This article is of interest to the following WikiProjects:

Alternative medicine A‑class This article is within the scope of WikiProject Alternative medicine, a collaborative effort to improve the coverage of Alternative medicine related articles on Wikipedia. If you would like to participate, please visit the project page, where you can join the discussion and see a list of open tasks.Alternative medicineWikipedia:WikiProject Alternative medicineTemplate:WikiProject Alternative medicineAlternative medicine articles A This article has been rated as A-class on Wikipedia's content assessment scale. Skepticism A‑class High‑importance This article is within the scope of WikiProject Skepticism, a collaborative effort to improve the coverage of science, pseudoscience, pseudohistory and skepticism related articles on Wikipedia. If you would like to participate, please visit the project page, where you can join the discussion and see a list of open tasks.SkepticismWikipedia:WikiProject SkepticismTemplate:WikiProject SkepticismSkepticism articles A This article has been rated as A-class on Wikipedia's content assessment scale. High This article has been rated as High-importance on the project's importance scale.

Suggested wording: "Evidence-based guidelines" are supported by one end of an ideological continuum among chiropractors; the other end employs a priori assertions without scientific substantiation in what commentators about chiropractic describe as an "antiscientific" stand." Please comment. ☺ Coppertwig (talk) 02:15, 5 August 2008 (UTC)[reply]

That sounds very good. Speaking of a priori assertions, here's an interesting critical comment about them:

• “The whole concept of Innate of course rests on accepting on faith the basic premises without hope of any concrete proof. From a strictly scientific viewpoint, Innate must be rejected out of hand because it fails the most fundamental requirement of science, namely testability. From the standpoint of logic, the whole concept of Innate depends on the logical fallacy called word magic. Giving names and definitions to unprovable spiritual entities like Innate and soul cannot guarantee their existence.”
• From: Subluxation – the silent killer - Ronald Carter, DC, MA, Past President, Canadian Chiropractic Association, quoting from: Wardwell W. Chiropractic: History and Evolution of a New Profession. St. Louis: Mosby Year Book, 1992:29.

While that quote doesn't use the exact term "unscientific", it comes as close as is possible and certainly describes it. -- Fyslee / talk 06:28, 5 August 2008 (UTC)[reply]

Thanks. Ah: "unscientific", yes, I agree that that quote is saying that. But not what I would call "antiscientific". "Unscientific" to me means scientific reasoning is not being used. "Antiscientific" to me means they believe scientific reasoning should not be used: it may be a much smaller fringe who believe that. And I'm not sure I agree with the first sentence of the quote. You might as well say "The use of the word 'instinct' implies that scientific proof will not be used, therefore behavioural psychologists are unscientific;" that would be false, in my opinion. ☺ Coppertwig (talk) 12:05, 5 August 2008 (UTC)[reply]

Ugh! My bad. Of course unscientific and antiscientific aren't the same thing. I just lost track of the exact thread here. Consider it just another bit of information. "Unscientific" is a word that would be supported by far more RS. -- Fyslee / talk 13:44, 5 August 2008 (UTC)[reply]

That was 1992. We shouldn't confuse the lack of RCTs as being unscientific. Case studies were used a lot in those days and were acceptable first steps in the scientific process even in medicine in the previous decades. That eventually led to scholarly interest in spinal manipulation and then the subsequent RCTs which have been extensive since. So what is unscientific or antiscientific about that? The next step is to design studies to address the next hypothesis that spinal dysfunction can cause other health issues. This is more difficult, of course, and expensive, but they in the works now that the financing is coming (slowly). What is unscientific or antiscientific about that? The only thing that the "other end" of chiropractic has done is identify that there are flaws in studies that do not consider all the variables that are involved in any vital system, or should I say complex emergent system. I think that is called skepticism. I suppose there are those that believe that there is some sort of Intelligent Design involved, but that is not limited to chiropractors, nor is it an anti-intellectual position to hold, or anti-science (though unscientific might apply?). Keating: "We would not reject psychiatry as science on the grounds that Freud's theories of anxiety, repression, or the unconscious have not been adequately tested. We do not reject the meaningfulness of a science of medicine on the grounds that most medical procedures have not been experimentally validated. Nor should we apply such standards to chiropractic as a determiner of its scientific viability." -- Dēmatt (chat) 15:56, 5 August 2008 (UTC)[reply]

