by many chiropractors"" (or "most chiropractors", depending on the definition of SMT and being able to source it). ☺Coppertwig10:49, 25 June 2008 (UTC)

I was thinking the ChiropracticTreatment procedures section would be a better place to have more details about the treatment procedures including spinal manipulation and the effectiveness section can focus on the effectiveness part. QuackGuru17:20, 25 June 2008 (UTC)

I left a massive response at Dematt's talk page which I believe addresses many of Coppertwig's concerns. I will include a modified version of that response below:

First, some background: SMT is a procedure which is performed by any number of practitioners. Chiropractors certainly are the most common practitioners to employ SMT; however you will also find PTs, DOs, and other healthcare professionals performing such procedures. Chiropractors, by way of education, are arguably the most qualified to perform SMT. Adjusting vertebrae is something they spend 4 years focused on learning. Chiropractic techniques for adjusting vertebrae are numerous and precise, and the methods which chiropractors use to adjust the spine are different from manipulations performed by other practitioners. In addition to varying techniques, the diagnosis which leads a chiropractor to perform a specific adjustment on a patient is wholly different from a PT, DO, etc. And - some may argue - that the "intent" behind a chiropractic adjustment is disparate from other practitioners performing their versions of SMT. With these key differences, in mind, allow me to continue...

In the early 1990s, the RAND Corporation completed a study entitled, "The Appropriateness of Spinal Manipulation for Low-Back Pain", which concluded positively for SMT. When chiropractors jumped on those conclusions to proclaim things such as "Chiropractic works!", the chiropractors were in turn jumped on by the researchers who said that these studies were not about chiropractic specifically, but rather SMT and that chiropractors were in effect misusing these studies. Dr. Paul Shekelle of RAND released this statement:

""...we have become aware of numerous instances where our results have been seriously misrepresented by chiropractors writing for their local paper or writing letters to the editor....RAND's studies were about spinal manipulation, not chiropractic... Comparative efficacy of chiropractic and other treatments was not explicitly dealt with.""

Another http://annals.org/cgi/content/full/147/7/478 source from the Annals of Internal Medicine tells us the following:

""The evidence is insufficient to conclude that benefits of manipulation vary according to the profession of the manipulator (chiropractor vs. other clinician trained in manipulation)...""

What I am trying to establish here is though chiropractors employ their specialized form of SMT, in terms of research, chiropractic SMT is not 1:1 with SMT as performed by other practitioners. This means that conclusions from general SMT efficacy or safety studies (as performed by non-chirorpactors) cannot just be blindly correlated to the efficacy or safety of chiropractic SMT.

That said, those in favor of inclusion of general SMT cite chiropractic researchers such as http://annals.org/cgi/reprint/137/8/701.pdf Haldeman Meeker who stated:

""We agree that many of the randomized trials we described were on spinal manipulation rather than specifically on chiropractic manipulation itself, but we believe that this is not a significant point. Chiropractors use all forms of manipulation. In the United States, more than 90% of all spinal manipulation services are provided by chiropractors, and research on spinal manipulation, like that on any other treatment method, is equally of value regardless of the practitioner providing it.""

Editors in favor of inclusion of general SMT studies are basing their rationale on Haldeman, stating that by presenting general SMT studies to show chiropractic's efficacy or safety, we are merely following in the footsteps of researchers such as Haldeman Meeker. In my opinion, herein lies the SYN violation.

First, please note that Haldeman states, "...many of the the randomized trials "'we"' described were on spinal manipulation rather than specifically on chiropractic manipulation itself..." I emphasized "we" because I think it should be made clear that Haldeman Meeker are only referring to the specific studies they reviewed and are not making a blanket statement about all general SMT studies.

Second, lets label Haldeman Meeker as "Source A". And then let's say we have some other review of general SMT research (as performed by a mix of professionals... DOs, PTs, DCs, etc). Let's call this other review "Source B". While Source B is of high quality and published in very reputable journal, it does not in any way make any specific conclusions about chiropractic SMT; rather its conclusions only deal with general SMT. In fact, other than stating that the reviewers looked at some chiropractic adjustments in their research, the review itself makes no other mention of "chiropractic". Now then, editors in favor of inclusion of Source B are justifying it by citing the rationale in Source A - that the difference between general SMT and chiropractic adjustments isn't significant in terms of research. So now we have the rationale of Source A justifying the inclusion of Source B leading the reader to a conclusion based on original research. Let's say that Source B concluded that SMT is ineffective for treating cooties. Using the rationale of Source A, some editors want to go a step further and conclude that chiropractic is therefore ineffective for treating cooties. We'll call this "Conclusion C", a conclusion which is unsourced and can only be synthesized by combining the rationale of Source A with the findings of Source B. Hence, we have the classic SYN scenario: A and B, so therefore C.

Now some of the editors in favor of inclusion are being slippery and stating that we are not directly stating that these general SMT efficacy and safety studies specifically apply to chiropractic. But I ask you, when the casual reader shows up at Chiropractic and sees a heading labeled "Scientific research" and a sub-header reading "Effectiveness" with an entry beginning, "The effectiveness of chiropractic treatment depends on the medical condition and the type of chiropractic treatment," are we really to expect that reader not to confound the evidence of general SMT with a conclusion specifically about chiropractic? I don't think so. The conclusion which every reader will come to will be based on original research - we, the editors, applying general SMT efficacy and safety studies to the efficacy and safety chiropractic specifically.

Please bear in mind, that there is some general SMT research which is highly-to-slightly favorable to the usage of SMT for certain conditions. There is some research which is not favorable. I favor treating them all equally in that if they are not making conclusions about chiropractic specifically, they do not belong in the Chiropractic article. They would be much better suited to the Spinal manipulation article.

Finally, please note that in addition to spinal manipulation, there is an article - albeit a bit rough - on spinal adjustment. This article is specifically about chiropractic SMT. As Dematt mentions above, chiropractors also employ many other procedures other than spinal adjustments and many of those procedures have their own articles at Wikipedia. My thought is that much of the "Scientific research" into efficacy and safety should be handled on the procedure articles. Chiropractic is big topic. It is a profession which incorporates many procedures. There are studies out there which analyze the efficacy of the entire chiropractic clinical encounter, and I believe - good or bad - those kinds of studies would be perfect for the Chiropractic article. However, going into such detail about spinal adjustment efficacy on the Chiropractic article doesn't seem very efficient especially when we have a spinal adjustment article in need of such content.

In sum, I believe we should excise from Chiropractic any studies which don't focus on chiropractic specifically, but rather general SMT as performed by other practitioners. These studies are out of place here, and the manner in which they are being justified for inclusion violates SYN. As an article about a profession, just as we wouldn't expect the article on Dentistry to go into much detail on the safety and efficacy of fillings, I don't think Chiropractic should go into much detail on the safety and efficacy of any of their employed procedures either. A brief overview and a link to the specific procedure articles will suffice. And one final note, Dentistry doesn't discuss safety or efficacy at all. It certainly isn't based on a lack of available research: http://scholar.google.com/scholar?q=dental%20efficacyie=UTF-8oe=utf-8rls=org.mozilla:en-US:officialclient=firefox-aum=1sa=Ntab=ws Dental efficacy, http://scholar.google.com/scholar?hl=enlr=client=firefox-aq=dental+safetybtnG=Search Dental safety. This begs the question, why is Chiropractic being treated so differently? Is it that Dentisty lacks safety and efficacy sections or is it the other way around? -- Levine211219:01, 25 June 2008 (UTC)

Dentistry is not related to chiropractic. Let's focus on improving this article. When chiropractors are the most common practitioners to employ SMT, that means SMT research is relevant. QuackGuru19:19, 25 June 2008 (UTC)

I offer Dentistry as a comparative article. With regards to your point "chiropractors are the most common practitioners to employ SMT, that means SMT research is relevant": We are not speaking in generalities here. We are speaking specifically in terms of the research. Are chiropractors the ones employing the SMT in the research? Sure, surgeons perform the most brain surgery, but what if there was a study on the efficacy of brain surgery as performed by monkeys. Would it be fair to use that research to describe the efficacy of surgeons merely because surgeons perform more brain surgery than monkeys do? What if we had a researcher stating that in the surgeries performed by monkeys which he studied, the difference between a brain surgeon and a monkey is not all that significant. Would it then be okay to include all studies of brain surgery as performed by monkeys in the surgeon article under the heading "Efficacy"? -- Levine211219:28, 25 June 2008 (UTC)

Is SMT related to chiropractic? Yes! Therefore, the research is relevant. It's that simple. QuackGuru19:33, 25 June 2008 (UTC)

Is Baseball related to Cricket? Yes! Therefore, Barry Bonds batting average must be relevant to Cricket. Levine211222:57, 25 June 2008 (UTC)

Haven't we seen this argument before, in Arbitrary section break (SYN cont'd)? I suggest following it up there instead of repeating it here. Eubulides23:38, 25 June 2008 (UTC)

Which argument? QuackGuru's or mine? I think mine continues to debunk QuackGuru's repeated point. -- Levine211200:18, 26 June 2008 (UTC)

We've seen both sides of the argument before. I disagree about the debunking, but again, let's continue the discussion in Arbitrary section break (SYN cont'd) rather than repeat it unnecessarily here. Eubulides00:52, 26 June 2008 (UTC)

(unindent) Coppertwig, the http://www.springerlink.com/content/q043129r2t274852/ link that you supplied us with a provides the prime example that illustrates that SMT is not synonymous with chiropractic. It basically states exactly the point:

"Abstract Chiropractic is the largest unorthodox health profession in the United States. It is licensed in all 50 states and its services covered by governmental and private health insurance. Yet chiropractic remains, in the opinion of medical commentators, an unscientific healing cult. Chiropractic holds that much illness is caused, directly or indirectly, by derangements in homeostasis that result from subtle vertebral malalignments called subluxations. Only a minority of straight chiropracters continue to provide spinal manipulation as their only treatment, while the majority mixers have embraced physical therapy, vitamin supplements and a wide variety of drugless symptomatic treaments. "'Clinical trials suggest that spinal manipulation has short-term benefit in back pain, but the success of chiropractic is not fully explained by that effect. The clinical art, though, as manifested in the chiropractor-patient interaction contributes greatly to chiropractic healing. This process promotes patient acceptance and validation, fulfills expectations, provides explanations and engages the patient's commitment."' The same process lies at the core of the art of medicine. Seeing the clinical art as it functions in chiropractic can help us to understand its independent power in medicine."(emphasis mine)

At least hopefully you can see that Levine, DigitalC and myself are not the only ones that see it this way. No, not all chiropractor use SMT, and no not all techniques are SMT (which include the dynamic thrust that is intended to create cavitation. Activator is not spinal manipulation. Logan Basic is not spinal manipulation. BEST technique is not spinal manipulation. There are also several hundred other techniques that chiropractors use depending on the patient. Not all include spinal manipulation, but they "are" all called Spinal adjustments. Does everyone here know what "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" means? Then how do we expect our readers to know what this means? -- Dematt Dēmatt 21:14, 25 June 2008 (UTC)

The http://www.springerlink.com/content/q043129r2t274852/ link confirms chiropractors employ spinal manipulation and they also employ other treatments too. If anyone want more weight given in the article on other treatments then make a specific suggestion. QuackGuru22:00, 25 June 2008 (UTC)

Haldeman Meeker's main point is relevant to all studies, not just the studies they reviewed. They wrote, "Chiropractors use all forms of manipulation. In the United States, more than 90% of all spinal manipulation services are provided by chiropractors, and research on spinal manipulation, like that on any other treatment method, is equally of value regardless of the practitioner providing it." These comments are not limited to just the studies they reviewed.

I don't see how Chiropractic Effectiveness will confuse casual readers. It states which results are for SMT and which are for chiropractic care, and it discusses the distinction between the two. Of course if this material is not discussed clearly enough, it would be nice to improve the wording to make it clearer.

I know of no reliable source specifically on the effectiveness of spinal adjustment. Recent reviews discuss spinal manipulation, and do not distinguish it from spinal adjustment. I don't think the distinction is significant for effectiveness.

It would be a good idea to add a section to Dentistry discussing effectiveness and safety, just as it is a good idea to have such sections in Chiropractic, in Pharmacology, in Traditional Chinese medicine, and in Acupuncture. The topic of effectiveness is more relevant to chiropractic than it is to dentistry: the effectiveness of chiropractic care is seriously questioned and this questioning is a primary reason for chiropractic's long history of controversy, whereas there is no similar controversy for the effectiveness of dental care.

