CMAJ article
Question:
the comparison is much like daylight and dark! — DR. ROLAND HICKS Doctor of Chiropractic Certified Chiropractic Sports Practitioner Iligitimi non carborundum
– Hide quoted text — Show quoted text -> x-no-archive: yes >Are you saying that cervical manipulation effectively treats the problems >for which the top 5 prescription meds are used? > I don’t think the topic was of efficacy…but rather the > associated risks. > OTOH, I am prepared to argue the risk comparison between > NSAIDs vs. chiropractic. > Atlas
Response:
NO! Did you think that was what I wrote? If so, read it again. — DR. ROLAND HICKS Doctor of Chiropractic Certified Chiropractic Sports Practitioner Iligitimi non carborundum – Hide quoted text — Show quoted text -> Are you saying that cervical manipulation effectively treats the problems > for which the top 5 prescription meds are used? > Michele > If the risks of taking one if not more of the 5 most prescribed > medications > is greater than the risk involved in a cervical manipulation would it make > more sense to make sure that the higher risk is greater known so that more > deaths could be avoided? That is my point. Not that the risk of > cervical > manipulation is hidden. When you compare the known/possible risks there > are > no comparison. To use the maybe, what if, dark alley analogies is not > scientific and borders on being hip deep in BS. > — > DR. ROLAND HICKS > Doctor of Chiropractic > Certified Chiropractic Sports Practitioner > Iligitimi non carborundum > > > post the numbers Kirk. > > > They still show that cervical manipulation is FAR less deadly than any > of > > > the 5 most prescribed medications. > > Read the papers, Roland. It is your field, after all. The numbers are > > unknown. Definitive prospective data has not yet been collected. But > the > > recent investigations of various neurologists have shown that the > previously > > reported incidence (aprox 1:1000000) is likely a vast underestimation. > > Your comparison to the five most prescribed medications is irrelevant. > We > need > > to know the risks involved with cervical manipulation, and we need a > clear > > picture of the benefits, regardless. > > — > > Kirk Kolas > > Ontario Veterinary College > > Class of 2002
Response:
– Hide quoted text — Show quoted text -> x-no-archive: yes >The topic was that cervical manipulations are less hazardous than the top 5 >prescribed meds. The only way to link the two with regard to their hazards >is if they are being used to treat the same conditions/problems. > NO, that is NOT the *only* way to link the two. Efficacy, > reproducability, validity, safety, etc… are all variables which can > be independently evaluated. >Therefore, >I am asking if DC’s use cervical manipulations to treat the same things the >top 5 prescriptions are used for. > According to RXlist.com, the top 5 meds are: > 1. Hydrocodone w/ apap > 2. Lipitor > 3. Premarin > 4. Synthroid > 5. Atenolol > So we’ve got drugs for pain, hypercholesteremia, birth > control, hypothyroidism, and hypertension. > Of these, pain control is well within the scope of > chiropractic. > OTOH, I don’t know of ANY of these respected drugs which can > rehabilitate and correct the cervical or lumbar lordosis. (Something > which I do). >As far as NSAID’s, I would agree that chiropractic treatment would be much >safer for some conditions, especially for chronic ones. There are also some >problems that would benefit from both DC’s & the limited use of NSAID’s more >than either alone. > Agreed. >As a nurse on an orthopaedic unit years ago, I had a patient who had been >paralyzed from the chest down after a DC performed a cervical adjustment on >him. Does that mean I think DC’s run around cracking necks to put folks in >wheelchairs? Of course not. I don’t think most DC’s are dangerous when >doing such manipulations, but I realize there are hazards. I’ve also seen >the results of surgery & medication that harmed patients too. To deny the >hazards isn’t reality & to exaggerate them isn’t either. > There are risks associated with *any* procedure. However, it > is important to put things into perspective. >My only mention of chiropractic treatment for specific conditions was to >point out the inability to accurately compare apples & oranges. Sorry if I >didn’t make it clear. > You are indeed arguing apples to oranges. But I don’t know if > you realize just how much. We can compare efficacy or clinical > appropriateness. And we can ALSO argue overall safety (restricting > our query to complications of stroke). > http://www.geocities.com/cbpdoc/strokestats.html > This chart clearly shows that there is a lower incidence of > stroke following chiropractic manipulation than many major medical > procedures. But there’s also data which shows an incidence of stroke > of unknown causes (3,700 per million). This could be interpreted that > you have a greater chance of having a stroke for no reason at all – > than by getting a chiropractic adjustment (which is 1-3 per million).
