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List of hot topics

Add new topics to the bottom of the list. Each topic should focus on a section of the article where major changes are needed, or on a new section to be added to the article. A topic will remain "hot" for at least 96 hours and no longer than 3 weeks. People can change which section of this talk page a topic is linked to, as long as it's essentially the same topic – or provide more than one link for a topic.

• History, starting 14:36, 28 June 2008 (UTC). Also see #History is hot topic, Talk:Chiropractic/Archive 24 #History improvements and Talk:Chiropractic/Archive 24 #History 3 improvements
• Current hot topic: Evidence basis, starting 13:31, 24 July 2008 (UTC). See Talk:Chiropractic/Archive 24 #Syn tag and #SYN and implicit conclusions.
• The lead. See Talk:Chiropractic/Archive 23 #Lead rewrite.
• Philosophy. See Talk:Chiropractic/Archive 25 #Philosophy 2 rewrite.
• Vertebral subluxation

The following signature is present to keep the archive bot from archiving this section: Eubulides (talk) 08:19, 14 July 2008 (UTC)

Discussion

It's been 3 weeks. Shall we arbitrarily move the "hot topic" link to the next topic? We can still continue to work on History, too. ☺ Coppertwig (talk) 23:02, 19 July 2008 (UTC) Signature for bot: 18:19, 25 July 2008 (UTC)

History

In the early 19th century, chemists and physicians alike shared a common vitalistic belief that, unlike inanimate objects, living objects had a substantial entity (or spirit) controlling their organic processes. Homeopaths and Eclectics had become the majority health care practitioners. Drugs, medicines and patent medicines were becoming more prevalent and were mostly unregulated and laced with compounds such as mercury, alcohol and cocaine. Somewhere around 1895, Davenport, Iowa magnetic healer Daniel David Palmer (D.D. Palmer) developed a theory that manual manipulation, especially of the spine, could cure disease. Although initially keeping the theory a family secret, in 1898 at his new Palmer School of Chiropractic he began teaching it to a few students, one of whom, his son Bartlett Joshua (B.J.) Palmer, became committed to promoting chiropractic, took over the Palmer School in 1906, and rapidly expanded its enrollment. By this time medicine had created the American Medical Association (AMA), absorbed the homeopaths and eclectics and organized into a major political force creating state laws that limited the practice of medicine, but the small chiropractic faction was not included.

Prosecutions and incarcerations of chiropractors for practicing medicine without a license grew common. To defend against medical statutes B.J. argued that chiropractic was separate and distinct from medicine, asserting that chiropractors "analyzed" rather than "diagnosed", and "adjusted" subluxation rather than "treated" disease. The Palmers continued to develop D.D.'s theory along vitalistic lines: 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. D.D. and B.J. both seriously considered declaring chiropractic a religion, which might have provided legal protection under the U.S. constitution, but decided 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).

D.D. and B.J. defined chiropractic as "practice by hand" or "straight" and did not use instruments or "mix" chiropractic with other remedies or cures. Chiropractors that did were coined "mixers". Tension soon developed between the two groups as mixers continued to develop new methods and open new schools to teach their proprietory techniques. In 1910 B.J. changed course and endorsed X-rays as necessary for diagnosis; this resulted in a significant exodus from the Palmer School 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 and ultimately sealed the fragmentation of chiropractic with the development of two professional associations; the mixer American Chiropractic Association(ACA) and straight International Chiropractors Association(ICA).

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. The AMA labeled chiropractic "an unscientific cult" and held that it was unethical for medical doctors to associate with an "unscientific practitioner". This culminated in a landmark 1987 anti-trust lawsuit, 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. 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 manual therapies for acute low back pain. 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.

History comments

• I take it that this section is intended as a working draft to replace Chiropractic #History.
• This draft is too long. Chiropractic #History is already overlong as a summary of a subarticle; it should not be made significantly longer.
• The first paragraph of this draft is almost entirely unnecessary in a brief summary. There is no need to talk about details such as when and where Andrew Taylor Still opened the ASO. The ASO is about osteopathy, not chiropractic.
• The phrase "After nine successful years," is not explained. I assume it means that Palmer was successful financially as a magnetic healer for nine years before developing chiropractic? I doubt whether this detail is important at this level, but if so it needs to be explained.
• The sentence "He gave the first chiropractic adjustment to a deaf janitor, Harvey Lillard, on September 18, 1895." is not supported by any reliable source and is almost certainly false.
• The sentence "By this time medicine had organized into a major political force creating state laws that limited the practice of medicine." is not supported by a reliable source and is unnecessary.

Eubulides (talk) 09:16, 12 July 2008 (UTC)

• "I take it that this section is intended as a working draft to replace Chiropractic #History." As we agreed that your version was just a start, there is still room for improvement. Unfortunately, the previous version got archived!
• "This draft is too long. Chiropractic #History is already overlong as a summary of a subarticle; it should not be made significantly longer." I'm thinking we can tweak everything quite a bit once I get it all in.
• "The first paragraph of this draft is almost entirely unnecessary in a brief summary. There is no need to talk about details such as when and where Andrew Taylor Still opened the ASO. The ASO is about osteopathy, not chiropractic." See Gleng's concerns below as well as on my talk page. There are many osteopaths that think the timing of the ASO is very important. This is why most DCs went to jail after all. It is also why DD was forced to come up with a date of that first adjustment. All very important as it set the tone for the entire century.
• "The sentence "He gave the first chiropractic adjustment to a deaf janitor, Harvey Lillard, on September 18, 1895." is not supported by any reliable source and is almost certainly false." I agree. We can deal with that.
• "The sentence "By this time medicine had organized into a major political force creating state laws that limited the practice of medicine." is not supported by a reliable source and is unnecessary." this is a good one pages 109 - 112. Are you thinking that political organized medicine had nothing to do with shaping chiropractic?

-- Dēmatt (chat) 01:47, 13 July 2008 (UTC)

• Obviously osteopaths think that Still and the ASO are important for osteopathic history, but that is osteopathy, not chiropractic. That sort of detail about some other profession is completely unnecessary in a brief summary of chiropractic history.
• I agree that organized medicine fought chiropractic for many years. But Chiropractic #History already says that. There is no need to lengthen the discussion of that battle here. The details can be put in Chiropractic #History.
• The goal of the proposed new paragraph is to say that chiropractic was not scientific initially, but neither was mainstream medicine. That point can be made quite briefly and sourced. There is no need to write a long paragraph, full of details that have nothing to do with chiropractic, to make that point. This paragraph is supposed to be a brief summary of Chiropractic #History; it is not supposed to grab one large section of Chiropractic #History and emphasize it here.
• The current rewrite of the Lillard incident is still not right. We don't have reliable sources saying that Palmer's encounter with Lillard led Palmer to hypothesize about manipulation.
• The rewrite claims that Palmer had "nine successful years" as a magnetic healer, but this is not sourced.
• The rewrite has removed the information that B.J. scornfully called mixers "mixers".
• No sources have been given for the claim "Tension soon developed between the two groups as mixers continued to develop new methods and open new schools to teach their proprietory techniques."
• The draft says the AMA excluded chiropractors and osteopaths, but the cited source about the AMA says they excluded osteopaths, chiropractors, Christian Scientists and other faith healers, midwives, and chiropodists. It would be better to say "osteopaths, chiropractors, faith healers, midwives, and chiropodists" if we're going to list who the AMA excluded.
• The phrase "With no laws to protect them" is redundant and can be removed.
• The phrase "Until 1983" has been removed; it needs to be retained.
• The phrase "essentially locking chiropractic out of the mainstream of health care" is not supported by a source.
• The phrase "and was hampered by antiscientific and pseudoscientific ideas that sustained the profession in its long battle with organized medicine" has been removed, but it is supported by a reliable source and is an important point.
• The sentences "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." have been removed, but they are supported by a reliable source and are an important point. The removed text is much more important and relevant to chiropractic today than the long paragraph about osteopathy in the 19th century etc.

Eubulides (talk) 09:00, 13 July 2008 (UTC)

I second Eubulides comments, especially the concerns about the removed text. That really surprised me. -- Fyslee / talk 15:39, 13 July 2008 (UTC)

See below. Nothing new here and still a work in progress. -- Dēmatt (chat) 18:21, 13 July 2008 (UTC)

Thanks for your help. This is still a work in progress and any comments help. Keep in mind that I am trying to write something that includes all pertanent information without overdoing it. Sometimes that means I have to add a bunch before taking some out. Also, remember, this is not only about medicine and chiropractic. It is illustrating the historical context to the state of health care at the time - this has to include all the things that affected the profession, science, medicine, a young country, bad treatments, quackery, monopolies, politics, legal issues, etc.. All these things are essential to understanding what chiropractic is, because it is more than just spinal manipulation :-).

• Obviously osteopaths think that Still and the ASO are important for osteopathic history, but that is osteopathy, not chiropractic. That sort of detail about some other profession is completely unnecessary in a brief summary of chiropractic history.

If you were here two years ago, you'd know that we had osteopaths adding all kinds of tidbits about how DD Palmer was not the first... this is my attempt to include their POV. I might be able to make it more succinct.

• I agree that organized medicine fought chiropractic for many years. But Chiropractic #History already says that. There is no need to lengthen the discussion of that battle here. The details can be put in Chiropractic #History.

I suspect you mean Chiropractic history. Chiropractic history should be a more inclusive description of a proper analysis made here. I am not purposely adding anything here, it just seems that any explanation seems to come back to that. I think it is important to make it as NPOV as possible so that the reader can't tell if we are advocating fro any particular side.

• The goal of the proposed new paragraph is to say that chiropractic was not scientific initially, but neither was mainstream medicine. That point can be made quite briefly and sourced. There is no need to write a long paragraph, full of details that have nothing to do with chiropractic, to make that point. This paragraph is supposed to be a brief summary of Chiropractic #History; it is not supposed to grab one large section of Chiropractic #History and emphasize it here.

No, the point was to bring context to the thought of the time. Medicine was only a small part of that then.. BTW, as Gleng noted, these vitalists were the ultimate scientists, so apparently I didn't make the point. I'll keep working on it.

• The current rewrite of the Lillard incident is still not right. We don't have reliable sources saying that Palmer's encounter with Lillard led Palmer to hypothesize about manipulation.

I'm open to suggestions here, but I think that a mention of Harvey Lillard is necessary because it is basic chiropractic history. How can we be considered and encyclopedia without including Lillard. It would be like considering discovery of the cause of yellow fever without mentioning the legend of Jesse William Lazear dying from a self inflicted mosquito bite. Though, it does need to be accurate.. if possible. -- Dēmatt (chat) 18:21, 13 July 2008 (UTC)

• The rewrite claims that Palmer had "nine successful years" as a magnetic healer, but this is not sourced.

It's in there.

• The rewrite has removed the information that B.J. scornfully called mixers "mixers".

So. It was removed in an attempt to NPOV. NPOV does not mean that we use verifiable sources to pass POV statements.

• No sources have been given for the claim "Tension soon developed between the two groups as mixers continued to develop new methods and open new schools to teach their proprietory techniques."

Yeah, you're right here... do you disagree with this statement?

Kaptchuk was where I saw it.

• The draft says the AMA excluded chiropractors and osteopaths, but the cited source about the AMA says they excluded osteopaths, chiropractors, Christian Scientists and other faith healers, midwives, and chiropodists. It would be better to say "osteopaths, chiropractors, faith healers, midwives, and chiropodists" if we're going to list who the AMA excluded.

Hmmm, I'll look at that.

• The phrase "With no laws to protect them" is redundant and can be removed.

I'll work on that.

• The phrase "Until 1983" has been removed; it needs to be retained.

I took that out because it was unclear. The years were from 1963 to 1983 I think and wasn't sure, so 'Until 1983' seemed to assume from the beginning (which I am not sure was the case). So I took it out.

• The phrase "essentially locking chiropractic out of the mainstream of health care" is not supported by a source.

I agree.

• The phrase "and was hampered by antiscientific and pseudoscientific ideas that sustained the profession in its long battle with organized medicine" has been removed, but it is supported by a reliable source and is an important point.

Again, reliable sources don't have to be used when they make NPOV violations, especially when taken from opinion pieces without attribution.

• The sentences "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." have been removed, but they are supported by a reliable source and are an important point. The removed text is much more important and relevant to chiropractic today than the long paragraph about osteopathy in the 19th century etc.

When I read the source it occurred to me that this is in the wrong section because it is current, not history. I din't mean to take it out of the article, just the history... though it probably needs work because it changed all the verbs to past tense.

I'll work on some of those here soon. Thanks for the input. -- Dēmatt (chat) 18:21, 13 July 2008 (UTC)

(outdent) Dematt, you write above:

• "NPOV does not mean that we use verifiable sources to pass POV statements."

If you really think about the consequences of that, then we can't include any POV here, no matter how well sourced. Maybe you didn't mean it quite the way it sounds to me. Actually all we do here is to include well-sourced POV. We don't even officially care whether it's totally "truth" or not, as long as it's well-sourced, since one person's absolute "facts" and "truth" are another person's "POV" and "opinion". NPOV does mean "that we use verifiable sources to pass POV statements." It's just a matter of attribution. It shouldn't appear to be editorial opinion and POV. To avoiid that we also use direct quotes. Coppertwig has made a comment that closely parallels yours, but ends with a good solution. -- Fyslee / talk 21:18, 13 July 2008 (UTC)

This is the part of NPOV that both Coppertwig and I seem to be simultaneously talking about. IOWs, our responsibility is to choose sources that explain those separate POVs without taking sides. Just because the source is verifiable doesn't mean we have to use it. If it is that relevant, that same word should be found in several verifiable sources. Words like "scornfully" are good for a secondary source, but we shouldn't import it here. Like you say, though, this does not mean that a POV gets left out, just that we explain it dispassionately and without taking sides. The sentence says the same thing, just as Coppertwig's suggestion says the same thing without using the POV wording. BTW, if I were writing a history of chiropractic, I would surely include these words along with the words mixers used for straights, and everybody called everybody else! (Steth comes to mind :-) (Though you have some good ones, too:-) There is a lot of drama there that would definitely sell books. -- Dēmatt (chat) 22:03, 13 July 2008 (UTC)

I agree with Eubulides that the first paragraph, mostly about what health care in general was like back then, is much longer than necessary. ☺ Coppertwig (talk) 01:39, 14 July 2008 (UTC)

Okay, I'll work on it. Thanks for all the comments. -- Dēmatt (chat) 13:01, 14 July 2008 (UTC)

I welcome Dematt's attempts to further improve Chiropractic #History. The goal of the first paragraph is an important goal, and is very important, in that it helps bring the section towards a NPOV. I also agree that we do not need to use a POV source's POV wording to explain something. - DigitalC (talk) 01:04, 15 July 2008 (UTC)

I don't see why adding so much detail about pre-chiropractic history adds NPOV. If the neutrality point is to say that mainstream medicine was just as unscientific as chiropractic was in the beginning, that point can be made briefly. Giving an entire paragraph to this theme, in what is supposed to be a brief history of chiropractic, smacks of apologetics and is a strong POV. This sort of weight is not given in standard histories of chiropractic; why give so much weight to it here? Eubulides (talk) 06:16, 15 July 2008 (UTC)

You keep saying that "medicine was just as unscientific as chiropractic". That's interesting. Do you think these vitalists were not scientific? Pasteur? Driesch? They were scientists. I disagree that other histories don't include context. I disagree that adding context adds POV.

Sorry, you're right, I should have said "as vitalistic", not "as unscientific". But the rest of my point remains. Yes, other histories include context, but they don't devote such a large fraction of their contents to the pre-chiropractic context. One sentence should be enough here; a paragraph is way overkill. Eubulides (talk) 17:28, 15 July 2008 (UTC)

(ec)I'm editing your history draft, Dematt. If I wasn't supposed to, or if you don't like my edits, feel free to revert or to ask me to revert. (and then we can discuss it ...) ☺ Coppertwig (talk) 01:21, 15 July 2008 (UTC)

Hey, that's the heart of collaboration. Nobody's perfect! I think your edits are an improvement. -- Dēmatt (chat) 16:55, 15 July 2008 (UTC)

This version is way too long and has a lot of unnecessary details. There is a lot of unnecessary context. It would be better to get to the point. I recommend starting over using the current History version and adding what you think is most nececessary. At this point, this rewrite is not it. QuackGuru 17:21, 15 July 2008 (UTC)

I suggest that the following sentences could perhaps be deleted: "Fueled by vitalist Louis Pasteur's ... take hold."; "Meanwhile, renowned scientists such as Wilhelm Roux and ... some sort of "spiritual entity"."; "Chiropractic leaders often invoked religious imagery and moral traditions."; "Early chiropractors also tapped into the Populist movement, ... Association (AMA).": "The longstanding feud between chiropractors and medical doctors continued for decades. " This last sentence is unnecessary, as the information can be deduced from the other sentences. In the version in the current article: "and was hampered by antiscientific and pseudoscientific ideas that sustained the profession in its long battle with organized medicine." can be deleted; I looked in Keating's primer and didn't see it, and it seems unnecessary anyway.

Here's another draft. I based it on both the current article version (576 words) and Dematt's draft above (796 words); this one has 595 words. Feel free to comment and to edit it.☺ Coppertwig (talk) 20:27, 19 July 2008 (UTC)

Thanks for the new draft. I agree with many but not all of the proposed deletions. I'll comment further below the draft. Eubulides (talk) 21:11, 21 July 2008 (UTC)

(outdent) I see that further changes have been made to this draft. However, it still has real problems with balanced coverage. Far too much time is spent on topics that are not important for chiropractic (cocaine, for example). And material highly relevant to recent history is still absent (recent competition from other health care professions). Although early chiropractic history is obviously important, the history since 1930 should consume at least a third, and preferably closer to a half of the space. Also, the total length of this section should be cut down so that it's no longer than what's in Chiropractic #History now (which is already too long). Eubulides (talk) 18:06, 25 July 2008 (UTC)

History (another draft)

Chiropractic was founded in the 1890s in Davenport, Iowa by Daniel David (D.D.) Palmer, who had turned from teacher and grocer to the magnetic healing developed by MD Andrew Taylor Still as an alternative to what he saw as the abusive nature of the drugs of that time. After nine successful years as a magnetic healer, Palmer had developed a theory about the cause of all disease, and an encounter with deaf janitor, Harvey Lillard, who reported that after two treatments he could hear quite well, convinced him that manual manipulation to reposition body parts could cure disease. Although initially keeping the theory a family secret, in 1898 at his new Palmer School of Chiropractic he began teaching it to a few students, one of whom, his son Bartlett Joshua (B.J.) Palmer, became committed to promoting chiropractic, took over the Palmer School in 1906, and rapidly expanded its enrollment.

