tag:blogger.com,1999:blog-3390054012370292935.post4564748797137538800..comments2023-05-08T05:40:51.720-04:00Comments on Perles of Wisdom: Science, sometimes - stroke and chiropracticDr. Stephen M. Perlehttp://www.blogger.com/profile/10842367889503625768noreply@blogger.comBlogger39125tag:blogger.com,1999:blog-3390054012370292935.post-75873476652488994932011-03-25T22:37:49.094-04:002011-03-25T22:37:49.094-04:00Thank you for your comment.
While it is true th...Thank you for your comment. <br /><br />While it is true that the services provided by chiropractic physicians are underutilized when it comes to the treatment of headache, neck and back pain I disagree with the your remainder of your comments in two important ways.<br /><br />1. chiropractic is not a method it is a profession. <br /><br />2. I assume that when you say chiropractic is effective that you mean that the services of a doctor of chiropractic. The current state of the evidence is such that one cannot support with good quality evidence the statement that our interventions are "the most effective". Unfortunately, at best, we can say that the evidence is very strong that some of the services offered by chiropractic physicians, most particularly spinal manipulation, is an effective treatment, not the most effective treatment for low back pain, neck pain and headaches. <br /><br />I know that this will seem like a semantic argument but when talking about scientific evidence these differences effective vs. most effective are important distinctions.Dr. Stephen M. Perlehttps://www.blogger.com/profile/10842367889503625768noreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-16645788833140933152011-03-25T03:45:44.216-04:002011-03-25T03:45:44.216-04:00Chiropractic is the most effective and least utili...Chiropractic is the most effective and least utilized method of headache neck and back pain treatment available.<br /><br /><a href="http://www.adelaidechiropractor.com.au/" rel="nofollow">chiropractor</a>Chirohttps://www.blogger.com/profile/17204330782764489292noreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-57930462882480986112010-11-27T00:50:54.817-05:002010-11-27T00:50:54.817-05:00As long as rumors about the safety of chiropractic...As long as rumors about the safety of chiropractic exist, we must work to educate the general public. The Foundation for Chiropractic Progress is doing a great job with campaigns by Jerry Rice and others. Every doctor DC needs to post articles proving efficacy of chiropractic and the fallacy of the stroke connection onto their website and work to educate the public, one patient at a time. In time, the public will come to know that chiropractic is the safest and most effective health care system available.seattle chiropractorhttp://www.downtownseattlechiropractic.comnoreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-38729869751689271682010-10-22T08:52:09.136-04:002010-10-22T08:52:09.136-04:00ianam,
You are correct IF a treatment is pointles...ianam,<br /><br />You are correct IF a treatment is pointless no level of risk or expenditure of money would be worthwhile. Your implication, I suspect, is that cervical manipulation is pointless. Unfortunately that belief is not supported by the scientific evidence and to ignore that evidence is just another example of what my blog posting is about. High quality scientific evidence shows that cervical manipulation is amongst a group of effective treatments. Is it a perfect treatment. No but neither is anything else and the alternatives offered by non-DCs don't appear to be any more effective and in fact pose greater known risks. <br /><br />SMPDr. Stephen M. Perlehttps://www.blogger.com/profile/10842367889503625768noreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-45121155456297103192010-10-22T02:53:46.400-04:002010-10-22T02:53:46.400-04:00"I have always been jealous of mathematics ab..."I have always been jealous of mathematics ability to remain concrete and just build upon its foundation of knowledge whereas science all too often takes seemingly endless baby steps toward a conclusion only to reverse direction suddenly and embrace the opposite notion."<br /><br />This is necessarily true because mathematics is based on logical deduction, whereas science is based on the best inference from the available evidence.ianamnoreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-74068061561826341392010-10-22T02:49:47.614-04:002010-10-22T02:49:47.614-04:00"Mathematical results are either false or tru..."Mathematical results are either false or true (that is, proven or false) and nothing in between."<br /><br />Um, the Professor of the Year is unfamiliar with Gödel? The set of provable, let alone proven, statements and the set of true statements are not coextensive.