But the CMAJ article talks about the chronic underestimation of serious complications that result from chiropractic manipulations. There is no reporting mechanism for chiropractic complication like there is for pharmaceutical complication. As a result, the chiropractic numbers look falsely optimistic. Additionally, your web page compares chiropractic adjustment for neck pain to carotid endarterectomy for carotid stenosis. Untreated neck pain can lead to what? More neck pain? Untreated carotid stenosis is at high risk for stroke. That isn’t even comparing apples and oranges, more like apples and whales.
Response:
Atlas: No dispute there. I think NSAID use should be limited, monitored very closely, & other modalities like chiropractic, PT, MT, etc. should be utilized. It still doesn’t change the fact that many of the conditions MD’s commonly treat — like cancer, diabetes, infections, etc. — generally require the use of procedures/meds that carry a higher risk. Then again, the conditions being treated are more likely to present more hazards & potentially more harm (with or without treatment) to patients than those a DC treats. Massage is extremely safe, although there have been cases of practitioners doing something potentially harmful to patients. Certainly less people are harmed each year from massage therapy than brain surgery. But then again, who can compare the two, since I’m not dealing with such a high risk population or high risk intervention? I’m sure my insurance premiums are lower than a brain surgeon’s, but it doesn’t mean the surgeon or his surgery is unecessarily hazardous — just that my patients have (for lack of a better phrase) "low risk" problems that I utilize "low risk" methods to help. DC’s do the same thing. Neither of us can really compare the non life-threatening problems we treat (which fortunately respond well to our low risk methods) with the problems seen by many MD’s that can prove to be lethal (that often require treatment that carries with it more risks). Michele
– Hide quoted text — Show quoted text -> x-no-archive: yes >The reason the DC’s procedures are safer is bcause they don’t treat problems >which require possibly riskier intervention. Cervical manipulations are a >relatively low risk intervention for non life-threatening problems. > People take NSAIDs for the same exact reason why others go to > the chiropractor. And yet, you have a 400% greater likelihood of > dying from NSAID use than from chiropractic. > Atlas
Response:
If one treats chronic lower back pain with drugs or chiropractic treatment, the risks can be compared fairly. If one person treats cancer with chemo & another treats whiplash with chiropractic, how can the risks be compared? They can’t. Different problems (with their own inherent risks without treatment), requiring vastly different treatments (a "safer" treatment which doesn’t have much effect on the problem isn’t "better", it’s simply ineffective) really can’t be compared side by side. The patients seen by DC’s with the problems treated by DC’s are one thing. The patients seen by MD’s that require surgery or medications (4 of the 5 drugs you mention fit that category) are another. Michele
– Hide quoted text — Show quoted text -> x-no-archive: yes >The topic was that cervical manipulations are less hazardous than the top 5 >prescribed meds. The only way to link the two with regard to their hazards >is if they are being used to treat the same conditions/problems. > NO, that is NOT the *only* way to link the two. Efficacy, > reproducability, validity, safety, etc… are all variables which can > be independently evaluated. >Therefore, >I am asking if DC’s use cervical manipulations to treat the same things the >top 5 prescriptions are used for. > According to RXlist.com, the top 5 meds are: > 1. Hydrocodone w/ apap > 2. Lipitor > 3. Premarin > 4. Synthroid > 5. Atenolol > So we’ve got drugs for pain, hypercholesteremia, birth > control, hypothyroidism, and hypertension. > Of these, pain control is well within the scope of > chiropractic. > OTOH, I don’t know of ANY of these respected drugs which can > rehabilitate and correct the cervical or lumbar lordosis. (Something > which I do). >As far as NSAID’s, I would agree that chiropractic treatment would be much >safer for some conditions, especially for chronic ones. There are also some >problems that would benefit from both DC’s & the limited use of NSAID’s more >than either alone. > Agreed. >As a nurse on an