The discussion about "Source A" and "Source B" and "Conclusion C" revolves around an interpretation of SYN that is far too strict, one that is not intended. Such an interpretation could be used to justify the removal of a large amount of perfectly reasonable material from Wikipedia. For example, an advocate of automobiles could use it to justify removal of road-safety statistics from AutomobileSafety (because road safety is not the same as automobile safety).

Eubulides

23:38, 25 June 2008 (UTC)

Just because Haldeman's opinion is that all general SMT research can be applied to chiropractic, does not me that we can therefore apply all general SMT research to chiropractic. That would be and is a SYN violation.

Why make the distinction between SMT and Chiropractic in the first place if only to use it as justification for presenting research not specifically about Chiropractic? Dump the general SMT studies and there is no need for the complicated explanation.

I believe we have seen several reliable sources dealing with chiropractic specifically. (Perhaps it is your interpretation of what makes a reliable source which is far too strict.) Regardless, the lack of sources does not open the door to sources not specifically about chiropractic.

I'll tell you what. Add sections to Dentistry dealing with efficacy and safety. And in those sections, use research of a treatment for a particular dental condition "as performed by non-dentists" which shows that treatment to be ineffective. Then use the conclusion of that research to state that dentistry is therefore ineffective. Let's see if that flies on that article.

I explained above quite clearly how the Automobile comparison is not relevant. If you can find other examples of where this interpretation of SYN applies, I would recommend that you fix the violation. Wikipedia is not in the business of posting original research.

-- Levine211200:18, 26 June 2008 (UTC)

Chiropractic Effectiveness does not apply all general SMT research to chiropractic. It clearly distinguishes SMT from chiropractic care in general.

The distinction between SMT and chiropractic is not being used as a justification for presenting SMT research. Besides, I have already said that I'd favor removing the citation to Meeker Haldeman and the accompanying phrase. I don't think the point is that important to the general reader.

I agree that there are some reliable sources on chiropractic care, and they are cited now in Chiropractic. But I was writing about spinal adjustment, not chiropractic care. I don't know of any recent reliable sources on the effectiveness of spinal adjustment per se. Generally speaking, the distinction between spinal adjustment and spinal manipulation is not significant from the point of view of effectiveness.

Talk:Dentistry is a better place for proposals for improving Dentistry.

It seems that you missed the followup point that discussed why the Automobile comparison is relevant. Please search for "Automobile safety (the topic of the article section AutomobileSafety) and road safety (the topic of the abovementioned sources of AutomobileSafety) are not synonymous." above; the containing comment was not responded to, as near as I can make out. I suggest continuing the topic up there; there's no point in duplicating the argument.

Eubulides

00:52, 26 June 2008 (UTC)

Since SMT does not equal chiropractic, there is no reason (or justification) for including it at Chiropractic Effectiveness. Mere mention of the conclusions of general SMT studies here makes it appear that these conclusions are somehow relevant to the subject at hand; chiropractic. This relevance has not been established, but rather merely propounded by Haldeman and some others. All the while, other researchers disagree or say that this relevance is unclear.

I'm glad at least you recognize that there is a distinction between the general SMT and the specific Chiropractic. Can you let me know what you feel the distinction is?

Here you say that "the distinction between spinal adjustment and spinal manipulation is not significant from the point of view of effectiveness". How did you arrive at this opinion? Haldeman? Application of this opinion to other sources is textbook SYN. If you feel that there aren't enough chiropractic specific pieces of research in this article currently then it is our job to find more. But the lack of sources currently used does not open the door to use irrelevant or questionably relevant sources.

I hope you understand my point with regards to Dentistry. If not, then please go to Talk:Dentistry and see how the editors there feel about basing efficacy of dentistry on studies of dental procedures as performed by non-dentists.

I've read your follow-up and still feel that the comparison is a poor one. Find a better comparative article and we'll talk. In all likelihood, you will have discovered another SYN violation.

-- Levine211201:11, 26 June 2008 (UTC)

The statement ""general SMT and the specific Chiropractic"" above is quite misleading. SMT can be general and specific, and adjustments can be general and specific. Chiropractors commonly use both general and specific adjustments, just as do PTs, DOs, and some MDs. This claimed specificity is even more dubious when one notes that many techniques that do not move or adjust the joints are identified and billed by chiropractors as "adjustments". Even a couple techniques where there is no physical contact of any kind (literally air space) between chiropractor and patient are claimed to be "adjustments" and billed as such. It's Medicare billing fraud, but happens thousands of times every single day. To be complete, the Spinal adjustment article needs to include all the techniques and gizmos that are labelled as "adjustments" by chiropractors. It's really eye-opening. -- Fyslee / 05:24, 26 June 2008 (UTC)

SMT does not "equal" chiropractic, but SMT is "highly relevant" to chiropractic, so there is good justification for mentioning SMT in Chiropractic.

No current reliable source claims that SMT is irrelevant to chiropractic.

SMT is the core form of treatment used in chiropractic care. They are not the same thing, of course, as some non-chiropractors use SMT, and not all chiropractic care is SMT.

Chiropractors prefer the term "spinal adjustment", but it means much the same thing as spinal manipulation. See, for example, Meeker Haldeman 2002 (PMID|11827498).

It is not SYN to use the terms interchangeably when reliable sources do so, any more than it is SYN for Automobile to use "automobile" and "car" interchangeably.

Again, any discussion of improvements to Dentistry belongs in Talk:Dentistry, not here.

The comparison to AutomobileSafety is far more apropos than the comparison to Barry Bonds. Please see the "the analogy to Barry Bonds does not hold up" and "Automobile safety … and road safety … are not synonymous" comments in Arbitrary section break (SYN cont'd) above. I suggest following up in Arbitrary section break (SYN cont'd), where these comments have not been substantively replied to.

Eubulides

08:04, 26 June 2008 (UTC)

Agreed. The comparisons between baseball and cricket, and using Barry Bonds are all very dubious and misleading examples. -- Fyslee / 14:09, 26 June 2008 (UTC)

SMT does not "equal" chiropractic, but SMT is "highly relevant" to chiropractic, so there is good justification for mentioning SMT in Chiropractic.

Nobody is suggesting that we don't mention SMT, especially as an essential part of a Spinal adjustment. Only that placing research that draws conclusion about SMT leads the reader to draw the same conclusions about chiropractic which is not appropriate for the Chiropractic article per SYN. -- Dematt Dēmatt 16:16, 26 June 2008 (UTC)

Agree with Dematt. Let's keep the details and research in the SMT and adjustment articles. -- Fyslee / 23:52, 26 June 2008 (UTC)

Chiropractors prefer the term "spinal adjustment", but it means much the same thing as spinal manipulation. See, for example, Meeker Haldeman 2002 (PMID|11827498).

(PMID|11827498) doesn't say much but Halderman does state: "Chiropractors use all forms of manipulation. In the United States, more than 90% of all spinal manipulation services are provided by chiropractors, and research on spinal manipulation, like that on any other treatment method, is equally of value regardless of the practitioner providing it." This is only saying that SMT studies are the same no matter who is using it, it is not saying that SMT is synonymous with chiropractic care. This means that SMT can be assumed to be just as effective when used by chiropractors or DOs, PTs, or MDs.. If DOs, PTs, and MDs also did the same things that DCs do along with SMT and for the same reasons, they would also be performing a spinal adjustment and can be considered chiropractic care. -- Dematt Dēmatt 16:16, 26 June 2008 (UTC)

Agreed. It is the reasoning ("for the same reasons") that makes the difference. Only chiropractors use SMT to correct vertebral subluxations. -- Fyslee / 23:52, 26 June 2008 (UTC)

It is not SYN to use the terms interchangeably when reliable sources do so, any more than it is SYN for Automobile to use "automobile" and "car" interchangeably.

Using a term interchangeably within the same article is acceptible. It is not acceptible for wikipedians to interchange the words researchers chose when the two are obviously not synonymous. -- Dematt Dēmatt 16:16, 26 June 2008 (UTC)

Agreed. The comparisons between baseball and cricket, and using Barry Bonds are all very dubious and misleading examples.

The comparison between SMT and chiropractic care is also... misleading. -- Dematt Dēmatt 16:16, 26 June 2008 (UTC)

If anyone has attempted to equate SMT and chiropractic care, that would indeed be incorrect. Chiropractic encompasses more than SMT, and even more than adjustments. -- Fyslee / 23:52, 26 June 2008 (UTC)

There is nothing wrong with discussing a highly relevant topic in Chiropractic, any more than it is wrong for Phishing to discuss homograph attacks, or for Automobile to discuss road safety.

Phishing only has one sentence about homographic attacks. I'm okay with 2 sentences about SMt. We could then balance it with other types of treatment. The question is what two sentences do we use? -- Dematt Dēmatt 19:24, 26 June 2008 (UTC)

Homographic attacks are far less important to phishing than SMT is to chiropractic. No known real-world phishing has involved homographic attacks, but SMT is core to chiropractic and is used every day. ChiropracticEffectiveness already talks about non-SMT treatments such as exercise and mobilization. No doubt this other material could be improved, but the emphasis should remain on SMT as SMT is the core and main treatment form in chiropractic. Eubulides21:13, 26 June 2008 (UTC)

Meeker Haldeman use "spinal adjustment" and "spinal manipulation" interchangeably, and write 'The core clinical action that all chiropractors agree upon is spinal manipulation. Chiropractors much prefer the term spinal “adjustment,” reflecting their belief in the therapeutic and health-enhancing effect of correcting spinal joint abnormalities.'

Eubulides

17:56, 26 June 2008 (UTC)

(☺ Coppertwig21:05, 28 June 2008 (UTC)Eubulides, you said, ""Assendelft ... found no evidence not because their study was small..."" We have no way of knowing that. You said that most of the studies they reviewed were weak and the remaining ones were not statistically significant. Statistical studies can never establish that two groups are exactly equal. When there is a lack of statistically significant result, there is always the possilibity that had a larger number of subjects been included, a statistically significant result would have been achieved. For example, Assendelft et al. say ""Compared with sham therapy, patients receiving treatment that included spinal manipulative therapy had clinically important short-term improvements in pain and on the RDQ...did not reach a conventional level of statistical significance."" If this improvement is caused by the therapy and the set of experiments is reproducible, then repeating the set of experiments enough times and aggregating all the results would produce a statistically significant result. A statistical result such as this which shows a clinically significant result which is not statistically significant cannot be used as evidence that the therapy has no effect. To get that sort of evidence, you would have to have the sort of statistical calculation which can conclude something like "If there is an effect, it's less than 10mm on the scale" (or whatever quantity). If the data show a clinically significant improvement, you're not going to be able to calculate a statistic of that type from that data that's of any use in persuading people that there's no effect. ☺ x Coppertwig 22:44, 28 June 2008 (UTC)

SYN says its example paragraph is original research "because it expresses the editor's opinion that, given the Chicago Manual of Style's definition of plagiarism, Jones did not commit it". It does not say the paragraph is original research merely "because it expresses the opinion that Jones did not commit plagiarism". The citation to the Chicago Manual of Style is integral to the example; without the citation, the paragraph would not be an example of SYN (it would merely be unsupported opinion, a different problem).

My original point was that a SYN violation requires that an explicit conclusion be in the text. The example paragraph in SYN has an explicit conclusion, namely that Jones's claim, if false, would mean Jones violated the Chicago Manual of Style's practice. That is what makes this an example of SYN. Simply stating facts, each supported by a citation, without an explicit conclusion, does not constitute SYN.

ASF gives an example of how to give facts without giving a conclusion. It says that instead of asserting ""The Beatles were the greatest band," we can say: "The Beatles had many songs that made the UK Singles Chart," and source this claim. But by an overenthusiastic misreading of SYN, a Beatles-skeptic could object that the claim "The Beatles had many songs that made the UK Singles Chart," implied the unstated conclusion that the Beatles were the greatest band; and the Beatles-skeptic could say that including the claim, even if sourced, would be a SYN violation. I disagree. I don't think the SYN objection applies to implications that can be drawn from the text. I think it applies to explicit conclusions that are in the text. Any reasonably-interesting text has infinitely many implications that can be drawn from it; if SYN were actually intended to apply to unstated implications, it could be used to wipe out most of what's in Wikipedia now.

We do have a way of knowing that Assendelft "et al." "found no evidence not because their study was small": we know that they reviewed over 1000 sources. That's not a small review; it's a large one. Hence their review being small can't be responsible for their finding no evidence.

I agree with your points about statistics, but I don't see their relevance to the article. Chiropractic does not say that chiropractic treatment has no effect.