I don't think the lack of RCTs is the major issue here. You'll have to take up your dispute with Carter and the other chiropractors mentioned in the article, who in 1992 (and already much earlier), based on the current data at the time and the obvious pseudoscientific nature of some traditional metaphysical chiropractic beliefs ((IOW evidence wasn't an issue and basically could (almost...;-) never be an issue in such cases)), were already criticizing the profession for not listening to the existing evidence and not attempting to catch up with it. Osteopathy had done that many years before, but chiropractic hadn't done it at the time, and still hasn't (unlike Osteopathic medicine) officially distanced itself from those original foundational beliefs. What is happening is a gradual slide towards science, but done in such a manner as to not wake too much notice. It would be damaging for the profession to openly admit it had been based on a fictive belief, and had been warned for a long time, but hadn't heeded the warnings. It's as if there is a hope that mainstream medicine won't notice the history, and will just accept a newer version "scientific" of chiropractic, without the majority of older (and younger) chiropractors being forced to give up their old beliefs. Division is seen as harmful to the profession. Maybe when enough of the old guard are gone from their leadership positions it will happen, but I really doubt it. -- Fyslee / talk 20:25, 5 August 2008 (UTC)[reply]

I don't think the lack of RCTs is the major issue here. I guess your right, otherwise half of medicine would be called pseudoscience. I think that is really the point here afterall; that mainstream is slowly moving toward chiropractic just as chiropractic is moving toward a more scientific explanation of what they do. The issue is whether chiropractic is a safe and effective way to treat patients as compared to the alternative which would be drugs or surgery. The super straights are definitely being dragged into mainstream, but they don't seem to want to give up their beliefs. The question is whether they have to (or should)? I guess that is why we need to make sure to remain NPOV. We need to make sure both (all) POVs are stated fairly without taking sides. If one side uses pejoratives, that is their choice, but wikipedians should recognize it as just that. We should explain that POV without the pejoratives. It's not that hard. If I wanted to call someone a "bastard", I could probably convince more to my side if I said that that person "stole my wife". Then he could either call me a "dick" or explain that I "wasn't paying attention to her." Then the reader could decide for themselves by wieght of the arguments. -- Dēmatt (chat) 15:33, 6 August 2008 (UTC)[reply]

Coppertwig, do any of the sources explicitly draw a relationship between Evidence based guidelines and the use of antiscientific reasoning. I have been looking and can't put the two together, I find that both sides have guidelines, but they disagree with each other. This is the web site for one side CCGPP and this is a powerpoint review of the straight's guideline process CCP. They both look reasonable. Keating's antiscience comment was made from the CCGPP group talking about the CCP group. -- Dēmatt (chat) 16:16, 5 August 2008 (UTC)[reply]

No, I didn't see any of the sources mentioning evidence-based guidelines in that context. I didn't write the first half of the sentence: I just copied what was there. Maybe the first half of the sentence needs to be reworded. The quotes I collected were focussed on the second half of the sentence and the "antiscientific" idea. Now we need to collect quotes about the scientific end. ☺ Coppertwig (talk) 12:48, 8 August 2008 (UTC)[reply]

That sounds reasonable. Yes, I think your version is an improvement over what is in there now. I still want to look at the EBM part of that sentence and then want to look at the "antiscientists" POV. -- Dēmatt (chat) 13:13, 8 August 2008 (UTC)[reply]

Thanks, Dematt. Well, if I'm subtracting correctly it's been over 3 days, and no one has objected ^{(17:14, 9 August 2008 (UTC))} to replacing what's there now with my suggestion at the top of this section, so I'm going ahead. We can continue to work on improving it; I think this version is better and meets the objection that it wasn't only Keating that said something like that. ☺ Coppertwig (talk) 13:20, 8 August 2008 (UTC)[reply]

There was an objection.[1] The current text has been watered down even more and it is hard to understand. The prior version only had the misleading text about only one researcher. The new text is worse. QuackGuru 17:54, 8 August 2008 (UTC)[reply]

Dear QuackGuru, I apologize for saying there was no objection and have struck out some of my words. I knew you didn't like the new text, but I also knew you didn't like the prior version. I'm sorry that I didn't understand that you thought the new text was worse. Thank you for your patience and calm manner in correcting my error. Here's another suggestion; I'm not sure if some aspects of this version have already been objected to by other editors or not; I welcome comments: ""Evidence-based guidelines" are supported by one end of an ideological continuum among chiropractors; the other end uses what chiropractic commentators describe as unsubstantiated claims and "antiscientific" reasoning." ☺ Coppertwig (talk) 17:14, 9 August 2008 (UTC)[reply]

We are discussing this matter.[2] The problems with the current text is worse than the previous text. The above proposal is readable. Here is a quick suggestion. Revert back to the previous version and focus only on improving the misleading part claiming it was only Keating. Just rewrite the Keating part and not the entire sentence. There is one thing missing from all of theses proposals by Coppertwig. There is the middle of the spectrum. QuackGuru 17:30, 9 August 2008 (UTC)[reply]

Thank you, QuackGuru. I had essentially done what you just suggested, though without actually reverting the article: I had gone back to the previous version and modified it to get the suggestion above. It seems to me that you're indicating that that last suggestion is better than the current or previous version. We need to wait for comments from others before putting it into the article; meanwhile feel free to suggest other versions. OK, maybe we need to say something about the middle. Do we have enough quotes from sources for that? Would you like to suggest some words about the middle? Also, the "evidence-based" end still needs work. ☺ Coppertwig (talk) 18:37, 9 August 2008 (UTC)[reply]