Prosecutions and incarcerations of chiropractors for practicing medicine without a license grew common. To defend against medical statutes B.J. argued that chiropractic was separate and distinct from medicine, asserting that chiropractors "analyzed" rather than "diagnosed", and "adjusted" subluxation rather than "treated" disease. In the early 19th century, chemists and physicians alike shared a common vitalistic belief that, unlike inanimate objects, living objects had a substantial entity (or spirit) controlling their organic processes. The Palmers continued to develop D.D.'s theory along vitalistic lines; 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. D.D. and B.J. both seriously considered declaring chiropractic a religion, which might have provided legal protection under the U.S. constitution, but decided against it partly to avoid confusion with Christian Science.

Tensions developed between "straight" chiropractors such as D.D. and B.J. who disdained the use of instruments, and those, scornfully called "mixers" by B.J., who advocated their use; some opened new schools to teach their proprietary techniques. In 1910 B.J. changed course and endorsed X-rays as necessary for diagnosis; this resulted in a significant exodus from the Palmer School 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 and ultimately sealed the fragmentation of chiropractic with the development of two professional associations; the mixer ACA and straight ICA.

By the 1930s chiropractic was the largest alternative healing profession in the U.S., but faced heavy opposition by organized medicine. The AMA labeled chiropractic "an unscientific cult" and held that it was unethical for medical doctors to associate with an "unscientific practitioner". 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. 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 manual therapies for acute low back pain. 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.

Comments on history (another draft)

"Chiropractic was founded in the 1890s in Davenport, Iowa by Daniel David (D.D.) Palmer, who had turned from teacher and grocer to the magnetic healing developed by MD Andrew Taylor Still". The cited source here is the autobiography of Andrew Still, which obviously does not support most of the claims in this part of the sentence. This sentence needs an appropriate source. Furthermore, I don't think Still's autobiography should need to be sourced at all; surely every detail in this sentence can be sourced by a reliable history of chiropractic, and if we really have go to that ancient primary source that is an indication that we are delving into a non-notable area. Also, there's certainly no need to mention that Still was an MD here. I am skeptical that Still needs to be mentioned at all. Eubulides (talk) 21:11, 21 July 2008 (UTC)

"After nine successful years as a magnetic healer" This isn't important enough to appear here. It's enough to say Palmer was a magnetic healer, which has already been said. Eubulides (talk) 21:11, 21 July 2008 (UTC)

"an encounter with deaf janitor, Harvey Lillard, who reported that after two treatments he could hear quite well" There is substantial doubt that this episode ever occurred as recounted by the Palmers. It should not be repeated here without giving the skeptical side. Eubulides (talk) 21:11, 21 July 2008 (UTC)

The citation to DD' Palmer's Lifeline is inappropriate here. These are Keating's notes, which never appeared in a peer-reviewed paper (and he published plenty of papers on this subject). We should not refer to Keating's notes directly; we should refer to his published papers or to other more-reliable sources. Eubulides (talk) 21:11, 21 July 2008 (UTC)

"In the early 19th century, chemists and physicians alike shared a common vitalistic belief that, unlike inanimate objects, living objects had a substantial entity (or spirit) controlling their organic processes." This neglects the important fact that orthodox medicine rejected vitalism even though chiropractic embraced it. Furthemore, it omits several other important ways in which chiropractic departed from mainstream medicine. Also, that source is not that reliable; we should be using a peer-reviewed journal for anything this basic. I suggest basing the discussion of vitalism etc. on far more-reliable and more-relevant sources, e.g., by paraphrasing ideas from the following quote:

"Emphasizing observation rather than experimentation, the ability of the commoner as well as the expert to be a scientist, a vitalist rather than a mechanist philosophy, and a mutually supportive rather than antagonistic relationship between science and religion, chiropractors had created an alternative science. This science justified their approach to healing, attacted supporters, furnished expertise for practitioners, and provided chiropractic at least some of the social and cultural authority derived from the aura surrounding science."

Eubulides (talk) 21:11, 21 July 2008 (UTC)

The draft removes the following text, which is important, relevant, and well-sourced: "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)." Eubulides (talk) 21:11, 21 July 2008 (UTC)

"some opened new schools to teach their proprietary techniques" This is undoubtedly true, but it needs to be supported by a citation. Eubulides (talk) 21:11, 21 July 2008 (UTC)

"The Palmers continued to develop D.D.'s theory along vitalistic lines" This is not supported by a reliable source, and it's pretty misleading: I don't think "the Palmers" collaborated on the time of day, much less on the development of D.D.'s theory. Eubulides (talk) 21:11, 21 July 2008 (UTC)

The draft replaces "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." with "By the 1930s chiropractic was the largest alternative healing profession in the U.S., but faced heavy opposition by organized medicine." This misses the important point that the pre-1930s growth was despite opposition, and that the opposition continued for decades more. Eubulides (talk) 21:11, 21 July 2008 (UTC)

The draft removes the important point that evidence-based research "was hampered by antiscientific and pseudoscientific ideas that sustained the profession in its long battle with organized medicine." Eubulides (talk) 21:11, 21 July 2008 (UTC)

The draft removes the even-more important point that "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." These are key issues in the recent history of chiropractic. Eubulides (talk) 21:11, 21 July 2008 (UTC)

OK, you caught me, Eubulides. ☺ I didn't look at the sources much but just rearranged the material from the current article version and the other draft. I may have ended up with footnotes in the wrong place etc. Thanks for agreeing with some of the proposed deletions. I may or may not find time to work on this more. Coppertwig (talk) 12:35, 22 July 2008 (UTC)

I took several of the more constructive criticisms and cut out or cleaned up a lot of the pre-chiropractic info from the first paragraph the first history above just to see what it would look like. -- Dēmatt (chat) 03:19, 25 July 2008 (UTC)

SYN and implicit conclusions

(outdent)

• 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 Misplaced Pages 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 (talk) 00:39, 1 July 2008 (UTC)

Eubulides said: "Every Misplaced Pages 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 WP: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 WP: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 WP: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 WP:V or WP: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. ☺ Coppertwig (talk) 02:26, 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 Misplaced Pages, which makes this particular objection suspect. Here is an analogy. Suppose I said that WP: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 WP: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 Misplaced Pages articles.

• Let's take, for example, the first citation used in the alphabetically-first featured medical article in Misplaced Pages, 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 Misplaced Pages. 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 WP: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 WP: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. WP: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 (talk) 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 WP: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 Misplaced Pages 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.

-- Dēmatt (chat) 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 Misplaced Pages" 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 (talk) 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.

-- Dēmatt (chat) 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 WP: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? -- Levine2112 00:44, 2 July 2008 (UTC)

If necessary, yes, let's ask at WP: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 WP: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 WP:SYN. Or, maybe you'd prefer that we ask at WP: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 WP:NOR/N perhaps we should first agree here on the wording of the question. ☺ Coppertwig (talk) 01:25, 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 WP: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 WP: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 (talk) 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 WP:NOR/N concerning whether or not the mention of SMT research in Chiropractic causes a WP: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? -- Levine2112 01:08, 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. Eubulides (talk) 16:41, 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. -- Levine2112 18:30, 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. Eubulides (talk) 20:51, 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. -- Levine2112 01:10, 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 WP:SYN if an article on topic X discusses a different topic Y that is core to X?"? Eubulides (talk) 05:48, 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. DigitalC (talk) 06:00, 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 WP:SYN example) rather than implied (i.e., implicit). Actually, in the WP:SYN example, the opinion expressed is implicit, not explicit. You agree that "it" means "plagiarism". WP: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 WP:SYN) mentions Jones and also mentions plagiarism. The idea about Jones and plagiarism is implicit in the juxtaposition of the sentences, yet WP: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. ☺ Coppertwig (talk) 01:20, 6 July 2008 (UTC)

• I continue to disagree with that characterization of the example in the WP: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.

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

Eubulides (talk) 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. Eubulides (talk) 21:15, 11 July 2008 (UTC)

No further comment, and it's been more than a week, so I added that sentence. Eubulides (talk) 06:49, 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 WP:SYN example." I don't understand your interpretation of WP:SYN. How do you explain the presence of the word "it", which I believe we've agreed represents "plagiarism", in this sentence of WP: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.) ☺ Coppertwig (talk) 23:02, 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. Eubulides (talk) 21:11, 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 (talk) 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. ☺ Coppertwig (talk) 13:31, 24 July 2008 (UTC)

The core question

Does it violate WP: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. QuackGuru 06:39, 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". DigitalC (talk) 10:34, 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 WP:SYN if an article on topic X discusses a related topic Y that is core to X? QuackGuru 17:37, 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 WP: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 WP:SYN if the justification for making such an assertion comes from some source Z?

-- Levine2112 20:20, 5 July 2008 (UTC)

"Again: Does it violate WP: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. DigitalC (talk) 01:56, 6 July 2008 (UTC)

Does it violate WP: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 care and is most frequently employed by chiropractors.

I have provided my evidence that spinal manipulation is core to chiropractic. When topic Y is related to topic X it is relevant. QuackGuru 18:27, 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? -- Levine2112 19:10, 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 my questions and provide your evidence of Syn or I will remove the Syn tag very soon. QuackGuru 23:11, 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 WP:NOR/N for a WP:3PO per WP:DR. Let's agree to statement/question which we will post there and then let's wait for third-party input. Sound reasonable? -- Levine2112 01:46, 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 (talk) 08:09, 8 July 2008 (UTC)

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

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 WP: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. QuackGuru 05:44, 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 WP:IDHT before. DigitalC (talk) 06:49, 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. Eubulides (talk) 08:09, 8 July 2008 (UTC)

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

Does it violate WP: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 care and is most frequently employed by chiropractors. That is strong evidence that spinal manipulation is core to chiropractic.

DigitalC or Levine2112, please present your evidence. I am still waiting. QuackGuru 18:53, 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 Chiropractic#Effectiveness under the first treatment condition (Lower Back Pain) is 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. -- Levine2112 20:13, 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. Eubulides (talk) 23:32, 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 WP:SYN if an article on topic X discusses a related topic Y that is core to X?

Please answer the question specifically. Thanks. QuackGuru 17:32, 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."

• 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. Eubulides (talk) 23:32, 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. -- Levine2112 01:41, 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 Misplaced Pages 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 (talk) 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 WP: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). -- Levine2112 07:42, 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 (talk) 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. DigitalC (talk) 09:45, 10 July 2008 (UTC)

Amen! -- Levine2112 16:04, 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 Misplaced Pages. 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 (talk) 17:28, 10 July 2008 (UTC)

<-- Well, Murphy is about questioning guidelines. It's title is, "Inconsistent grading of evidence across countries: a review of low back pain guidelines." It's conclusions are, "Treatment recommendations for nonspecific LBP, particularly spinal manipulation, remain inconclusive. Guideline developers need to consider guidelines in neighboring countries and reach consensus on how evidence is graded and incorporated into guidelines. Guidelines should continue to be regularly updated to incorporate new evidence and methods of grading the evidence." Murphy also discusses that using RCTs to decide treatment guidelines for complimentary methods is likely flawed... "When it comes to appraising the evidence with regard to complementary medicine interventions such as SMT, perhaps the time has come to consider that the RCT is less able to show the efficacy of this particular intervention. Other research designs could be considered; perhaps one could suggest a fusion of qualitative and quantitative research designs, or a more pragmatic approach may be required, where clinical trials are conducted in the clinical setting itself, with patients receiving SMT in their usual treatment environment. A recent example of how this treatment intervention can be appraised is shown by the UK Beam Trial Team in 2004.21" Of course the UK Beam Trial was much more complimentary of chiropractic care/physcial therapy/osteopathic care because it studied them in the offices where they were performed - which of course is what this discussion is about. IOWs, 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. It says nothing about whether SMT is a legitamate intervention or not, much less chiropractic care or it's efficacy. Therefore it is not appropriate for use to comment on the effectiveness of chiropractic care. We can use it under the Low back pain article to discuss guidelines quite appropriately. -- Dēmatt (chat) 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.TheDoctorIsIn (talk) 21:00, 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 (talk) 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. Eubulides (talk) 21:15, 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? -- Dēmatt (chat) 01:57, 12 July 2008 (UTC)

• The "area" is the use of spinal manipulative therapy to treat low back pain. Eubulides (talk) 09:16, 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 WP: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 WP: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 WP:SYN violation. So why is moving the text such a common suggestion?

Eubulides (talk) 21:15, 11 July 2008 (UTC)

WP:SYN is a subform of WP: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. -- Dēmatt (chat) 03:22, 12 July 2008 (UTC)

When all the sentences are verified that means there never was Syn. QuackGuru 06:42, 12 July 2008 (UTC)

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

What does "Both sentences are verifiable" mean? Which sentences are being referred to here? Eubulides (talk) 09:00, 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 (talk) 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.

-- Dēmatt (chat) 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."

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 (talk) 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 Misplaced Pages 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. ☺ Coppertwig (talk) 23:02, 19 July 2008 (UTC)

Coppertwig, I understand your interpretation of SYN, but how do you interpret this from the first paragraph of WP: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 Misplaced Pages 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. -- Dēmatt (chat) 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, ☺ Coppertwig (talk) 13:31, 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? -- Dēmatt (chat) 14:16, 24 July 2008 (UTC)

Proposed wording for NOR/N

Following up on #Draft questions would not resolve disagreement above, I have drafted below proposed wording for an WP:NOR/N request. Here's how I came up with it. Looking at similar requests already on that page, I don't think generic questions like "Is it possible for an idea which is expressed implicitly but not explicitly in an article to be a SYN violation?" would be that helpful. Once things get too generic, the answer will come back "it depends", which means that a generic question that begins "Is it possible..." will always be answered "Yes, depending on the circumstances" which won't give us much help on this particular question. So we need to be somewhat more specific.

The draft wording is in #SYN and chiropractic's evidence basis below. Eubulides (talk) 21:11, 21 July 2008 (UTC)

SYN and chiropractic's evidence basis

Does Chiropractic #Evidence basis have a significant synthesis problem?

In the opinion of the section's critics, the section is a WP:SYN violation when it presents specific research on spinal manipulation (SM) as evidence of effectiveness of chiropractic care as opposed to the whole range of treatments performed by chiropractors (not just SM), because the reader may confuse the assertions about spinal manipulation specifically as being assertions about chiropractic treatment in general.

In the opinion of the section's proponents, the section clearly distinguishes SM research from other research, every claim in the section is directly supported by a reliable source, standard practice in evidence-based chiropractic relies on SM research, and excluding highly-relevant mainstream research would raise serious WP:WEIGHT problems.

See also Syn tag and SYN and implicit conclusions.

(end of draft wording) Eubulides (talk) 21:11, 21 July 2008 (UTC)

Comments on proposed wording for NOR/N

(Please put comments on draft wording here.) Eubulides (talk) 21:11, 21 July 2008 (UTC)

• When we state, "standard practice in evidence-based chiropractic relies on general-SM studies", we should probably qualify this with a source or suggest that there are sources out there that support this opinion. This is key because this is where the critic's claim of SYN lies. Sources which state that conclusions from general SM research can be applied to make conclusions about chiropractic SM are the "Source B" component of the the critic's claim of SYN. (Whereas, the general SM studies are the "Source A".) Considering that this is a SYN question, I actually think it would be a good idea to clearly illustrate the alleged "A + B and therefore C" scenario. I really think that's all we have to do. Then the respondents on the noticeboard can just examine the formula and determine if it equates to SYN. Sound reasonable? -- Levine2112 non 21:32, 21 July 2008 (UTC)

• I'd rather keep the question short; it's already overlong as it is, compared to the questions already asked at WP:NOR/N. The longer the question is, the less likely it'll get answered.
• I suggest that any lengthy argument about "Source A" and "Clause B" and so forth be put in the talk page, and that the question itself merely contain a wikilink to the lengthy argument.
• I'd rather not have the "Proponents of this section" sentence edited in favor of the critics. That sentence should argue the proponents' side, not the critics' side.
• Do you have any specific wording-change proposals? They could include wikilinks to the talk page or the talk page archives.

Eubulides (talk) 05:45, 22 July 2008 (UTC)

I am not suggesting that we put in "any lengthy argument"; however, this is a question for the NOR/N specifically about SYN. Therefore, we must illustrate what the critic's perceive as "A + B so therefore C". If you think the question is overlong now, then I would suggest cutting something out. But clearly the perceived "A + B so therefore C" formula must be illustrated for the NOR/N as this formula is at the heart of any SYN discussion. Let's make it extremely clear what Source A states, what Source B states and what the perceived Conclusion C is, because this is core to the SYN charge and we must provide any noticeboard respondents with complete clarity. Once we get that wording in there, then we can talk about including "wikilinks to the talk page" or "any specific word-change proposals". Please take a crack at inserting the perceived "A + B so therefore C" formula into the question as I think it would be a good-faith exercise in "writing for the enemy", so to speak. Thanks for your efforts to resolve this dispute in good faith, Eubulides! -- Levine2112 06:22, 22 July 2008 (UTC)

I don't think this would be a good idea, as I think it will make the question way too long. Obviously you disagree, though. I doubt whether I can do full justice for text I disagree with, so can you please propose a specific wording change? Thanks. Eubulides (talk) 06:33, 22 July 2008 (UTC)

Sure, here it goes:

::::Critics of the section say the section employs SYN when it cites sources on SM in general (as opposed to studies specifically on chiropractic SM), because these citations imply to the reader that general-SM studies are relevant to chiropractic, a conclusion that these studies themselves do not make. Whereas there exists some Source A which applies conclusions from some non-chiropractic SM research to make conclusions about chiropractic SM, and whereas there exists some Research B which studies non-chiropractic SM as performed by non-chiropractic practitioners and makes no conclusions about chiropractic SM specifically whatsoever. Thus, there is a rationale that since there exists some Source A which applies non-chiropractic research to make conclusions about chiropractic, therefore it is okay for our article to use non-chiropractic Research B to make or imply some Conclusion C about chiropractic SM. Hence, "A and B, so therefore C."

I think that is pretty clear. It's pretty much my position here in this dispute, though I don't know how well it represents the positions of Dematt, DigitalC, TheDoctorIsIn, GlenG, and several other editors on the critical side here. I'd love input from them here, as well as from the supporting side (just Eubulides and QuackGuru, I believe). -- Levine2112 07:02, 22 July 2008 (UTC)

OK, I agree with the general idea being discussed here of the question to be asked focussing directly on the reason for this particular SYN tag, noting though that the more general question I suggested will probably not be answered and may need to be addressed later when some other issue arises. Here's an attempt at a short version of the question:

::::::Does the evidence basis section of Chiropractic contain a SYN violation because it discusses the effectiveness of spinal manipulation (SM) baseed on studies of SM performed by various professionals, not just chiropractors, studies which made no conclusions about the effectiveness of chiropractic? Does this mislead the reader about the effectiveness of chiropractic? Another study states that research on SM in general is relevant to studies of chiropractic effectiveness (make sure this wording agrees with the source); does citing this study fix the SYH violation or make it worse?