Eubulides

02:40, 29 June 2008 (UTC)

With regards to the Beatles point. To make it applicable here, there would have to be a third-party source which makes no mention of the Beatles specifically but claims that the way to determine the greatest band is to measure how many songs of theirs made the UK Singles Chart. Then, in the Beatles article, an editors cites that source and a source stating that they had the most songs to make the UK Singles Chart and thus imply that the Beatles were the greatest band ever. In essence, that is what is going on here at Chiropractic. We have a source describing general SMT research conclusions. We have a source which says that it is okay to apply general SMT studies to chiropractic. And we are using both of those to imply that the conclusions of the general SMT study apply to chiropractic. Just like the Beatles example, this is based on original research of the synthesized variety. -- Levine211222:13, 29 June 2008 (UTC)

I agree that the overenthusiastic interpretation of SYN could be used to justify removal of the Beatles citation in the scenario you give. It could also be used to justify removal of the Beatles citation in the scenario I gave. In both cases, however, the interpretation goes far beyond what SYN actually says. Eubulides07:34, 30 June 2008 (UTC)

I disagree that this is an overenthusiastic interpretation of SYN. I have read through the archives at NOR/N and have actually read several instances of editors describing similar circumstances where the "Conclusion C" is implied and the editors seem to alway agree that SYN violations apply to these cases as well. If that doesn't satisfy you though, perhaps we can post our particular dispute at that noticeboard and read what others think. Sound reasonable? -- Levine211200:00, 1 July 2008 (UTC)

I just now visited NOR/N and didn't see what you saw. Perhaps you could be more specific? There was a lot of text to wade through, and I could easily have missed it. Anyway, I would not be opposed to mentioning this dispute there (you could wikilink to Talk:Chiropractic Syn tag) and see what happens. Eubulides00:39, 1 July 2008 (UTC)

SM vs SMT

Meeker and Haldeman use a different definition of spinal manipulation: "The procedure "'in its broadest definition"' describes application of a load (force) to specific body tissues with therapeutic intent. This load, which has traditionally been delivered by hand, can vary in its velocity, amplitude, duration, and frequency, as well as anatomic location, choice of levers, and direction of force." (emphasis mine)

This defintion would certainly include mobilization, activator, and most other forms of spinal adjustment. In fact, this would be a definition of spinal adjustment. This is not the spinal manipulation that we are talking about in the safety section. Coppertwig is right. We need make sure they are all talking about the same spinal manipulation. Do the other sources use this definition? We need to make sure before we consider using it in this article, otherwise we are comparing apples to oranges. They go on to say: "Many still think “chiropractic” is synonymous with “spinal manipulation,” but as described below, this is only partially accurate." They also say: "chiropractors also provide many other treatments and counselling services. Physical therapies such as heat, cold, electrical methods, and rehabilitation methods are common (28, 29). Chiropractors usually suggest therapeutic exercises and general fitness recommendations to most patients, and give advice to many patients about nutrition, vitamins, weight loss, smoking cessation, and relaxation techniques (30). Many chiropractors use other forms of CAM, with emphasis on massage, acupressure, and mineral and herb supplements (23)"

-- Dematt Dēmatt 19:07, 26 June 2008 (UTC)

Reading Meeker and Halderman more thoroughly, it is apparent that they are using a broad definition of spinal manipulation that would include most of the techniques that chiropractors would consider spinal adjustments.

"To date, at least 73 randomized clinical trials of a "'broadly defined spinal manipulation"' procedure can be found in the English-language literature. Most trials have been published in general medical and orthopedic journals (for example, British Medical Journal, Journal of the American Medical Association, Spine). Nineteen papers were published in the chiropractic peer-reviewed literature (for example, Journal of Manipulative and Physiological Therapeutics). Most first authors have medical degrees, and 23 papers were written by chiropractors. Authors did not necessarily publish in the literature of their profession. While publication bias cannot be ruled out, there is no evidence of it in this information." (emphasis mine)

That is why it's findings were more positive towards spinal manipulation (because it included other techniques).

This should be useable here because it is talking about spinal adjustments and would not be using SYN. The problem is the loose definition of spinal manipulation and I agree with Coppertwig that we cannot move on until we address this definition. -- Dematt Dēmatt 21:09, 26 June 2008 (UTC)

-- Dematt Dēmatt 21:09, 26 June 2008 (UTC)

I agree there is confusion here between what ACA (and Meeker Haldeman) call "spinal manipulation therapy" (SMT, the broader term), and what the ACA calls "spinal manipulation" (the narrower term). SMT includes spinal manipulation, and spinal manipulation is the most common form of SMT used in chiropractic care, but there are forms of SMT other than spinal manipulation. I made http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=221952165oldid=221922157 this change to Chiropractic Treatment procedures to try to clear up the definitional problems. I will review Chiropractic Scientific research and fix confusions in this area. Eubulides21:13, 26 June 2008 (UTC)

I reviewed all sources cited in ChiropracticScientific research, and looked at the rest of the article more briefly, and made http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=221966035oldid=221952165 this change to fix all the confusions in this area that I found. I did not carefully review ChiropracticHistory as I expect that section is about to be replaced by something like History 2 soon. Eubulides22:18, 26 June 2008 (UTC)

I'm thinking we need to try some other sources. I notice the ACA calls it spinal manipulation/adjustment, but they do seem to try to cover everything. I am pretty sure this is different than the SMT or spinal manipulation that the research is talking about. It is talking about the spinal manipulation that includes a dynamic thrust and audible cavitation or "crack". Let's keep looking. -- Dematt Dēmatt 01:33, 27 June 2008 (UTC)

You're welcome to try other sources, but I suspect you'll come up dry unless you look at sources that are so old or low-quality that they don't really qualify here. I read all the sources cited in Chiropractic Scientific research. I looked not only at the terms the researchers used, but also checked their definitions and intended meanings. I found one case (Bronfort "et al." 2008, PMID|18164469) where the researchers made the point (in the very first sentence of their article! I guess they knew it was a big deal) that they were using "spinal manipulation therapy" to denote what the ACA calls "spinal manipulation". The other reviews all seemed to be agreeing with the ACA terminology; some (e.g., Ernst) made a point of citing the ACA. By "other reviews" I include the other reviews coauthored by Bronfort. I found no sources who distinguished "adjustment" from "manipulation"; on the contrary, I found several sources saying there was no significant difference as far as scientific studies go. For example, http://ccgpp.org/lowbackliterature.pdf the CCGPP guidelines talk about "high velocity, low amplitude (HVLA) procedures, often termed adjustment or manipulation, and mobilization" and thereafter uses "HVLA" and "manipulation" interchangeably. Eubulides02:36, 27 June 2008 (UTC)

Agree it's not a simple task, and it was ultimately not particularly fruit bearing. I think most sources consider HVLA (the one with the cavitation) as spinal manipulation (SMT) as you say, Bronfort even goes on to describe the positioning and thrust that gets the cavitation and "small gas bubbles". The ACA definition may be the errant one. Though as you note, some sources have fed off this, both chiropractic and medical sources. It might be interesting to notice, though, that medicine seems to consider manipulation of joints as putting the joints through motions that do not include cavitation... maybe there is confusion there as well.. does medical research confound the two. -- Dematt Dēmatt 13:31, 27 June 2008 (UTC)

My impression is different, and that most sources studying this issue with chiropractic in mind consider SM to be essentially equivalent to HVLA, and consider SMT to include not just SM but also mobilization etc. That is, my impression is that the ACA definition is the most common one, with Bronfort being the notable exception. However, as you say, there is a lot of confusion in this area. I just now checked a high-quality medical paper (Hancock "et al." 2007, PMID|17993364) which I found sort-of-random by searching Google Scholar for "manipulative review" and looking at results since 2006; and this paper agreed with the ACA in including mobilization within SMT but not within SM. So if that's what you meant when you wrote "medicine seems to consider manipulation of joints as putting the joints through motions that do not include cavitation" then Hancock "et al." 2007 is a counterexample. Eubulides21:53, 27 June 2008 (UTC)

I disagree that the ACA definition is the most common one used. How can we determine this? If we could determine that the reviews were studying the ACAs version then we can use them. I have no reason to assume this, though. -- Dematt Dēmatt 03:28, 28 June 2008 (UTC)

In some cases (Ernst) the reviews simply cite the ACA; that settles it. In others the reviews don't cite the ACA, but their usage of SM and SMT are clearly consistent with the ACA; for example, if a review distinguishes SM from mobilization and does not mention SMT, it's using terminology consistent with the ACA. In still others, the reviews aren't entirely clear. You have to use your best judgment in reading the review. Eubulides07:49, 28 June 2008 (UTC)

The ACA seems to have a word for all of them; 1) it defines "manipulation" as the HVLA cavitation manipulation, chiropractic spinal manipulation/adjustment" (The one I'm calling SMT/A). It does also talk about the "broad" spinal manipulation therapy. The question is which is the one that the primary studies are using and the reviews are collating.

I'm not sure what you mean by "if a review distinguishes SM from mobilization and does not mention SMT, it's using terminology consistent with the ACA"

What I meant was that if a review distinguishes SM from mobilization, then the thing it is calling "SM" is what the the ACA is calling "SM"; it is not what the ACA is calling "SMT". Eubulides07:34, 30 June 2008 (UTC)

"'Two points:"' (1) I strongly suspect that this confusion (SMT meaning "only" spinal manipulation vs. the ACA version of "including" other techniques to affect the spine) is so common as to be the norm. Before you brought the ACA version to our attention here, I had never noticed any distinction. SMT was always used in the context of (and referring specifically to) spinal manipulation/adjustments/HVLA thrust. They can - with the exception of that single ACA use (and far from all other ACA uses) and a couple others where they specifically include other spinal techniques than spinal manipulation - be considered synonymous. Unless there is specific exception made, they are synonymous to the ordinary DC, PT, DO, and MD, and should be assumed to mean spinal manipulation/adjustment/HVLA. I agree with Dematt that "it is talking about the spinal manipulation that includes a dynamic thrust and audible cavitation or "crack". Let's keep looking." This agrees with the CCGPP guidelines and probably 98% of other sources in chiropractic and other literature. The ACA's all inclusive definition is a very exceptional and unusual case that renders its definition nearly unusable, except when discussing the case itself. It is pretty much the exception that proves the rule. I know you may disagree, but I'm trained in using spinal manipulation in my career, and have studied the subject for years, as well as studying the chiropractic profession, its literature, its jargon, and its history. The ACA definition is an exception not shared by the way the term is used in research or the field.

(2) You write: ""I found no sources who distinguished "adjustment" from "manipulation"; on the contrary, I found several sources saying there was no significant difference as far as scientific studies go."" I agree on all counts, except that straight chiros (students from Sherman and all the Life and Palmer schools, and all sympathizers with the ICA and WCA) will make a "'philosophical"' difference (and claim a "'physical"' difference, when in fact there is none). (You ""found no sources"" because you must not have looked at straight literature, which is myriad.) They claim that they are more physically specific (when they aren't). What "is" more "specific" is their intent, IOW they are manipulating an imaginative image of what they believe - and get their patients to believe - is happening, based on their philosophically-driven beliefs. Physically there is no difference and the research shows no difference. So, to summarize, there is ""no significant difference as far as scientific studies go,"" but "straights do make a philosophical distinction" which expresses the original and basic version of chiropractic held by all chiros (including mixers) until relatively recently. -- Fyslee / 05:24, 27 June 2008 (UTC)

(outdent)

I agree there is probably other confusion within reliable sources about SM versus SMT. I am skeptical that it is the norm, though. I had noticed authors saying "SM" sometimes, and "SMT" at other times, and didn't take the distinction seriously until today. In rereading the sources, it appears that many authors already knew about the distinction. (These guys are good. :-) Admittedly in several cases the authors use the terms SM or SMT without making it clear whether they are using ACA's definitions or some other definitions; in those cases I simply assumed they were using the "standard" definition.

I also agree with you about straight chiros and SA. However, the philosophical distinction between SM and SA has little practical bearing on what should go into Chiropractic Scientific research.

Eubulides

07:53, 27 June 2008 (UTC)

Fyslee, we're coming from the same direction. The question, of course, is who is doing the weaving? Is it the people that perform 95% of all manipulations - which, btw, if we included other hands on methods, I doubt chiropractors would be the one performing 95% because that now includes thousands of procedures that physical therapists perform every day... hmm. ACA and Ernst calls spinal manipulation anything that involves hands on the spine with a therapeutic intent... hmm. Did they all use research that was meant to be for SMT(cavitation) and then change their definitions to draw in more... ? Can we tell... ? Are we supposed to care... ?