Here's a version; I think the only problem is that the sentence is now too long! "An idealogical continuum among chiropractors stretches from support for "evidence-based guidelines" at one end, through such principles as vitalism, holism and rationalism, to the use of what chiropractic commentators describe as unsubstantiated claims and "antiscientific" reasoning: a system of belief which commentators have called "ethically suspect" when practitioners' beliefs are to patients' detriment." ☺ Coppertwig (talk) 22:40, 10 August 2008 (UTC)[reply]

All this attribution is making the sentence longer. It would be easier to read if we left out the attribution. The reference is the attribtution anyhow. I don't understand the reason for having the quote marks. The text is verified. I think we can remove the quote marks. QuackGuru 02:44, 11 August 2008 (UTC)[reply]

Characterizing a subset of chiropractors as "antiscientific" sounds like an opinion to me, not a fact. If it's a fact, then it's not just a word, but something about the real world that can be expressed in different words. What do you think it means? Perhaps it could be stated, without prose attribution, in different terms which would seem to have a NPOV tone. I think "antiscientific" has multiple meanings, some of which are not accurate descriptions of the subset of chiropractors being talked about. ☺ Coppertwig (talk) 23:13, 13 August 2008 (UTC)[reply]

"Antiscientific" is the most common word used by reliable sources to refer to this phenomenon; we shouldn't shy away from the word, or insist on putting it in quote marks, simply because some Wikipedia editors think it's unpleasant. In Chiropractic the word "antiscientific" has its usual meaning, as described in Antiscientific: it describes a position that is critical of science and the scientific method. What other meanings did you have in mind? Eubulides (talk) 18:37, 14 August 2008 (UTC)[reply]

I thought Gleng had referred to more than one definition. In any case, if we can establish that chiropractors from that end of the spectrum refer to themselves as "antiscientific", then it can be considered NPOV terminology; otherwise, it's an opinion expressed by outside commentators.

Here's a suggested version with shorter sentences: "Chiropractic ideology stretches along a continuum. At one end is support for "evidence-based guidelines". Many types of principles, such as holism and naturalism, are found in the middle of the spectrum. The other end uses what chiropractic commentators describe as antiscientific reasoning and unsubstantiated claims; commentators have called this system of belief "ethically suspect" when practitioners' beliefs are to patients' detriment." ☺ Coppertwig (talk) 02:41, 15 August 2008 (UTC)[reply]

• It is bizarre to quote a phrase like "evidence-based guidelines". What's next? Why not quote "profession" and "diagnosis" while we're at it? Why not put quote marks into Chiropractic's lead sentence so that it ends up something like the following?

Chiropractic is a health care "profession" that focuses on "diagnosis", "treatment", and "prevention" of mechanical "disorders" of the musculoskeletal system and their "effects" on the nervous system and "general health", with special "emphasis" on the spine.

These questions are not entirely rhetorical: I fail to see any rhyme or reason to the overquoting being proposed. If the rule really is "If some editor thinks someone disagrees with a claim, then put the claim in quote marks." then large chunks of Chiropractic will eventually be quoted, which is silly. If the rule is something else, then I honestly don't know what it is.

• It is not at all necessary to 'establish that chiropractors from that end of the spectrum refer to themselves as "antiscientific"'. It is not our job to worry about the sensibility of fringe practitioners. It is not the job of someone proposing text to prove that it's NPOV; if that were the case, no text could ever be added to Wikipedia.
• All that is necessary is to use terminology used by reliable mainstream consensus sources. "Antiscientific" and "evidence-based guidelines" and "ethically suspect" are part of the mainstream consensus, and Chiropractic is inaccurately presenting the consensus when it puts quote marks around those phrases, just as it would be inaccurate if Chiropractic quoted terms like "profession" and "diagnosis" in the lead sentence.
• To get to the suggested wording: like Chiropractic, that version suffers from the problem that it incorrectly suggests that holism and naturalism are common in the middle of the spectrum but rare at the ends. On the contrary, holism is shared by most chiropractors of all persuasion.
• Furthermore, holism and naturalism are not that relevant in the context of the sentence, which is talking about evidence-based guidelines, their opponents, and proponents. (The current wording also shares this problem.)
• Furthermore, the proposed wording fits even worse into the context, which is talking about evidence-based medicine and guidelines.
• Furthermore, like the current wording, the suggested wording incorrectly talks about "a system of belief". The sources don't say that antiscientific reasoning and unsubstantiated claims are "a system of belief". They say that Palmer's Postulates are a system of belief, but that's quite a different thing.
• Furthermore, like the current wording, the suggested wording talks about "when practitioners' beliefs are to patients' detriment", which doesn't accurately summarize what the source actually says (namely, "when they allow the practitioner to maintain a 'faith, confidence and belief' in that paradigm to the patient's ultimate detriment").
• In short, the recent rewording has made this passage substantially worse: it has caused the passage to stray from the sources, and has introduced material that doesn't belong in a section on evidence basis.
• With all the above in mind, I suggest the following wording instead:

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

Eubulides (talk) 09:27, 15 August 2008 (UTC)[reply]

Whether it is fact or opinion is rather irrelevant. We include both as long as they are well-sourced. Unless it is basic and incontrovertible common knowledge, it needs attribution since Wikipedia is not about truth, but about well-sourced facts and opinions. -- Fyslee / talk 06:37, 15 August 2008 (UTC)[reply]

I agree that opinions and facts need sourcing; I disagree that the use of terms like "antiscientific" or "ethically suspect" requires quote marks or in-text attributions when the opinions containing those terms are not controversial (which they are not, among reliable sources). Eubulides (talk) 09:27, 15 August 2008 (UTC)[reply]

I don't like seeing too many individual words being in quotes. I'd rather see the whole sentence or sentences, which we can do under fair use, and we do all the time here at Wikipedia. There is no rule against it if done properly. We can sometimes abbreviate the quotes by ..... out the superfluous parts, leaving only the point we are trying to bring out in that section.

There are at least two reasons for using the quotes, one of which is reasonable, and the other a compromise because of editorial disputes if we don't. NPOV demands that we ensure that readers don't mistake what is written for editorial opinion. It must be clear it is the opinion of a source. That's not necessary when it's incontrovertible common knowledge. Unfortunately chiropractic patients, many chiropractors, and certain editors here consider obvious facts (to the mainstream) to be controversial, so we need to do it for them. This is also educational. That compromise also helps to defuse edit wars. Yes, it's a compromise, but the article needs to be written "from" all POV, and "to" all POV. Such a compromise won't hurt anything. -- Fyslee / talk 20:06, 15 August 2008 (UTC)[reply]

If the sources are using the Wikipedia definition of "antiscientific", then we can paraphrase it: "the other end is critical of science and the scientific method".

Here's an argument that "antiscientific" is not neutral in tone: One test for whether something is neutral in tone is whether it's used by people on both sides of a controversy. I argue that it's rare or nonexistent for anyone to characterize their own position as "antiscientific", and to support that: "unscientific" has 50 times as many Google hits as "antiscientific", but the two-word combination "our unscientific" has about 2000 times as many Google hits as "our antiscientific", and the 4 hits for the latter are all things like "our antiscientific opponents", i.e. are not about people calling their own views antiscientific. Similarly, "unsubstantiated claims" is not neutral in tone. I can see someone saying "what I'm saying is not supported by scientific evidence," but not likely "I'm making an unsubstantiated claim". "Claim" is listed in WP:Words to avoid.

Putting quote marks around something can't be "inaccurate" if the phrase is a correct quote.

By the way, I support this edit which inserts a prose attribution elsewhere: good NPOV edit, Eubulides. For the continuum sentence we're working on: actually, I'm OK with leaving off the quotation marks as such, as long as the prose attributions are there (e.g. "what commentators describe as..."). Again: NPOV requires a neutral tone, and that Wikipedia doesn't assert opinions.

I suggest the following, which I think addresses some of Eubulides' points: Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end uses what chiropractic commentators describe as unsubstantiated claims and antiscientific reasoning, which commentators have called "ethically suspect when they allow the practitioner to maintain a 'faith, confidence and belief' in that paradigm to the patient's ultimate detriment"." Or alternatively, "Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end uses what chiropractic commentators describe as unsubstantiated claims and antiscientific reasoning, which commentators have called ethically suspect when they let practitioners maintain their beliefs to patients' detriment.", which includes wording you had put in, Eubulides, for the ethics part, although I added prose attribution. ☺ Coppertwig (talk) 03:30, 16 August 2008 (UTC)[reply]

Let me start with a preliminary comment. Your closing wording seems pretty good, at least on a quick read through, and my further comments here should be taken as separate comments about your other remarks.

I feel that several straw men are being introduced.