If this is too long, perhaps only the first sentence could be used. ☺ Coppertwig (talk) 12:35, 22 July 2008 (UTC)

I think this is really good, Coppertwig, as it really implies the A, B, C without spelling it out. Here is a slightly revised version:

::::::Does the evidence basis section of Chiropractic contain a SYN violation because it discusses the effectiveness of spinal manipulation (SM) based on studies of SM in general (SM as performed by various professionals, not just chiropractors) studies which made no conclusions about the effectiveness of chiropractic SM specifically? Does this mislead the reader about the effectiveness of chiropractic SM? Another study states that research on SM in general is relevant to studies of chiropractic SM effectiveness (make sure this wording agrees with the source); does citing this study fix the SYN violation or make it worse? Essentially, if one source says that it is okay to apply general SM research to make conclusions about chiropractic SM, does that give us license to draw the same conclusions about other sources?

I feel that my last question/sentence above really distills this to the core issue. Thoughts? -- Levine2112 20:05, 22 July 2008 (UTC)

A few statistics. The wording in #SYN and chiropractic's evidence basis devotes (by my count) 48 words to critics of the section and 39 words to supporters. Levine2112 originally proposed adding 143 words to the critical side. Coppertwig proposes adding (by my count) 64 words to the critical side and 17 words to the supportive. Levine2112 responded by proposing (by my count) 103 critical and 17 supportive words. Adding any of these three changes hardly sounds fair, as more weight was already being given to the critical side. What to do? Eubulides (talk) 23:19, 22 July 2008 (UTC)

Let's not get bogged down in word count stats just yet. Let's first seek writing for clarity of the issue at hand. That said, I don't think that Coppertwig nor my responding version is intended to be wording for the supporters or the critics. The intent (at least my intent) was to combine rather than divide the points of view here. After all, doesn't my last question alone summarize the core of the dispute without being worded for the supporters nor the critics?

::::::::If one source says that it is okay to apply general SM research to make conclusions about chiropractic SM, does that give us license to draw the same conclusions about other sources?

If you feel that this isn't a neutral question, perhaps you could suggest a revision and/or explain why you feel it isn't neutral. -- Levine2112 00:18, 23 July 2008 (UTC)

Levine2112 listed me as being on the "critical" side, but I thought I was neutral/undecided on this SYN issue. Also, I thought we were going to try to straighten it out by clarifying the various definitions of SM and SMT in various contexts; some work was done on that but I'm still confused about it.

Suggestion: Use Eubulides' draft wording, but if it's desired to shorten it, then delete the "Here's the background" paragraph (and spell out SM the first time it appears). Also reduce the number of words when giving the additional links at the end, by saying simply "See also (link) and (link)."

Re Levine2112's last suggested wording: I would append "about other sources".☺ Coppertwig (talk) 02:14, 23 July 2008 (UTC)

Thanks for the suggestions. I deleted the "Here's some background" paragraph, spelled out SM, and reduced the words at the end, as you suggested. Eubulides (talk) 05:17, 23 July 2008 (UTC)

I would be reluctant to use Eubulides version. Let's examine the sentences in his/her proponents section:

::::::::::: Proponents of the section say that every claim in the section is directly supported by a reliable source, that standard practice in evidence-based chiropractic relies on general-SM studies, and that excluding highly-relevant mainstream research would raise serious WP:WEIGHT problems.

First, "standard practice in evidence-based chiropractic relies on general-SM studies". This should be clarified. Eubulides says that this is standard practice and bases his opinion off of a couple of sources. However, I and others have shown him/her sources where this is refuted; where either chiropractors or non-chiropractors have stated that general SM studies should not be used to draw conclusions about chiropractic SM.

Second, "excluding highly-relevant mainstream research" is an opinion. Especially the "highly relevant" portion. It is Eubulides' contention that this research is "highly-relevant". Also, no one is talking about excluding mainstream research in general, yet this is what is insinuated here. I welcome mainstream research. What's more I welcome highly-relevant mainstream research. And by highly-relevant, I mean mainstream research which is specifically about chiropractic. If it isn't about chiropractic, it isn't highly-relevant. -- Levine2112 02:34, 23 July 2008 (UTC)

Suggestion: re-write the "critics say" section the way you like it, but in the same number of words. Insert "what they consider to be" before "highly-relevant mainstream research". ☺ Coppertwig (talk) 03:03, 23 July 2008 (UTC)

• I like that suggestion as well; we should let the critics write the section describing the critical viewpoint. I disagree with Levine2112's criticism of the proponents' section, naturally; the proponents should be allowed to make their case as well.
• As for the proponent viewpoint, I don't think "what they consider to be" is necessary there. It's quite clear from the context that the text in question is being written from the proponents' viewpoint.
• Similarly, it isn't necessary to insert a "what they consider to be"-like qualifier before the phrase "these citations imply to the reader" in the critical section. Obviously, it's the critics who are asserting that these citations imply something to the reader, and we don't have to repeat that here.

Eubulides (talk) 05:17, 23 July 2008 (UTC)

If we are each going to be making our cases, we should at least be doing that honestly and clearly. If something is an opinion, it should be made clear as Coppertwig suggests (i.e. "what they consider to be"-like qualifier). I don't want to move forward on this until we all can at least agree to this basic principle in fairness. -- Levine2112 22:49, 23 July 2008 (UTC)

It shouldn't be necessary to add "proponents of the section say" in front of every clause in that sentence. That will make the sentence longer and harder to read. If its leading "Proponents of the section say that" isn't clear enough, how about replacing the phrase with "In the opinion of the section's proponents," and making the obvious grammatical changes to the rest of the sentence? Similarly for the critical section, of course. Eubulides (talk) 23:04, 23 July 2008 (UTC)

Give it a whirl and I will try and base the critic's section on your lead. Let's not worry about word count yet. Let's focus on making this clear. Perhaps we should start off with an agreed statement of fact. Thoughts? -- Levine2112 23:08, 23 July 2008 (UTC)

OK, I reworded it as I suggested above. Originally I drafted what I assumed was an agreed statement of fact, but removed that "Here's some background" paragraph after Coppertwig suggested removing it. We could resurrect it, I suppose; but all other things being equal, shorter is better. Eubulides (talk) 23:49, 23 July 2008 (UTC)

• "Chiropractic #Evidence basis discusses the evidence basis for chiropractic treatment" - This is part of the problem. Chiropractic #Evidence basis doesn't discuss the evidence basis for chiropractic treatment, it discusses the evidence basis of various conservative treatment procedures, that may be employed by Chiropractors or other health care practitioners. The implication that this is disussing effectiveness of chiropractic treatment IS the SYN violation. - DigitalC (talk) 23:22, 21 July 2008 (UTC)

• Please see the above comments about keeping the question itself short, the above suggestion for doing this by wilinking into the talk page, and the above request for specific wording-change proposals. Eubulides (talk) 05:45, 22 July 2008 (UTC)

• I would suggest changing "Chiropractic #Evidence basis discusses the evidence basis for chiropractic treatment" to "Chiropractic #Evidence basis discusses the evidence basis for various treatment methods, focusing on spinal manipulation (SM)..." - DigitalC (talk) 05:54, 22 July 2008 (UTC)

• OK, thanks, done, except "various" sounded a bit discursive; I used "several" instead. Eubulides (talk) 06:33, 22 July 2008 (UTC)

I agree with DigitalC here; that the SYN violation is that we are placing evaluations of specific conservative treatments (like spinal manipulation) and passing them off as evaluations of chiropractic care. I don't even think we should be discussing evaluations of spinal adjustments in this article because there are so many different types they shoud be handled in their own articles. But, I don't see where this is reflected in anything that has been changed or written so far. I admit though that I may be missing something. -- Dēmatt (chat) 03:07, 24 July 2008 (UTC)

Nothing is being passed off. Every statement in Chiropractic #Evidence basis accurately describes its source. If the source talks about SM, the statement talks about SM. Eubulides (talk) 05:06, 24 July 2008 (UTC)

Dematt, could you suggest a specific change in wording of the question? How about this: "In the opinion of the section's critics, the section is a WP:SYN violation when it cites sources on spinal manipulation (SM) in general (as opposed to SM performed by chiropractors specifically or, more to the point, the full range of chiropractic treatment, not just SM), because the reader may think the assertions apply to chiropractic treatment."

There was nothing wrong with the "here's some background" part; it's just that the suggestion had been made to make the question shorter; I agree that shorter tends to be better.☺ Coppertwig (talk) 13:31, 24 July 2008 (UTC)

Well, my contention has been that discussing the good information in the wrong article is a form of synthesis because it implies to the reader that conclusions about one leads to conclusions about the other. So mine would look something like this:

• In the opinion of the section's critics, the section is a WP:SYN violation when it presents specific research on spinal manipulation as evidence of effectiveness of chiropractic care as opposed to the whole range of treatments performed by chiropractors (not just SM), because the reader may confuse the assertions about spinal manipulation specifically as being assertions about chiropractic treatment in general.

I might be missing part of other's issues as well, so it probably still needs tweaking. -- Dēmatt (chat) 03:06, 26 July 2008 (UTC)

OK, thanks, I switched to that wording, and to balance added "the section clearly distinguishes SM research from other research" to the wording on the other side. Can anybody suggest further tweaking? Eubulides (talk) 08:31, 26 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 care and is most frequently employed by chiropractors. QuackGuru 02:46, 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. DigitalC (talk) 04:16, 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. Eubulides (talk) 05:17, 23 July 2008 (UTC)

We are also disputing that Chiropractic#Evidence base is implying that chiropractic care equals spinal manipulation. Chiropractors do much more than perform manipulation. -- Dēmatt (chat) 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. Eubulides (talk) 05:06, 24 July 2008 (UTC)

Reliable sources

While working my way through the sources on this article, I see several are articles published in Dyn Chiropr (Dynamic Chiropractic). This does not appear to be a peer-reviewed journal, but instead is more of a tabloid-format periodical, which is heavy on the ads. Has there been a discussion about whether or not this meets WP:RS standards? Please note that I have no strong opinion at this point as to whether it is a reliable source, I'm just acting here as a source-checker, and asking to see if this has been discussed or not? --Elonka 12:04, 7 July 2008 (UTC)

Your characterization of Dynamic Chiropractic is correct: it's not peer-reviewed and contains a high percentage of biased and unreliable junk. Not every article in Dyn Chiropr is unreliable, though. Do you have concerns about a particular citation? Eubulides (talk) 16:53, 7 July 2008 (UTC)

What criteria are you using to determine which articles in Dynamic Chiropractic are or are not reliable? --Elonka 18:13, 8 July 2008 (UTC)

DC is the most widely read of all chiropractic publications. It is very notable, probably the most notable and representative of all chiropractic publications. It is an accurate window into the soul of the profession at any given time. I receive it, and I know chiropractors who line their bird cages with it.

It is indeed an advertising rag, including having (to this day) hardly a single page (that's not hyperbole!) without advertisements for some form of quackery or get-rich-quick "practice building" scheme/scam. This is par for the course in chiropractic and many chiropractors don't consider it problematic, since they believe this stuff. There are historical reasons for this situation. The problem is old and chiropractic's leading historian has scolded the profession for it a long time ago:

• But the kernels of quackery (i.e., unsubstantiated and untested health remedies offered as "proven") are ubiquitous in this profession.3,4 I dare say that health misinformation (if not quackery) can be found in just about any issue of any chiropractic trade publication (and some of our research journals) and much of the promotional materials chiropractors disseminate to patients. the recent unsubstantiated claims of the ACA are exemplary. "Quackery in Chiropractic" - Keating (1991)

Unfortunately for the profession the editor (Petersen, who is not a DC) owns the magazine and its advertising company and he does nothing to curb the nonsense that detracts from the profession's image (among non-DCs). Little has changed since 1991, at least for DC magazine.

In spite of that, it also includes some excellent articles that are good sources for the opinions of leaders and other notable chiropractors. All chiropractic leaders write in it, all subjects of interest are discussed there, all controversies usually get mentioned, and the letters to the editor are very interesting reading ;-) As a source of such opinion it is useful here. Attribution might solve any problems. -- Fyslee / talk 05:20, 11 July 2008 (UTC)

Similar question with Chiropractic Diplomatic Corps, specifically this pdf. Has this been discussed as to whether or not it meets the standard of "Reliable Source"? Thanks, Elonka 13:35, 7 July 2008 (UTC)

The question hasn't come up. As far as I can tell the Chiropractic Diplomatic Corps is a one-man operation and the source in question should be considered to be self-published. The only news item I found on that source with a quick search is here. Eubulides (talk) 16:53, 7 July 2008 (UTC)

CDC is not a "one-man operation". It is a non-profit, non-governmental organization based in Canada. Other executive members of the CDC are listed here. DigitalC (talk) 23:07, 7 July 2008 (UTC)

Sure, but having multiple executive members is not inconsistent with their being a one-man operation. Lots of one-man operations have a large board (that's how you raise money :-). By the way, it may be difficult to find out more about them, as it's not clear that they still exist. Their last newsletter is dated 1Q2006. Their current activities page is dated 2005. The 2007 story I mentioned above, the only item I found for them in the popular press, is the last record I can find for them. Of course their lack of existence now doesn't mean they weren't a reliable source back then. Still, that source very much has the feeling of a self-published paper. Eubulides (talk) 23:32, 7 July 2008 (UTC)

The newsletter may be a one man operation, but CDC is not. For instance, (from the site under current activities, then India) In March of 2004, Dr. Gary Auerbach, past and founding President of the World Federation of Chiropractic (WFC), began a dialogue at the invitation of Dr. Roberta Ritson, External Relations officer of the World Health Organization. He was queried as to the ability of the chiropractic profession to provide spinal health promotion to the urban poor in a “Healthy City Initiative” being implemented in Bangalore, India. In addition, it also mentions activity in 2007 - "February 2007 was the inaugural presentation of the Straighten Up! India activities when Dr. Kirk was the keynote speaker at a Bangalore and Karnataka conference on Workers' Health and Occupational Safety. Chiropractic continues to be invited to contribute its special healthcare focus in the state of Karnataka, India." - None of this negates that the source does appear to be self published. DigitalC (talk) 01:30, 8 July 2008 (UTC)

I would encourage everyone to look at WP:REDFLAG with respect to these two sources. Surely we can do better than those. ScienceApologist (talk) 00:43, 11 July 2008 (UTC)

If they were making scientific claims, then that would apply. As sources of opinion, and when properly attributed, REDFLAG might not apply. -- Fyslee / talk 05:27, 11 July 2008 (UTC)

WP:REDFLAG deals with redflag claims, not with sources. What claims are you objecting to SA? DigitalC (talk) 05:36, 11 July 2008 (UTC)

• The CDC document is used to reference this claim - "Chiropractic is well established in the U.S., Canada and Australia". This doesn't seem like a suprising claim, it doesn't report a statement that seems out of character, and I don't see this claim being contradicted by the prevailing view within the relevant community. Do you feel that this claim alters medical or scientific assumptions, even though it is not a scientific claim? For the record, The US, Canada, and Australia have the highest number of practicing chiropractors. They each have a CCE. They all have multiple Chiropractic schools. DigitalC (talk) 05:42, 11 July 2008 (UTC)

Again, what claims are you objecting to ScienceApologist? DigitalC (talk) 04:04, 15 July 2008 (UTC)

If I may make a few comments. From Sackett, writing in the BMJ "The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. .... Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming tyrannised by evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. Without current best evidence, practice risks becoming rapidly out of date, to the detriment of patients." Is the claim that a significant number of chiropractors would dissent from this verifiable? It is sourced first to an opinion expressed in Skeptical Inquirer.

Skeptical Inquirer perhaps should in all fairness be looked at in the same context as Dynamic Chiropractic; both are frank non-peer reviewed vehicles of opinion, the latter differs in being a vehicle for both skeptical and supportive opinions.

The second source states, in its summary "In summary, the present study found overall positive perceptions of research in a sample of chiropractors and massage therapists practicing in Alberta with most of them acknowledging the importance of research to validate their practice. In contrast, self-reported research use was low, and differed significantly between the 2 professional groups. Based on the data and evidence in the literature, it appears that the more frequent research use reported by chiropractors may be related to the chiropractic profession's relatively research-oriented culture, their more intense research education, and exposure to research during their professional training. As a result of their training, chiropractors may be more confident in their research skills and ability to apply evidence-based findings in their practice."

Does this really support the statement in the article?

On history, I have commented on ahistorical presentation on Dematt's talk page.Gleng (talk) 11:46, 11 July 2008 (UTC)

Hi Gleng. I see that you are speaking in reference to this first section on Chiropractic#Evindence base.

• "The principles of evidence-based medicine have been used to review research studies and generate practice guidelines outlining professional standards that specify which chiropractic treatments are legitimate and perhaps reimbursable under managed care. Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims. A 2007 survey of Alberta chiropractors found that they do not consistently apply research in practice which may have resulted from a lack of research education and skills. Evidence-based chiropractors possess the ability to apply research in practice. Continued education enhances the scientific knowledge of the practitioner."

• Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims.

Is the claim that a significant number of chiropractors would dissent from this verifiable?

I doubt we can find anything that says that any group of chiropractors would dissent from Sackett . -- Dēmatt (chat) 02:51, 12 July 2008 (UTC)

• A 2007 survey of Alberta chiropractors found that they do not consistently apply research in practice which may have resulted from a lack of research education and skills.

Does this really support the statement in the article?

No.

This is the kind of thing that I see that I consider WP:SYN. When we pick pieces of the source and juxtaposition them to infer things that the author did not express. I would appreciate any help in cleaning some of these up!

Thanks for clarifying Gleng's remarks. They seem to be a continuation of a discussion elsewhere, and I couldn't make heads or tails of them without your clarification. Let me follow up, now that I understand them:

• The claim "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims." is sourced to Keating 1997. Keating is widely considered to be a reliable source in the matter of history and philosophy of chiropractic. For example, he wrote the History and Philosopy chapters of Principles and Practice of Chiropractic, the leading chiropractic textbook. I see no reason to doubt this source simply because Keating published it in Skeptical Inquirer.
• Like Dematt, I doubt that we can find anything that says that any group of chiropractors dissent from Sackett. But I don't see why that's relevant. After all, I doubt that we can find anything that says that any group of chiropractors agrees with Sackett either. I don't think chiropractors have been asked about Sackett, by any reliable source.
• Suter et al. (PMID 17320731), the cited source, does support Chiropractic's claim "A 2007 survey of Alberta chiropractors found that they do not consistently apply research in practice which may have resulted from a lack of research education and skills." Suter et al. wrote in their abstract "It appears that in Canada neither chiropractors nor massage therapists consistently apply research in practice, which may result from a lack of research education and research skills."