<br /><br />As for strokes and chiropractic -- that the chance of suffering a stroke from expending time and money on something pointless is low to nonexistent is no reason to do so.ianamnoreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-86018079357003091682010-10-13T20:48:20.558-04:002010-10-13T20:48:20.558-04:00Fabulous article, this is the kind of work that ne...Fabulous article, this is the kind of work that needs public attention to help combat the scaremongering that goes on.Dr. Nickhttps://www.blogger.com/profile/12692192804507971017noreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-62023880528651578762010-09-17T03:22:25.341-04:002010-09-17T03:22:25.341-04:00Chiropractic care has proven beneficial and effect...Chiropractic care has proven beneficial and effective to those who undergo chiropractic therapy. <br /><br /><a href="http://walkervillechiropractic.com.au/" rel="nofollow">Chiropractor Adelaide</a>Chiropractor Adelaidehttps://www.blogger.com/profile/00509414115387883196noreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-25375728305635395362010-07-26T23:36:47.080-04:002010-07-26T23:36:47.080-04:00Great article! I have always been jealous of mathe...Great article! I have always been jealous of mathematics ability to remain concrete and just build upon its foundation of knowledge whereas science all too often takes seemingly endless baby steps toward a conclusion only to reverse direction suddenly and embrace the opposite notion. Is coffee good for us? Oh, it's not? How about now? Wait, how about now? Oh, it's good again? Thank goodness.<br /><br />Brett L. Kinsler, DCAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-69522347735043474282010-07-26T19:44:01.455-04:002010-07-26T19:44:01.455-04:00This comment has been removed by a blog administrator.J. Jacksonnoreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-84940628521921156992010-05-08T08:04:48.431-04:002010-05-08T08:04:48.431-04:00drtouchinsky.com said...
[quote]A very well balan...drtouchinsky.com said... <br />[quote]A very well balanced post. I'd like to see what biased skeptics like Hall and Barret would say about this.[/quote] <br /><br /><br /><br />David Gorski ('Orac' of quackwatch/Hall/Barrett affiliation) opines: <br /><br /><br />quote:<br />--------------------------------------------------------------------------------<br />"We do not have enough evidence to be able to say that neck manipulation is futile and unsafe endeavor under all circumstances."<br />A statement of similar accuracy:<br /><br />"We do not have enough evidence to be able to say that vaccines do not cause autism under all circumstances."<br /><br />I fear that some antivaxer will quote mine me when they see this, but the above is, strictly speaking, a true statement. Does that mean we should accept the claim that vaccines cause autism? Of course not. We have considerable evidence from large, well-designed trials, all of which have failed to find a link between vaccines and autism. If there is a risk, it is incredibly tiny.<br /><br />In terms of chiropractic, we have lots of evidence that cracking people’s necks does them no good. We also have pretty good evidence that in some people it carries a not inconsequential risk of stroke. However, as you say, we cannot prove that “under all circumstances” chiropractic manipulation of the neck is of no benefit. However, we can say that, if there are circumstances in which it might benefit, they are pretty darned limited–rather like how we can say that if vaccines do contribute to autism it must be sufficiently rare as not to be detectable in all the large studies done. The difference, of course, is that, even if that tiny risk of autism from vaccines existed, the benefits of vaccines are real and tangible. They are quantifiable. Not so chiropractic manipulation of the neck.<br /><br /><br />--------------------------------------------------------------------------------<br /><br />Perhaps he/they could be invited to participate here. <br /><br />It would be ineresting to engage him/them in a "real" evidence-based conversation......as opposed to his/their "preaching to the choir".Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-47204522584593707242010-05-07T16:09:42.257-04:002010-05-07T16:09:42.257-04:00Dr. Perle,
Thank you for taking the time to write...Dr. Perle,<br /><br />Thank you for taking the time to write a fair and balanced article on the risk of a CVA with manual manipulative therapy.<br /><br />David RadfordBackTalkhttps://www.blogger.com/profile/17977786937202533130noreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-74780077677793725552010-05-02T18:28:39.921-04:002010-05-02T18:28:39.921-04:00A very well balanced post. I'd like to see wh...A very well balanced post. I'd like to see what biased skeptics like Hall and Barret would say about this. <br /><br />Buddy Touchinsky, D.C.<br />www.drtouchinsky.comAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-38872882121720955922010-04-25T06:21:17.130-04:002010-04-25T06:21:17.130-04:00Great Article.Great Article.Dr Saxon Selveynoreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-85880422284323436502010-04-23T14:58:27.272-04:002010-04-23T14:58:27.272-04:00Dr. Perle,