orthopaedic unit years ago, I had a patient who had been >paralyzed from the chest down after a DC performed a cervical adjustment on >him. Does that mean I think DC’s run around cracking necks to put folks in >wheelchairs? Of course not. I don’t think most DC’s are dangerous when >doing such manipulations, but I realize there are hazards. I’ve also seen >the results of surgery & medication that harmed patients too. To deny the >hazards isn’t reality & to exaggerate them isn’t either. > There are risks associated with *any* procedure. However, it > is important to put things into perspective. >My only mention of chiropractic treatment for specific conditions was to >point out the inability to accurately compare apples & oranges. Sorry if I >didn’t make it clear. > You are indeed arguing apples to oranges. But I don’t know if > you realize just how much. We can compare efficacy or clinical > appropriateness. And we can ALSO argue overall safety (restricting > our query to complications of stroke). > http://www.geocities.com/cbpdoc/strokestats.html > This chart clearly shows that there is a lower incidence of > stroke following chiropractic manipulation than many major medical > procedures. But there’s also data which shows an incidence of stroke > of unknown causes (3,700 per million). This could be interpreted that > you have a greater chance of having a stroke for no reason at all – > than by getting a chiropractic adjustment (which is 1-3 per million). > Atlas
Response:
The reason the DC’s procedures are safer is bcause they don’t treat problems which require possibly riskier intervention. Cervical manipulations are a relatively low risk intervention for non life-threatening problems. Put a scalpel in someone’s hand for aneurysm surgery & we’re talking much higher risk, but the problem itself has more hazards than those treated by DC’s. [Just an example -- we could be talking about diabetes, cancer, heart disease, or any other potentially dangerous health issue.] Infections, secondary complications all increase hazards. My nursing malpractice insurance is incredibly cheap. Ditto for my massage malpractice costs. I don’t diagnose, prescribe, operate, etc. The procedures I use are very safe (although nothing is ever 100% risk-free), but the conditions I work on are also low risk. MD’s are often dealing with more serious cases, some of which need treatment with surgery or drugs which carry a higher risk. Maybe a fairer way to set malpractice insurance costs would be to analyze the risks of a condition *without* treatment & then with various types of treatment. Michele
– Hide quoted text — Show quoted text -> x-no-archive: yes >Because they treat different problems, with MD’s working with sicker >patients. > AND the DC’s procedures are safter (which is the main point). > Atlas
Response:
Are you saying that cervical manipulation effectively treats the problems for which the top 5 prescription meds are used? Michele
– Hide quoted text — Show quoted text -> If the risks of taking one if not more of the 5 most prescribed medications > is greater than the risk involved in a cervical manipulation would it make > more sense to make sure that the higher risk is greater known so that more > deaths could be avoided? That is my point. Not that the risk of cervical > manipulation is hidden. When you compare the known/possible risks there are > no comparison. To use the maybe, what if, dark alley analogies is not > scientific and borders on being hip deep in BS. > — > DR. ROLAND HICKS > Doctor of Chiropractic > Certified Chiropractic Sports Practitioner > Iligitimi non carborundum > > post the numbers Kirk. > > They still show that cervical manipulation is FAR less deadly than any > of > > the 5 most prescribed medications. > Read the papers, Roland. It is your field, after all. The numbers are > unknown. Definitive prospective data has not yet been collected. But the > recent investigations of various neurologists have shown that the > previously > reported incidence (aprox 1:1000000) is likely a vast underestimation. > Your comparison to the five most prescribed medications is irrelevant. We > need > to know the risks involved with cervical manipulation, and we need a clear > picture of the benefits, regardless. > — > Kirk Kolas > Ontario Veterinary College > Class of 2002
Response:
> post the numbers Kirk. > They still show that cervical manipulation is FAR less deadly than any of > the 5 most prescribed medications.