• You write: "NPOV requires a neutral tone, and that Wikipedia doesn't assert opinions." Whatever it is you may mean, NPOV doesn't require that all content be neutral in tone. On the contrary. Yes, "'antiscientific' is not neutral in tone." So what? The tone of the authors should be preserved. We as editors should be neutral in our tone. We should not introduce our opinions and twistings of wordings to neutralize non-neutral sourced wordings. That would be improper editorializing. We should just be true to our sources. If we twist the POV wordings of our sources into something "neutral", we have violated NPOV by introducing editorial bias, IOW we are making "Wikipedia ... assert opinions." If we do that, why use sources? We use them to document that the precise opinions and wordings of the sources actually exist. It is not Wikipedia who is asserting an opinion, it is our sources.
• You also write: "it's rare or nonexistent for anyone to characterize their own position as "antiscientific"" Indeed. That would be expecting a near impossibility, which would be unusual and unreasonable. It's a straw man. We couldn't care less how they characterize "themselves" in this particular setting. We are documenting that critics say it, and that happens all the time. BUT...BUT, in this case chiropractic critics (so much for them not describing themselves as "antiscientific"! Wow! That's amazing) are actually doing that, which makes the case extremely strong. Chiropractors will brush off the accusations of outside critics as further evidence of an AMA conspiracy. It is much harder when it is chiropractic's leading historian, along with a chiropractic university president, a few professors, and some researchers, who are all saying it. THAT must not get lost in our furvor to NPOV everything by editiorially defusing the impact of what these chiropractors are saying about what is going on in their own profession.
• This reminds me of another similar situation, where accusations of quackery have been levelled at the profession since its inception, and promptly denied by the profession. Well, when the president of the American Chiropractic Association tried to claim that such claims were a myth, Keating immediately wrote a heated letter to the editor, in which he directly addressed the deception being perpetrated by the president: "The so-called "quackery myth about chiropractic" is no myth. If anyone doubts the continuity of quackery in the profession, he has only to turn to pages 31 and 35 of the same issue of Dynamic Chiropractic." and "It escapes me entirely how Dr. Downing, the ACA, MPI, and Dynamic Chiropractic can suggest that there is no quackery in chiropractic. Either these groups and individuals do not read the chiropractic literature or have no crap-detectors. I urge a reconsideration of advertising and promotion policies in chiropractic."[3] Note that Keating uses Jarvis of the National Council Against Health Fraud (NCAHF) as a source, since he knew that the NCAHF and Jarvis (it's then-president) were (and are) highly recognized experts on the subject of quackery, and they were correct about chiropractic. Chiropractic was (and is, IMO) filled with quackery. Keating was eulogized with these words: "Keating never varied in championing the good, ridiculing the quackery, and in urging us to explore and empirically test chiropractic."[4]

(Note that these are RS and can be used.) Other sources on this subject: [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16]

BTW, I have used wiki indents instead of your "br" breaks, since this makes it easier to find line breaks, at least for me. I hope you don't mind. It shouldn't make any visible difference.

Please remember that my remarks aren't about your final wording. That would take more study by me before I'd give a final opinion on them. -- Fyslee / talk 07:13, 16 August 2008 (UTC)[reply]

It's fine if the word "antiscientific" is there, tone and all, as long as it's with prose attribution. If it were there as a direct Wikipedian assertion, that's when the tone would be a problem. WP:NPOV#Impartial tone says "The tone of Wikipedia articles should be impartial, neither endorsing nor rejecting a particular point of view." With an earlier version that baldly stated that one end of the spectrum was "antiscientific", I found it jarring: I would be reading along, thinking, yes, this sounds like a normal Wikipedia article, and then suddenly, "Hey, what's this doing here? This doesn't sound like Wikipedian tone at all. This sounds like something that's just been added and hasn't been reverted out yet." It's not a disagreement with what's being claimed, only with the way it's stated. Similarly, the word "quackery" is non-neutral in tone. If it's proven or admitted that someone knowingly made false claims, a Wikipedia article can state that the person "knowingly made false claims", but not, in my opinion, that they engaged in "quackery" (without prose attribution) even if it means the same thing: the word "quackery" is generally used only by critics. OK, I'll use indents in preference to line breaks. ☺ Coppertwig (talk) 12:28, 16 August 2008 (UTC)[reply]

I think we are basically in agreement. Readers shouldn't be in doubt about who says what, especially about controversial or strong wordings. In this case, we have leading chiropractors and leaders criticizing what they see going on in their own profession. They admit the outside critics are correct and they want to clean chiropractic up and make it acceptable. They know that this type of behavior, which is very traditional, needs to stop. Only then will they be able to get the cultural authority they desire. Another leader who makes the same points is Carter, a former president of the Canadian Chiropractic Association, who replies to a common claim "Subluxation – the silent killer", by showing how claims[17][18] about vertebral subluxations are killing the profession. Of course he is siding with Keating who describes how damaging "chiropractic gobbledygook", "shenanigans", and "outrageous claims" [19] are for the profession. (More RS...!) -- Fyslee / talk 15:09, 16 August 2008 (UTC)[reply]

(Handshake.) ☺ Coppertwig (talk) 15:47, 16 August 2008 (UTC)[reply]

Antiscientific: suggested rewording 2

Coppertwig's last proposal:

Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end uses what chiropractic commentators describe as unsubstantiated claims and antiscientific reasoning, which commentators have called ethically suspect when they let practitioners maintain their beliefs to patients' detriment.

still has problems.