Eubulides (talk) 09:16, 12 July 2008 (UTC)

I have been thinking about the ahistorical aspects that you mentioned on my talk page and think maybe we might be able to manage it by bringing over that first paragraph from Chiropractic history that mentions Louis Pasteur and putting it on top of the history that we have. Then if we move the history section to the top, that would allow us to address the historical aspects of vitalism early and grow the article into the present.. that way the lead would work out the same way. Whatcha think? -- Dēmatt (chat) 02:54, 12 July 2008 (UTC)

Well I'm just an observer here. It seems obvious to me that the three sentences beginning "Evidence based guidelines ..."should just be ditched; they don't say much at all, they just sound as though they're trying to say something important, but what they do say is probably wrong and probably unverifiable even if true. You know the problems with ahistoricism, you know what to avoid; DD Palmer was a man of his times, and what he believed was pretty much the same kind of thing as most scientists and physicians of the time believed. They were mostly vitalists, and mostly believers in God, and in intelligent design as we would describe it now. Gleng (talk) 08:05, 12 July 2008 (UTC)

Please take a look at #History to see what I was thinking for addressing your concern about Chiropractic taking an ahistorical path. -- Dēmatt (chat) 01:19, 13 July 2008 (UTC)

I've been trying to play catch-up on this topic thread and I have to say that Gleng's suggestion that 'the three sentences beginning "Evidence based guidelines ..." should just be ditched' seems to be the most logical and painless way to proceed. I fully support this suggestion. -- Levine2112 02:18, 15 July 2008 (UTC)

The first sentence is supported by multiple reliable sources, and no reliable sources have been proffered in disagreement. It is not "logical" to remove sourced text merely because one disagrees with it. No reliable sources have been proffered in disagreement. Eubulides (talk) 06:16, 15 July 2008 (UTC)

All three sentences are supported by reliable sources. The point they're trying to make is that evidence-based medicine is controversial within chiropractic, and that a significant number of chiropractors don't use it or believe in it. This is a significant point for the Evidence basis section of Chiropractic, and the point should not be removed completely. However, I agree that the sentences could be trimmed. The essential point in the four (not three) sentences beginning with "Evidence-based guidelines ..." could be made by keeping the first sentence and omitting the last three. Eubulides (talk) 09:16, 12 July 2008 (UTC)

I agree with Eubulides. The point needs to be made, but it could be done in a more concise manner. -- Fyslee / talk 14:48, 12 July 2008 (UTC)

Evidence-based medicine is controversial in all aspects of health care, including medicine and physical therapy. Are you suggesting that medical doctors and physical therapists are pseudoscientists as well? Just because we have a source that says something doesn't mean we have to use it. Besides, the Keating source was 10 years old. In EBM years, that is about 70 :-) Things have changed a lot in health care since then - including chiropractic. See if you can find a more current source for something like that and then maybe we'd have something to go with. -- Dēmatt (chat) 20:58, 12 July 2008 (UTC)

I'm not exactly sure what you mean. EBM isn't controversial in mainstream medicine. It is the desire of mainstream medicine to weed out the chaff and improve practice. Now if professions resisted clear evidence and continued to practice in antiquated ways, then there'd be a problem. It wouldn't exactly be pseudoscientific, but other unfavorable terms might apply. That's where the "ahistorical" matter may lead us off track. Yes, it's unfair to judge current matters by historical facts, but when those historical foibles are continued by significant parts of the profession in spite of clear evidence to the contrary, and leaders make fun of that EBM evidence because it comes from the side of the "enemy" and those who have persecuted the profession (AMA, et al), well, then we need to recognize that criticism of that type of opposition and lagging behind the times is proper. I've read so much of that in chiropracic literature, Dynamic Chiropractic, and chiropractic websites that nothing surprises me anymore. While the EBM movement is a relatively recent development in medical history, chiropractic has been loath to adopt it, and certain factions of the profession still oppose its findings, while giving lipservice to EBM. Just take the "Journal of Subluxation Research", for example. Its very existence says loads about a dilemma the profession isn't willing to deal with effectively. We're dealing with ancient historical POV and practices being preserved and guarded, not just ahistoricism. It isn't history. It's current reality for too many DCs. -- Fyslee / talk 03:12, 13 July 2008 (UTC)

It depends what you understand by EBM. The broad definition as given by Sackett is uncontroversial in medicine, and I'd be surprised if it was controversial in chiropractic; the cited Alberta study indicated that most chiropractors supported the principles of EBM even if some were unsure how to apply them in practice. EBM is however frequently misunderstood as sole reliance on RPCTs, and this emphasis is also controversial in medicine (as expressed by Sackett). Fyslee may well be right in everything he says, and Eubolides below. But the peer reviewed source quoted says that chiropractors generally support the principles of EBM, while the Keating source is an opinion, not explictly about EBM, in an opinion source. Keating is a good source of opinion, whether he writes in Skeptical Inquirer or Dynamic Chiropractor, I am not suggesting deleting it. I am suggesting that thought be given to distinguishing clearly between evidence of fact and evidence of opinion.Gleng (talk) 09:35, 13 July 2008 (UTC)

Maybe we should consider the "peer reviewed" source as optimistic opinion too... Fortunately we only have to provide RS for both "facts" (what some at times might consider "opinions") and opinions. We use both here at Misplaced Pages because we document everything about a subject. If they are unusually controversial, we attribute them. Keating's opinion carries alot of weight and we're fortunate that he was able to retain the status he had in the profession his whole life. No one else comes even close to understanding the inner workings and history of the profession like he did. Quoting from above:

• The claim "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims." is sourced to Keating 1997.

That's about as accurate as it gets, even today. -- Fyslee / talk

I agree with Fyslee that EBM sees far more opposition from chiropractic practitioners than it does from mainstream medical practitioners. Some chiropractors favor EBM, but many don't. They view EBM as makework prescribed by government beancounters, they think that the evidence doesn't really matter, and they think that decisions on whether chiropractic will be used are, at bottom, political decisions that have little to do with the evidence. There is certainly some cynicism like this on the mainstream medical side too, but it's less. I don't have a reliable source that will justify everything I've said in this paragraph, though. Eubulides (talk) 09:00, 13 July 2008 (UTC)

Sounds like you've been reading Keating! He wasn't afraid to criticize precisely those trends and attitudes, which are still common. -- Fyslee / talk 15:57, 13 July 2008 (UTC)

Antiscientific reasoning

Re this wording: "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims." This is not NPOV wording. Just because one reliable source (of opinion) uses similar wording doesn't mean the Misplaced Pages article has to present it in that way as fact. I don't think anyone would say that they themselves are making unsubstantiated claims. The same idea can be expressed in neutral language: they "rely on intuition rather than proof" or they "consider proof unnecessary". Does anyone consider themself to be "antiscientific"? I doubt it. There's probably a neutral term for that, too: maybe "ascientific"? "nonscientific"? "intuitive"? Another option is to use prose attribution: "the other end employs what chiropractic historian Keating calls 'antiscientific ... reasoning' and 'unsubstantiated claims'." The Misplaced Pages article should be written in such a way that everyone would agree that it's true, and so that the reader doesn't get the feeling that the writer of the article had a particular, identifiable POV. ☺ Coppertwig (talk) 19:08, 13 July 2008 (UTC)

• Obviously the fringe element of chiropractors themselves would not agree their claims are unsubstantiated (they would say things like "It worked for Lillard"); but that is true for believers in any fringe topic. It's inappropriate to reword language from a reliable source in an attempt to avoid offending straight practitioners, who are firmly on the scientific fringe, and this article should not bowdlerize Keating.
• It is unrealistic to insist that Chiropractic be written "in such a way that everyone would agree that it's true". Chiropractic is a controversial topic. Writing so that everyone (or even every Misplaced Pages editor) would agree that it's true is a recipe for removing important mainstream material from this article. That is not how Misplaced Pages ought to work. If this article is written properly according to Misplaced Pages standards, fringe chiropractors (and they are significant minority of chiropractors) should disagree with large chunks of the article.
• "Antiscientific" is the proper philosophical term here. It was used by the source, and we shouldn't water it down.
• I get the feeling that there's some concern here that Keating, no matter how good his reputation on chiropractic history and philosophy is, may have erred on this particular point, or perhaps his opinion is dated. That would be a reasonable concern if Keating's views in this area were seriously disputed in reliable sources. But they're not. On the contrary, his views in this area are mainstream. You can see an example of this in the following quotation from a 2005 reliable source not coauthored by Keating, a source that is talking about D.D. Palmer's postulates:

'Despite the critical threats to the validity of this paradigm, a sizable proportion of the profession still holds these postulates to be valid. The segment of the profession that continues to hold firmly to Palmer's Postulates do so only through a suspension of disbelief. Given that one of the philosophical pillars of science is skepticism, a suspension of disbelief or a lack of skepticism, is evidence of antiscientific thinking. These stratagems to avoid the truth that Palmer's Postulates are unproven might be beneficial to the chiropractor, but are ethically suspect when they allow the practitioner to maintain a "faith, confidence and belief" in that paradigm to the patient's ultimate detriment.'

• This newer source makes the additional point that strategems by some chiropractors to avoid evidence-based review raise serious ethical issues. Perhaps that point should be added to Chiropractic #Evidence basis? It's an important point, no?

Eubulides (talk) 21:55, 13 July 2008 (UTC)

We should place the same value on the Nelson et al. 2005 source that was quoted above by Eubulides as we would for anything from Dynamic Chiropractic and Skeptical Inquirer. Think about it; is there a verifiable source that shows that anything but a tiny minority "maintain a "faith, confidence and belief" in that paradigm to the patient's ultimate detriment"? I would assume (and could likely be wrong) that there would be a lot of patient's that had ultimate detriment occurring to them. I don't see that the research (even their own) is backing that up. This is an opinion piece of course and makes a good argument for the mainstreaming of chiropractic into the spinal care model. It is also the SPOV view which is just one view. We are certainly obligated to fully explain their POV, but we don't have to use their descriptive term for their antithesis - at least not without attribution and "quotes" as Coppertwig suggests. We also have to be careful what we call mainstream view because we don't really know what that means. Is it a matter of majority? majority of what? experts? chiropractors? lay people? MDs? scientists? chiropractic scientists? PhDs? -- Dēmatt (chat) 00:08, 14 July 2008 (UTC)

• I gave Nelson et al. 2005 as one example of a recent source agreeing with what's currently cited in Chiropractic. There are others. Here's another: Hughes 2007 (PMID 17996344) places chiropractic in the context of CAM, focuses more on the philosophy of users of CAM rather than practitioners of CAM, has a section called "Antiscientific perspectives on CAM", and explains the popularity of chiropractic and other CAM treatments by saying (for example), "the increase in the seriousness with which people regard CAM might reflect the decreasing seriousness accorded to mainstream science".
• This makes for three reliable sources agreeing that antiscientific attitudes are a notable issue in chiropractic. I don't know of any reliable source claiming they are not a real issue.
• "is there a verifiable source that shows anything but a tiny minority"; Keating's point is that there is a significant minority of chiropractors that use antiscientific and pseudoscientific reasoning. I don't agree that it's a "tiny" minority. The exact size of this minority, of course, is not something that one can nail down to the nearest percentage point, but it's certainly substantial enough to be mentioned here, as part of a spectrum of beliefs, which is what Chiropractic currently says.
• "we don't have to use their descriptive term" What other descriptive term is supported by a reliable source?
• For this particular point, "mainstream" includes both mainstream medicine and mainstream chiropractic.

Eubulides (talk) 01:52, 14 July 2008 (UTC)

Are you asking us to consider Hughes 2007 as a source for this article? That would be scraping the bottom of the barrel for sure. I suppose we could say that "clinical psychologists consider that chiropractic is not a valid treatment for anything psychological." But that would be a good example of SYN because it would be misplaced in this article as I don't know that chiropractors are making those claims. Maybe I'm misunderstanding you though. -- Dēmatt (chat) 12:57, 14 July 2008 (UTC)

• I wasn't suggesting adding Hughes 2007 (PMID 17996344) to Chiropractic; I was simply noting it as another reliable source that makes the point about antiscientific attitudes and chiropractic.
• Some chiropractors are making claims like that, I'm afraid. Hughes 2007 says "Although the majority of chiropractic consultations are for back pain, practitioners recommend chiropractic for a range of other conditions including depression and anxiety." Hughes cites Brockman 2007 (doi:10.1016/j.clch.2006.08.004) as an example.
• Although I wasn't suggesting adding Hughes, I did suggest adding some text about ethical concerns. That suggestion wasn't specific; I'll make a concrete proposal in #Evidence basis rewording proposal below.

Eubulides (talk) 18:23, 14 July 2008 (UTC)

Evidence basis rewording proposal

Following up on the discussion in #Reliable sources, which discussed shortening some of the text and adding a new topic, namely ethical concerns, I propose to replace this text in Chiropractic #Evidence basis:

Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims. A 2007 survey of Alberta chiropractors found that they do not consistently apply research in practice which may have resulted from a lack of research education and skills. Evidence-based chiropractors possess the ability to apply research in practice. Continued education enhances the scientific knowledge of the practitioner.

with this text:

Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims, stratagems that are ethically suspect when they let practitioners maintain their beliefs to patients' detriment.

Eubulides (talk) 18:23, 14 July 2008 (UTC)

Well, it is one POV. We can use it but we would have to figure out who to attribute it to and who it is talking about. Probably we can consider it from the far right (reform) and about the far left (straight). Here is the course syllabus for the Evidence-Based Chiropractic from Palmer West for the summer of 2008. This is a supposedly straight school. The class looks pretty thorough... it even uses Glengs Sacket textbook as a recommended reading. That's the part II syllabus, too. Notice it's three hours a week... times 15 weeks... times 2 for part I... thats 90 hours for EBM. We might have to consider Keating 1997 is out of date, no? -- Dēmatt (chat) 22:03, 14 July 2008 (UTC)

Wow, check this one out, even Sherman Chiropractic College of Straight Chiropractic is doing research. This is the most straight you can get. It is so straight that its graduates can't even practice in most states in the US. I mean, we are talking minority straight POV (maybe even objective straight) and they even have a science research program. Of course we have no idea about the quality of this research, but we can't say ascientific, or antiscientific is coming from the schools. I'm still thinking that if there is anything out there that is negative, it's not so much antiscience as much as anti-competition. Maybe they just don't like their competition. Either way, I would think the word antiscience is used pejoratively in this case.. and we need more to verify that we aren't talking about a small minority that have "detrimented their patients" :-) -- Dēmatt (chat) 22:41, 14 July 2008 (UTC)

Apparently CCE has requirements for Clinical competencies so I would suppose that all CCE accredited schools have to follow these. This was at the bottom of that Palmer West Syllabus from above.

Required CCE Clinical competencies addressed:

1. Professional Issues Attitudes: Acknowledge the societal obligation of the profession to produce research, and appreciate the importance of research in education, clinical practice and to the growth of the profession.
2. Professional Issues Attitudes: Demonstrate a desire and an ability to critically evaluate new and current knowledge.
3. Professional Issues Knowledge: Understand the need to maintain a breadth and depth of knowledge and skills necessary for the practice of chiropractic through continuing education.
4. Professional Issues Skills: Demonstrate an ability to use personal computers and other business and communication technologies.
5. Professional Issues Skills: Demonstrate the ability to critically review clinical research literature.
6. Diagnostic Studies Knowledge: Demonstrate an understanding of the clinical indications for and the relative value of diagnostic studies.
7. Diagnosis / Clinical Impression Attitudes: Understand the importance of collecting sufficient clinical information in order to avoid reaching a premature diagnosis or clinical impression.
8. Diagnosis / Clinical Impression Knowledge: Demonstrate reasoning and understanding in using sources (such as the available literature and clinical experience) to support the diagnostic impression.
9. Diagnosis / Clinical Impression Knowledge: Demonstrate an ability to develop the clinical impression by recognizing and correlating significant information.
10. Diagnostic Studies Attitudes: Recognize the importance of considering benefits, costs and risks

I really don't see that we can ask for more? -- Dēmatt (chat) 22:55, 14 July 2008 (UTC)

I don't see anything in the CCE statement, or the Haneline's course listing at Palmer West, or the list of papers at Sherman, that would undermine the proposed text. The CCE has been favoring mixers since at least the 1950s and represents the mainstream chiropractic position, and its statement doesn't mention evidence-based anything. Sherman's list of papers doesn't talk about evidence-based medicine. Haneline's course at Palmer West is just one course; it no more shows that straights favor EBM than (say) a course on Islam at the University of Texas would show that Texans are Islamic. Let's please see some reliable sources, ideally published in peer-reviewed journals, that address the general topic, rather than scouring the net for isolated dribs and drabs that we would have to make inferences from. Eubulides (talk) 23:15, 14 July 2008 (UTC)

Hehe, I like that, dribs and drabs :-). But the point, of course was that they aren't antiscientific, and straights do use EBM. I think those sources are as good as any opinion piece citing one primary source. When we write edits that we know not to be true, that's POV editing. -- Dēmatt (chat) 01:21, 15 July 2008 (UTC)

• None of those three sources are on point. None of them say anything about "antiscientific" one way or another. And none of the sources say that straights use EBM. Only one of the sources even mentions EBM, and that source doesn't say anything about straights.
• Furthermore, even if this evidence were on point (which it's not), it is extremely weak: none of it appears in a peer-reviewed journal, or any journal at all. It's just random webpages pulled off the net.
• In contrast, we have multiple reliable sources published in peer reviewed journals, including the leading chiropractic historian of the past two decades, agreeing about the "antiscientific".
• This isn't a close call; there are good sources agreeing with the "antiscientific", and no sources disagreeing.

Eubulides (talk) 06:16, 15 July 2008 (UTC)

I'll go one further and say that the CCE, Haneline and Sherman sources are better than any opinion piece - especially one citing just one primary source. Calling straights "anti-scientific" should not be given any weight except perhaps in the context of an attributed opinion. Frankly though, I don't think this opinion merits any mention as it has been summarily refuted by the reliable sources at hand. -- Levine2112 02:21, 15 July 2008 (UTC)

It has not been refuted; it's not even disputed by these sources. The CCE, Haneline and Sherman sources do not disagree with the "antiscientific". And they do not appear in peer-reviewed journals. Two of them are merely course listings. The CCE is more authoritative, but it doesn't address the issue. Eubulides (talk) 06:16, 15 July 2008 (UTC)

Levine2112 claims "it has been summarily refuted by the reliable sources". Levine2112, please provide your specific evidence. QuackGuru 18:00, 15 July 2008 (UTC)

Just read (or re-read) the sources which Dematt has provided here. Eubulides interpretation here is way off. The CCE, Haneline and Sherman sources establish scientific practices and education. -- Levine2112 17:39, 16 July 2008 (UTC)

The Sherman source doesn't say anything about evidence-based medicine, or about antiscience. Neither does the CCE source. The Haneline source mentions evidence-based medicine, but it says nothing about antiscience; and it's merely a course-catalog listing. None of these sources are nearly as authoritative as the peer-reviewed journal articles that are talking about the antiscientific philosophy of a minority of chiropractors. And, although these sources do supply evidence that research methods are used in chiropractic, they do not address the question whether a minority of chiropractors have an antiscientific philosophy. For many years straights were notorious for doing "research" that wasn't scientific, but was merely designed to confirm the straights' philosophy; nothing in these new sources says that this practice has changed. Eubulides (talk) 18:10, 16 July 2008 (UTC)

"For many years straights were notorious for doing "research" that wasn't scientific, but was merely designed to confirm the straights' philosophy;" I bet that's harder to do that than to design real tests. You would have to give them credit for that :-)

Seriously, though, we can probably work with some of this stuff, we just need to explain it better, I think.