Eubulides, I agree our combined "Eureka moment" has definitely left us in a conundrum. Fyslee and my understanding has always been the same about SMT (cavitation). Both of us use these procedures every day. At least we are now all on the same page in understanding the issue - even if the issue has changed for all of us. Unfortunately, it doesn't bring us any closer to solving the SYN issue. Only now it appears that we can't assume SMT(straight) is synonymous with SMT(mixer) and/or SMT(medicine). I'm remaining open to more thoughts on this.

""The philosophical distinction between SM and SA has little practical bearing on what should go into Chiropractic Scientific research"" I'm not so sure it's that simple. It's that philosophical bearing that determines the frequency of use, the understandings and expectations by the patient, the psychosocial impact of the doctor-patient relationship, etc.. The differences might be huge for all we know. This is Levine's point, that we can't make that leap to assume that SMT research on a few "cracks" by someone is the same as SA.

-- Dematt Dēmatt 12:47, 27 June 2008 (UTC)

ACA, Ernst, and most other sources do not call "spinal manipulation anything that involves hands on the spine with a therapeutic intent". They use the term "spinal manipulation" to talk about HVLA. From their point of view the broader term is "spinal manipulative therapy", not "spinal manipulation".

If Bronfort is the only major dissenter about what "SMT" means, I think we should just stick with the "standard" usage in Chiropractic without comment.

If there are more dissenters then I suspect we should cover the terminological problems under Chiropractic Treatment procedures, but I would still advocate sticking with the ACA terminology elsewhere in the article for sanity's sake. This reminds me of autism, where there is a sometimes bewildering lack of standardization in terminology; Autism works around this problem by discussing terminology in Autism Classification, saying which terms will be used in the rest of the article, and then sticking with that elsewhere. We can do something similar in Chiropractic Treatment procedures but I hope it doesn't come to that.

No reliable source says, or even leaves open the possibility, that there might be a huge difference between SM and SA as far as scientific investigation goes. On the contrary, we have multiple reliable sources saying there's no significant difference.

Chiropractic Scientific research says absolutely nothing about SA, so I don't see how one could possibly object on SYN grounds to its coverage of SA.

Eubulides

21:53, 27 June 2008 (UTC)

"No reliable source says, or even leaves open the possibility, that there might be a huge difference between SM and SA as far as scientific investigation goes." I feel as if you are ignoring my commentary here. I have presented research which says the evidence is insufficient to conclude that benefits of manipulation vary according to the profession of the manipulator (chiropractor vs. other clinician trained in manipulation). I have presented rebuttal from a researcher who was bothered that chiropractors were using his general spinal manipulation research to claim that chiropractic works: ""...we have become aware of numerous instances where our results have been seriously misrepresented by chiropractors writing for their local paper or writing letters to the editor....RAND's studies were about spinal manipulation, not chiropractic... Comparative efficacy of chiropractic and other treatments was not explicitly dealt with."" Now, I'd like to present more disagreement to your claim that spinal manipulation = chiropractic in terms of research. http://www.wcanews.com/archives/1999/dec/dec99i.htm From the President of the World Chiropractic Alliance: ""...spinal manipulation is not the same as chiropractic adjustments. Unfortunately, many people use the two terms as though they were interchangeable... While M.D.s, D.O.s, and even P.T.s might be able to manipulate a spine, it takes years of specialized training to properly give a chiropractic adjustment."" That's definitely an extreme view , but it is yet another significant view which supports why confounding SM or SMT research with the efficacy of chiropractic is problematic. Above you write, "We have multiple reliable sources saying there's no significant difference." And yet we also have multiple reliable sources saying there is a difference. So, if we are to take only the opinions of the multiple sources which say there is no difference between SMT and SA, and use those opinions as justification for including SMT studies to describe the efficacy of chiropractic SA, it creates such a clear-cut, textbook, and obvious SYN violation that I am finding difficult to understand how you don't recognize this. "A" says this, so let's apply that rationale to "B" so we can include statement "C" in our article. This is the classic SYN violation. -- Levine211222:40, 27 June 2008 (UTC)

I agree that a significant minority of chiropractors say there's a philosophical difference between SA and SM. But my point was that there's not a huge difference "for the purpose of scientific investigation". The quote from the WCA does not contradict this point.

It might be a good idea for Chiropractic Philosophy to discuss the difference in philosophy between SA and SM, but this wouldn't affect the contents of Chiropractic Scientific investigation; the two terms are interchangeable from the point of view of scientific investigation, and for convenience Chiropractic Scientific investigation employs the term used in mainstream publications.

The RAND researcher of course made a valid point, but Chiropractic Scientific investigation clearly distinguishes SM from chiropractic and does not make the error of misrepresentation that he warned against. That section does not have the problem of "including SMT studies to describe the efficacy of chiropractic SA". It doesn't even mention SA.

Eubulides

23:13, 27 June 2008 (UTC)

Yes it does contradict that point. Read the whole article, not just what I quoted.

Perhaps. But there is little reason to discuss SM at all in this article other that to say chiropractors employ a form of SM called SA and here is what makes SA distinct. The bulk of this should be handled in the spinal adjustment article though.

If you agree to that, then why include any research not specifically studying chiropractic in this article? It seems that in the absence of chiropractic specific research, you believe we are justified in including general SMT research which make no direct correlations to or conclusions about chiropractic. That wholly inappropriate. Furthermore, adding the disputed rationale of a few researchers to your justification has created a clearcut SYN violation. -- Levine211223:55, 27 June 2008 (UTC)

I read the whole WCA opinion piece, and it is not coherent on this point. It clearly argues that SA is not SM. It does not, however, say that there is a huge difference between SA and SM from the point of view of scientific investigation. It never mentions SA in the same sentence as scientific investigation. It has just one sentence on research, which says "controlled research started showing that chiropractic does work". But chiropractic care is not the same as SA.

The view that SA differs greatly from SM, on philosophical grounds, is certainly held by the straights, as the WCA piece suggests; but this is a minority viewpoint within chiropractic, which in turn is a minority viewpoint within health care. The mainstream view is that there's no significant difference from the point of view of scientific investigation, and this article should reflect that. It would be a major violation of WEIGHT if this minority opinion were used to justify removal of important mainstream scientific evidence from the article.

It is important to discuss spinal manipulation in Chiropractic, just as it is important to discuss (say) acupuncture in Traditional Chinese medicine, or to discuss anesthetics in Anesthesiology. These treatments are core to the respective professions.

Eubulides

07:49, 28 June 2008 (UTC)

"I agree that a significant minority of chiropractors say there's a philosophical difference between SA and SM. But my point was that there's not a huge difference for the purpose of scientific investigation".

SM is just the HVLA cavitation maneuver applied with the intention of restoring joint movement. SA includes SM as well as other techniques (activator, flexion distraction, logan basic, etc. that are not forms of HVLA manipulation). Chiropractic care also includes heat, ice, muscle stim., exercises, advice, massage, acupuncture, nutritional advice, smoking cessation, weight management, etc.. This represents a "huge" difference for purposes of scientific investigation.

"It might be a good idea for Chiropractic Philosophy to discuss the difference in philosophy between SA and SM, but this wouldn't affect the contents of Chiropractic Scientific investigation; the two terms are interchangeable from the point of view of scientific investigation, and for convenience Chiropractic Scientific investigation employs the term used in mainstream publications".

The two terms SA and SMT/A are interchangeable for the purposes of scientific investigation of chiropractic care and Chiropractic Scientific investigation. SM and SA are not interchangeable. What is your interpretation of the definition of the term used in mainstream publications that Chiropractic Scientific investiagation employs?

"Perhaps. But there is little reason to discuss SM at all in this article other that to say chiropractors employ a form of SM called SA and here is what makes SA distinct. The bulk of this should be handled in the spinal adjustment article though."

I agree with this in principle. -- Dematt Dēmatt 03:28, 28 June 2008 (UTC)

It sounds like, by your definition, SA is closer to SMT than it is to SM. I don't know of mainstream scientific publications that use this definition.

I don't know what "SMT/A" is.

Mainstream scientific publications by and large don't use the term "SA"; when they do, they tend to equate it with SM for the purposes of their papers.

I continue to think scientific evidence on SM/SMT/SA/whatever belongs in Chiropractic. Evidence should not be banished to a subarticle on the grounds that straight chiropractors do "adjustment" not "manipulation". Manipulation, under whatever name one calls it, is core to the profession.

Eubulides

07:49, 28 June 2008 (UTC)

Yes, we are obviously using different definitions of SM, SA, and SMT. Nobody is saying that evidence should be banished to a subarticle, only that (similar to history) we give an abridged version of twoor three paragraphs that states "conclusions" from V and RS about "chiropractic" with links to the main artcles. -- Dematt Dēmatt 22:02, 29 June 2008 (UTC)

I agree with Dematt here. Banishing relevant evidence to a sub-article is a strawman argument. Rather, what is being suggested is that any studies which are about general SMT should be placed in the spinal manipulation and studies specifically about chiropractic should be retained/added to this article (and relevant details should be placed in spinal adjustment). I think this is extremely logical and rather reasonable. -- Levine211222:17, 29 June 2008 (UTC)

This appears to be a proposal to banish all discussion of the effectiveness of SMT to a subarticle, and to not even summarize the discussion here. That would not be a reasonable approach, for reasons already mentioned.

I am not opposed to slimming down the discussion of effectiveness; but slimming down is not the same as removing all discussion of SMT effectiveness.

For many months Chiropractic had a long discussion of effectiveness and cost-effectiveness that was strongly biased in favor of chiropractic (i.e., zero evidence from the skeptical side); see, for example, http://en.wikipedia.org/w/index.php?title=Chiropracticoldid=206435256Movement_toward_science. Nobody proposed moving that discussion to a subarticle. The current discussion of the same subject is about the same length as the old one (I count 1016 and 1014 words, respectively). It would be odd to argue that the new discussion is so long that it should be moved to a subarticle, given that the old one was the same length, and was never objected to.

Eubulides

07:34, 30 June 2008 (UTC)

The effectiveness of HVLA SMT and SA need to be on the articles that discuss those treatment modalitities. The effectiveness of chiropractic needs to be on this page. We wouldn't put the effectiveness of chiropractic care on either of those pages. However, if the net effectiveness of chiropractic care is equal to the effectiveness of SMT then this conversation would be moot anyway because we should be able to see that when we look at the reviews.

1) The link that you give was listed under the History section of that version of the article. Previous versions did have it under the science section. It was used to balance a NPOV version of chiropractic that was worked on for two years by some very skeptical editors. 2) Each of those reference information about "chiropractic care" (Manga, The Workers Comp studies). The British Medical Association info, etc. is not about science and was in the AMA vs chiropractic section previously and in your version was in the history section. However, I agree that the initial Manga and The Workers Comp studies are now historical studies that do not need to be in this section. We shouldn't be concerned if the article ends up being pro or con chiropractic, only that it is NPOV. Every POV is under the same restrictions. If we find an article that says SMT is beneficial for ear infections, we don't use it here either. I am not concerned about length, though brevity should be a goal. There is no reason to repeat studies that all say the same thing as long as the weight issue is handled NPOV. Juxtapositioning is important to avoid SYN as well.

-- Dematt Dēmatt 12:57, 30 June 2008 (UTC)

There is no evidence of SYN. The SYN tag can be removed now.

Slimming the effectiveness section is not the same as removing all of the highly relevant information of SMT effectiveness.

Dematt and Levine2112, do you both want to remove all the relevant information of SMT or do you both want to summarize the info.

Please be specific. QuackGuru17:20, 30 June 2008 (UTC)

Much evidence of SYN has been presented and the dispute continues. Thus, removing the SYN tag now would be immature and disruptive.

SMT studies not particularly about chiropractic care are not "highly relevant". This is just your opinion (and perhaps the opinions of some researchers). Justifying the inclusion of SMT studies here either with your opinion or the opinion of researchers not specifically describing the SMT study in question is a clear cut violation of SYN.

No. (If I may speak for both of us...) We are in favor of removing all of the "'irrelevant"' SMT information.

I believe our specificity on this issue is abundantly clear, but if you have any specific questions about anything which you're still unclear, feel free to ask. -- Levine211200:08, 1 July 2008 (UTC)

SYN and implicit conclusions

"Related discussion: Proposed wording for NOR/N"

Talk:Chiropractic/Archive ??Proposed wording for NOR/N --

No specific evidence of any explicit conclusions (which are necessary for SYN violations) has been presented. All the conclusions that have been presented are implicit conclusions, conclusions that are not present in the text. This is dubious evidence for an alleged SYN violation: every major Wikipedia article has a huge number of implicit conclusions which could be used to allege SYN violations under a rule where an implicit conclusion would mean a SYN violation.