• It says "commentators" twice, which is overkill.
• In the context where someone is saying something, "commentator" is an empty word. It is the same as saying "someone". It would be better to reword the sentence to avoid this empty word.
• The phrase "chiropractic commentators" isn't accurate, as not all the "commentators" in question are chiropractors. Notably, Keating himself was not a chiropractor. Other non-chiropractor "commentators" have made similar points, e.g., Cooper & McKee 2005 (PMID 12669653), or Giordano in Giordano & Keating 2005 (doi:10.1016/j.jmpt.2004.12.018).
• Perhaps the phrase "chiropractic commentators" was intended to mean "commentators on chiropractic" rather than "commentators who are chiropractors"? If so, the phrase is still empty: in the context of someone making comments it still just means "someone". Either way, the phrase is ambiguous, which is to be avoided.
• Here is a proposed rewrite that addresses the above issues, while (I hope) still addressing the issue of not making the opinion seem to be that of the Wikipedia editors.

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

Eubulides (talk) 07:28, 17 August 2008 (UTC)[reply]

No comment, so I installed that rewrite. Eubulides (talk) 21:32, 21 August 2008 (UTC)[reply]

Silence does not imply consent. This version you installed is flawed because it lacks necessary attribution. Please wait for some consensus before re-installation. -- Levine2112 ^discuss 21:52, 21 August 2008 (UTC)[reply]

As an outsider, I think ScienceApologist may have offered the clearest suggestion thus far. [20] -- Levine2112 ^discuss 22:24, 21 August 2008 (UTC)[reply]

No, unfortunately, the combined pair of edits introduced several problems.

• It duplicates the phrase about "ethically suspect". Surely this is not intended.
• It removes the clear connection about the "ethically suspect" phrase, and the source that supports it (Nelson et al. 2005, PMID 16000175). Surely this is not intended either.
• It introduced the word "detractors" without making it clear that the "detractors" in question are criticizing straight chiropractic dogma, not chiropractic in general. (Almost all the "detractors" are chiropractors.)
• It introduced the phrase "Critics have described guidelines that are not evidence-based as being ethically suspect" but the source does not talk about "guidelines that are not evidence-based", it talks about "stratagems to avoid the truth that Palmer's Postulates are unproven", which is quite a different thing.
• It introduces the phrase "run the risk", but the source doesn't talk about risk in this context.
• The version I suggested does have the necessary attribution. It cites its sources. And as a concession to the Simon-says style, preferred by some editors here, it has an "are considered" phrase to make it clear that we are talking about the sources' opinion, not Wikipedia's opinion.
• Given the above problems, some of which are serious mischaracterization of the sources, I again suggest the phrasing proposed above; it does not suffer from those problems. If there's some way that the phrasing is unclear, which is what ScienceApologist seemed to be suggesting in the change log, it would be helpful if it could be explained why it's unclear.

Eubulides (talk) 22:42, 21 August 2008 (UTC)[reply]

I agree that SA's edit made the text no longer match the source. However, I believe that "chiropractic commentators" should be put back in. I don't see this as being vague, I see it as clearly describing people who are commenting about chiropractic. - DigitalC (talk) 23:25, 21 August 2008 (UTC)[reply]

Thanks for your comment. If your interpretation is correct, then the phrase is empty; for example, "what chiropractic commentators describe as [something about chiropractic]" means "what people who are saying something about chiropractic say is [something about chiropractic]". Also, putting that same empty phrase twice in the same sentence is overkill, surely. Eubulides (talk) 23:46, 21 August 2008 (UTC)[reply]

I think that if we changed "commentators" to "critics", this may solve the issue - though I don't think this is that big of a deal. -- Levine2112 ^discuss 23:50, 21 August 2008 (UTC)[reply]

Critics is original research. QuackGuru 23:59, 21 August 2008 (UTC)[reply]

I don't think it needs to be included twice. However, some form of attribution is necessary to determine WHO considers it unsubstantiated claims. - DigitalC (talk) 00:27, 22 August 2008 (UTC)[reply]

Agreed. -- Levine2112 ^discuss 00:28, 22 August 2008 (UTC)[reply]

The Simon-says style is problematic unless you know who the Simon is that is saying something. Better to follow something like WP:ASF. The term "anti-science" is a bit novel, implying, according to our page on on the subject, both non-scientific ideas and direct opposition to scientific ideas. Why not simply say this? Guidelinese which are not evidence-based are neither based upon science and oppose scientific ideas. If this isn't what the reader is supposed to get out of this sentence, then what is it?

The nonsense about chiropractic commentators has to go. It is a meaningless phrase. My idea for phrasing would be to say something along the lines of what non-evidence based chiropractic guidelines are (in relation to scientific evidence, for example) and what the risks associated with those guidelines are. Please just state the facts plainly and clearly. Try to avoid WP:FRINGE#Particular attribution.