Read the papers, Roland. It is your field, after all. The numbers are unknown. Definitive prospective data has not yet been collected. But the recent investigations of various neurologists have shown that the previously reported incidence (aprox 1:1000000) is likely a vast underestimation. Your comparison to the five most prescribed medications is irrelevant. We need to know the risks involved with cervical manipulation, and we need a clear picture of the benefits, regardless. — Kirk Kolas Ontario Veterinary College Class of 2002
Response:
The topic was that cervical manipulations are less hazardous than the top 5 prescribed meds. The only way to link the two with regard to their hazards is if they are being used to treat the same conditions/problems. Therefore, I am asking if DC’s use cervical manipulations to treat the same things the top 5 prescriptions are used for. And depending on exactly which meds we are discussing, I would be surprised if cervical manipulations would be effective treatment for the problems those meds are used for, so the DC’s wouldn’t be treating the same problems, right? If the DC’s are treating *different* problems than the drugs do, the comparison is skewed. As far as NSAID’s, I would agree that chiropractic treatment would be much safer for some conditions, especially for chronic ones. There are also some problems that would benefit from both DC’s & the limited use of NSAID’s more than either alone. As a nurse on an orthopaedic unit years ago, I had a patient who had been paralyzed from the chest down after a DC performed a cervical adjustment on him. Does that mean I think DC’s run around cracking necks to put folks in wheelchairs? Of course not. I don’t think most DC’s are dangerous when doing such manipulations, but I realize there are hazards. I’ve also seen the results of surgery & medication that harmed patients too. To deny the hazards isn’t reality & to exaggerate them isn’t either. My only mention of chiropractic treatment for specific conditions was to point out the inability to accurately compare apples & oranges. Sorry if I didn’t make it clear. Michele
– Hide quoted text — Show quoted text -> x-no-archive: yes >Are you saying that cervical manipulation effectively treats the problems >for which the top 5 prescription meds are used? > I don’t think the topic was of efficacy…but rather the > associated risks. > OTOH, I am prepared to argue the risk comparison between > NSAIDs vs. chiropractic. > Atlas
Response:
<"Any half twit with two brain cells could figure it out. Why do chiropractors generally have lower malpractice insurance rates?"> Because they treat different problems, with MD’s working with sicker patients. If DC’s treated cancer, their malpractice rates would no doubt go up. Ditto for insulin dependent diabetics & others. <"As far as informed consent, I inform my patients that taking OTC meds is more deadly than my treatment."> Misinformation just like those who would say that DC’s go around injuring people willy nilly. Michele
Response:
> > Actually, the article does not say what you are implying. > What am I implying? I posted the numbers.
You were implying that "arterial dissections following cervical manipulation are approx. 1: 5.85 million". We know this is a vast underestimation that merely addresses incidents that chiropractors are "aware of" due to insurance claims. You were implying that this data was representative of the true incidence. > Post the numbers, I’m sure the forums readers would like to see them.
Better yet, I’ll post the URL to a good review of the topic: http://www.jrsm.org/cgi/reprint/94/3/107.pdf > But we do know that there are insignificant in comparison to medical > intervention deaths for spinal treatment.
Do we? How is this possible, if the risks of SMT are not known… and the benefits even less known? > (2) lack of communication between neurologists and chiropractors/PTs/etc.. > have led to > a gross underreporting of CVAs, > The door of medical communication is usually closed to chiropractors not by > chiropractors. So whose fault is that?
Not true. Collaborative research does occur in this area… however chiropractic practitioners and *associations* seem more interested in distorting the numbers than they do in investigating the problem. > and (3) chiropractors seem bent on attempting > to minimize the significance of these findings. > Chiropractic detractors seem bent on attempting to maximize the significance > significant causes of DEATH.