SMT studies are highly relevant to chiropractic. SMT is at the core of chiropractic, and the highest-quality SMT studies are written by chiropractors and are aimed at chiropractors. The relevance is not just "perhaps the opinions of some researchers": it is the opinion of the leading researchers in the field, researchers like Haldeman and Meeker and Ernst, and no leading researcher disagrees. Omitting SMT from Chiropractic would be like omitting acupuncture from Traditional Chinese medicine.

I'm not aware of any specific wording proposal that would address the SYN problem. It sounds like a major rewrite of Chiropractic Scientific research section is being considered, but no specific wording has been proposed.

Eubulides

00:39, 1 July 2008 (UTC)

Eubulides said: ""Every Wikipedia article has a huge number of implicit conclusions."" That's a straw man argument. Nobody is saying we should take out everything from which a reader could draw a conclusion. What SYN is saying is to take out material which is there specifically for the purpose of leading the reader to one specific conclusion (if that conclusion is not in one of the sources). It's similar to questions being disallowed on cross-examination in a court if they're "leading questions"; it doesn't mean all questions which have answers are disallowed. Is there any reason for including effectiveness-of-SMT studies in this article other than to lead the reader to a conclusion about effectiveness of chiropractic care? If so, the material would have to be presented in such a way that it does not seem to be leading to only one possible conclusion, unless that conclusion is expressed in the source.

Eubulides said, ""The example paragraph in SYN has an explicit conclusion, namely that Jones's claim, if false, would mean Jones violated the Chicago Manual of Style's practice. That is what makes this an example of SYN."" Ah, no! That is not what SYN says! It says ""...Jones did not commit it."" "it" means "plagiarism", or, if you will, the Chicago Manual of Style's (CMOS's) definition of "plagiarism". Do you agree, Eubulides, that the word "it" refers to "plagiarism", or do you have a different interpretation of that sentence? Also, it's saying that the point is that Jones did "not" commit it. The paragraph also says something about Jones violating something in the CMOS, but that is not the point: the point is about Jones not committing something, i.e. plagiarism: an idea which is expressed implicitly, but not explicitly, in the paragraph.

I guess I wanted to include something in the article that effectively meant ""We're not saying that SMT equals chiropractic, but..."" However, I guess it isn't actually possible to include anything along those lines without violating V or SYN. Maybe there's no way to take a SYN violation and add something to it to make it no longer a SYN violation: except that I still think a heading "Effectiveness of SMT" might help. Maybe the whole second paragraph of the Effectiveness section is essentially trying to do that and could be gotten rid of.

Re Eubulides' argument that there used to be a long pro-chiropractic effectiveness section: I think we need to argue on the basis of what would make a good article, not OTHERSTUFFEXISTED arguments. If the earlier section was too long, perhaps it should have been shortened. If it was actually about effectiveness of chiropractic itself rather than SMT, maybe the same arguments for shortening it didn't apply.

I think the key is looking closely at the definitions. From the above discussion it seems to me that maybe some of the sources are covering a broad range of chiropractic manipulation techniques and as such seem to me to be relevant to this article. Also, if a study has "chiropractic" in the title or states that it's evaluating the effectiveness of chiropractic etc., it's probably relevant here. I'm in the process of getting access to some of the sources and should have them within a day or two, and should have more comments after that.

Re needing a proposal of specific wording: you're right, of course, Eubulides. Go for it, Levine2112 or Dematt or anyone else. I might come up with something eventually if others don't.

QuackGuru, I understand that in your opinion there is no SYN violation, but in other people's opinion there is a problem, so the tag should stay until it's resolved. You could explain in more detail where you see the flaws in the arguments about SYN violations. ☺ Coppertwig02:26, 1 July 2008 (UTC)

Thanks again for your comments. You've certainly given us some food for thought. Some followup:

"Nobody is saying we should take out everything from which a reader could draw a conclusion." Obviously this objection is not to "everything". It is objecting only to the "conclusion" that SMT studies are relevant to chiropractic. My point is that the same sort of objection could be applied to most statements in Wikipedia, which makes this particular objection suspect. Here is an analogy. Suppose I said that MOS entails a guideline called the "Verb Guideline" which lets any editor successfully object to any claim that contains a verb. And suppose I invoked the Verb Guideline to object to the contents of Chiropractic Philosophy, on the grounds that the section contains verbs, and defended this invocation with the argument "Nobody is saying we should take out everything containing a verb". Technically this defense would be true, but it's missing the point: the Verb Guideline is misguided and would let any editor successfully challenge just about anything. The proposed misreading of SYN would have powers similar to those of the Verb Guideline, and should therefore be viewed with a great deal of caution.

Come to think of it, this whole argument about the relevance of SMT being a "conclusion" is 100% backwards. The objection being raised here is actually to an "assumption" in Chiropractic Scientific investigation, not to a "conclusion". The assumption is that SMT is highly relevant to chiropractic care. This assumption is a mainstream assumption, but it is disputed by the straights (a minority of chiropractors who have an antiscientific philosophy), who assert that chiropractors do spinal adjustment, not SMT, and that SMT is irrelevant to chiropractic. It is this mainstream "assumption" that is being objected to. The objection argues that Chiropractic Scientific investigation, by making the mainstream assumption, is leading the unwary reader to the "conclusion" that SMT is relevant. But that is an indirect and weak argument, whose main virtue is that it brings SYN into play. The direct argument is the argument about the assumption, not about the indirect proof-by-contradiction "conclusion".

"What SYN is saying is to take out material which is there specifically for the purpose of leading the reader to one specific conclusion (if that conclusion is not in one of the sources)." What is the "one specific conclusion" in question? Levine2112 seems to be arguing that this "conclusion" is that studies of SMT are relevant to chiropractic. But that sort of argument, if taken to this kind of extreme, could be used about a vast number of citations used in many Wikipedia articles.

Let's take, for example, the first citation used in the alphabetically-first featured medical article in Wikipedia, which (as of this writing) happens to be Action potential. Action potential says "Electrical signals within biological organisms are generally by ions, which may be either positively charged cations or negatively charged anions." and cites page 9 of Johnston Wo 1995 (ISBN|0-262-10053-3). But this citation is not about action potential; it is about something else. So Action potential is "violating" SYN here, because it is written with the purpose of leading the reader to the (unstated) conclusion that cations and anions are relevant to the topic of action potential.

Of course, this is a ridiculous example: anyone familiar with action potential knows that cations and anions are highly relevant to the topic, and it's eminently reasonable for Action potential to talk about cations and anions and to cite a source on them. If pressed by a skeptic, an editor could probably even cite a source saying that anions and cations are relevant to action potential. But then the skeptic would say "A-HA! You're violating SYN, by tying together two different sources to make a conclusion! One source talks about anions and cations; the other says that anions and cations are relevant to action potential! That's a SYN violation!"

This sort of argument, when taken to such an extreme, could be applied to "most" citations in Wikipedia. A sufficiently-motivated skeptic can always say "A-HA! You need another source B to show that this source A is relevant!". And then there will be an infinite regress, and an article will never be able to cite any source.

The only way to forestall this sort of Carrollian argument, in the end, is to apply common sense. Of course cations and anions are highly relevant to action potential, and of course there is no reasonable objection to citing a source on cations and anions in Action potential.

Chiropractic is similar. It's true that SMT is not exactly the same as chiropractic, but it is also true that SMT is the core topic of chiropractic. If Chiropractic did not discuss SMT extensively, it would not be encyclopedic. Common sense says that Chiropractic should discuss SMT, a core topic, and cite reliable sources about it.

I agree that the "it" in SYN's "Jones did not commit it" stands for plagiarism, but I don't follow the rest of your argument. If the problem solely lies in the editor's opinion that Jones did not commit plagiarism, then the fix suggested by SYN ("a reliable source is needed "that specifically comments on the Smith and Jones dispute" and makes the same point about the "Chicago Manual of Style" and plagiarism…") would not in fact fix the problem, as the passage's insertion would still have been motivated by the editor's opinion. The example SYN violation does not occur merely because the editor had an opinion. There is another essential component to the violation, namely, that the text contained a conclusion ("If Jones's claim that he consulted the original sources is false, this would be contrary to the practice...") that is not supported by any source.

There certainly is a way to take a SYN violation and add something to make it no longer a SYN violation. SYN gives an example of repair via addition of a source, an example that I quoted in the previous bullet.

I agree that we should argue on the basis on what would be a good article.

A mechanical rule like "'chiropractic' in the title" is completely inappropriate here. It would be absurd to require Action potential to cite only sources that have the phrase "action potential" in their titles. Chiropractic is similar.

Eubulides

06:32, 1 July 2008 (UTC)

I apologize for squeazing in here, but this seems to be the last of the SYN arguments. Eubulides said "...then the fix suggested by SYN ("a reliable source is needed "that specifically comments on the Smith and Jones dispute" and makes the same point about the "Chicago Manual of Style" and plagiarism")" is not complete. There is an additional sentence that clarifies your discussion; "In other words, "'that precise analysis must have been published by a reliable source"' in "relation to the topic" before it can be published in Wikipedia by a contributor. (emphasis mine)

This is where your issue lies. The point is that there needs to be "'one"' source that says "'both"' things - AND they need to be in relation to the topic.

Our Science section violates both of these - we are using two sources to synthesis an implied conclusion AND we are doing it in the wrong article. The rules are there to prevent POV warriors from creating original analysis in the wrong articles such as we have done. We need to respect the spirit of that rule by following its suggestion.

-- Dematt Dēmatt 16:20, 1 July 2008 (UTC)

Hey, no problem squeezing in, we have plenty of room!

I agree that the fix I gave was incomplete (I just now added a "…" to the quote in my previous comment, to mark that incompleteness) but this doesn't affect my points, which were (1) that a SYN violation does not occur merely because the editor had an opinion, and (2) a SYN violation can be fixed by adding text.

I disagree that Chiropractic Scientific investigation is original analysis, unless we change the definition of "original analysis" to be a much broader term than intended ("it's 'original analysis' unless the entire text of the article is transcribed verbatim from a single source external to Wikipedia" would be broad enough :-). Similarly, I disagree that Chiropractic Scientific investigation reflects the work of POV warriors (this is a new allegation, is it not? aren't specific details needed for an allegation like that?) or that it is in the wrong article. If Chiropractic Scientific investigation is indeed guilty of all these sins, then lots of Featured articles are rife with SYN violations, which is a bit hard to believe.

Eubulides

17:34, 1 July 2008 (UTC)

Thanks for acknowledging the fix. I realize it wasn't intentional, only perhaps wasn't considered in your remarks. However, 1) the SYN violation occurs when the editors opinion gets expressed when the sources were not explicitly expressing the same opinion about the subject at hand. 2) I agree, the Syn violation can be fixed by adding a reference that specifically states the same two arguments and reaches the same conclusion about the subject at hand. It doesn't have to be verbatum, but it should reflect what the author concluded (not what he used to reach his conclusion) or we are doing the author a disservice to reference him/her.

I wasn't alleging that any of us are POV warriors on this page. Only that the policy was designed to keep it from happening. No, we are pretty tame here on this page. Believe me, two years ago we had a guy who really was pushing to say that chiropractors were pseudoscientists. He referenced one study and said that chiropractors used chiropractic to cure homosexuality. Of course no-one had access to the research but him, but once we got it we found out the study was by a psychiatrist who mentioned the word chiropractor once. When we contacted him, the psychiatrist was upset that we had misrepresented his work. Taken out of context anything can be made to say anything.

-- Dematt Dēmatt 21:26, 1 July 2008 (UTC)

Dematt is really expressing what my replies would be in a much more eloquent way than I could write. I also agree with Coppertwig's assessment above of the issue at hand. Eubulides, if you still disagree about implied SYN violations, I would request that we take the matter to NOR/N for investigation. Perhaps we just start off by getting feedback on the policy in general (without specific application to chiropractic or SMT or whatever). That way, we know if SYN can be the result of an implied conclusion in general. Then, depending on what the consensus is on that, we can then ask for comment on how and if that applies to the situation at hand. Sound reasonable? -- Levine211200:44, 2 July 2008 (UTC)

If necessary, yes, let's ask at NOR/N. But we may be able to resolve it with discussion here instead. I think it would help, Eubulides, if you would answer my question as to what the pronoun "it" represents in the clause "Jones did not commit it" at SYN. Perhaps you could also give an example of something at a featured article that you think would be a SYN violation according to our interpretation of SYN. Or, maybe you'd prefer that we ask at NOR/N; or, if I have time, maybe tomorrow, I might search there for a similar question having already been asked. If we ask at NOR/N perhaps we should first agree here on the wording of the question. ☺ Coppertwig01:25, 2 July 2008 (UTC)

"the SYN violation occurs when the editors opinion gets expressed when the sources were not explicitly expressing the same opinion about the subject at hand" Yes, if the editor's opinion is "expressed" (i.e., explicit, as in the SYN example) rather than "implied" (i.e., implicit).

