A systematic review of systematic reviews of spinal manipulation [by] E. Ernst

See also  A systematic review of systematic reviews of spinal manipulation: responses 

I just came across an article about the Ernst piece, published in the London Times on April 15:
It works for me: chiropractic [by] David Mattin
Excerpt: A study by Edzard Ernst, the professor of complementary medicine at Exeter University, last month provided more ammunition for the sceptics. “There is little evidence that spinal manipulation is effective in the treatment of any medical condition,” he wrote in the Journal of the Royal Society of Medicine. His review of 16 previous studies claims that chiropractic is no better for back pain than conventional treatments. But David Reed, 40, a City banker and keen golfer, insists that chiropractic got him back on the tee after a DIY disaster in November.   Read the full article here. Here is the article by Edzard Ernst, published in the Journal of the Royal Society of Medicine
A systematic review of systematic reviews of spinal manipulation
    E Ernst and P H Canter
    J R Soc Med 2006;99 192-196.  Free full text

Objectives: To systematically collate and evaluate the evidence from recent systematic reviews of clinical trials of spinal manipulation. Design: Literature searches were carried out in four electronic databases for all systematic reviews of the effectiveness of spinal manipulation in any indication, published between 2000 and May 2005. Reviews were defined as systematic if they included an explicit and repeatable inclusion and exclusion criteria for studies. Results: Sixteen papers were included relating to the following conditions: back pain (n=3), neck pain (n=2), lower back pain and neck pain (n=1), headache (n=3), non-spinal pain (n=1), primary and secondary dysmenorrhoea (n=1), infantile colic (n=1), asthma (n=1), allergy (n=1), cervicogenic dizziness (n=1), and any medical problem (n=1). The conclusions of these reviews were largely negative, except for back pain where spinal manipulation was considered superior to sham manipulation but not better than conventional treatments. Conclusions: Collectively these data do not demonstrate that spinal manipulation is an effective intervention for any condition. Given the possibility of adverse effects, this review does not suggest that spinal manipulation is a recommendable treatment.
Correspondence to: Professor E Ernst
E-mail: Edzard.Ernst@pms.ac.uk

Free full text    View all chiropractic posts.


One Response

  1. Just back from the ACC/RAC conference and met with doctors who have done some extensive review of Dr. Ernst's work. He clearly is not ethical (Why? I really have no idea) and while he is a prolific writer he appears to have his own agenda which is not above falsifying data to satisfy his purposes, it appears.

    While maybe I shouldn't be surprised, I was quite shocked initially at the claims of the following authors and then astounded at the poor and anemic response to their criticism by Ernst.

    Morley J, Rosner AL, Redwood D A case study of misrepresentation of the scientific literature: recent reviews of chiropractic. J Altern Complement Med. 2001 Feb;7(1):65-78; discussion 79-82.

    "Accurate use of published data and references is a cornerstone of the peer-review process. Statements, inferences, and conclusions based upon these references should logically ensue from the data they contain. When journal articles and textbook chapters summarizing the safety and efficacy of particular therapies or interventions use references inaccurately or with apparent intent to mislead, the integrity of scientific reporting is fundamentally compromised. Ernst et al.'s publication on chiropractic include repeated misuse of references, misleading statements, highly selective use of certain published papers, failure to refer to relevant literature, inaccurate reporting of the contents of published work, and errors in citation. Meticulous analysis of some influential negative reviews has been carried out to determine the objectivity of the data reported. The misrepresentation that became evident deserves full debate and raises serious questions about the integrity of the peer-review process and the nature of academic misconduct."

    Comment in:
    J Altern Complement Med. 2001 Apr;7(2):127-8.
    J Altern Complement Med. 2001 Aug;7(4):307-9.
    J Altern Complement Med. 2001 Feb;7(1):1-3.
    J Altern Complement Med. 2001 Feb;7(1):13-4.
    J Altern Complement Med. 2001 Jun;7(3):220.
    J Altern Complement Med. 2001 Jun;7(3):223-4.
    J Altern Complement Med. 2001 Jun;7(3):224-5.
    J Altern Complement Med. 2001 Jun;7(3):225-7.
    J Altern Complement Med. 2001 Jun;7(3):227.

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