I doubt that the neurologists involved in these studies care much about "casting light away" from other causes of death. They are simply reporting findings. Detractors certainly do like to emphasize the importance of these risks mostly because the benefits of cervical manipulation are often overstated. > It seems that since science can not determine whom would be at risk for a > stroke following a cervical manipulation, the chiropractic detractors would > like to stop all manipulation "because they are afraid of the dark > (unknown)" regardless of the benefits received with cervical manipulation. > This is not an acceptable solution to the problem.
True. But there are still many "upper cervical specialists" and others within the profession who adjust the neck for any number of reasons. I think the onus falls on your profession to create some guidelines for the use of cervical manipulation. There have been reports of complications from cervical manipulation for presenting complaints that have nothing to do with the cervical spine! Certainly these "adjustments", in light of the recognized risks, are inappropriate. http://www.aucco.org/page2.html http://www.nucca.org/home.htm http://www.erinelster.com/conditions.html http://www.uppercervical.org/ http://www.life.edu/newlife/professional/postgrad/UpperCervicalConfer… etc… — Kirk Kolas Ontario Veterinary College Class of 2002
Response:
I posted the numbers and gave you the journal and article. I did not imply that this data was representative of the true incidence. Read the article. Any half twit with two brain cells could figure it out. Why do chiropractors generally have lower malpractice insurance rates? Could it be that time has shown that chiropractic is a safer form of care and therefore the ins. company can charge lesser rates and still make money hand over fist? >Do we? How is this possible, if the risks of SMT are not known… and the > benefits even less known?
Please if you are going to make such ludicrous statements please attempt to tie it to some form of documentation. Collaborative research does occur in this area… however > chiropractic practitioners and *associations* seem more interested in distorting > the numbers than they do in investigating the problem.
The statement starts off rather gentle, then more accusations and generalizations without a shred of documentation follows. > I doubt that the neurologists involved in these studies care much about "casting > light away" from other causes of death. They are simply reporting findings. > Detractors certainly do like to emphasize the importance of these risks mostly > because the benefits of cervical manipulation are often overstated.
I did not attempt to place the researches into the dubious class of detractors. You are only attempting to make it look as I did. If the universal knowledge of cervical manipulation is so limited (according to you), how can you assume that the risks of cervical manipulation are underestimated and the benefits of such is overstated? HUH? >Certainly these "adjustments", in light of the recognized risks, are > inappropriate.
This is the point that you have yet to grasp. There are no recognized risks. I could do every test known to man on my next patient and I would have little to no more information to determine if the next patient would or would not stroke out following a cervical manipulation. However, I have experienced the benefit of cervical manipulations as a patient, doctor, father, husband, family member and friend. I have no qualms what so ever in recommending, performing and supporting the art and science of cervical manipulation. Until you can show that the risks outweigh the benefits, my clinical studies are all I need to safely treat my patients. As far as informed consent, I inform my patients that taking OTC meds is more deadly than my treatment. — DR. ROLAND HICKS Doctor of Chiropractic Certified Chiropractic Sports Practitioner Iligitimi non carborundum
Response:
If the risks of taking one if not more of the 5 most prescribed medications is greater than the risk involved in a cervical manipulation would it make more sense to make sure that the higher risk is greater known so that more deaths could be avoided? That is my point. Not that the risk of cervical manipulation is hidden. When you compare the known/possible risks there are no comparison. To use the maybe, what if, dark alley analogies is not scientific and borders on being hip deep in BS. — DR. ROLAND HICKS Doctor of Chiropractic Certified Chiropractic Sports Practitioner Iligitimi non carborundum
– Hide quoted text — Show quoted text -> post the numbers Kirk. > They still show that cervical manipulation is FAR less deadly than any of > the 5 most prescribed medications. > Read the papers, Roland. It is your field, after all. The numbers are > unknown. Definitive prospective data has not yet been collected. But the > recent investigations of various neurologists have shown that the previously > reported incidence (aprox 1:1000000) is likely a vast underestimation. > Your comparison to the five most prescribed medications is irrelevant. We need > to know the risks involved with cervical manipulation, and we need a clear > picture of the benefits, regardless. > — > Kirk Kolas > Ontario Veterinary College > Class of 2002
Response:
<snip> >We need >to know the risks involved with cervical manipulation,
Hmmm. And those of mercury amalgams in the mouth? > and we need a clear >picture of the benefits, regardless.