-- Dēmatt (chat) 01:07, 17 July 2008 (UTC)

Re "to patients' detriment": if I understand correctly, the source is subtitled "Debate": it's an expression of opinion. As Dematt says, it would have to be attributed. We might be able to cite something to provide another perspective. Suggested wording: "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims"; the ethics of the maintenance of such beliefs by practitioners when they may be to patients' detriment have been called into question by the authors of a debate article, but a chiropractic panel emphasizes the importance of a holistic, patient-centered approach." ☺ Coppertwig (talk) 23:02, 19 July 2008 (UTC)

• The source is clearly an opinion piece, but it is not subtitled "Debate"; it is one of two articles (the other being Wyatt et al. 2005, PMID 16001976) that were put into a "debate" section by the editors of the journal.
• We have already run into a similar situation in Chiropractic's citation of DeVocht 2006 (PMID 16523145), an opinion piece that was part of a debate (the opposing side being Homola 2006, PMID 16446588). In that case, there was no need to weaken the text by noting explicitly that DeVocht is a "debate" article; and there is no need to weaken the text here either. In both cases the points being sourced are not disputed by the other side.
• I don't see how the the proposed addition of "but a chiropractic panel emphasizes the importance of a holistic, patient-centered approach" is relevant here. Holism and patient-centered approaches are entirely compatible with evidence-based medicine. The topic of holism and patient-centered approaches are relevant for Chiropractic #Philosophy, but the source you give is pretty old (1995) and is not that strong; Chiropractic #Philosophy already makes that point and cite better sources.

Eubulides (talk) 21:11, 21 July 2008 (UTC)

This seems a very sensible suggestion to me. I suspect that Keating's use of "antiscientific" was simply rhetoric for the sake of effect, and certainly not really a statement of a philosophical position somewhere between Hobbes and Feyerebend (as suggested by a fairly incoherent article on Misplaced Pages). Nothing wrong with a robust rhetorical statement, it conveys the spirit of a skeptical opinion, and should be attributed as coming from someone whose opinion is worth noting (which it does), but it should not be mistakable as a statement of fact. "Unscientific" I would have less trouble with, but anti-scientific... well ... if these chiropractors were campaigning to stop research into chiropractic I'd feel there was some grounds for the claim.Gleng (talk) 16:41, 21 July 2008 (UTC)

Keating's use of "antiscientific" is not simply rhetoric. He repeated the wording in many sources that were published in peer-reviewed journals and standard textbooks in chiropractic. The same wording has appeared in other sources, as mentioned above. As Antiscientific makes clear, one does not need to campaign to stop research into a subject to have antiscientific ideas. Eubulides (talk) 21:11, 21 July 2008 (UTC)

That it is published in peer reviewed journals, however often, doesn't make it any less an opinion, and it is certainly a noteworthy opinion. The Hughes article that you quote, as you rightly point out does not suggest that chiropractic is antiscientific, it only speculates that CAM is popular amongst those who are skeptical of science. That is speculation, plausible, but speculation, it also is plausible speculation that many turn to CAM because of medical conditions which have not been resolved by conventional treatment, as suggested by the House of Lords select committee report into CAMs. In any case, the Hughes paper seems irrelevant to the issues here. The term "antiscience" may indeed be ill defined and changing constantly, but has generally been applied to those who have attacked scientific research and science teaching: in the 70s it was a charge levelled at those on the left concerned about the dehumanizing effects of technology, in the 90s mainly against creationism and intelligent design, now also against Greenpeace, animal rights protestors, and those who oppose GM crops. Gleng (talk) 21:48, 21 July 2008 (UTC)

Gleng (talk) 21:48, 21 July 2008 (UTC)

• Again, I wasn't suggesting using Hughes as a source in Chiropractic.
• I disagree that the term "antiscience" is reserved for people who attack scientific research and teaching. As Antiscience says, "Antiscientific views generally claim that science is non-objective method generating non-universal knowledge, and that scientific reductionism is flawed. Antiscience criticises the perceived power and influence of science, and objects to what proponents perceive as an arrogant or closed-minded attitude amongst scientists." This is pretty much how many chiropractors view mainstream medicine in general and evidence-based medicine in particular.

and these are quite common criticisms of science and medicine from other scientists. Skepticism and self criticism are hallmarks of scientific attitudes, it would be absurd to characterise these views as intrinsically antiscientific. They may be characteristics of antiscience views, but cannot be defining characteristics.Gleng (talk) 11:16, 22 July 2008 (UTC)

What can I say? It sounds like now you're disagreeing with Antiscience, and would prefer "antiscience" to mean something different from what it usually does. Eubulides (talk) 23:19, 22 July 2008 (UTC)

Well I certainly question whether Antiscience is a reliable source; my point is that these may be features of antiscience but cannot be distinguishing features if they are shared by scientists. Four legs are features of a dog but everything with four legs is not a dog.Gleng (talk) 00:22, 24 July 2008 (UTC)

You are correct that Antiscience is not a reliable source for Misplaced Pages purposes (Misplaced Pages is not supposed to cite itself as an authority). However, it is a reasonable summary of antiscience. And of course we are not relying on Antiscience to support the claim that antiscientific attitudes are at one end of the chiropractic spectrum; we are relying on reliable sources outside Misplaced Pages. The claim in question is about "antiscientific reasoning", not antiscience in general; perhaps this addresses some of your concern about the use of the term "antiscientific". Eubulides (talk) 05:06, 24 July 2008 (UTC)

• Antiscience also says "antiscience first arose as a reaction against scientific materialism", which neatly captures the connection between antiscience and the vitalism behind straight chiropractic.

Indeed. This though is a reference to 18th century origins, when virtually all science was vitalistic, in other words antiscience then was in opposition to contempoarry (vitalistic) science. If it captures the connection, it does so by an ahistorical synthesisGleng (talk) 11:16, 22 July 2008 (UTC)

Antiscience does not say that antiscience first arose in opposition to vitalism. It says antiscience arose as a reaction to scientific materialism. This places antiscience firmly on the vitalistic side of the vitalism/materialism schism that is already well-documented in Chiropractic #Philosophy, and it helps to explain why Keating and others say that the vitalistic tradition of the straights has antiscientific components. Eubulides (talk) 23:19, 22 July 2008 (UTC)

Well, Antiscience counts Hobbes as the archetypal antiscientist of the 18th century. Something seems seriously adrift here because Hobbes is generally regarded as an arch reductionist: his "rejection of matter-spirit dualism and his emphatic affirmation of the one-world realism that lies at the heart of modern science..." Just shows the problems of ahistorical syntheses (or possibly of a pretty dreadful blunder in Antiscience). Of any scientist of the 18th century Hobbes is probably the one who was not a vitalist. In his argument with Boyle, his position was anti-empiricist - he argued (putting it oversimply) that, in this case, facts were shaky, reason was sound. He had a point at least, in that he revealed an error in Boyle's theory which Boyle duly put right Gleng (talk) 00:48, 24 July 2008 (UTC)

• In this discussion about "antiscientific", one side has cited multiple reliable sources (Keating, and others, in peer-reviewed journals) supporting the use of the term "antiscientific" to describe one end of the chiropractic spectrum, and the other side has cited no reliable sources disputing the use of the term. If there's no dispute among reliable sources, that should end the discussion as far as Misplaced Pages is concerned, no?

Eubulides (talk) 05:45, 22 July 2008 (UTC)

The one peer reviewed source quoted above (Hughes) is contradicted here in JAMA "Patients who use CAM do not harbor antiscientific or anticonventional medicine sentiments, nor do they represent a disproportionate number of the uneducated, poor, seriously ill, or neurotic." . The Nelson source simply cites Keating for the statement, published in Skeptical Inquirer, a non peer-reviewed, frank skeptical opinion source. But in 2001, in J Can Chiropr Assoc, Keating writes “… despite all of these genuinely progressive steps, the chiropractic profession here in North America may be slipping backwards. I perceive that we are at risk of returning to the antiscientific and dogmatic traditions that we have worked so hard to shake off during the past several decades. " Now to me at least, this form of expression "at risk of returning..." etc does suggest that Keating believed that Chiropractic as a profession has reformed itself, even though some chiropractors still adhered to outdated modes of thinking. Now, dogmatic adherence to theories is a problem, but a problem issue in medicine and indeed in science itself, as recognised since Thomas Kuhn's dissection of the scientific method. Kuhn indeed regarded dogmatic adherence to theories as an almost universal feature of science in practice, and a feature integral to scientific progress. In summary, again, I think it is right to note critical opinions of chiropractic, with attribution and possibly a date stamp, but it would be unscientific to foster confusion between what is fact and what is opinion.Gleng (talk) 11:16, 22 July 2008 (UTC)

Well said, Gleng. I agree with your comments above. Eubulides, just because a sources doesn't specifically say that "antiscience" doesn't apply doesn't mean it supports the use of that term: otherwise we would have to state that there are purple aliens from another planet in Joe Smith's backyard if a source states that there are and no source can be found stating that there aren't, etc. Repetition of the word many times by an author does nothing to transform it from opinion to fact. ☺ Coppertwig (talk) 12:35, 22 July 2008 (UTC)

When the source specifically states antiscience that means it is sourced. Why are we judging the source when we are following the source. More than one sources says antiscience anyhow. Something simple like this should not be so complicated. QuackGuru 14:51, 22 July 2008 (UTC)

• There is not just "one peer reviewed source quoted above". There is also Nelson et al. 2005. Nelson et al. clearly agree with Keating's assessment and they are a reliable source as well. Other sources can also be supplied. For example:

• "Finally, alternative care often seems to shelter an antiscience attitude. For instance, women with breast cancer who believe that cancer spreads by air and that chiropractic care is an effective anticancer therapy often present at a late stage, which is associated with great suffering, short survival, and staggering cost of care." -- Tanvetyanon 2005 (PMID 15956016)
• "This protective shield apparently prompted a segment of the profession to extend its comfort zone by adopting not only an antimedicine but an antiscientific stand.... Although this antiintellectual position persists in a small percentage of chiropractors in this twenty-first century, the profession never developed a broad-based consensus around Stephenson's 33 principles." -- Reed B. Phillips, page 72 of the latest edition of Principles and Practice of Chiropractic, the leading textbook on chiropractic
• "Lastly, the ACC claims that chiropractors use the 'best available rational and empirical evidence' to detect and correct subluxations. This strikes us as pseudoscience, since the ACC does not offer any evidence for the assertions they make, and since the sum of all the evidence that we are aware of does not permit a conclusion about the clinical meaningfulness of subluxation." -- Keating et al. 2005 (PMID 16092955)

• The claim "Patients who use CAM do not harbor antiscientific or anticonventional medicine sentiments" (Jonas 1998, PMID 9496994) is an entertaining one. Jonas supports this claim solely by two citations, both of which disagree with the claim.

• The first citation, Furnham & Forey 1994 (PMID 8071452), is a survey of alternative practitioners in London that mentions dozens of alternative medicine styles but (as far as I can tell) nowhere mentions chiropractic, which means it's not that relevant here. Furthermore, Furnham & Forey write (page 468) that their results could be explained by patients who "have embraced the underlying philosophies and, thus, become more critical" of conventional medicine. They go on to write, "Or, it could be that their underlying beliefs about the causes of illness and treatment have meant a conflict between their ideas and the principles of modern medicine that led them to use an AP." ("AP" means "alternative practitioner".) In other words, Furnham & Fory 1994 do not at all support the claim about alternative medicine in general; on the contrary, they suggest the opposite of the claim.
• The second citation, Vincent et al. 1995 (PMID 10159673), does not address chiropractic at all: it covered only acupuncture, homeopathy, and osteopathy. Again, its conclusions are diametrically opposite to the claim about antiscientific attitudes. Its Table V (page 402) shows a significant (P < 0.01) negative correlation between attitude toward science and use of complementary medicine.

Hence this claim of Jonas 1998 is extremely dubious; I can only surmise that it was an error in the source. In any event, the evidence supporting the claim refers solely to non-chiropractic data, so it's not that relevant here.

• So now we have five reliable sources, including Keating himself in a 2005 peer-reviewed journal article, supporting the claim that antiscientific and/or pseudoscientific attitudes are notable and relevant to how chiropractors practice. In contrast, no reliable sources have been supplied asserting the contrary. Eubulides (talk) 23:19, 22 July 2008 (UTC)

It's not complicated, Coppertwig made an eminently reasonable proposal to word it "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims";"; that preserves the message, states it as an opinion and attributes it. The one peer reviewed source mentioned above (Hughes) uses antiscientific to characterise patient beliefs and is contradicted by a peer reviewed source (in JAMA) that is at least as strong (it's a peer reviewed secondary source citing two peer reviewed primary sources for the explicit statement of contradiction)Gleng (talk) 16:07, 22 July 2008 (UTC)

There is no need to attribute this to Keating in the text, just as there is no need to attribute (say) the existence of an efficacy controversy to DeVocht in the text. It suffices to attribute this to Keating in the citation. I suppose that we could add several more citations to support the point; but this shouldn't be necessary, as the point is not controversial among reliable sources. Eubulides (talk) 23:19, 22 July 2008 (UTC)

Vincent reference etc.

The Vincent reference clearly states that "There is no evidence of a flight from science characterising all complementary patients, but rather...a pluralism and pragmatism on the part of patients" Other relevant quotes include "The fact that there were relatively few consistent group difference suggested that there are few clear cut differences between complementary and general practice patients." "The most powerful overall predictor, clearly associated with a relative preference for complementary medicine, related to a belief in the importance of psychological factors in illness" "Complementary medicine patients may therefore be better health-educated than those using exclusively the orthodox medicine sector." "all four groups were clear that orthodox medicine was necessary for severe, life threatening illnesses. Complementary medicine is seen as relatively more effective for minor and chronic conditions by the GP group, and as being generally superior to orthodox medicine for these conditions by the acupuncture and homeopathy groups." Nothing in this reference indicates that "anti-scientific thinking" is a major issue among CAM patients is generally; these words are not used nor anything equivalent to them, indeed the whole tone of the article is consistent with patient attitudes being a rational judgement based on selective judgements about perceived efficacy of different forms of treatment, informed by experience of both orthodox and CAM treatments, and judgements that tend to be similar for GP patients as well as CAM patients. The inference that more skeptical views about the effectiveness of orthodox treatment for problems with a psychological component is indicative of an antiscientific attitude seems just wrong to me. It does seem to me that the view that skepticism about the effectiveness of orthodox medicine is equivalent to antiscientific attitudes is just false. Attitudes of patients may be ill informed, but this does not make them antiscientific in general, quite the contrary, patients are making pragmatic choices based on experience and knowledge, however imperfect that knowledge and subjective that experience may be.

Multiplying direct or indirect quotes from Keating or attributions to Keating does not alter the fact that this is an opinion, expressed in these terms by one person, notable and noteworthy as he is. If "antiscience" had objective factual content my view would be different, but it does not.

The Reed B. Phillips quote above is interesting "this antiintellectual position persists in a small percentage of chiropractors in this twenty-first century". Is it right to give prominence in this article to views held only by a small percentage of chiropractorsGleng (talk) 12:53, 23 July 2008 (UTC)

This is a three-ringed circus, medicine, science and chiropractic, and it would be a mistake to think that views of scientists about medicine are uncritical; they wouldn't be scientists if they were. As Steve Jones writes in The Language of the Genes, "Scientists, in general, despise doctors." That's an opinion, not a fact, and I wouldn't want it to be confused as such however notable the author is. Perhaps they despise some CAM practitioners more. Perhaps many medics despise chiropractors, and perhaps many chiropractors despise organised medicine. But the claim here is that a significant number of chiropractors despise science. This, of all these possibilities, is the only one I really doubt.Gleng (talk) 13:28, 23 July 2008 (UTC)

I agree, then, that the statement should be attributed as opinion by Keating. I think we also need to make sure we address why some of these chiropractors don't agree with evidience based guidelines, particularly that they are concerned that it will pigeonhole them into treating all patients the same way, will be used by insurance companies to deny coverage (i.e. the same reasons MDs are concerned), etc.. There are plenty of sources for these objections I am sure. -- Dēmatt (chat) 15:48, 23 July 2008 (UTC)

There is no need to attribute anything. We should not attribute it to the source just because some editors disagree with the leading historian on chiropractic. The fact is not controversial and is verified. QuackGuru 17:05, 23 July 2008 (UTC)

It is not verified to be fact, it is verified as an opinion, and is indeed controversial. - DigitalC (talk) 05:42, 25 July 2008 (UTC)

(outdent)

• None of the above comments addressed the point that the three sources in question are not about chiropractic. Vincent et al. 1995 (PMID 10159673), Furnham & Forey 1994 (PMID 8071452), and Jonas 1998 (PMID 9496994) do not mention chiropractic at all, and they are not derived from any chiropractic data. Their relevance to this discussion is dubious.
• Not that it's relevant, but I continue to disagree with the characterization of Vincent et al., which clearly shows a negative correlation between attitude toward science and use of complementary medicine. This does not contradict Vincent's comments about "There is no evidence of a flight from science characterising all complementary patients..." (emphasis mine), as we are talking about some, not all, patients. And the evidence of Vincent et al. is entirely consistent with the claim in Chiropractic about there being an ideological continuum, one end of which employs antiscientific reasoning.
• The cited sources are not all "direct or indirect quotes from Keating". Tanvetyanon 2005 (PMID 15956016), for example, is an independent source: it is not an indirect quote from Keating, and does not cite Keating. And even when reliable sources are citing Keating, that's still strong evidence that this is mainstream opinion. For example, when Nelson et al. 2005 (PMID 16000175) cite Keating and agree with him, we have the case of eight respected researchers in chiropractic, from five different chiropractic institutions, agreeing with Keating on this point.
• In contrast, so far we've seen zero reliable sources disagreeing with Keating on this point.
• It is right to mention the opinion of the straights in Chiropractic. Their opinion is that of a significant minority, and Chiropractic should give it due weight. By my count Chiropractic #Evidence basis currently devotes only 10 out of 1450 words to the antiscientific attitudes of the straights. This is not at all overkill considering the significance of the straights within chiropractic; if anything, it's underkill.