Excellent article. I think this artic...Dr. Perle,<br /><br />Excellent article. I think this article explains it best!<br /><br />JJAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-9382706853347872182010-04-23T04:30:30.911-04:002010-04-23T04:30:30.911-04:00Wayne Hoskins said:
Thanks for the article Stephen...Wayne Hoskins said:<br />Thanks for the article Stephen. Very well written, good use of analogies and review of the literature. Keep up the good work.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-86355415248755917442010-04-20T10:31:58.289-04:002010-04-20T10:31:58.289-04:00Great well balanced article. I appreciate the com...Great well balanced article. I appreciate the comprehensive reporting on such a controversial topic.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-20689274717716759342010-04-19T23:21:50.256-04:002010-04-19T23:21:50.256-04:00Thank you for not just writing about chiropractic ...Thank you for not just writing about chiropractic issues but the issue of truth and science in general. <br /><br />For many people in our litigious society it is, in fact, easy to be emotional and not analytical when looking for blame when something goes wrong.<br /><br />Your article is even-handed and fair and allows the reader to understand and draw their own conclusions on this issue. Every death by arterial dissection is a person that someone cared about and it is easy to be drawn into a desire to find something (anything) to point a finger at for causation.<br /><br />Thank you for caring about science in general and chiropractic in particular.Dr. Gerald J. Lane DC MPH CMEhttps://www.blogger.com/profile/08285115268430207140noreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-39605511020315312062010-04-19T18:36:27.025-04:002010-04-19T18:36:27.025-04:00Great work Stephen, I needed that!Great work Stephen, I needed that!Kevin Michaudnoreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-34514686503464867802010-04-19T17:37:09.398-04:002010-04-19T17:37:09.398-04:00Stephen,
This is an extremely well written articl...Stephen,<br /><br />This is an extremely well written article. You have throughly expressed yourself in a scientific manner, one that the world of science will understand. This article deserves to be published in all newspapers across the land. What we need is more in the chiropractic world to write like you do and join the remainder of the world in the 21st Century and discharge themselves from the past. Thank you once again, you have made me and other like thinkers in this profession very happy,<br /><br />TomAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-17971444539354008922010-04-19T14:47:10.816-04:002010-04-19T14:47:10.816-04:00Dr. Perle,
Thank you for standing up for our prof...Dr. Perle,<br /><br />Thank you for standing up for our profession.<br /><br />Marina GadaborshevUnknownhttps://www.blogger.com/profile/09462861840194200732noreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-61413942970770480412010-04-19T12:26:19.244-04:002010-04-19T12:26:19.244-04:00Dr. Broussard,
Thanks for reminding us that the l...Dr. Broussard,<br /><br />Thanks for reminding us that the limits of science are real but when the science is there we can't use the excuse that science has limits to ignore the science.<br /><br />SMPDr. Stephen M. Perlehttps://www.blogger.com/profile/10842367889503625768noreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-13349342055849779142010-04-19T11:27:56.796-04:002010-04-19T11:27:56.796-04:00This article reminded me of the famous review done...This article reminded me of the famous review done on anecdotal evidence on the effectiveness of parachutes. <br /><br />Their conclusions: As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.<br /><br />http://www.bmj.com/cgi/content/abstract/327/7429/1459<br /><br />Sometimes the science is not all there yet.<br /><br />Andre A. Broussard, D.C.Unknownhttps://www.blogger.com/profile/12051533481415990144noreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-44901815714456931622010-04-19T11:05:53.423-04:002010-04-19T11:05:53.423-04:00Thanks so much Stephen!
Great article. I think n...Thanks so much Stephen!<br /><br />Great article. I think now the responsibility is upon chiropractors and other physicians that treat patients with head and neck pain to be cognizant of the signs of a stroke in progress and properly refer. It is regretful that sometimes those signs aren't always clear.<br /><br />Blum CL. Chiropractic & Stroke - What Are Our Responsibilities. Journal of Vertebral Subluxation Research. July 2008: 1-4.<br /><br />Charles L. Blum, DCUnknownhttps://www.blogger.com/profile/00786238588073786689noreply@blogger.comtag:blogger.com,1999:blog-3390054012370292935.post-7066647074722190022010-04-19T10:22:15.867-04:002010-04-19T10:22:15.867-04:00Excellent review of the topic.Excellent review of the topic.Dr. Krebshttps://www.blogger.com/profile/05821904670870260487noreply@blogger.com