Missing: Simon Singh CIF article in the Guardian

[Jack of Kent]

I have now blogged on this: http://jackofkent.blogspot.com/2008/...roprators.html

[Blue Wode]

Three more bloggers have jointed in, two of whom have posted the original full text of Simon Singh’s Beware The Spinal Trap article:

Any Chiropractors Want To Sue Me As Well?
http://thewelshpharmacist.blogspot.com:80/2008/08/any-chiropractors-want-to-sue-me-as.html

British Chiropractic Association suing Simon Singh!
http://www.mrhunnybun.com/2008/08/british-chiropractic-association-suing.html

Another Back-Cracking Quack Attack – The Sequel
http://thinking-is-dangerous.blogspot.com/2008/08/another-back-cracking-quack-attack_18.html


But the real reason for this post - does anyone know where the ‘British Chiropractic Association v. Simon Singh’ thread over at JREF has gone? Fortunately, it still seems to be accessible at Holfordwatch:

British chiropractors join the legal intimidation party
http://holfordwatch.info/2008/08/16/british-chiropractors-join-the-legal-intimidation-party/

[Blue Wode]

But the real reason for this post - does anyone know where the ‘British Chiropractic Association v. Simon Singh’ thread over at JREF has gone?

Mystery solved.

It's now been made a sticky at the top of the JREF Science forum index:
http://forums.randi.org/forumdisplay.php?f=5

[Blue Wode]

Blogging from the past 24 hours…

Oh FFS – British Chiropractic Association issues write against Simon Singh
http://www.twonilblankblank.com/2008/08/19/oh-ffs-%e2%80%93-british-chiropractic-association-issues-writ-against-simon-singh/

First Canadian blog to post the entire text of Beware the spinal trap:
http://somecanadianskeptic.blogspot.com/

And the Think Humanism forum has posted it as well:
http://www.thinkhumanism.com/phpBB3/viewtopic.php?f=14&p=37279


A round-up of previous bloggings (some of which have been updated)…

British chiropractors join the legal intimidation party
http://holfordwatch.info/2008/08/16/british-chiropractors-join-the-legal-intimidation-party/

Chiropractors try to silence Simon Singh
http://www.quackometer.net/blog/2008/08/chiropractors-try-to-silence-simon.html

Chiropractors sue Simon Singh – prefer legal action to evidence
http://gimpyblog.wordpress.com/2008/08/17/chiropractors-sue-simon-singh-prefer-legal-action-to-evidence/

The libellous Simon Singh article on chiropractors
(Gimpy again with the full text of the original Guardian article plus refs.)
http://gimpyblog.wordpress.com/2008/08/17/the-libellous-simon-singh-article-on-chiropractors/

On Simon Singh against Chiropractors
http://jackofkent.blogspot.com/2008/08/on-simon-singh-against-chiroprators.html

British Chiropractic Association suing Simon Singh!
http://www.mrhunnybun.com/2008/08/british-chiropractic-association-suing.html

Any Chiropractors Want To Sue Me As Well?
http://thewelshpharmacist.blogspot.com/2008/08/any-chiropractors-want-to-sue-me-as.html

Another Back-Cracking Quack Attack – The Sequel
http://thinking-is-dangerous.blogspot.com/2008/08/another-back-cracking-quack-attack_18.html

Pseudoscientists Sue Simon Singh
http://skepchick.org:80/blog/?p=2200

Litigation instead of evidence
http://skepti.net:80/index.php/2008/08/litigation-instead-of-evidence/

British Chiropractic Association Afraid of Criticism
http://jdc325.wordpress.com:80/2008/08/18/bca-afraid-of-criticism/

JREF sticky thread
http://forums.randi.org/showthread.php?t=121214

[FarSideOfTheMoon]

Blogging is all good, but do you think any of the mainstream press will run with this? Hopefully not the BBC because they have to present both sides of the argument with equal validity...

[Blue Wode]

Blogging is all good, but do you think any of the mainstream press will run with this?