Well, I've hunted through accounts of chiropractic on NHS websites (its available on the NHS and 25% of GPs refer patients to them), on Select committee reports, BMJ clinical reviews, NIH information pages - none seem to think that antiscientific attitudes are worth mentioning at all. But I wasn't suggesting losing any words, only clarifying their status.Gleng (talk) 00:57, 24 July 2008 (UTC)

I wouldn't expect clinical reviews or government websites to talk about the attitudes about the practitioners one way or the other. Eubulides (talk) 05:06, 24 July 2008 (UTC)

• Chiropractic does not say that a significant number of chiropractors "despise science"; it merely says that one end of a continuum among chiropractors "employs antiscientific reasoning and makes unsubstantiated claims", which is not at all the same as despising science.
• Like QuackGuru, I disagree that this mainstream opinion should be attributed to Keating in the text. It's not just Keating's opinion; it's the opinion of every recent reliable source that we've found on the topic. It would be incorrect to imply that this opinion is just Keating's, or that it's controversial among reliable sources.

Eubulides (talk) 18:55, 23 July 2008 (UTC)

Quackguru's comment is worth noting; he confuses what you rightly call opinion with fact. That's exactly my point. It can be easily be confused unless you declare it as opinion.Gleng (talk) 00:57, 24 July 2008 (UTC)

To state an opinion as if it is a fact is worse than to use weasel words. If it's an opinion that X is true, then it's worse to just have a Misplaced Pages article state "X is true." than for the article to state "Several commentators have stated that X is true." In this case, I didn't quite catch whether there was more than one reliable source making the "antiscientific" claim about chiropractic specifically, but if so, we might say something like "what commentators such as chiropractic historian Keating have called "antiscientific"..."; or just say "commentators" and use footnotes to specify who they are.☺ Coppertwig (talk) 01:46, 24 July 2008 (UTC)

The style you are proposing is not used in Chiropractic, nor is it common in Misplaced Pages. The vast majority of claims in Misplaced Pages are opinions, but we rarely see phrases like "So-and-so said" in front of them. Phrases like "So-and-so said" are needed only in special circumstances, and this isn't one of them.

Let's take one example of where the proposed style would take us. The very first claim in Chiropractic is an opinion, not a fact. Here it is:

"Chiropractic (...) is a complementary and alternative medicine health care profession...."

As this opinion is sourced to Nelson et al. 2005 (PMID 16000175), I suppose the proposed style would mean the first sentence would have to be rewritten to be something like this:

"According to commentators like Craig F. Nelson, Dana J. Lawrence, John J. Triano, Gert Bronfort, Stephen M. Perle, R. Douglas Metz, Kurt Hegetschweiler, and Thomas LaBrot, chiropractic (...) is a complementary and alternative medicine health care profession...."?

Obviously this would be a bad idea. If we were to adopt this strategy when editing, the length of the text of Chiropractic would double, and it would become much harder to read, for no good reason. A reader who wants to know the source for the opinion that chiropractic is a CAM profession can simply follow the citation to Nelson et al.; there's no need to mention the source explicitly in the text. The case of "antiscientific" is similar.

Eubulides (talk) 05:06, 24 July 2008 (UTC)

I agree that we can work something using Coppertwig's suggestions along the lines of NPOV#Attributing and substantiating biased statements that will be NPOV. -- Dēmatt (chat) 03:27, 24 July 2008 (UTC)

No evidence has been presented that the statement about "antiscientific" is biased. We've found multiple reliable sources, independently published in peer-reviewed journals, agreeing with the statement. We've found zero reliable sources disagreeing with it. Eubulides (talk) 05:06, 24 July 2008 (UTC)

The evidence that "antiscientific" is biassed is that chiropractors do not, apparently, refer to themselves as "antiscientific"; also it simply sounds pejorative. Also you yourself, Eubulides, referred to it as "opinion". Note that we don't need reliable sources to verify these arguments since we're not proposing to insert the statement "'antiscientific' is biassed" into the article. Not everything needs to be prose-attributed, but this statement sounds jarring and non-NPOV if baldly stated as if Misplaced Pages is asserting it as fact. Misplaced Pages asserts facts, or things that seem to be facts based on reliable sources; not opinions. Several editors including myself consider it important to attribute it and have explained why. No reason has been presented not to attribute it, other than that it's stated by more than one source: but I think maybe the other sources were not mentioning chiropractic specifically? and if they were, then a more complex attribution can be made, as I suggested above. ☺ Coppertwig (talk) 13:31, 24 July 2008 (UTC)

Please see #Inserting "Keating says" below. Eubulides (talk) 16:25, 24 July 2008 (UTC)

Inserting "Keating says"

Related discussion: Reliable sources

It appears that my comments about this "Keating says" insertion have not been clear enough.

• "is a CAM profession" is also pejorative to the straights, and I expect to many mixers. They do not concede that chiropractic is "complementary" or "alternative" to anything: they view it as a primary or mainstream health care approach. I expect that to a straight, calling chiropractic "complementary" is far more pejorative than calling it "antiscientific".
• We have multiple reliable sources, not just Keating, who all agree on the "antiscientific" point. It is not reasonable to attribute this opinion only to Keating in the text, as that makes it appear to the reader that it's just the opinion of one guy. If attribution is to occur in the text, it should be to all the sources, to make it clear to the reader that this is the consensus opinion.

The reliable sources you suggest are Hughes who uses the word antiscientific once in the heading of a section (" Antiscientific perspectives on CAM" that does not refer directly to chiropractic at all, but to discussion of postmodernist attitudes amongst CAM users. It certainly does not support the claim in the text about chiropractors. Tanvetyanon 2005 is in a peer reviewed journal, but is a letter - these are opinion pieces and not peer reviewed. Be careful what doors you open. If you accept letters attacking papers as reliable sources that opens a floodgate of published letters from chiropractors and others expressing often ludicrous viewpoints. We're left with Keating I think, I think in one peer reviewed opinion piece.Gleng (talk) 09:05, 25 July 2008 (UTC)

I suggested several reliable sources other than Hughes and Tanvetyanon, and I have just added these sources (all in peer-reviewed journals or in the leading textbook on chiropractic) in Chiropractic here. Eubulides (talk) 18:06, 25 July 2008 (UTC)

• Inserting the "Keating says" here makes the article less balanced. Before this change, Chiropractic used a consistent style for attributing opinions about chiropractic: it simply supplied a citation. And yet here, for one opinion that is critical of chiropractic, we are using a different style that casts doubt on the opinion, by making it appear to be the opinion of just one guy. This raises serious NPOV issues. It is not right to insert phrases like "Keating says" in front of statements critical of chiropractic, casting doubt on them, while leaving all supporting opinions unqualified; that obviously leads to an unbalanced presentation.

This is a misunderstanding of intent. The object here is not to dilute the criticism itself but to not apparently endorse the way it is expressed. If the criticism embodies legitimate concerns, let those be expressed without using terms which are offensive and (my concern) intellectually untenable. The criticism is that some chiropractors adhere dogmatically to untested theories that invoke unneccessary assumptions.Why not put it that way? That's exactly what Keating says he means.Gleng (talk) 09:25, 25 July 2008 (UTC)

Regardless of the intent of the change, its actual effect is to dilute mainstream opinion. The terms are certainly not offensive in the usual sense; they are nothing like four-letter words or anything like that. And the reliable sources using the terms evidently do not think they are intellectually untenable or offensive. The mainstream characterization of straight chiropractic includes not only dogmatism, but go well beyond that: they include the use of antiscientific and pseudoscientific thinking. Eubulides (talk) 18:06, 25 July 2008 (UTC)

• Unlike the "antiscientific" point, which is not controversial among reliable sources, the "chiropractic is CAM" point is controversial. And yet with this change, Chiropractic goes out of its way to imply a controversy in "antiscientific", while ignoring the controversy in "chiropractic is CAM". This is a serious NPOV problem.

Well even Keating argues that the theory of VSC is a perfectly valid scientific construct for example, so his criticism is not about all contentious straight views but specifically about dogmatism and unneccessary assumptions. These I wouldn't dispute at all; I'd merely note that these are endemic in science and medicine, so antiscientific is overblown rhetoric. Gleng (talk) 09:25, 25 July 2008 (UTC)

Yes, obviously VSC is a valid scientific construct, but the point of Keating, and many other reliable sources, that part of the chiropractic spectrum employs antiscientific and pseudoscientific reasoning in order to defend their dogma on that subject. This is a well-known problem in chiropractic, it's not contentious among reliable sources, and Chiropractic should not attempt to downplay it. Eubulides (talk) 18:06, 25 July 2008 (UTC)

And can't we state the problem while avoiding value-laden pejoratives? Their choice expresses the authors subjective distaste. That's the POV issue, if its not attributedGleng (talk) 21:35, 25 July 2008 (UTC)

The current version of Chiropractic says "antiscientific" just once, and attributes it in the text as well as citing it in a footnote; there seems to be some consensus that this sort of thing is appropriate. Eubulides (talk) 23:48, 25 July 2008 (UTC)

• The "chiropractic is CAM" opinion is just one example: I chose it purely because it's the first claim in the article. There are dozens of other examples like this scattered throughout the article. Many of these opinions are supportive of chiropractic and pejorative of medicine. If it is necessary to put "Simon says" in front of each opinion that might offend somebody, we have a lot of work to do; and we certainly should not be focusing solely on the critical opinions.

Eubulides (talk) 16:25, 24 July 2008 (UTC)

Again, the objection is to inserting a gratuitously insulting term as though it carried clear factual content without even attributing it to what is really a source that is extremely unusual in using it in a peer reviewed paper in this way. It's not an objection to criticism, indeed for me it devalues the integrity of any message it intends to convey.Gleng (talk) 09:25, 25 July 2008 (UTC)

It's not "extremely unusual" for reliable sources to use terms like "antiscientific" and "pseudoscientific" to talk about the reasoning used by the straights. Terms like these are used by many sources, and no reliable source disagrees with them. Obviously you find them "gratuitously insulting", but reliable sources in refereed journals are publishing them, so evidently mainstream authors and editors don't find them gratuitously insulting, and there doesn't seem to be a controversy about this among reliable sources. Eubulides (talk) 18:06, 25 July 2008 (UTC)

Yes, we have slowly removed all attributed phrases, haven't we. I was going to point out the Janse phrase, but I see we lost that one, too. I have no problem attributing chiropractic as a CAM according to the NIH. Fyslee and I had this conversation a long time ago and only found that the US categorizes things this way anyway. Keep in mind that while reforms would consider it complementary, straights consider it alternative. I think that is the only reason it sticks. If you tried to change it to one or the other, that would be a problem. -- Dēmatt (chat) 18:26, 24 July 2008 (UTC)

• I am disappointed that a revert war is now brewing, with almost none of the above bulleted points being addressed by the other side. It would be more helpful to address these points, instead of merely pressing the revert button.
• To address the single bullet you did respond to: It wouldn't be correct to attribute "chiropractic is CAM" to the NIH, as the NIH didn't make that decision, Congress did. I'm sure we could find reliable sources on both sides of that controversy, though. For starters, there's Redwood et al. 2008 (PMID 18435599), which says that by a wide margin, chiropractors themselves reject the claim that they are CAM practitioners. So it's quite clear that the "chiropractic is CAM" opinion is controversial among reliable sources. In contrast, we've found zero reliable sources disputing the claim that some chiropractors use antiscientific reasoning.

Eubulides (talk) 20:44, 24 July 2008 (UTC)

Nor would I expect you to, for the reasons given below that you have not addressed - that "antiscientific" is not a coherent term but a pejorative. It is generally avoided in serious journals. Search on PubMed reveals only a handful of references, generally talking about frankly antagonistic sectors (GM protest, stem cells etc) - a joint search with chiropractic throws up none; perhaps these searches miss some, but I've tried. Nothing as I've said on NHS sites, NIH sites, AMA sites, select committee sites - nothing anywhere, no mention. And its not surprising, if Hobbes is antiscientific what modern scientist isn't? Apart from Keating, there's one paper that talks of antiscientific attitudes in patients - I havent accessed that yet, and one letter (these aren't peer reviewed by the way) in opposition to a supportive article on chiropractic. It seems to me that you are confusing critical comments with pejorative comments. I don't see any objection to objective criticism, only to subjective expressions of distaste.Gleng (talk) 21:22, 24 July 2008 (UTC)

"Antiscientific" is pejorative to people who think that science is a good thing and that viewpoints opposed to science are a bad thing. It is not a pejorative in the wider scheme of things, a wider scheme that includes straight chiropractic. Again, you've done extensive searches and have found zero reliable sources disputing the use of the word "antiscientific" in this context. I have done similar searches and have found several reliable sources supporting the use of the term. We should not let our personal prejudices and reactions to terminology override the mainstream consensus on this point, a consensus expressed by several independent reliable sources. Eubulides (talk) 21:38, 24 July 2008 (UTC)

As I understand it, straight chiropractic was conceived from the outset as a scientific alternative to then current medical practice (have I got this wrong Dematt?) - the idea that straight chiropractic is antagonistic to science seems wholly contrary to the philosophy behind it, as seen by them. We may not think much of their science, but they're not anti-science. You are right that people who are antagonistic to science would not see it as a pejorative. But only if they read into it something not intended by Keating, or understood by most readers. In effect, you're using the isolated use of antiscientific in a single chiropractic publication as evidence of mainstream consensus use, and seeking peer reviewed articles rebutting this rare use. Gleng (talk) 10:39, 25 July 2008 (UTC)

"As I understand it, straight chiropractic was conceived from the outset as a scientific alternative to then current medical practice" This is exactly right. The issues have never been about science. Chiropractic was born out of a perceived need to pull away from the drugging and surgeries that were in practice at the time. Choosing the vitalistic approach does not make it unscientific, antiscientific, or pseudoscientific. It just makes it difficult to prove. In days of old, invoking religious answers was common to explain the things that we did not understand, or could not prove. Vitalism does not in itself require a spiritual being, if it did - 95% of chiropractors would shun it. No, the "vitalism" that chiropractors look to just supposes that life cannot be explained totally through reduction of the material - it is more than the sum of it's parts. This is not unique to chiropractic, it is a philosophy of science issue that chiropractors don't claim to know the answers to, but as those who study this understand, reductionism has not been able to answer all the questions of how life interacts to create health. Be aware, though (and Gleng make sure I've got this right), that Emergent behavior appears to be the keyword now, and thanks to new breakthroughs in Computational Biology, it looks like scientists may be making headway here. If nothing else, I hope that we as wikipedians realize that taking sides with any of these approaches will do a disservice to all of us. To pretend that we know any of it would be erroneous. At this point, while each side (straight, reform, medicine) may have an opinion, that is all that it is. Changing behavior based on opinion would be a political choice, not one based on science, antiscience, antiintellectualism, or pseudoscience. -- Dēmatt (chat) 00:01, 26 July 2008 (UTC)

That's right. Complex systems can display behaviour that is not predictable from the behaviour of lower level parts; this is emergent behaviour. Many higher level concepts (e.g. intelligence, cognition, motivational states - hunger, fear etc) are thought to be emergent properties of complex systems. Such concepts are essentially "vitalistic" but without the mystical mumbo jumbo. Gleng (talk) 12:08, 26 July 2008 (UTC)

Sources indicate antiscience and it is not necessary to apply attribute. The bulleted text at the top of this section should not be ignored again. If this continues it may have to go to ANI. QuackGuru 02:11, 25 July 2008 (UTC)

Straight chiropractors themselves probably do say they're "scientific", even today, but reliable mainstream chiropractic and science sources say the straights use antiscientific reasoning. We should not let a fringe within chiropractic dictate our summary of what the mainstream says. The use of terms like "antiscientific", "pseudoscientific", and "antiintellectual" is not isolated to a single chiropractic publication; it's in common use in many reliable sources, and we have found no reliable source that disagrees with these descriptions. I have taken the liberty of adding some more reliable sources here, since there seems to be some confusion on this subject: because the older version of Chirorpactic cited only Keating, many people seemed to think that only Keating holds the opinion in question, which is obviously not the case. Eubulides (talk) 18:06, 25 July 2008 (UTC)

This is highly referenced. QuackGuru 17:04, 25 July 2008 (UTC)

Antiscientific three times

Do we realize that we state Keating's opinion about "antiscientific reasoning" three-times in this article?! Talk about a WP:WEIGHT violation. We should attribute and mention it maybe once and then be done with it. -- Levine2112 17:22, 25 July 2008 (UTC)

It is an important point and is well worth summarizing in the lead, as well as in the body. The two places where it is mentioned in the body are both important: one is with respect to the evidence basis (or scientific research). The other is in discussing the history of chiropractic and why serious research did not begin until the 1970s and was hampered by antiscientific and pseudoscientific attitudes. Eubulides (talk) 18:06, 25 July 2008 (UTC)

Phillips RB (2005). "The evolution of vitalism and materialism and its impact on philosophy". In Haldeman S, Dagenais S, Budgell B et al. (eds.) (ed.). Principles and Practice of Chiropractic (3rd ed. ed.). McGraw-Hill. pp. 65–76. ISBN 0-07-137534-1. {{cite book}}: |edition= has extra text (help); |editor= has generic name (help)CS1 maint: multiple names: editors list (link) Is this one of the sources to verify the antiscience text? See ref 74. We should not attribute source after source. I see no reason for that. QuackGuru 17:27, 25 July 2008 (UTC)

Those sources source Keating's opinion in that regard. It's actually page 64 (not 74) of Principles and Practice of Chiropractic where the word "antiscience" appears in a chapter of the book written by Keating and it is merely in a footnote reference back to the source of Keating's opinion already cited here. -- Levine2112 17:29, 25 July 2008 (UTC)

Where the word "antiscience" appears is merely in a footnote reference back to the source of Keating. That's WP:V.