Curing homosexuality? Wow. Well, I've read all the sources to Chiropractic Scientific investigation and I think it's safe to say that none of them are being misrepresented that badly!...

Above I wrote, 'I agree that the "it" in SYN's "Jones did not commit it" stands for plagiarism...' Looks like you missed that?

Above I gave Action potential as an example of an article that would have a SYN violation under the proposed interpretation. As I mentioned, I simply picked the first citation in the alphabetically first medical article I could find; this wasn't chosen as the best or strongest example.

I like the idea of agreeing on the wording of the question here first. Sometimes, you can resolve the answer to a question simply by resolving the wording of the question.

Eubulides

05:15, 2 July 2008 (UTC)

I agree that we may be able to find the answer merely by agreeing first on the question. Anyone want to take a first stab?

Just so we are clear, we will be formulated a question for NOR/N concerning whether or not the mention of SMT research in Chiropractic causes a SYN violation as the justification for including said SMT research in Chiropractic is based on third-party researchers of the opinion that it is okay to relate SMT efficacy and safety research with Chiropractic's efficacy and safety.

Do we all agree that this is the basic plan we will be following here? -- Levine211201:08, 3 July 2008 (UTC)

The phrases you're using would belong to a formulation of the question from your point of view, which is understandable. I would formulate it as a question whether an article on topic X can cite sources on a different topic Y that is core to X. Clearly, coming up with the wording of the question will be tricky. Perhaps both sides should get a budget of (say) 25 words each? Or whatever budget you like. Eubulides16:41, 3 July 2008 (UTC)

I would say that even in your generic formulation, you too are understandably phrasing it from your point of view. We - as editors incapable of OR - know that Y is core to X without some other source Z suggesting that it may be. Does that sound reasonable to say? I don't know that word budgeting is a good idea in terms of limiting expression; however it may help to avoid convolution. Then again, there is a fine line between succinct clear expression and convolution. -- Levine211218:30, 3 July 2008 (UTC)

Yes, yes, that was the formulation from the other side. As for the budget, I don't much care what it is, so long as the question is roughly balanced from both sides. How about this idea? You propose specific wording for the question, using as many words as you like, and I'll propose specific wording to add to the question, using no more words than you used. That way, there's no budget, but there's still a rough equality. Other editors are of course free to propose other wordings too. Eubulides20:51, 3 July 2008 (UTC)

To be honest, I tend to work better the other way around. I like to see other people's thoughts first and then see if I can hone my own from there. So please feel free to craft your own question first. Don't worry about budget. That much said, if I am struck with the perfect phrasing, I will jump in a formulate my take. -- Levine211201:10, 4 July 2008 (UTC)

There's no rush, and no need to be perfect at the first try. How about if we start with the following phrasing, which is (of course) from my viewpoint: "Does it violate SYN if an article on topic X discusses a different topic Y that is core to X?"? Eubulides05:48, 4 July 2008 (UTC)

Sorry I haven't been able to contribute lately, but the last few weeks have been very hectic IRL. I don't think that anyone is saying that we cannot cite sources about topic Y on the article for topic X. The problem is that in a section on "Effectiveness of X", we are presenting research on the effectiveness of Y, and that the section is overwhelmingly dedicated to the effectiveness of Y, while sources exist that discuss the effectiveness of X. It is also important to note that Y has its own article, where effectiveness of Y would be better discussed. DigitalC06:00, 4 July 2008 (UTC)

Draft questions would not resolve disagreement

Eubulides and Levine2112, thanks for providing draft questions, but answers to those questions would not solve the disagreement we've been having about SYN. I suggest that if necessary, we ask at the noticeboard a question something like ""Is it possible for an idea which is expressed implicitly but not explicitly in an article to be a SYN violation?"" Talking about Y in an article about X may or may not be a SYN violation.

Eubulides, where you said: ""Yes, if the editor's opinion is "expressed" (i.e., explicit, as in the SYN example) rather than implied (i.e., implicit)." Actually, in the SYN example, the opinion expressed is implicit, not explicit. You agree that "it" means "plagiarism". SYN says ""This entire paragraph is original research, because it expresses the editor's opinion that, given the "Chicago Manual of Style's" definition of plagiarism, Jones did not commit it."" Therefore, the idea that SYN says is expressed is an idea which involves Jones and plagiarism, i.e. that Jones did not commit plagiarism (according to a certain definition). Yet no sentence in the example paragraph described as a synthesis (the last example paragraph in SYN) mentions Jones and also mentions plagiarism. The idea about Jones and plagiarism is implicit in the juxtaposition of the sentences, yet SYN uses the verb "expresses".

Eubulides, thanks for the Action potential example. You said, ""So Action potential is "violating" SYN here, because it is written with the purpose of leading the reader to the (unstated) conclusion that cations and anions are relevant to the topic of action potential."" I respectfully disagree; that sentence does not look to me as if it is written with that purpose. Besides, cations and anions may well be relevant and their relevance may be verifiable by reliable sources

Re this example provided by Eubulides: """A-HA! You're violating SYN, by tying together two different sources to make a conclusion! One source talks about anions and cations; the other says that anions and cations are relevant to action potential! That's a SYN violation!""" It's good that you give examples like this, because it gives an opportunity to clear up misunderstandings. As long as the idea is expressed in some reliable source, it's OK to express it in this article (provided due weight and other policies and guidelines are followed).

Re Eubulides saying ""This sort of argument, when taken to such an extreme..."" Nobody is suggesting taking arguments to extremes. There is a genuine concern here by some editors that stating something about effectiveness of SMT will mislead many readers into thinking they've just read something about effectiveness of chiropractic and concluding that chiropractic has the level of effectiveness stated. I think this is a reasonable concern and that we need to study the definitions of SMT (thank you, Dematt, Eubulides, Fyslee and Levine2112 for having done some work on that already; I'm sorry that I haven't had time yet) and figure out how to present the information so that it doesn't lead to a SYN violation.

Since chiropractors also use nutrition and exercise etc., one thing that might help might be to give a brief statement about overall effectiveness of nutrition (with a link to a nutrition article) and a brief statement about overall effectiveness of exercise, etc. This would, in my opinion, avoid conveying to the reader the impression that the statements of effectiveness of SMT are statements of effectiveness of overall chiropractic treatment. ☺ Coppertwig01:20, 6 July 2008 (UTC)

I continue to disagree with that characterization of the example in the SYN example. The example text contains the editor's explicit opinion, and that opinion is key to the example. The explicit opinion is clearly in the sentence "If Jones's claim that he consulted the original sources is false, this would be contrary to the practice recommended in the "Chicago Manual of Style", which requires citation of the source actually consulted." Remove that sentence, and the following two sentences make no sense whatsoever and would have to be removed as well; this would remove the SYN violation in this example.

Re Action potential: "I respectfully disagree; that sentence does not look to me as if it is written with that purpose. Besides, cations and anions may well be relevant and their relevance may be verifiable by reliable sources " Of "course" cations and anions are relevant to action potential: action potential wouldn't exist without them. This is true regardless of whether we can find a reliable source saying "cations and anions are relevant to action potential". So, the only real difference cited between the Action potential example and the Chiropractic example is "that sentence does not look to me as if it was written with that purpose", the purpose being to draw the reader to the (unstated) conclusion that cations and anions are relevant to action potential. I disagree with you: I think the sentence "was" written with that purpose. But regardless of whether we agree about that sentence's intent, our speculations about the motivation of the author of the sentence are far too slender a reed to prove or disprove a SYN violation. If "that sentence does not look to me as if it was written with that purpose" is all that's needed to disprove a SYN violation for Action potential, why doesn't it also suffice to disprove a SYN violation for Chiropractic?

"As long as the idea is expressed in some reliable source, it's OK to express it in this article" In that case we are OK here. Every idea that is expressed in Chiropractic Scientific investigation is also expressed in a reliable source. (The argument here is over implicit ideas, not about ideas that are expressed explicitly.)

I still think this is really a dispute over "assumptions", not over "conclusions".

We could easily add something about exercise therapy. For example:

A 2005 systematic review found that exercise appears to be slightly effective for chronic low back pain, and that it is no more effective than no treatment or other conservative treatments for acute low back pain.cite journal |journal= Cochrane Database Syst Rev |date=2005 |issue=3 |pages=CD000335 |title= Exercise therapy for treatment of non-specific low back pain |author= Hayden JA, van Tulder MW, Malmivaara A, Koes BW |doi=10.1002/14651858.CD000335.pub2 |pmid=16034851

I don't know of any reliable source on using nutrition to treat back pain or similar complaints.

Eubulides

10:32, 6 July 2008 (UTC)

Any further thoughts? If not, I'm inclined to add the above sentence to Chiropractic Effectiveness under "Low back pain". I doubt whether this will resolve the SYN dispute but it does seem like an improvement. Eubulides21:15, 11 July 2008 (UTC)

No further comment, and it's been more than a week, so I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=225754358oldid=225736943 added that sentence. Eubulides06:49, 15 July 2008 (UTC)

Thanks for adding that sentence about exercise, Eubulides. I guess I've been busy with other things.

Re """Of course" cations and anions are relevant to action potential: action potential wouldn't exist without them."": LOL!! quite right.

Re ""I continue to disagree with that characterization of the example in the SYN example."" I don't understand your interpretation of SYN. How do you explain the presence of the word "it", which I believe we've agreed represents "plagiarism", in this sentence of SYN: ""This entire paragraph is original research, because it expresses the editor's opinion that, given the Chicago Manual of Style's definition of plagiarism, Jones did not commit it.""? The word "plagiarism" does not appear anywhere in the sentence ""If Jones's claim that..."" which you quote. What do you think is the OR conclusion in the Smith and Jones example? That is, what is the unverified conclusion being expressed in that example?

I'm sorry if I said I was cogitating about something and then disappeared; however, I did suggest wording for a question to the NOR noticeboard.

Re ""that sentence does not look to me as if it was written with that purpose"": Eubulides, it would help if you say whether you think the sentences in the chiropractic effectiveness section look to you as if they're intended to give the reader the impression that chiropractic has a certain level of effectiveness, i.e. the level of effectiveness described for SMT. (Sorry if I asked that already.) ☺ Coppertwig23:02, 19 July 2008 (UTC)

Re "it" and "plagiarism". Yes, I agree that the second "it" means "plagiarism". Still, I don't agree that the example turns on an implicit claim. Core to the example is the unsourced explicit claim "If Jones's claim that he consulted the original sources is false, this would be contrary to the practice recommended in the Chicago Manual of Style, which requires citation of the source actually consulted". The example would lose its force without this unsourced explicit claim, and the following discussion "This entire paragraph is original research..." wouldn't make sense without the unsourced explicit claim. Chiropractic Evidence basis doesn't contain claims like this, so arguing by analogy from this example is not likely to produce useful conclusions.

The suggested wording for a question to the NOR noticeboard was too vague to be useful, I'm afraid. I have follow up with a new section Proposed wording for NOR/N. Eubulides21:11, 21 July 2008 (UTC)

The sentences in the Chiropractic Effectiveness do not give the reader the impression that chiropractic has a "certain level of effectivness". On the contrary, the section starts right off by denying that impression, saying "The effectiveness of chiropractic treatment depends on the medical condition and the type of chiropractic treatment." Furthermore, the section repeatedly states that a lot is unknown about the effectiveness of chiropractic, using phrases like "The efficacy of maintenance care in chiropractic is unknown" and "There is continuing conflict of opinion on the efficacy of SMT"; this also contradicts any impression that chiropractic has a "certain level of effectivness".

Eubulides

21:11, 21 July 2008 (UTC)

Eubulides, you haven't answered my question: how do you explain the presence of the word "it", meaning "plagiarism", in that sentence? I don't understand how you're interpreting that sentence, which seems to me to state clearly which claim is being identified as "original research" in the example. ☺ Coppertwig13:31, 24 July 2008 (UTC)

The core question

Does it violate SYN if an article on topic X discusses a related topic Y that is core to X?

Please answer the above question directly or both the neutrality and SYN tag will be removed very soon.