You find that right AFTER *you* have a back or neck problem. Had any actual experience Kirk? Jan The world cares very little about what a person knows; it is what the person is able to do that counts. Booker T Washington
Response:
>post the numbers Kirk. >They still show that cervical manipulation is FAR less deadly than any of >the 5 most prescribed medications. >POST THE NUMBERS OF YOUR AUTHORITY!
From one of the authors of the recent Royal Society of Medicine stusy > Some colleagues and I have recently published
a survey of 239 British neurologists.2 During a 12-month period, these neurologists claimed to have seen 35 serious complications of spinal manipulation, including seven patients with brainstem stroke, two with stroke in the carotid artery territory, one with acute subdural haematoma, three with myelopathy and three with cervical myclopathy. Perhaps the most important result was that under-reporting was 100% – none of these cases had previously been reported. " These are just the ones getting to neurologists. It is known within medicine that these occur and publishing them is not news any more. A recent study in the MJA showed angiograms of vertebral artery dissection after chiropractic manipulation with in these cases relatively minor and temporary neurological signs. "Scare tactics"? Peter Moran
Response:
- Hide quoted text — Show quoted text -> and (3) chiropractors seem bent on attempting > > to minimize the significance of these findings. > Chiropractic detractors seem bent on attempting to maximize the >significance > significant causes of DEATH. >I doubt that the neurologists involved in these studies care much about >"casting >light away" from other causes of death. They are simply reporting findings. >Detractors certainly do like to emphasize the importance of these risks >mostly >because the benefits of cervical manipulation are often overstated. > It seems that since science can not determine whom would be at risk for a > stroke following a cervical manipulation, the chiropractic detractors would > like to stop all manipulation "because they are afraid of the dark > (unknown)" regardless of the benefits received with cervical manipulation. > This is not an acceptable solution to the problem. >True. But there are still many "upper cervical specialists" and others >within >the profession who adjust the neck for any number of reasons. I think the >onus >falls on your profession to create some guidelines for the use of cervical >manipulation. There have been reports of complications from cervical >manipulation for presenting complaints that have nothing to do with the >cervical >spine! Certainly these "adjustments", in light of the recognized risks, are >inappropriate. >http://www.aucco.org/page2.html >http://www.nucca.org/home.htm >http://www.erinelster.com/conditions.html >http://www.uppercervical.org/ >http://www.life.edu/newlife/professional/postgrad/UpperCervicalConfer… >etc… >– >Kirk Kolas
Just think about the harm being caused by those "straight" Chiros, who believe that all dis-ease is a matter of A1-A2 misalignment.
Response:
> Actually, the article does not say what you are implying.
What am I implying? I posted the numbers. The article reports > the incidence of stroke by using data collected from the chiropractic > insurer. This form of reporting grossly underestimates the true incidence of > stroke/CVA associated with manipulation. This is why Haldeman reports the > results as "the likelihood that a DC would be made aware".
I am aware. But does that change the numbers as reported? > The best data to date has come from retrospective and prospective surveys of > neurologists conducted in the UK and Canada. The Journal of the Royal Society > of Medicine 2001; 94:107-110 has an excellent review of the best data > collected thus far.
Post the numbers, I’m sure the forums readers would like to see them. > The only firm conclusions that can be drawn at this point are: (1) we don’t > have a clear picture of the number of strokes cause by manipulation
But we do know that there are insignificant in comparison to medical intervention deaths for spinal treatment. (2) lack > of communication between neurologists and chiropractors/PTs/etc.. have led to > a gross underreporting of CVAs,
The door of medical communication is usually closed to chiropractors not by chiropractors. So whose fault is that? and (3) chiropractors seem bent on attempting > to minimize the significance of these findings.