ScienceApologist (talk) 15:31, 22 August 2008 (UTC)[reply]

• I agree about "chiropractic commentators" of course. The current wording is "chiropractic researchers", which isn't that much better and in some sense is worse. Wikipedia is not supposed to say "researchers say".
• The original sources say "antiscience". If we were to expand this into a discussion of nonscientific ideas and direct opposition to scientific ideas, we'd be going beyond what the sources all say. If we focus on what just one source says (Keating, say) then we'd leave the impression that only Keating thinks that way. If we focused on what Keating said and then mentioned lots of other sources that agree, it'd get pretty long, but I suppose we could do it that way if there is consensus. (Consensus on this page! Hah!)
• Talking about chiropractic guidelines would be reasonable. Here is a proposal to do that: append the following wording to the lead paragraph of Chiropractic #Evidence basis:

Assessments of three major chiropractic treatment guidelines found that the Mercy guidelines (1993)^[1] are mostly valid but rely on dated scientific studies, that the 1998 version of the Council on Chiropractic Practice guidelines^[2] fail to address scientific evidence objectively, and that the International Chiropractors Association guidelines (2000)^[3] conflict with scientific evidence; the latter two guidelines were assessed as not suitable for use in clinical practice.^[4]

Eubulides (talk) 18:46, 22 August 2008 (UTC)[reply]

Two problems: "are considered" sounds a little too strong to me, as if everyone considers it; and the ethics part seems to being asserted without prose attribution.

Two more suggestions, trying to take your points into consideration:

"Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end uses what researchers about chiropractic describe as unsubstantiated claims and antiscientific reasoning, and have called ethically suspect when they let practitioners maintain their beliefs to patients' detriment."

"Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end uses what are described as unsubstantiated claims and antiscientific reasoning and have been characterized as ethically suspect when they let practitioners maintain their beliefs to patients' detriment."

I'm OK with putting in stuff about the middle of the spectrum. I oppose the use of words like "strategy" or "tactic" without prose attribution in connection with the ethics here (and I'm not sure the source used these words anyway); these words seem to imply that people are purposely believing things in order to achieve some goal, and therefore are not NPOV here since that's not a verifiable fact.

In any case, QuackGuru, please don't put in statements about ethics without prose attribution: it's a violation of NPOV. Wikipedia doesn't make assertions about what is or is not ethical. ☺ Coppertwig (talk)

The source (which you can follow; it's freely readable) says "strategem". If we're going to use prose attribution, which is what your proposals above are using, then we should use the words used by the source rather than watering them down. So I propose the following wording instead, based on your second suggestion:

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

Eubulides (talk) 09:33, 24 August 2008 (UTC)[reply]

That sounds excellent. When in doubt, quote the source. -- Fyslee / talk 17:41, 24 August 2008 (UTC)[reply]

Eubulides, you write above: "I agree about "chiropractic commentators" of course. The current wording is "chiropractic researchers", which isn't that much better and in some sense is worse. Wikipedia is not supposed to say "researchers say"." I'm not sure what you mean. "Chiropractic commentators" can mean anybody, including non-chiropractors, and is thus too vague. My substitution, "chiropractic researchers", describes the authors of the research. That's pretty neutral and is specific attribution, IOW it states they are from within the profession in one way or the other. (Keating wasn't himself a chiropractor, but a professor and its foremost historian.) When describing criticisms, it is especially important to state just who is doing it, hence my substitution. That substitution isn't a general "researchers say" (for lack of anything better to say), but is specific attribution and thus a desirable wording in this case. If that weren't the case, your observations would be on target. -- Fyslee / talk 20:41, 22 August 2008 (UTC)[reply]

I don't think we've established that Keating was a chiropractor. ☺ Coppertwig (talk) 21:56, 22 August 2008 (UTC)[reply]

Oops! Of course you're right. The phrase, strictly speaking, doesn't have to mean that each of the performers of the research is a chiropractor, but that they are from the chiropractic side of the fence, so to speak. I'll revise the above to avoid further misunderstandings. Keating was never a chiropractor, but a chiropractic professor in several schools and the premier historian for the profession, holding several positions of trust and honor. I don't think we need to change that wording, unless you think it might be misunderstood. If so, we should tweak it. We could even use the reference text to state the positions of each author, which is a pretty prestigious list of notables in the profession. -- Fyslee / talk 01:12, 23 August 2008 (UTC)[reply]

"Chiropractic researchers" can easily be misunderstood to mean researchers who are chiropractors. But even if we reword it as "researchers into chiropractic", or something like that, it's still an empty phrase. Wikipedia should not use phrases like "researchers say" or "scientists say". Eubulides (talk) 09:33, 24 August 2008 (UTC)[reply]

Okay....then what should we say? We need an accurate and unambiguous form of attribution. How about:

"... what is considered by several notable researchers within the profession many chiropractic researchers to be..."? (Italics are the newer wording.)