Me thinks we should not continue a discussion when no evidence of SYN has been presented. QuackGuru06:39, 5 July 2008 (UTC)

Again, this is too simplistic. Of course it is valid to mention topic Y on an article X. However, what we have is a bunch of research on the effectiveness of topic U,W,Y, Z under the heading of "Effectiveness of X". DigitalC10:34, 5 July 2008 (UTC)

DigitalC claims "what we have is a bunch of research on the effectiveness of topic U,W,Y, Z under the heading of "Effectiveness of X"."

However, no evidence has been presented to back up the claim. Both tags will be removed very soon if no evidence is presented.

The question below is a core question. Please answer it directly and be specific. Please present specific evidence to back up your comments.

Again: "Does it violate SYN if an article on topic X discusses a related topic Y that is core to X?" QuackGuru17:37, 5 July 2008 (UTC)

I agree with DigitalC here. QuackGuru's question is far too simplistic for the matter at hand. We are dealing with research about SMT in general here and using it to make assertions about the efficacy and safety of Chiropractic. Perhaps the question should be asked as such:

Does it violate OR if an article on topic X uses efficacy and safety research about a more general topic Y to make assertions about the efficacy and safety of topic X? Further, does it violate SYN if the justification for making such an assertion comes from some source Z?

-- Levine211220:20, 5 July 2008 (UTC)

"Again: Does it violate SYN if an article on topic X discusses a related topic Y that is core to X? ". Again - this question is overly simplistic, and is a strawman argument. As for answering it directly, I believe I did when I stated "Of course it is valid to mention topic Y on an article X." There is obviously no consensus to remove to SYN tag at present, and to do so would be disruptive editing, for which you may be blocked. DigitalC01:56, 6 July 2008 (UTC)

Does it violate SYN if an article on topic X discusses a related topic Y that is core to X? Nope.

There is no violation of Syn. If you think the core question is overly simplistic and is a strawman argument then please provide your evidence.

Levine2112 agrees with DigitalC but DigitalC has not provided any evidence of Syn.

It does not violate Syn to use related topic Y information that is a core to topic X.

Justification for using related information does not come from source C. It comes from the fact the spinal manipulation is related to chiropractic.

DigitalC claims "what we have is a bunch of research on the effectiveness of topic U,W,Y, Z under the heading of "Effectiveness of X"."

So far no evidence has been presented by DigitalC. DigitalC, please present your evidence.

Some editors claim that there is Syn but no evidence has been presented. This may be a case of I don't like it.

DigitalC wrote in part: "There is obviously no consensus to remove to SYN tag at present, and to do so would be disruptive editing, for which you may be blocked."

However, there is no evidence of Syn and no evidence that this is a complex issue has been presented. This is a simple issue. When spinal manipulation is a core to chiropractic it is related. Related information is relevant. Please provide any evidence of Syn or both tags will be removed.

Here is what the current are states: Spinal manipulation is the most common treatment used in chiropractic care53 and is most frequently employed by chiropractors.54

I have provided my evidence that spinal manipulation is core to chiropractic. When topic Y is related to topic X it is relevant. QuackGuru18:27, 6 July 2008 (UTC)

Here's a question for you to answer: How do we know that we can attribute safety/efficacy research studying SMT as performed by non-chiropractors to the safety/efficacy of SMT as performed by chiropractors? -- Levine211219:10, 6 July 2008 (UTC)

Here is my point. SMT is related to chiropractic. We can attribute safety/efficacy research studying SMT because it is related to chiropractic. Related information is relevant. Now then, please comment on http://en.wikipedia.org/w/index.php?title=Talk:Chiropracticdiff=prevoldid=223959836 my questions and provide your evidence of Syn or I will remove the Syn tag very soon. QuackGuru23:11, 6 July 2008 (UTC)

I disagree. Just because something is "related" to another thing does not mean that there is a 1:1 correlation amongst their respective research. (Bocce is closely related to pétanque but there is not a 1:1 correlation between player stats. Same goes for bowls.) Including general SMT research in an article about chiropractic is deceptive to the reader. It is too easy for a reader to confound SMT safety/efficacy research with the safety/efficacy of chiropractic. The answer to your question lies with the usage of third-party sources stating that it is okay to confound SMT research with chiropractic. These third-party sources are being used to justify the inclusion of general SMT research (not covered by the third-party source) into this article. I think it is time we post this to NOR/N for a 3PO per DR. Let's agree to statement/question which we will post there and then let's wait for third-party input. Sound reasonable? -- Levine211201:46, 8 July 2008 (UTC)

There is nothing "deceptive" about Chiropractic Evidence basis: it clearly states when it is talking about chiropractic in general vs SM in particular.

I disagree that it is "too easy for a reader to confound". The text is worded clearly. We should have some respect for the readers.

In Draft questions would not resolve disagreement Coppertwig said he was cogitating about yet another draft at a question for NOR/N or whatever; he wasn't happy with either of our drafts. Others are also welcome to draft a question, of course.

Eubulides

08:09, 8 July 2008 (UTC)

According to Levine2112's argument we can never apply any type of related information to any article on Wikipedia.

These third-party sources are not being used to justify the inclusion of SMT research. I already explained that before.

When something is related that is core to chiropractic it is relevant. No evidence of Syn has been presented.

DigitalC claims "what we have is a bunch of research on the effectiveness of topic U,W,Y, Z under the heading of "Effectiveness of X"."

Levine2112 agreed with DigitalC but DigitalC has not presented any evidence of Syn. DigitalC or Levine2112, please present your evidence.

Does it violate SYN if an article on topic X discusses a related topic Y that is core to X? That is the core question. If you think it is too simplistic then provide your evidence that this is a complex issue. There is no evidence that this is complex. We have related research that is core to chiropractic. Related research is relevant. It's simple. QuackGuru05:44, 8 July 2008 (UTC)

The issue is more complex than your simplistic "core question", because we are not simply discussing a related topic. We are confounding the effectiveness of spinal manipulation with the effectiveness of chiropractic, because we are putting it in a section titled Effectiveness of Chiropractic. The "related research" is not neccessarily core to chiropractic. If a study is performed on SMT by physiotherapists, is that "core to chiropractic"? This has been repeated many times, and you are simply ignoring the input of other editors. You have been warned about IDHT before. DigitalC06:49, 8 July 2008 (UTC)

Chiropractic Evidence basis does not cite any study "performed on SMT by physiotherapists". And it does not confound the two issues; it states clearly when it is talking about SM and when it is talking about chiropractic care in general. Eubulides08:09, 8 July 2008 (UTC)

Levine2112 agreed with DigitalC but DigitalC and Levine2112 have not presented any evidence of Syn.

Does it violate SYN if an article on topic X discusses a related topic Y that is core to X? That is the core question. If you think it is too simplistic then provide your evidence that this is a complex issue. There is no evidence that this is complex. We have related research that is core to chiropractic. Related research is relevant.

DigitalC claims "The issue is more complex than your simplistic "core question", because we are not simply discussing a related topic." But no evidence has been presented.

Here is what the current are states: Spinal manipulation is the most common treatment used in chiropractic care53 and is most frequently employed by chiropractors.54 That is strong evidence that spinal manipulation is core to chiropractic.

DigitalC or Levine2112, please present your evidence. I am still waiting. QuackGuru18:53, 8 July 2008 (UTC)

Again, 1) chiropractic is more than spinal manipulation and 2) chiropractors use different manipulation techniques than do other practitioners and 3) chiropractors diagnose and prescribe spinal manipulation in a manner wholly different than other practitioners. Thus, we can all see the pitfalls in using non-chiropractic spinal manipulation research and applying directly to chiropractic spinal manipulation conclusions. That said (and I hope fully recognized and agreed to), let's start over from the top. The first ref used in ChiropracticEffectiveness under the first treatment condition (Lower Back Pain) is http://www.ncbi.nlm.nih.gov/pubmed/16949948 this one. Does this ref make any conclusions specifically about the efficacy of chiropractic in terms of Lower Back Pain? Were the researchers studying chiropractic manipulation or manipulations performed by other practitioners? Do the researchers say that their conclusions about general SMT can be directly applied to chiropractic with regards to its efficacy in treating Lower Back Pain? Please quote from the conclusions/methodology of this research. (I don't have access to see the research in full.) Thanks. -- Levine211220:13, 8 July 2008 (UTC)

I think we all agree that chiropractic ≠ spinal manipulation. Your questions about the first ref are addressed in the Murphy et al. 2006 subsection below. Eubulides23:32, 9 July 2008 (UTC)

DigitalC claims "what we have is a bunch of research on the effectiveness of topic U,W,Y, Z under the heading of "Effectiveness of X"."

However, no evidence has been presented to back up the claim. Levine2112 agreed with DigitalC and Levine2112 has not presented any evidence to back up his agreement with DigitalC.

Therefore, the core question still stands until specific evidence demonstrates this issue is more complex.

Does it violate SYN if an article on topic X discusses a related topic Y that is core to X?

Please answer the question specifically. Thanks. QuackGuru17:32, 15 July 2008 (UTC)

Murphy et al. 2006

Responding to Levine2112's question in the previous subsection about Murphy "et al." 2006 (PMID|16949948):

The sentence we're talking about in Chiropractic Effectiveness is:

"There is continuing conflict of opinion on the efficacy of SMT for nonspecific (i.e., unknown cause) low back pain; methods for formulating treatment guidelines differ significantly between countries, casting some doubt on the guidelines' reliability.cite journal |journal= J Manipulative Physiol Ther |date=2006 |volume=29 |issue=7 |pages=576–81, 581.e1–2 |title= Inconsistent grading of evidence across countries: a review of low back pain guidelines |author= Murphy AYMT, van Teijlingen ER, Gobbi MO |doi=10.1016/j.jmpt.2006.07.005 |pmid=16949948"

There is nothing deceptive about how this sentence characterizes its source. The sentence does not say "efficacy of chiropractic SMT" or "efficacy of spinal adjustment" or anything like that. It says "efficacy of SMT" because the source says "efficacy of SMT".

The source covers in some detail four randomized controlled trials (RCTs), looking for how these trials' results affected clinical treatment recommendations for low back pain (LBP). Of the four trials, three (PMID|12865832, PMID|12394892, and PMID|12045509) studied chiropractic care, and one (PMID|12838090) studied osteopathic manipulation.

The source does not come to any conclusions about whether either general SMT or chiropractic care are efficacious. Its conclusions are (briefly) that "the treatment of LBP remains as ambiguous as before and that the way best evidence is being interpreted could play a large role in this."

Hope this helps. Eubulides23:32, 9 July 2008 (UTC)

My read on this is that only 2 of the 4 studies looked at chiropractic and neither of those two studied chiropractic independently from other treatments studies. However, that is neither here nor there because we are not citing those four studies but rather Murphy et al. which looks at those four studies and draws conclusions. But these conclusions are not about chiropractic. They are about SMT in general. Including this source here, even if summarizing it faithfully, is inappropriate because it is not saying anything about chiropractic. Rather, we are inferring that it has something to do with chiropractic (even though the source doesn't make this claim). That's OR. Then, the inference which we are making is based on other sources which say it is okay to make such an inference. That's SYN. -- Levine211201:41, 10 July 2008 (UTC)

Which of the 3 studies I mentioned (PMID|12865832, PMID|12394892, and PMID|12045509) do you think did not look at chiropractic? I'm guessing the last one (Hsieh "et al." 2002), because it doesn't say "chiropractic" in its abstract. But it did look at chiropractic. It split patients randomly into 4 groups: back school, myofascial therapy, chiropractic joint manipulations (the Diversified technique), and combined chiropractic joint manipulation and myofascial therapy.

Sorry, I don't know what is meant by "neither of those two studied chiropractic independently from other treatments studies". All the studies were conducted independently of each other, and of other studies.

Conflicts in treatment guidelines that cover the core area of chiropractic are highly relevant to chiropractic.

Claiming that citing a source like this is "original research" is like claiming that it's original research when Genetics cites sources on evolution (which it does). A critic of Genetics might say "How do we know Darwin's book "On the Origin of Species" is relevant to genetics? The book never mentions genetics. Citing Darwin on genetics is original research. This citation must be removed from Genetics." If criticisms like this were considered to be valid ones, large chunks of high-quality Wikipedia articles would need to be discarded.

In short, it's not original research to cite a highly relevant source and accurately summarize what it says.