No reason has been given to attribute every source. Do you have any references that differ from the current sources. QuackGuru 17:40, 25 July 2008 (UTC)

But it is still Keating's opinion. He is merely citing himself in a chapter of a book which he wrote. He doesn't even support the claim we are stating in this article. It is just a reference which happens to have the word "antiscience" in it. That's all. Several references have been supplies which differ from Keating opinion. And at the very least, we should not be restating Keating's opinion three times in our article! -- Levine2112 17:46, 25 July 2008 (UTC)

There seems to be some confusion here. The citation in Chiropractic #Evidence basis to Principles and Practice of Chiropractic is not to Keating. It is to Phillips, which is a different chapter. This is not the case of Keating merely citing himself. Eubulides (talk) 18:06, 25 July 2008 (UTC)

The bullet points still haven't been addressed by the above comments. I took the initiative to start working on the most urgent bullet point, namely that the current edit mischaracterizes "antiscientific" by implying that only Keating makes this claim. I did this by adding three citations to other mainstream sources that make similar claims on this topic. These sources are Nelson, Lawrence, Triano, Bronfort, Perle, Metz, Hegetschweiler & LaBrot 2005 (PMID 16000175), Keating, Charlton, Grod, Perle, Sikorski & Winterstein (PMID 16092955), and Phillips 2005 (in Principles and Practice of Chiropractic, 3rd ed.). The first two of these sources are peer-reviewed; the last one is a chapter in the leading current textbook on chiropractic. I hope this lays to rest any concerns that editors have that the opinion in question is merely that of the leading chiropractic historian of the last 15 years.

This doesn't fix that bullet point, though, as the text still says this:

'the other end employs what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims"'

This text no longer accurately summarizes what the cited sources say, since the cited sources now include 15 mainstream chiropractic researchers who agree on this topic. It's no longer appropriate to use Keating's name (unless we also use 14 other names, which is unrealistically awkward). Nor is it appropriate to use quote marks, since the various sources uses different words (e.g., "antiintellectual", "pseudoscientific") to make similar points. So I suggest that we replace the text with this:

'the other end employs what chiropractic researchers call antiintellectual, antiscientific or pseudoscientific reasoning'

Eubulides (talk) 18:06, 25 July 2008 (UTC)

In response to Eubulides' points: (Edit conflict. This was in response to the bulleted points at the top of the "Inserting "Keating says"" section, and to a comment by QuackGuru. I had originally intended to say here but forgot: Thank you, Eubulides, for clearly organizing and restating your points, and I'm sorry if I hadn't read the previous discussion thoroughly enough.) _{(13:20, 26 July 2008 (UTC))}

• If "is a CAM profession" is pejorative, then it violates WP:NPOV, which states "The tone of Misplaced Pages articles should be impartial, neither endorsing nor rejecting a particular point of view." The existence of one part of the article which violates NPOV is not an excuse for another article to also violate NPOV in order to match it.
• "multiple reliable sources, not just Keating": Others have stated in the discussion above that all of the other sources are either citing Keating, or are not talking about chiropractic.
• Balance: if there are any statements from another viewpoint which are also mere opinions, are also ultimately traceable to one relevant reliable source, and are stated in the article as if they are fact, then please point them out; probably they need to have prose attributions attached, too. Or, undue weight could be addressed in some other way. Again, the existence of some NPOV violations doesn't justify other NPOV violations.
• Re "antiscientific" not being controversial: as I pointed out earlier, it's fallacious reasoning to assert that we must take something as universally agreed merely because no one has negated it using precisely that word. (see my comment re purple aliens.)
• Re "Simon says": I think it would be good to go through the article and make sure all opinions have prose attributions attached. Only uncontroversial, verifiable facts should be stated as if they are facts.

QuackGuru said, "Sources indicate antiscience and it is not necessary to apply attribute." Actually, those sources are expressing an opinion, not a fact. The word "antiscience" is a pejorative label with more than one possible meaning; applying it to a group is not asserting a fact. If we find out what Keating meant, perhaps a verifiable statement in other words could be based on it and asserted as fact, if it really is verifiable as fact from reliable sources. If it's a fact, it's something about the real world which can be expressed in different words so as to avoid a non-NPOV pejorative tone.\

I agree with Levine2112's edit which re-instated the prose attribution of "antiscientific" to Keating and caught two more uses of this word. Please don't repeatedly delete this prose attribution which is supported by many editors of this page and required by the NPOV policy. I agree with Levine2112 that per WP:UNDUE, the use of this word should be reduced to once in the article. Coppertwig (talk) 18:19, 25 July 2008 (UTC)

• In some circles "is a chiropractor" "chiropractic" is pejorative: does this mean that Chiropractor Chiropractic must quote every use of the term "chiropractic", and attribute the quote in the text? Surely not.
• I don't recall the claim "all of the other sources are either citing Keating, or are not talking about chiropractic". In any event, the claim is incorrect. The Phillips source (which Levine2112 deleted without discussion!) is about chiropractic, and does not cite Keating. Here's the citation: Phillips RB (2005). "The evolution of vitalism and materialism and its impact on philosophy". In Haldeman S, Dagenais S, Budgell B et al. (eds.) (ed.). Principles and Practice of Chiropractic (3rd ed. ed.). McGraw-Hill. pp. 65–76. ISBN 0-07-137534-1. {{cite book}}: |edition= has extra text (help); |editor= has generic name (help)CS1 maint: multiple names: editors list (link)
• So this opinion is not "ultimately traceable to one relevant reliable source", and it should not be treated specially in Chiropractic.
• Furthermore, it is misleading for the text to imply that only Keating holds this opinion, or that the opinion is controversial among reliable sources. It is not controversial among reliable sources. Many sources agree with it. Despite considerable search, zero reliable sources have been found that disagree with it.
• I don't understand the significance of the "purple aliens" remark. No reliable sources have been been proffered that dispute the claim of antiscientific reasoning using any terminology. If you look for "pseudoscience" or "antiintellectual" or any roughly-equivalent term, reliable sources all use words like these to describe the sort of ideas or thinking used in straight chiropractic. No reliable sources disagree on this point.
• This antiscientific reasoning is a significant problem in chiropractic. It is a primary reason that chiropractic has not been accepted within mainstream medicine. Downplaying this significant problem is an important WP:WEIGHT problem of its own.

Eubulides (talk) 19:36, 25 July 2008 (UTC)

and here we're getting to the root of the issue; antiscientific is not being used for any philosophical or objectively coherent meaning, but as a surrogate for "pseudoscientific" that somehow sounds more serious, somehow worse that unscientific and much worse than mistaken. Antiscience or antiscientific is virtually absent from the entire PubMed literature base, and pseudoscience and pseudoscientific are rare, in both cases almost vanishingly rare in connection with chiropractic. This is not a sign of endorsement of chiropractic, it is a sign of objective treatment of controversial issues avoiding offensive terms that have no coherent meaning. If something is wrong, it's enough to say its wrong, and if chiropractic's theories are not accepted more widely maybe its because they are unconvincing or unneccessary. Hyperbole or rhetoric makes the objectivity of the case look suspect. Avoidable pejoratives simply antagonise the neutral reader. Gleng (talk) 20:30, 25 July 2008 (UTC)

These terms are used in the standard primer on chiropractic history, and in the most-popular textbook on chiropractic. They are used by chiropractic researchers, not by mainstream medical researchers (which may help to explain why they're so rarely mentioned in Pubmed), but that doesn't mean that they are not notable terms within the context of Chiropractic. Again, zero reliable sources disagree with the point that antiintellectural/antiscientific/pseudoscientific/whatever-you-want-to-call-it is a significant and continuing problem within chiropractic. It would be a violation of WP:WEIGHT not to mention this significant problem.

Well that explains why a joint search for chiropractic and antiscience produses no hits at all, though PubMed carries some chiropractic journals. But I'm not sure here of the logic - mainstream medicine and science doesn't use it, but one end of the chiropractic continuuum does occasionally uses it about the other, so it would be right to use it here?Gleng (talk) 21:21, 25 July 2008 (UTC)

"in some circles "is a chiropractor" is pejorative: does this mean that Chiropractor must quote every use of the term "chiropractic", and attribute the quote in the text? Surely not." Whether or not someone is a chiropractor is a fact, not an opinion. This fact can be verified by determining if the person has a license to practice chiropractic. DigitalC (talk) 23:30, 25 July 2008 (UTC)

Ouch, my comment was not coherent; it mixed "chiropractic" and "chiropractor". I have corrected it. Sorry about the confusion. The point about "chiropractic" being pejorative to some people remains. In controversial areas, lots of words can become pejoratives, I'm afraid. Eubulides (talk) 23:48, 25 July 2008 (UTC)

Antiscience and ahistorical syntheses

From the outset I objected that "antiscientific" was a pejorative masquerading as objective; that it had rhetorical force, that it expressed distaste, but was an opinion and because its nature might be confused should be flagged as that. It is a catch-all descriptor of diverse groups antagonistic to science, lacking a coherent operational definition. Eubolides countered by saying that antiscience had a philosophical pedigree, and its origins in the 18th century attack on scientific materialism by Thomas Hobbes captured the essence of the vitalistic theories held by straight chiropractors. This is a comprehensive misunderstanding. Thomas Hobbes was vehemently opposed to vitalism, and was an arch reductionist; his views read as almost a manifesto of modern scientific method "Everything is best understood by its constitutive causes. For, as in a watch or some such small engine, the matter, figure and motion of the wheels cannot be well known except it be taken asunder and viewed in parts." Hobbes was attacking the materialism of the empiricists, who believed that understanding could be gained by speculative theory and experiment; he argued for close observation and rigorous reason. "Antiscientific" as used by Keating is not congruent with this position. It may be possible to trace some connection; indeed it may be possible to change "husband" to "cuckold" in ten moves, but not I think without cheating.

What is left is evidence of misunderstanding of what "antiscientific" might mean, and evidence that the opinions it gives voice to are confusable with fact. Now is its use controversial? Must we annotate every opinion? Well chiropractic as a CAM is not controversial as it is a view held by chiropractors themselves. If straight chiropractors describe their position as antiscientific then I will happily accept it is not controversial, but I don't think that they do. Perhaps they are so small a minority that they can be disregarded, the 3% of Reed Phillips: but if this is true then are their views worthy even of mention?

Thus it seems that the philosophical attribution of a meaning to antiscientific is unfounded here; what remains is its opinionated nature, that expression of perhaps merited distaste. Let it be said, but let it not be confusable with fact; in kind it is no different from other pejorative expressions, and that it is used by a few authors repeatedly does not make it more objective. Hitler is almost universally regarded as evil, but it is still a subjective judgement. Hitler wisely refrains from using it or any equivalent judgemental statement.Gleng (talk) 09:43, 24 July 2008 (UTC)

WP:TL;DR and Godwin's law. Rewordings or attribution could probably help in this case. Do you have a proposed rewording to correct what you see as the PoV nature of current references to "antiscience" in the article? Jefffire (talk) 10:21, 24 July 2008 (UTC)

Coppertwig's suggestion above was to rephrase the disputed text as "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims"". Seemed fine to me.Gleng (talk) 10:51, 24 July 2008 (UTC)

Sound as a pound to my eyes. Jefffire (talk) 10:55, 24 July 2008 (UTC)

Sorry, I had to look that up! Apparently "Sound as a pound" indicates agreement. I haven't been paying attention to exchange rates, so I have no idea whether the pound is sounder than other currencies at the moment. ☺ Coppertwig (talk) 14:16, 24 July 2008 (UTC)

Thanks. OK, I put in the wording attributing "antiscientific" to Keating. I count four editors supporting this edit (Jefffire, Gleng, Coppertwig and Dematt) versus two opposing (Eubulides and QuackGuru). Also, I don't see positive reasons given for opposing the edit: only that it's "unnecessary". (Unless, as I said, there are other sources specifically mentioning chiropractic, in which case the attribution can be modified.) Eubulides may not see a distinction between attributing "antiscientific" and attributing statements like "is a complementary and alternative medicine health care profession". but don't worry: I do see a distinction, so the article won't turn into a pincushion of prose-attributions. As Gleng pointed out, chiropractors themselves consider themselves to be in "complementary and alternative medicine"; but _{(18:19, 25 July 2008 (UTC))} I think it would be difficult to find chiropractors referring to themselves as "antiscientific". ☺ Coppertwig (talk) 14:30, 24 July 2008 (UTC)

The only objection I have heard to CAM is that it is an oxymoron. How can something be complementary (used with) as well as alternative (used instead of) - its like new & improved. I see no problem with attribution here, and perhaps we will need to attribute more in the article (Eubulides suggested we would need to attribute DeVocht). However, I disagree that statements of fact need to be attributed. - DigitalC (talk) 23:59, 24 July 2008 (UTC)

Perhaps you missed the discussion in #Inserting "Keating says" on this subject? Coppertwig (who cited Gleng, but I don't see Gleng making this claim) was incorrect to claim that "chiropractors themselves consider themselves to be in 'complementary and alternative medicine'". Redwood et al. 2008 (PMID 18435599) says that by a wide margin, chiropractors themselves reject the claim that they are CAM practitioners. Eubulides (talk) 18:06, 25 July 2008 (UTC)

Commented-out reference

ImperfectlyInformed asked, "why was this reference commented out?" When two or more consecutive sentences are supported by the same reference, as in this case, the footnote only needs to go after the last one. The reference was left there, commented-out, to assist with editing, for example if the sentence gets moved; or to discourage people from adding fact tags, as you were going to do: it worked, didn't it? ☺ Coppertwig (talk) 20:56, 20 July 2008 (UTC)

Would have worked much better with a brief explaining note... but soon after I looked at it, I saw that a similar statement was cited near the lead. So it doesn't matter so much for close readers, a group of which I am not always a part. :p II | (t - c) 01:14, 21 July 2008 (UTC)

Well, after your edit, I went to add such explaining notes in all the places where I'd done that in the article, but decided not to, because they would take up too much space. If someone else wants to add such notes that's fine with me, though. ☺ Coppertwig (talk) 01:44, 21 July 2008 (UTC)

Archiving

This talkpage has again ballooned to a size which limits participation: Over 220K (and some editors have browsers that cannot easily handle anything over 32K). I don't think we need to pare back to a 32K size, but getting back to under 100K would be good. There is an archive bot trying to manage this page, but it is being blocked because of the way that section headers are being used. In other words, it archives sections that start with level 2 headers (==title==). However, if there is a single message within any of the level 3 headers (===subtitle===) of that section that is recent, the bot assumes that the entire level 2 section is recent, and won't archive any of it.

To address this problem, I recommend more frequent use of level 2 headers, or perhaps "downgrading" a subsection when it appears that it has gone inactive. For example, if there is a section "==Stuff==", and there is a level 3 subsection within it, "===Painting===", and the subsection is no longer active, but other subsections within "Stuff" are active, then we could change the subsection's header to "==Stuff: Painting==", and then the bot would recognize and archive it. Or, at that point the subsection could simply be archived manually. Another option is to move lengthy subsection discussions off to a subpage. Whichever way it is handled, I recommend that something be done, otherwise this page is going to continue to grow to even more unmanageable levels. --Elonka 17:54, 24 July 2008 (UTC)

Would collapsing templates address this problem? I came across a talk page the other day (unfortunately I can't recall which one), which had sections that were collapsed. So, given that something in a level 3 subsection is quite related to the other subsections under that level 2 heading, we might not want them sent to the archive yet. However, if we could collapse the previous level 3 subsections until we are ready to archive the whole section, that might be an improvement? Another example would be the proposed History section. The proposed text could be collapsed, with the comments about it uncollapsed. - DigitalC (talk) 00:46, 25 July 2008 (UTC)

(page currently at 300K and growing). Collapsed sections help with the scroll, but unfortunately not with the download. The entire (uncollapsed) page is still downloaded by the browser, it's just displayed as though it's smaller than it actually is. My recommendation at this point is to do partial archives of "inactive" sections of certain large threads, and just link to the archives via a {{sidebox}}. --Elonka 04:08, 27 July 2008 (UTC)

Evidence basis rewrite

The practice of evidence based medicine means integrating the doctor's clinical expertise with the best available external clinical evidence from systematic research in making decisions about the care of individual patients. The best available external clinical evidence is not restricted to randomized trials and meta-analyzes, but also involves tracking down the best external evidence with which to answer the specific clinical questions for that particular patient. Chiropractors have several database utilities that are designed to provide doctors with information that fosters best patient care practice. These include DCConsult and the Index of Chiropractic Literature. Chiropractors also employ consensus guidelines which are guidelines that are developed by experts in the field.

Evidence basis rewrite comments

I have started by taking some of the sentences that concerned evidence based guidelines from different subsections of Chiropractic#Evidence basis and brought them into the initial paragraph where they help to explain the reasons that physicians are concerned about the abuse of evidence based guidelines. I believe it is NPOV and accurate. I have not thoroughly checked the references yet. -- Dēmatt (chat) 02:00, 25 July 2008 (UTC)

Suggestion: drop "anyway" from "validity of these guidelines anyway." and instead use "validity of these practice guidelines." -- Fyslee / talk 05:03, 25 July 2008 (UTC)

Done. -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

Overall, this version seems extremely solid. Nice work! -- Levine2112 17:12, 25 July 2008 (UTC)

Thanks! Still more work to do though! -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

This version has problems. For example, the part that says Those that are opposed are concerned is not NPOV. The current version without attribution is best. QuackGuru 17:17, 25 July 2008 (UTC)

Please describe why you feel that sentence is not NPOV? Please refer to the source when possible. -- Levine2112 17:43, 25 July 2008 (UTC)

Yep, hard to fix something that doesn't look broken. Any suggestions? -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

I suggest that you can just say "some are concerned..." it may also be a concern amogst supporters of EBM that the research base is not always specifically about chiropractic. But generally think you've done a good job. I think it is helpful to start by explaining what EBM is as it is so often misunderstoodGleng (talk) 11:11, 26 July 2008 (UTC)

• If the idea is to take text away from some other section and put it here, then we also need to see what the other section will look after the text is removed from there. Can you please show the entire proposed change, rather than just this part of it? (I did take the opportunity of migrating the recent change to Chiropractic into this part of the proposal]].)

No preconceived intentions other than to follow the sources and fix synthesis problems so that we can remove the tag. So far just some re-arranging. Not sure I see where you've migrated anything? -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

• I haven't migrated the text in question. As I understand it, this draft proposes migrating text (like "Many controlled clinical studies of SM are available, but their results disagree") from other paragraphs into the first paragraph of Chiropractic #Evidence basis. If so, then we need to see what the other changed paragraphs will look like as well, in order to see what the entire proposal is. Eubulides (talk) 02:40, 26 July 2008 (UTC)

• The new phrase "Those that are opposed are concerned that" is not supported by a reliable source. QuackGuru also objected to this phrase on NPOV grounds, but the lack of a source is even more worrisome to me.

You really think it needs one? -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

Yes; that phrase is a claim that the chiropractors who employ antiscientific reasoning etc. are are concerned that research has focused on SM in general. But we don't have a reliable source saying that. And in fact, I expect that the actual concern is also shared by many chiropractors who stick to scientific reasoning, so I am concerned that the phrase may in fact be misleading. Finding and citing reliable sources on this topic will help to dispel this concern. Eubulides (talk) 02:40, 26 July 2008 (UTC)

There is a continuum; I assume that includes those that object for reasons that are not antiscientific. But I did make some changes try and clarify this. -- Dēmatt (chat) 05:30, 26 July 2008 (UTC)

• The "These" in the new phrase "These chiropractors" is not supported by a reliable source.