IMO, it’s unlikely that the mainstream press will initially run with the story, not only because of the scoldings it has received in the past from the General Chiropractic Council (GCC)…
http://www.skeptics.org.uk/forum/showpost.php?p=40405&postcount=3

…but also because most editors will be aware that the GCC recently lodged a semi-successful complaint with the Press Complaints Commission about several chiropractic articles which appeared in the press, one of which (‘Chiropractors are a waste of money’) the British Chiropractic Association managed to have deleted from the Daily Telegraph’s website. See page 7 here:
http://www.gcc-uk.org/files/page_file/WEBSITE_GCCNews23.pdf


So it could be that the press will be waiting for further, more concrete, developments. Meanwhile, here’s the latest on the matter from Simon Singh himself:

Unhappy Chiropractors

As some of you may have heard, I am being sued for libel by the British Chiropractic Association. I cannot say much at the moment, but I will return to the subject in due course. In the meantime, thanks for the emails of support and the various blogs backing my position. I have not had time to reply – as you can imagine, I am fairly busy at the moment – but the support is much appreciated.

That paragraph is lifted from Simon’s latest (e)newsletter which was sent out to subscribers today. Unfortunately, it doesn’t seem to be on his site yet:
http://www.simonsingh.net/home.html

[Acleron]

Blogging is all good, but do you think any of the mainstream press will run with this? Hopefully not the BBC because they have to present both sides of the argument with equal validity...

Good point, I've just done a Google news for 'Simon Singh libel OR sue' and not even the Grauniad has an article, balanced or not.

[Jack of Kent]

I guess the MSM will be fairly quiet until either (a) the Claim/Defence are published or (b) one side issue a press release. Until then, they would just have to repeat the Sunday Telegraph story.

It is still a very early stage in the litigation process.

[Blue Wode]

Here’s a particularly interesting excerpt from a blog post by the Ministry of Truth:

…the public kicking that another bunch of woo merchants - homeopaths - has gotten over the last year or so may have spooked the BCA but, casting around for information presents a rather more enticing and plausible explanation as to why they might want to prevent the publication of adverse commentary in the press and any kind of critical public debate surrounding the efficacy and risks of chiropractic…


…and to see that explanation first hand one need only take a short trip over to the website of NICE the National Institute for Clinical Evidence, where we find that one of things they’re working on is a new set of clinical guidelines for the treatement of non-specific lower back pain.

Yep, its the key to the NHS gravy train. If NICE approves the use of chiropractic manipulation as part of the treatment regime for lower back pain then the door opens to chiropractors taking referrals from the NHS under contracts in which the NHS pays their fees and before you can say ‘vested interest’ you’ve got a whole bunch of chiropractors on what is effectively the public payroll. Little wonder then that just about the last thing that the BCA want right now is science journalists asking all sorts of awkward questions like ‘is there any evidence to show that it works?’ and ‘what kind of risks might patients face when referred for a course of woo?’.

I’m speculating, of course, but the idea that this might all be motivated by nothing more than a desire to avoid adverse publicity and awkward question while the door to a taxpayer funded gravy train lies tantalising before them makes about as much sense as an explanation for the threat of legal action against Singh as anything else I can think of…



…its just a shame that no one thought to mention the Streisand Effect to the BCA before they tried it on.

http://www.ministryoftruth.me.uk/2008/08/19/can-you-libel-woo/

There might be more than a kernel of truth in the above. For example, if you look at the general information page for those NICE clinical guidelines which are currently being developed, see here…
http://www.nice.org.uk/guidance/index.jsp?action=byID&o=11645re

…you’ll see included in the Guideline Development Group (GDG) members’ list…
http://www.nice.org.uk/nicemedia/pdf/LowBackPainGDGMembersList270407.pdf

…a ‘Peter Dixon’ who is described as a chiropractor with “experience and working knowledge of non specific low back pain”. Well, Peter Dixon happens to be the current Chairman of the UK chiropractic regulatory body, the General Chiropractic Council (GCC). For a very interesting example of his work in that professional capacity see here:
http://www.gcc-uk.org/files/link_file/DAILY%20MAIL%2012%20December%202006.pdf

Indeed, his presence on that panel developing the NICE guidelines is also confirmed in this recent GCC newsletter (page 7):

In the pipeline

NICE is developing a guideline on low back pain: the acute management of patients with chronic (longer than six weeks) non-specific low back pain. The GCC’s Chairman, Peter Dixon, is a member of the guideline development group, which is Chaired by Professor Martin Underwood. Publication of the guideline is expected in May 2009

http://www.gcc-uk.org/files/page_file/WEBSITE_GCCNews23.pdf

What troubles me is, can a man who recently insisted that “there’s no available evidence to show that manipulation of the neck by chiropractors has ever caused a stroke” be a trusted member of a clinical excellence team? In other words, where is his cautionary attitude? To learn more about Peter Dixon, scroll down this link until you come to ‘Edzard Ernst again challenges chiropractors in UK’:
http://www.healthwatcher.net/chirowatch.com/cw-cervical.html

Well worth a read.


