Week 12 Flashcards
(14 cards)
Who was Morris Fishbein, and what was the AMA’s “Committee on Quackery”?
Fishbein was Secretary of the AMA who led a campaign to discredit chiropractic, aiming to block its recognition and insurance inclusion.
What was the Wilk v. AMA case about?
A 1976 antitrust lawsuit where chiropractors successfully argued the AMA conspired to eliminate chiropractic, resulting in a court ruling against the AMA.
How did the AMA violate antitrust laws?
By engaging in an illegal boycott and attempting to isolate chiropractors from mainstream healthcare through restrictive ethical codes.
What was Edmund Ernst’s criticism?
He claimed chiropractic neck manipulation was dangerous, citing deaths and underreporting—though his conclusions were criticized for overstating risk without strong evidence.
What was the aim of the Global Summit?
To assess the effectiveness of SMT for non-MSK conditions through a systematic review of RCTs.
What were the Global Summit findings?
High-quality RCTs showed no evidence that SMT was effective for non-MSK conditions like colic, asthma, hypertension, dysmenorrhea, and migraine.
What criticisms were made of the Summit?
Ignored supportive treatments commonly used with SMT
Relied only on RCTs (excluded practice-based evidence)
Overstated policy implications
Excluded dissenting opinions
Used narrow P-value logic
Collapsed multiple unrelated conditions into one analysis
What did dissenters propose as a better conclusion?
That evidence is inconclusive and more research is needed. SMT should not be promoted for non-MSK disorders based on current evidence, but lack of evidence ≠ proof of ineffectiveness.
Why was Safer Care Victoria involved in chiropractic care?
Media exposure of videos showing infant adjustments triggered public and professional concern, leading to a formal review.
What did the review of pediatric chiropractic care involve?
Analysis of 50 studies (RCTs & observational)
Focused on conditions like colic, asthma, LBP, torticollis, and scoliosis
Looked at efficacy, safety, and reporting of adverse events
What were the conclusions of Safer Care Victoria & Pediatric Chiropractic Care?
Positive evidence for: LBP, pulled elbow, premature infants
Inconclusive for colic and asthma
More research needed due to lack of robust data
Adverse effects were uncommonly reported
What did the conclusions of Safer Care Victoria & Pediatric Chiropractic Care trigger in Australia?
Greater scrutiny by AHPRA, the Chiropractic Board of Australia (CBA), and advocacy for evidence-based standards and careful public communication.
What is the CBA’s position on pediatric chiropractic care?
Pediatric care must be evidence-informed
Chiropractors must work within their scope
Interventions must consider risk/benefit, consent, and patient safety
Marketing or publishing unsupported claims is discouraged
How should chiropractors act in pediatric cases?
Refer to other healthcare providers when needed
Clearly explain risks, benefits, and alternatives to parents
Maintain professional standards and avoid unsupported treatment claims