Chiropractic detractors seem bent on attempting to maximize the significance significant causes of DEATH. Draw your own conclusions. Strawman argument. It seems that since science can not determine whom would be at risk for a stroke following a cervical manipulation, the chiropractic detractors would like to stop all manipulation "because they are afraid of the dark (unknown)" regardless of the benefits received with cervical manipulation. This is not an acceptable solution to the problem. (The baby/bathwater saying would look good here.) — DR. ROLAND HICKS Doctor of Chiropractic Certified Chiropractic Sports Practitioner Iligitimi non carborundum – Hide quoted text — Show quoted text -> The Oct. 2 issue of CMAJ reports that arterial dissections following > cervical manipulation are approx. 1: 5.85 million. > The likelihood that a DC would be made aware of a dissection following a > manipulation of the neck 1: 8.06 million office visits, 1: 5.85 million > cervical manipulations, 1: 1430 chiropractic practice years and 1: 48 > chiropractic practice careers. Literature(science) is unable to identify > those patients at greater risk for stroke following cervical manipulation. > "This most recent study establishes such an extremely low degree of risk, > that patients can feel confident about the safety of neck manipulations > performed by chiropractors." Paul Carey, D.C., one of the principal > authors of the study. > Boo Halloween is over! > Put your scare tactics away they are nonscientific. > — > DR. ROLAND HICKS > Doctor of Chiropractic > Certified Chiropractic Sports Practitioner > Iligitimi non carborundum
Response:
post the numbers Kirk. They still show that cervical manipulation is FAR less deadly than any of the 5 most prescribed medications. POST THE NUMBERS OF YOUR AUTHORITY! — DR. ROLAND HICKS Doctor of Chiropractic Certified Chiropractic Sports Practitioner Iligitimi non carborundum
– Hide quoted text — Show quoted text -> Actually, the article does not say what you are implying. The article reports > the incidence of stroke by using data collected from the chiropractic > insurer. This form of reporting grossly underestimates the true incidence of > stroke/CVA associated with manipulation. This is why Haldeman reports the > results as "the likelihood that a DC would be made aware". > The best data to date has come from retrospective and prospective surveys of > neurologists conducted in the UK and Canada. The Journal of the Royal Society > of Medicine 2001; 94:107-110 has an excellent review of the best data > collected thus far. > The only firm conclusions that can be drawn at this point are: (1) we don’t > have a clear picture of the number of strokes cause by manipulation (2) lack > of communication between neurologists and chiropractors/PTs/etc.. have led to > a gross underreporting of CVAs, and (3) chiropractors seem bent on attempting > to minimize the significance of these findings. > — > Kirk Kolas > Ontario Veterinary College > Class of 2002 > The Oct. 2 issue of CMAJ reports that arterial dissections following > cervical manipulation are approx. 1: 5.85 million. > The likelihood that a DC would be made aware of a dissection following a > manipulation of the neck 1: 8.06 million office visits, 1: 5.85 million > cervical manipulations, 1: 1430 chiropractic practice years and 1: 48 > chiropractic practice careers. Literature(science) is unable to identify > those patients at greater risk for stroke following cervical manipulation. > "This most recent study establishes such an extremely low degree of risk, > that patients can feel confident about the safety of neck manipulations > performed by chiropractors." Paul Carey, D.C., one of the principal > authors of the study. > Boo Halloween is over! > Put your scare tactics away they are nonscientific. > — > DR. ROLAND HICKS > Doctor of Chiropractic > Certified Chiropractic Sports Practitioner > Iligitimi non carborundum
Response:
The Oct. 2 issue of CMAJ reports that arterial dissections following cervical manipulation are approx. 1: 5.85 million. The likelihood that a DC would be made aware of a dissection following a manipulation of the neck 1: 8.06 million office visits, 1: 5.85 million cervical manipulations, 1: 1430 chiropractic practice years and 1: 48 chiropractic practice careers. Literature(science) is unable to identify those patients at greater risk for stroke following cervical manipulation. "This most recent study establishes such an extremely low degree of risk, that patients can feel confident about the safety of neck manipulations performed by chiropractors." Paul Carey, D.C., one of the principal authors of the study. Boo Halloween is over! Put your scare tactics away they are nonscientific. — DR. ROLAND HICKS Doctor of Chiropractic Certified Chiropractic Sports Practitioner Iligitimi non carborundum
Response:
> The Oct. 2 issue of CMAJ reports that arterial dissections following > cervical manipulation are approx. 1: 5.85 million.
