Week 12 Flashcards
(18 cards)
Who was Morris Fishbein?
AMA Secretary and JAMA Editor; led attacks on chiropractic via the AMA’s “Committee on Quackery.”
What was the goal of the AMA’s Committee on Quackery?
Prevent chiropractic Medicare coverage and accreditation; discourage inter-professional relationships.
What was the significance of the Wilk v. AMA case?
Chiropractors sued the AMA for illegal boycott; court ruled in favor of chiropractors in 1987.
What was Edmund Ernst’s criticism?
Claimed neck manipulation has caused deaths; called for public health warnings; his article lacked robust evidence and was heavily criticized.
What was the aim of the Global Summit?
Assess SMT effectiveness for non-musculoskeletal (NMSK) disorders via systematic review.
What were the conclusions of the Global Summit?
No evidence that SMT is effective for non-MSK conditions (e.g., colic, asthma, dysmenorrhea, migraine).
What were the criticisms of the Global Summit’s conclusions?
Excluded supportive therapies used in real practice
- Narrow selection of RCTs
- Conclusions exceeded data
- Policy implications unfounded
- Dissenting voices not allowed to publish
Why was the dissent article important?
It challenged methodological bias, lack of generalizability, and exclusion of diverse evidence sources.
What is a limitation of only using RCTs in such reviews?
RCTs alone may not capture the complex, multimodal nature of clinical chiropractic care.
What sparked the Safer Care Victoria review?
Public complaints and media scrutiny over videos showing chiropractic care on infants.
What did the Safer Care Victoria review assess?
Evidence, safety, and regulation of pediatric manual therapy (e.g., SMT) in Australia.
What did the SCV review conclude?
Mixed/inconclusive evidence
- Need for more rigorous studies
- Rare adverse events
- Importance of regulation and reporting
What was the CBA’s response?
Emphasized evidence-based care, safety, consent, and professional conduct in pediatric care.
What is the ACA’s stance on pediatric care?
Advocates for more research and better education to avoid regulatory issues and support safe practice.
- What were the criticisms launched toward the methodology, results, and conclusions of the Global Summit?
Narrow evidence base (only 6 RCTs)
Excluded non-RCT evidence and supportive care (e.g., exercise, advice)
Generalized from small samples
Policy recommendations not discussed during the Summit
Dissenting authors silenced
P-values misused (p > 0.05 ≠ no effect)
Biological conditions lumped together inappropriately
- What were the primary recommendations from Safer Care Victoria pertaining to chiropractic pediatric care?
Acknowledge gaps in high-quality evidence
Encourage ongoing reporting and oversight
Require proper informed consent and communication
Promote further research into pediatric SMT effectiveness and safety