Returning to the blogosphere, here’s some more excellent reading:

‘Self-Destructing Chiropractors’
http://jonathanhearsey.com/?p=60

Simon Singh versus… the chiropractors?
http://castingoutnines.wordpress.com/2008/08/19/simon-singh-versus-the-chiropractors/

Anyone else see the problem with the headline?
http://yunshui.wordpress.com/2008/08/18/anyone-else-see-the-problem-with-the-headline/

Bloggers Behind Simon Singh – Where The News Is At
http://podblack.com/?p=855

If you don’t have anything nice to say, say it on lawyer’s headed paper
http://www.dougalstanton.net/blog/index.php/2008/08/19/if-you-dont-have-anything-nice-to-say-say-it-on-lawyers-headed-paper/

[FarSideOfTheMoon]

The comments about back pain remind me, I heard this on the radio this morning.

http://news.bbc.co.uk/1/hi/health/7568948.stm

Long-term back pain can be relieved through encouraging sufferers to adopt good posture through the Alexander technique, say UK researchers.
The technique teaches patients how to sit, stand and walk in a way that relieves pain by focusing on their coordination and posture.
Until now there had been little evidence of the therapy's long term effectiveness. The latest work is published in the British Medical Journal.

No need to derail this thread, but it illustrates the importance of evidence and continued research.

[Blue Wode]

The comments about back pain remind me, I heard this on the radio this morning...it illustrates the importance of evidence and continued research.

So true.

Although a great deal of data are already in for chiropractic spinal manipulation, the frequency and severity of its adverse effects still needs to be studied.

This, apparently, is the evidence for spinal manipulation so far:

Virtually all experts agree that the best available evidence in any area of health care is that provided by Cochrane reviews. The Cochrane Collaboration is a worldwide network of independent scientists dedicated to systematically summarising the totality of the evidence related to specific medical subjects in a rigorous and transparently impartial fashion. Four Cochrane reviews of spinal manipulation are available today.

Back pain is by far the condition most frequently treated by chiropractors. The Cochrane review of spinal manipulation for back pain summarised 39 clinical trials [2004].1 The authors’ conclusions were very clear: ‘There is no evidence that spinal manipulative therapy is superior to other standard treatments for patients with acute or chronic low back pain.’

A Cochrane review of spinal manipulation and mobilisation for mechanical neck disorders evaluated 33 clinical trials [2002].2 The authors found that, combined with exercise, these approaches were promising, but ‘the evidence did not favour manipulation and/or mobilisation done alone or in combination with various other physical medicine agents; when compared to one another, neither was superior.’2

Another Cochrane review summarised the available trials of chiropractic treatment for asthma [2005].3 The authors found only two such studies and ‘neither trial found significant differences between chiropractic spinal manipulation and a sham manoeuvre on any of the outcomes measured.’

Finally, a Cochrane review assessed five trials of spinal manipulation for dysmenorrhoea [2001].4 The authors concluded that ‘there is no evidence to suggest that spinal manipulation is effective in the treatment’ of this condition.

The value of chiropractic
http://www.medicinescomplete.com/journals/fact/current/fact1002a02t01.htm

A systematic review of systematic reviews of spinal manipulation (2006)

Conclusions: Collectively these data do not demonstrate that spinal manipulation is an effective intervention for any condition. Given the possibility of adverse effects, this review does not suggest that spinal manipulation is a recommendable treatment.

http://jrsm.rsmjournals.com/cgi/content/full/99/4/192

Adverse effects of spinal manipulation: a systematic review (2007)

Conclusions Spinal manipulation, particularly when performed on the upper spine, is frequently associated with mild to moderate adverse effects. It can also result in serious complications such as vertebral artery dissection followed by stroke. Currently, the incidence of such events is not known. In the interest of patient safety we should reconsider our policy towards the routine use of spinal manipulation.

http://jrsm.rsmjournals.com/cgi/content/full/100/7/330

Adverse Events Associated With Pediatric Spinal Manipulation: A Systematic Review (2007)

Conclusions: Serious adverse events may be associated with pediatric spinal manipulation; neither causation nor incidence rates can be inferred from observational data. Conduct of a prospective population-based active surveillance study is required to properly assess the possibility of rare, yet serious, adverse events as a result of spinal manipulation on pediatric patients.

http://pediatrics.aappublications.org/cgi/content/full/peds.2006-1392v1

NB. The reviewers comment that despite the fact that spinal manipulation is widely used on children, paediatric safety data are virtually nonexistent.