You really think it needs one?-- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

Yes, for the same reason as before. We don't have a reliable source equating the set of chiropractors who employ antiscientific reasoning etc. with the chiropractors who voice concerns about stealing SM procedures, and in fact I am concerned that these sets of chiropractors are substantially different. Eubulides (talk) 02:40, 26 July 2008 (UTC)

• The phrase "and they are typically of low quality" (referring to clinical studies on SM), which was present in the source, is absent here. It seems important; why omit it?

It seemed POV and unnecessary as everyone knows that clinical studies are not as good quality as RCTs. I think that is the point that was made by the source as well. -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

I doubt that the typical Misplaced Pages reader will know this. For one thing, the text doesn't even say that the studies are typically clinical studies rather than RCTs. The low quality of studies is an important point, and should be summarized in this section, rather than expecting the reader to follow the citation in order to see the point. Perhaps you meant to leave the low-quality sentence in the source paragraph? This is why we need to see the edited source paragraphs as well as the edited destination paragraph. Eubulides (talk) 02:40, 26 July 2008 (UTC)

Just a query. If the source criticises the low technical quality of the clinical trials then I'd support Eubolides here, if the source is referring to low quality in the EBM context (i.e. possibly well conducted but of low weight as far as systematic assessment is concerned because of small numbers/single centre etc) then a different wording might be better. Gleng (talk) 11:11, 26 July 2008 (UTC)

• The phrase "leaving questions about the validity of these guidelines anyway" which Coppertwig spotted as a grammar problem, is not supported by the source. The source talks only about guidelines for low back pain, not about guidelines for chiropractic care in general.

Good point. It doesn't belong in the effectiveness for low back pain section either then. -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

Sure it does. It's about low back pain. Eubulides (talk) 02:40, 26 July 2008 (UTC)

• As mentioned above, I suggest replacing this:

the other end employs what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims".

with this:

the other end employs what chiropractic researchers call antiintellectual, antiscientific or pseudoscientific reasoning, stratagems that are ethically suspect when they let practitioners maintain their beliefs to patients' detriment.

Eubulides (talk) 18:06, 25 July 2008 (UTC)

Still an ongoing discussion on that one. See below. -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

I certainly agree that its right to mention ethical issues somewhere. All professions have theirs - academic medicine with conflict of interest, medical practice with overprescribing, science with fraud etc.; I'd have thought that the major ethical concern with chiropractic has been over advertising. Obviously it must be a concern if patients are deflected from effective care, but is there evidence of much actual harm arising from straight chiropractic, or is this mainly fear that it might? Gleng (talk) 22:43, 25 July 2008 (UTC)

I don't know of any scientific evidence about actual harm arising from chiropractic (either straight or mixer) due to deflection. Certainly there is anecdotal evidence of deflection, as well as a few (quite rare) documented cases of harm due to treatment, but that is not scientific evidence. Eubulides (talk) 23:48, 25 July 2008 (UTC)

I agree that we should mention ethical issues NPOV. Of course, these get complicated too ;-) Do appreciate all the help we can get! -- Dēmatt (chat) 01:54, 26 July 2008 (UTC)

I see that further edits have been made but it seems to be a work-in-progress; some lengthy quotes about EBM have been added, which aren't that relevant here, and there's still material (e.g., "'steal' SM procedures) taken from other paragraphs but it's not clear how the other paragraphs will be altered. So I'll hold off further comments for now. Eubulides (talk) 08:31, 26 July 2008 (UTC)

Yes, still a work in progress and I simply had to get some sleep :-) Re: EBM stuff added; I am waiting to see how the SM decision works out. After Coppertwig seemed to think that we can use good information even if it is not specific to one article, I think it is perfectly reasonable to explain EBHC so that the reader can understand the various POVs concerning it. BTW, I just quoted straight from Sackett for now, but will paraphrase soon (though I think Coppertwig and Gleng are good at this, too). Notice that Sackett explains that EBM is not restricted to RCTs. I was considering that we can include other types of research that help a doctor evaluate patients. Ie., in the absense of RCTs, we might be able to find sources that make some EBM choices based on the latest expert consensus type guidelines. Of course, we would have to explain that as well. -- Dēmatt (chat) 15:28, 26 July 2008 (UTC)

I've rewritten my rewrite in a totally different direction. It seemed that the information that I had was going nowhere so I followed what I thought the reader would want to know. It's just a start again, and needs some balance, so feel free to give some advice. -- Dēmatt (chat) 04:07, 27 July 2008 (UTC)

Inaccurate insertion of "Simon says" phrases

I see now that what I predicted earlier would happen, is indeed starting to happen: this edit inserted two more "Simon says" remarks, and inserted quotation marks, in order to weaken the discussion. In these cases, the "Simon says" remarks were not accurate, as the source in question is by Keating and two other authors, not by Keating alone. Also, the newly-inserted quotation marks are not strictly accurate. Furthemore, the edit made the controversial change of removing "pseudoscientific" (a point that is made by the source). It also unnecessarily removed wikilinks. I'll sew what I can do to fix all this now, but I wish controversial changes like this were discussed first, before being made. Eubulides (talk) 18:06, 25 July 2008 (UTC)

Actually, my edits were discussed above first. My issue is that we are stating Keating's "antiscience" opinion three times in this article. That is most certainly a WP:WEIGHT violation. I have reduced it to one time. -- Levine2112 18:14, 25 July 2008 (UTC)

• No, all that was said above was "we should not be restating Keating's opinion three times in our article". That is not a discussion of specific edits; it is a statement of a problem.
• The changes introduced errors, as discussed above, and I will try to repair them on short notice. It would have been more helpful to discuss the specific edits first.
• It is not a WP:WEIGHT violation to mention an important topic once in the body and to summarize it in the lead. The straights's dogma/pseudoscience/antiscience/antiintellectual/whatever-you-want-to-call-it is an important reason chiropractic continues to have problems with mainstream medicine, and this problem needs to appear in the lead. In an attempt to reach a compromise I will attempt to reword it without the word "antiscience", which appears to be a hot-button among sveral editors.
• I continue to disagree with the idea of making controversial changes like this without specific discussion of the edits first. This is not a good way to move forward in this controversial article.

Eubulides (talk) 19:36, 25 July 2008 (UTC)

I have attempted a quick workaround of the problem with this edit, which does the following:

• Restore the discussion of the issue to the lead, without using the hot-button word "antiscientific". This discussion uses terminology that comes from "Chiropractic History: a Primer", while avoiding the hot-button word.
• Move the single use of the word "antiscientific" from Chiropractic #History to Chiropractic #Evidence basis. The problem of antiscientific/pseudoscientific/antiintellectual/whatever-you-want-to-call-it is a continuing one, so if it's going to be mentioned in one place, it's better not to imply that the problem has gone away by putting it into the History section.
• Restore the point that evidence-based guidelines are supported by some chiropractors. Removing this point was not discussed, and I assume it was inadvertent.
• Restore the citations to Phillips in PPC; this is an independent source (which does not cite Keating) about the issue.
• Restore the citation to the "subluxation or dogma" paper, as it is a relevant source here (as elsewhere in the article).
• Add a phrase talking about ethical issues; this was suggested in #Antiscientific reasoning above, and nobody has objected to this particular phrase.

Eubulides (talk) 21:09, 25 July 2008 (UTC)

• "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs what chiropractic researchers call antiintellectual, antiscientific or pseudoscientific reasoning, stratagems that are ethically suspect when they let practitioners maintain their beliefs to patients' detriment."

This sentence gives the impression that all chiropractic researchers call some undescribed set of chiropractors antiintellectuals, antiscientific or pseudoscientific. I think what other editors are suggesting is that, rather than using the words antiscience, ps.... that we use the reasons that these particular researchers call them that instead. That way we avoid the pejorative sensations that the words themselves present without explanation.

BTW, is it okay if I make changes to the article without first getting consensus here, too. I'm okay with that if you are. -- Dēmatt (chat) 00:26, 26 July 2008 (UTC)

• It doesn't call the undescribed set antiscientific; it merely says that they employ antiscientific reasoning, which is a different thing.
• I don't think the other editors were saying that the word "antiscientific" be removed; only that it not be mentioned more than once and that it be attributed in the text; the current version does that.
• I'd rather that we stick to the advice "Please read this page and discuss substantial changes here before making them." which has long been at the top of this talk page. I wish we had followed that advice in this instance.

Eubulides (talk) 00:41, 26 July 2008 (UTC)

• The references that we have sourced do not say anything about a continuum that I can see. They all do seem to be opinion pieces; in fact as Coppertwig enlightened us, they are part of a debate within chiropractic. Why don't we consider phrasing it in the context of a chiropractic debate such as, "The debate within chiropractic circles is whether resistance to evidence based guidelines is justifed or is based on anti-scientific reasoning and unquestioning adherence to dogmatic beliefs." This way, we as wikipedians avoid taking sides. I'm not sure that it fits in the evidence based section though, unless we lost a link somehwere.

• I'm not sure what you mean by "opinion pieces"; by the "Simon says" standard being proposed, I'd guess that all the sources currently cited by Chiropractic are opinion pieces, so in that sense, yes, they are opinion pieces. But this particular point is not controversial among reliable sources, and it's not being debated as far as I can see. The paraphrase you suggest is about evidenced-based guidelines and would clearly fall within the subject of Chiropractic #Evidence basis; however, I don't know of any reliable source that would support that paraphrase. Eubulides (talk) 02:40, 26 July 2008 (UTC)

• I wish we had followed that advice in this instance. I think Coppertwig did. I wish we had followed it in every instance. That is the only fair way and it actually encourages collaboration, rather than destroys trust. -- Dēmatt (chat) 01:15, 26 July 2008 (UTC)

• Yes, Coppertwig did, but this section (#Inaccurate insertion of "Simon says" phrases) was not prompted by Coppertwig's edits. It was prompted by later edits that were not discussed before being installed.

Eubulides (talk) 02:40, 26 July 2008 (UTC)

Oh, I returned it to the consensus version that Coppertwig made. I still don't see the continuum part. I really thought we had something that said that. -- Dēmatt (chat) 04:46, 26 July 2008 (UTC)

I see, but this version still has a problem. The text says:

'what chiropractic historian Keating calls "antiscientific" reasoning and "unsubstantiated claims"'

but the citations are not just to Keating 1997; they are also to Phillips 2005 (an independent source: he doesn't cite Keating) and to Keating, Charlton, Grod, Perle, Sikorksi, and Winterstein 2005. We need to fix the text to match the sources, which are not just Keating. The quote-marks are no longer appropriate, since we're citing some non-Keating sources, and they don't all use those exact words. To fix this I propose changing the abovementioned text to look like the following instead:

'what chiropractic researchers call antiscientific reasoning and unsubstantiated claims'

Eubulides (talk) 08:31, 26 July 2008 (UTC)

Thank you, Eubulides, for your effort in working towards a consensus version. The reference Keating, Charlton, Grod, etc. 2005 apparently does not contain the word "antiscientific". I'm not sure if I can access Phillips 2005: does it use that word?

Re "the other end employs what chiropractic researchers call antiintellectual, antiscientific or pseudoscientific reasoning": The phrase "chiropractic researchers" could easily be misinterpreted to mean researchers who are chiropractors, leading to an erroneous impression that we're saying that chiropractors are calling themselves antiscientific etc. A list of several pejorative terms seems unnecessary and leads to a non-neutral tone even if it's in a quote or indirect quote.

Re "'what chiropractic researchers call antiscientific reasoning and unsubstantiated claims'" OK except for my concerns about the phrase "chiropractic researchers". How about "commentators" or "commentators about chiropractic" or "researchers about chiropractic" or "commentators such as chiropractic historian Keating" or possibly just "researchers"?

You said that the prose attributions had been added for the purpose of weakening the phrase. That isn't my purpose. The purpose is to satisfy NPOV. The statement can be very clear and strong, as long as it's neutrally worded. How about something like "...the other end relies on postulates which are not scientifically established"? Does that express the concept sufficiently? If not, can you find a way to explain it in a phrase like that, rather than relying on individual words such as "antiscientific" which may mean different things to different people? Such a phrase may not need prose attribution, if we can agree that it's a verifiable fact expressed in neutral terms. ☺ Coppertwig (talk) 18:37, 26 July 2008 (UTC)

Re "...the other end relies on postulates which are not scientifically established". That's going to be hard to reference. Maybe this is where we can bring in the "low quality research" somehow. Though realistically, according to Murphy, they are all citing the same research but ending up with different consensus versions of guidelines. IOWs, mixers and straights have different guidelines that were consensus guidelines. The first were the Mercy Guidelines by Haldeman in the 1990s that got a lot of flack from the straights so they made their own, which included the same research but must have allowed more visits or something. Since then, I think the CCPG? guidelines were developed and again the straights have developed their own, only this time I think it is just the WCA straights(minority). My question would be, whose EBM guidelines are we talking about? -- Dēmatt (chat) 00:47, 27 July 2008 (UTC)

Complementary and alternative

I take back the pincushion remark. Eubulides has stated that "The very first claim in Chiropractic is an opinion, not a fact." I now realize that Eubulides is right about this. However, NPOV requires that Misplaced Pages articles not present opinions as if they are facts, so we need to change this. I suggest deleting "complementary and alternative" from the first sentence, making it "Chiropractic is a health care profession..." Later in the article, the phrase "complementary and alternative" can be used with appropriate prose attribution.
If the article becomes peppered with prose attributions, so be it. It must conform to the WP:NPOV policy, which states "Assert facts, including facts about opinions—but do not assert the opinions themselves." (emphasis in the original.) We can take as a model the Circumcision article, which has many prose attributions, largely due to the careful, precise work of Jakew who worked hard to ensure that the article conforms to NPOV. It's hard to find any statement in the Circumcision article about which anyone is likely to say "But that's not true!" This article needs to be elevated to that standard. ☺ Coppertwig (talk) 18:19, 25 July 2008 (UTC)

This sounds to be entirely reasonable. I would support such an edit. -- Levine2112 18:22, 25 July 2008 (UTC)

• The Circumcision article is not a model of text attribution for every opinion. Let's take the very first claim in the body of Circumcision:

"For infant circumcision, clamps, such as the Gomco clamp, Plastibell, and Mogen are often used."

This is an opinion, not a fact, because the word "often" is a judgment call made by the cited source (Holman et al. 1995, PMID 7625325). Were the "Simon says" style actually used, this sentence would have to be worded like this:

"According to the physicians John R. Holman, Evelyn L. Lewis, and Robert L. Ringler, for infant circumcision, clamps, such as the Gomco clamp, Plastibell, and Mogen are often used."

(As it happens, this wording is also incorrect, because "often used" is not what the cited source actually says; but that is a problem for Circumcision, not for Chiropractic.)

• This is just one example, the first thing I looked at in Circumcision; I'm sure there are many others.
• What this illustrates, is that WP:NPOV does not require the proposed style, even in controversial articles such as Chiropractic or Circumcision. It is common and entirely appropriate to state and source mainstream opinions, where no reliable sources disagree with the opinions, without putting "Simon says" in front of each sentence.
• For this reason, I disagree with adding "Simon says" to "complementary and alternative". It suffices to cite reliable sources on the topic; we shouldn't add "Simon says" all over the place.

Eubulides (talk) 19:36, 25 July 2008 (UTC)

One more point. The proposed replacement '"Chiropractic is a health care profession..."' also fails the proposed "Simon says" rule, since it is merely an opinion (not a fact) that chiropractic is health care. See, for example, Chiropractic and its Role in the Health-Care Profession, which says "I would suggest that chiropractic is not health care, but neither is it more than health care. It is something different altogether, so different that it defies description and comparison to health care." This source is not a reliable mainstream source (it is the FACE, a straight-chiropractic website), but if the rule is that we have to put "Simon says" in front of every opinion expressed in Chiropractic, then we cannot simply say "Chiropractic is a health care profession" in the lead. Eubulides (talk) 21:24, 25 July 2008 (UTC)

I think that you are over-reacting. I and others objected to expressing judgemental opinion in a way that seemed to allow those opinions to be understood as fact. We also objected because the word antiscientific has no consistent objective meaning, and didn't endorse its use in this way in a serious encyclopedia. You might say, with postmodernists, that all language is value laden and everything is opinion - that is indeed a philosophically anti-science position. That's not our position. Scientists don't generally see a real problem is distinguishing facts from interpretion, and interpretation from opinion. Who objected to the lead sentence? Is it a real objection, or was it just to make a point?

"Chiopratctic is a health care profession is a factual statement. It may be wrong, in which case put it right, but "health care profession" is an objective descriptor with an operational definition. "X is antiscientific reasoning" is a judgemental opinion, unless it is used in a contect where there is a relevant operational definition of "antiscientific reasoning". You pointed to Antiscience for this, which, as I detailed above, led to Hobbes ....] (talk) 18:19, 26 July 2008 (UTC)

Keating also says

"Chiropractors have long abided by the principle of restoring health through restoring life balance. In the US, 50% of all deaths are due to poor lifestyle choices. Health problems due to poor lifestyle produce the most chronic, debilitating, and medically untreatable diseases of our day. The 21st century chiropractor will be vigilant for the manifestations of a stressful and often unhealthy lifestyle. The chiropractor of the future will address subluxations beyond the spine – to nutrition, sleep, stress, family, and community. Recognizing that alcohol and drug abuse, depression, and suicide may be symptoms of deeper “diseases of meaning,” chiropractors may play a greater role in community health, health education and disease prevention. By encouraging healthy behaviors, the 21st century chiropractor could play a role in decreasing over-reliance on expensive and risky technological medicine."(Chiropractic History: A Primer)

This is the paradigm that reform chiropractic (of which Keating, Triano, Perle, -and the 11 other chiropractors mentioned above) is suggesting for the future of chiropractic. As you can see, it is not much different from the straight "vision". This needs to be incorporated into the article at some point. -- Dēmatt (chat) 23:00, 25 July 2008 (UTC)

• Just to clarify, this is not just Keating on the author list, and I suspect by looking at the style that one of his coauthors actually composed most of those words, although Keating as a coauthor obviously stood by them.
• I agree that Chiropractic should do a much better choice of discussing lifestyle, nutrition, etc. This subject has come up several times on the talk page. The logical place to improve the discussion is Chiropractic #Treatment procedures, which currently only briefly alludes to these topics in the table.

Eubulides (talk) 23:48, 25 July 2008 (UTC)

Education etc

Since UK chiropractors are mentioned in this section, may be appropriate to cite The GCC, the statutory body analagous to the General Medical Council in the UK.Gleng (talk) 14:52, 26 July 2008 (UTC)

I put it in, make sure I got it right! -- Dēmatt (chat) 04:52, 27 July 2008 (UTC)

References

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