What does CMAJ stand for?
Response:
Actually, the article does not say what you are implying. The article reports the incidence of stroke by using data collected from the chiropractic insurer. This form of reporting grossly underestimates the true incidence of stroke/CVA associated with manipulation. This is why Haldeman reports the results as "the likelihood that a DC would be made aware". The best data to date has come from retrospective and prospective surveys of neurologists conducted in the UK and Canada. The Journal of the Royal Society of Medicine 2001; 94:107-110 has an excellent review of the best data collected thus far. The only firm conclusions that can be drawn at this point are: (1) we don’t have a clear picture of the number of strokes cause by manipulation (2) lack of communication between neurologists and chiropractors/PTs/etc.. have led to a gross underreporting of CVAs, and (3) chiropractors seem bent on attempting to minimize the significance of these findings. — Kirk Kolas Ontario Veterinary College Class of 2002 – Hide quoted text — Show quoted text – > The Oct. 2 issue of CMAJ reports that arterial dissections following > cervical manipulation are approx. 1: 5.85 million. > The likelihood that a DC would be made aware of a dissection following a > manipulation of the neck 1: 8.06 million office visits, 1: 5.85 million > cervical manipulations, 1: 1430 chiropractic practice years and 1: 48 > chiropractic practice careers. Literature(science) is unable to identify > those patients at greater risk for stroke following cervical manipulation. > "This most recent study establishes such an extremely low degree of risk, > that patients can feel confident about the safety of neck manipulations > performed by chiropractors." Paul Carey, D.C., one of the principal > authors of the study. > Boo Halloween is over! > Put your scare tactics away they are nonscientific. > — > DR. ROLAND HICKS > Doctor of Chiropractic > Certified Chiropractic Sports Practitioner > Iligitimi non carborundum
Response:
> > The Oct. 2 issue of CMAJ reports that arterial dissections following > cervical manipulation are approx. 1: 5.85 million. > What does CMAJ stand for?
Canadian Medical Association Journal. — Kirk Kolas Ontario Veterinary College Class of 2002
Response:
Canadian Medical Association Journal — DR. ROLAND HICKS Doctor of Chiropractic Certified Chiropractic Sports Practitioner Iligitimi non carborundum
– Hide quoted text — Show quoted text -> The Oct. 2 issue of CMAJ reports that arterial dissections following > cervical manipulation are approx. 1: 5.85 million. > What does CMAJ stand for?
Response:
>The Oct. 2 issue of CMAJ reports that arterial dissections following >cervical manipulation are approx. 1: 5.85 million. >The likelihood that a DC would be made aware of a dissection following a >manipulation of the neck 1: 8.06 million office visits, 1: 5.85 million >cervical manipulations, 1: 1430 chiropractic practice years and 1: 48 >chiropractic practice careers. Literature(science) is unable to identify >those patients at greater risk for stroke following cervical manipulation.
See the words, "would be made aware"? It seems that for you guys, (further) ignorance is bliss.
Response:
nice try knall in fact — DR. ROLAND HICKS Doctor of Chiropractic Certified Chiropractic Sports Practitioner Iligitimi non carborundum
– Hide quoted text — Show quoted text ->The Oct. 2 issue of CMAJ reports that arterial dissections following >cervical manipulation are approx. 1: 5.85 million. >The likelihood that a DC would be made aware of a dissection following a >manipulation of the neck 1: 8.06 million office visits, 1: 5.85 million >cervical manipulations, 1: 1430 chiropractic practice years and 1: 48 >chiropractic practice careers. Literature(science) is unable to identify >those patients at greater risk for stroke following cervical manipulation. > See the words, "would be made aware"? > It seems that for you guys, (further) ignorance is bliss.
Response:
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