Eubulides

05:19, 10 July 2008 (UTC)

It doesn't matter if all of the four studies Murphy looked at were exclusively about chiropractic techniques performed by chiropractors studied by chiropractors and published in chiropractic journals. We are not sourcing those studies. We are sourcing Murphy. And if Murphy does not make any conclusions about chiropractic specifically then we cannot use his source to make a claim about chiropractic (without violating OR). The only rationales which have been repeatedly provided here are that "we are following the leading researchers" and that "SMT is core to chiropractic". The former is a clearcut SYN violation and the latter has even been refuted by yourself just above (SMT != chiropractic). -- Levine211207:42, 10 July 2008 (UTC)

Murphy "et al." is not being used "to make a claim about chiropractic". The sentence we're talking about in Chiropractic Effectiveness does not mention chiropractic. In that respect it is like the following sentence in Genetics, which does not mention genetics: "Mutations and the selection for beneficial mutations can cause a species to evolve into forms that better survive their environment, a process called adaptation."

It is not a SYN violation to follow the leading researchers here, just as it is not a SYN violation for Genetics to follow the leading researchers and to discuss evolution.

"SMT is core to chiropractic" is entirely consistent with "chiropractic ≠ spinal manipulation". X can be core to Y even when Y≠X.

Eubulides

08:16, 10 July 2008 (UTC)

Of course it is being used "to make a claim about chiropractic". It is in a section called Chiropractic Effectiveness! This immediatedly confounds the effectiveness of chiropractic with whatever effectiveness is being discussed in this section. DigitalC09:45, 10 July 2008 (UTC)

Amen! -- Levine211216:04, 10 July 2008 (UTC)

That is like saying "Of course On the Origin of Species is being used to make a claim about genetics. That citation is in the Genetics article! But Darwin never mentions genetics. So this is SYN and all the material supported by Darwin should be removed." Similarly for road-safety statistics and Automobile. And so on and so on.

If it is SYN merely to provide a source on a relevant topic and to summarize that source accurately, then SYN arguments could be used to remove large high-quality chunks of Wikipedia. That is not what SYN is for. It is for removing original research, not for removing summaries of what reliable sources say on relevant topics.

Eubulides

17:28, 10 July 2008 (UTC)

Dematt Dēmatt 18:47, 10 July 2008 (UTC)

DeMatt us right on point here. . . this research is not bad but it is in the wrong article here. . . much better suited on Low Back Pain article. Eubilide's point about Darwin and Origin of Species is a red herring. . . and - or a strawman here.TheDoctorIsIn21:00, 10 July 2008 (UTC)

Dematt pointed out that "the only thing that we should be getting from Murphy is that using SMT studies to create guidlelines for low back pain results in varied guidelines that basically renders the process suspect and therefore inconclusive". But this point agrees with what's in Chiropractic now. The only thing that the article is getting from Murphy "et al." is the above-quoted sentence about conflict among guidelines and differing methods used to formulate the guidelines.

Dematt also pointed out that "it is not appropriate for use to comment on the effectiveness of chiropractic care". But Murphy "et al." is not being used to support a claim about the effectiveness of chiropractic care. It is being used to support a claim about a relevant topic, namely, that evidence-based guidelines disagree in this area (and why they disagree).

Eubulides

15:55, 11 July 2008 (UTC)

One more thing: why is the example about Genetics and Darwin a red herring? Or Automobile and road safety? The examples seem apropos to the question as to whether an article about X can discuss a relevant (but not identical) topic Y. It would be helpful if someone who thinks these examples are not apropos could explain why they think that way. Eubulides21:15, 11 July 2008 (UTC)

Eubulides understands my point that Murphy "is not being used to support a claim about the effectiveness of chiropractic care." However, he seems to think that, "It is being used to support a claim about a relevant topic, namely, that evidence-based guidelines disagree in this area (and why they disagree)." What is the "area" that they disagree? -- Dematt Dēmatt 01:57, 12 July 2008 (UTC)

The "area" is the use of spinal manipulative therapy to treat low back pain. Eubulides09:16, 12 July 2008 (UTC)

Why would moving cure SYN?

Let's try to look at the problem in a different way. Several times the discussion about SYN issues in Chiropractic Evidence basis has been accompanied by suggestions to move that section to Spinal manipulation (or some similar article) on the grounds that Chiropractic Evidence basis is original research and violates OR policy. I just now thought of a problem with that suggestion: original research is original research regardless of where it's reported. For example, if I reported my original research that one's thoughts can affect one's genetic makeup, it wouldn't matter if I reported that research in Chiropractic, in Genetics, in Thought, or in "Science" for that matter; it would be original research no matter where it was reported.

What that in mind, if Chiropractic Effectiveness is original research, it would remain original research after it's moved. And hence moving the text wouldn't affect the issue as to whether it is a SYN violation. So why is moving the text such a common suggestion?

Eubulides

21:15, 11 July 2008 (UTC)

SYN is a subform of OR. While all SYN is OR, not all OR is SYN. Your thoughts about thoughts changing genetic makeup would be OR no matter where you put it unless you found a source that explicitly came to that conclusion. If you did find a source for it and then placed it in the Intelligent Design article, a related subject, to make a point that the author did not explicitly intend, it would be SYN. When we place correct information in the wrong article or section, that is SYN. -- Dematt Dēmatt 03:22, 12 July 2008 (UTC)

When all the sentences are verified that means there never was Syn. QuackGuru06:42, 12 July 2008 (UTC)

Not true, see SYN. Both sentences are verifiable. -- Dematt Dēmatt 21:25, 12 July 2008 (UTC)

What does "Both sentences are verifiable" mean? Which sentences are being referred to here? Eubulides09:00, 13 July 2008 (UTC)

"If you did find a source for it" But the hypothesis was that my theory is original research; if I find a source for my theory then my theory is no longer OR and it's no longer an example of the problem I had in mind.

I agree that not all OR is SYN, but I don't see how that affects the argument (sorry, I don't understand the relevance of Intelligent Design here).

Let me try again. Suppose I expressed my theory (that one's thoughts can affect one's genetic makeup) by a discussion D that stitched together various sources on related topics and then stated my conclusion in a clear SYN violation. And suppose I placed D in Genetics. Surely we all agree that it would not cure the SYN violation to move D to some other article. It wouldn't matter if I moved D to Thought, or to a completely irrelevant article like Rosy Bindi; D would be a SYN violation no matter where it appeared.

Now, suppose I take the sentence sourced to Murphy "et al." 2006, which is alleged to be a SYN violation in Chiropractic, and copy this sentence (citation and all) to Rosy Bindi, a completely irrelevant article. Would it still be a SYN violation there?

Eubulides

09:16, 12 July 2008 (UTC)

"But the hypothesis was that my theory is original research". Then you would follow part one of my response which was "Your thoughts about thoughts changing genetic makeup would be OR no matter where you put it"

"but I don't see how that affects the argument" If your argument is that it is OR, then it will always be OR. If it is not OR, it can still be SYN if you put it in Intelligent Design.

"stated my conclusion in a clear SYN violation." This is different than your initial description. I agree that if you SYN a conclusion, then it is SYN everywhere.

"suppose I take the sentence sourced to Murphy "et al." 2006, which is alleged to be a SYN violation in Chiropractic, and copy this sentence (citation and all) to Rosy Bindi, a completely irrelevant article. Would it still be a SYN violation there?" It depends on why it was a SYN violation. If it is because the "conclusion was SYN", then the sentence would be SYN no matter which article you put it in. Certainly if it were a properly sourced statement drawing the correct conclusion it would be SYN in the Rosy Bindi article.

-- Dematt Dēmatt 21:25, 12 July 2008 (UTC)

"Your thoughts about thoughts changing genetic makeup would be OR no matter where you put it" Yes, that's right.

"If it is not OR, it can still be SYN if you put it in Intelligent Design." I don't see how that can possibly be. SYN is a special case of OR. All SYN is OR.

"Certainly if it were a properly sourced statement drawing the correct conclusion it would be SYN in the Rosy Bindi article." The sentence in question is properly sourced. Here it is again:

"There is continuing conflict of opinion on the efficacy of SMT for nonspecific (i.e., unknown cause) low back pain; methods for formulating treatment guidelines differ significantly between countries, casting some doubt on the guidelines' reliability.cite journal |journal= J Manipulative Physiol Ther |date=2006 |volume=29 |issue=7 |pages=576–81, 581.e1–2 |title= Inconsistent grading of evidence across countries: a review of low back pain guidelines |author= Murphy AYMT, van Teijlingen ER, Gobbi MO |doi=10.1016/j.jmpt.2006.07.005 |pmid=16949948"

This sentence accurately summarizes its source; it states no conclusions that are not stated in the source. So, if I understand you correctly, you are saying that if this sentence were moved to Rosy Bindi (a completely unrelated article), it would be a SYN violation there?

Eubulides

09:00, 13 July 2008 (UTC)

Dematt, I disagree with your interpretation, if I understand it correctly. Placing a properly sourced statement in a wholly irrelevant article would not be a SYN violation (unless by placing it there it implied something; for example, placing a statement about people of a certain ethnicity in a biography of someone who is not of that ethnicity could seem to imply that the person is of that ethnicity). It's only a SYN violation if there's a stated or (according to editors other than Eubulides) implied conclusion; the conclusion is the "original research". Otherwise, it would merely be irrelevant, and could be deleted for that reason.

When it says ""In other words, that precise analysis must have been published by a reliable source in relation to the topic before it can be published in Wikipedia by a contributor"" it means, in my opinion, that in order to state or imply that Jones did not commit plagiarism, you need a source that states or implies that Jones did not commit plagiarism. It's not about what the title of the article containing that claim is. ☺ Coppertwig23:02, 19 July 2008 (UTC)

Coppertwig, I understand your interpretation of SYN, but how do you interpret this from the first paragraph of SYN:

""Material published by reliable sources can inadvertently be put together in a way that constitutes original research. Synthesizing material occurs when an editor comes to a conclusion by putting together different sources. If the sources cited "do not" explicitly reach the same conclusion, or "'if the sources cited are not directly related to the subject of the article"', then the editor is engaged in original research. Summarizing source material without changing its meaning is not synthesis; it is good editing. Best practice is to write Wikipedia articles by taking claims made by different reliable sources about a subject and putting those claims in our own words on an article page, with each claim attributable to a source that makes that claim explicitly.""(emphasis mine) Are you saying that you think this it is just OR to put it in the wrong article, not SYN? Of course, one reason I am complaining is because it is in the wrong article (the other is that it implies that studies about SMT incorrectly imply the same conclusion to chiropractic care in general). Are you saying I should be calling it OR instead? Perhaps this is the communication gap the Eubulides is having as well. -- Dematt Dēmatt 20:44, 21 July 2008 (UTC)

To Dematt: where it says ""if the sources cited are not directly related to the subject of the article"": To me, this does not mean that every time someone cites a source not directly related to the subject of an article they are engaged in original research. Rather, this statement is within the context of the sentences that come before it: in other words, when someone puts sources together in order to form a conclusion, and those sources are not directly related to the subject of the article, then they're engaged in original research. It wouldn't make sense to say someone is doing original research simply because they put a sourced statement on a page where it's irrelevant. I don't see how that could be considered to be "research". But collecting sources to form a conclusion is considered to be research. I would say that putting a single sourced statement under a heading (section heading or article title), where doing so leads the reader to a conclusion not stated in the source, could also be considered to be "original research". Regards, ☺ Coppertwig13:31, 24 July 2008 (UTC)

Coppertwig, "It wouldn't make sense to say someone is doing original research simply because they put a sourced statement on a page where it's irrelevant." What would you call it? -- Dematt Dēmatt 14:16, 24 July 2008 (UTC)

Is spinal manipulation research highly relevant?

If it isn't about chiropractic, it isn't highly-relevant? Wrong. Spinal manipulation is core to chiropractic. Thus, the spinal manipulation research is related and relevant.

Spinal manipulation is the most common treatment used in chiropractic care54 and is most frequently employed by chiropractors.55 QuackGuru02:46, 23 July 2008 (UTC)

Chiropractic spinal manipulation (that is, performed by Chiropractors) is core to chiropractic. Spinal manipulation performed by non-chiropractors is NOT core to chiropractic. DigitalC04:16, 23 July 2008 (UTC)

If only it were that simple! What's being disputed here are reviews on spinal manipulation that rely on both chiropractic and non-chiropractic data. Eubulides05:17, 23 July 2008 (UTC)

We are also disputing that ChiropracticEvidence base is implying that chiropractic care equals spinal manipulation. Chiropractors do much more than perform manipulation. -- Dematt Dēmatt 03:17, 24 July 2008 (UTC)

It's true that chiropractors do more than manipulation. Chiropractic Evidence basis covers these other treatments, where evidence basis is available. Eubulides05:06, 24 July 2008 (UTC)

References

reflist