Cost-Effectiveness of Complementary Therapies in the United Kingdom—A Systematic Review (2006)

Conclusions: Prospective, controlled, cost-effectiveness studies of complementary therapies have been carried out in the UK only for spinal manipulation (four studies) and acupuncture (two studies). The limited data available indicate that the use of these therapies usually represents an additional cost to conventional treatment.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17173105

So although spinal manipulation’s not a useless treatment, it’s not looking good for chiropractors at the moment.

[Jack of Kent]

Later this week I will set on my Blog the ten questions BCA members should perhaps now be asking of the BCA about launching this case.

Nothing controversial, just questions dealing with what one would hope a responsible professional representative body should have properly considered before risking (a) members' money, (b) possibly the reputation of the BCA, and (c) perhaps even the reputation of Chiropractic itself, on what increasingly appears to me to be a rather unfortunate enterprise.

It may well be that the BCA will have fully addressed the issues my questions will raise. After all, they did tell the Sunday Telegraph that a lot of thought had gone into the decision...

[Acleron]

Later this week I will set on my Blog the ten questions BCA members should perhaps now be asking of the BCA about launching this case.

Nothing controversial, just questions dealing with what one would hope a responsible professional representative body should have properly considered before risking (a) members' money, (b) possibly the reputation of the BCA, and (c) perhaps even the reputation of Chiropractic itself, on what increasingly appears to me to be a rather unfortunate enterprise.

It may well be that the BCA will have fully addressed the issues my questions will raise. After all, they did tell the Sunday Telegraph that a lot of thought had gone into the decision...

Given your admitted education and experience would it be possble to just tell us perhaps three of those questions.

[Blue Wode]

Two more blogs today (the first isn’t for the faint-hearted)….

Bone-cracking Quacks
http://thehystericalshriekinggriefoftwats.blogspot.com/2008/08/bone-cracking-quacks.html

Simon Singh sued by the British Chiropractic Association
http://homoeconomicusnet.wordpress.com/

And, surprisingly, today’s Guardian has published small chiropractic promo piece:

There's a lot more to chiropractic than crunching and clicking bones and joints, according to Tim Hutchful from the British Chiropractic Assocation.

More…
http://www.guardian.co.uk/lifeandstyle/2008/aug/21/healthandwellbeing

Yes, indeed. How about he tells the public about all the quackery that helps chiropractors to stay in business:
http://www.skeptics.org.uk/forum/showpost.php?p=41640&postcount=12

[Blue Wode]

Another 24 hours, and another round of blogging. Today we have…

More idiocy from chiropractors
http://norburynewlywed.blogspot.com/2008/08/more-idiocy-from-chiropractors.html

Chiropractors versus Simon Singh
http://geoglyphs-ramblings.blogspot.com/2008/08/chiropractors-versus-simon-singh.html

Back crack quack attack - it’s a legal matter, baby
(A look at the potential legalities of the case)
http://draust.wordpress.com/2008/08/21/back-crack-quack-attack-its-a-legal-matter-baby/

An ex-chiropractor speaks out
http://dcscience.net/?p=248

The plausibility of CAM on the NHS
(Comments related to the BCA’s recent action from a skeptical osteopath)
http://jonathanhearsey.com/?p=61


Further reading:

http://www.cam-research-group.co.uk/POI/The%20scope%20of%20chiropractic%20practice%20a%20s urvey%20of%20chiropractors%20in%20the%20uk%20-%20Aranke%20Pollentier%20-%20Clinical%20Chiropractic%202007%2010%203%20pg%20 147-155.pdf

[Aranka Pollentier and Jennifer M. Langworthy, The scope of chiropractic practice: A survey of chiropractors in the UK. Clinical Chiropractic, Volume 10, Issue 3, September 2007, Pages 147-155.]