That's very accurate and certainly unambiguous. The only way to get more specific without OR is to actually name them and their prominent positions (possibly as text in the ref). It's quite the list. I have communicated with more than one over the years and they're amazing people who are fighting an uphill battle. -- Fyslee / talk 17:41, 24 August 2008 (UTC)[reply]

(outdent) The problem with this wording, as with any wording like "chiropractic researchers" and "researchers into chiropractic", is that it makes it sound like only DC researchers, or researchers whose research topic is chiropractic, share the opinion that some chiropractors have antiscientific beliefs. But this is far from the case; it's a mainstream opinion, which is shared by many eminent researchers that fall into neither category, including Arthur Kornberg, Baruj Benacerraf, Cornelis de Jager, Eugenie Scott, Martin Gardner, Kendrick Frazier, Mario Bunge, Elie Shneour, and Antony Flew. See Kondro 1999 (PMID 10075565) and DeRobertis et al. 1999. Hence my proposal avoids the phrases in question. Eubulides (talk) 22:05, 25 August 2008 (UTC)[reply]

I started to review the 2nd paragraph of the body of Chiropractic for Simon-says issues, and immediately ran into a more serious problem: the 2nd paragraph is not at all supported by the cited source. Here's the 2nd paragraph:

Chiropractic philosophy goes beyond manipulating the spine. Like naturopathy and several other forms of complementary and alternative medicine, chiropractic assumes that all aspects of a patient's health are interconnected, which leads to the following perspectives:^[5]

However, the cited source does not say that chiropractic philosophy goes beyond manipulating the spine. Nor does it say that naturopathy and several other forms of CAM assume that all aspects of a patient's health are interconnected. Nor does it say that chiropractic assumes that all aspects of a patient's health are interconnected.

Some variant of the 2nd paragraph's claims can no doubt be supported by reliable sources somewhere, but in rereading the paragraph, I don't see how it adds anything to the text: the previous paragraph already made the point that chiropractic philosophy goes beyond manipulating the spine, and the next bullet talks about holism, which is the theory that aspects of a patient's health are interconnected. So the 2nd paragraph is redundant. Worse, the wording in the 2nd paragraph is that of a sales pitch for chiropractic, which is to be avoided in an encyclopedia article. Therefore, I propose replacing the 2nd paragraph with this:

Chiropractic philosophy includes the following perspectives:^[5]

Eubulides (talk) 21:11, 14 August 2008 (UTC)[reply]

No further comment, so I made the change. Eubulides (talk) 22:48, 20 August 2008 (UTC)[reply]

In reviewing #Simon-says in 2nd sentence, I noticed a similar problem in the lead's summary of that sentence. The first sentence in the lead appears to endorse the chiropractic theory that mechanical disorders of the musculoskeletal system have a leading role in general health. The cited source talks about this theory in its section "What is the Chiropractic Hypothesis", so I propose the following simple solution, supported by the source, which is to add the word "hypothesized" to the lead sentence, as follows (the added word is italicized):

Chiropractic (from Greek chiro- χειρο- "hand-" + praktikós πρακτικός "concerned with action") is a health care profession that focuses on diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system and their hypothesized effects on the nervous system and general health, with special emphasis on the spine.^[6]

Eubulides (talk) 22:11, 14 August 2008 (UTC)[reply]

That sounds pretty good. One other quibble..... why not move this part (from Greek chiro- χειρο- "hand-" + praktikós πρακτικός "concerned with action") to the footnotes? It makes for difficult reading. I wish we would make that the standard in Wikipedia articles. Many of them suffer from this ugly stuff. -- Fyslee / talk 06:44, 15 August 2008 (UTC)[reply]

To help with the quibble I moved the etymology to a quote box. Eubulides (talk) 09:27, 15 August 2008 (UTC)[reply]

Beautiful solution! The lead reads much better know. -- Fyslee / talk 20:12, 15 August 2008 (UTC)[reply]

No further comment, so I made the change. Eubulides (talk) 22:48, 20 August 2008 (UTC)[reply]

This change introduced the following quote within a citation:

'Conclusion: The majority (69%) of the chiropractors in this sample rejected being characterized as CAM practitioners, showing some preference for the term IM (27%).'

This quote is slightly incorrect (it doesn't match the source), but more importantly it's not needed. It simply mimicks what is in the main text, which is this:

'A 2008 survey stated that 69% of DC chiropractors disagree with the categorization of chiropractic as CAM, with 27% having some preference for the term "integrated medicine."'

The quote in question is freely readable. This sort of style is not at all needed, and if used consistently would double the length of the article.

It is useful to include quotes at some times, if the source is not freely readable and the point is controversial or obscure. But this isn't one of those cases, so I reverted the change.

Come to think of it, perhaps the use of quote= could overcome our impasse over how to attribute words like "antiscientific" that are controversial to some editors here. Eubulides (talk) 19:30, 16 August 2008 (UTC)[reply]

It may be controversial to some editors but it is NOT controversial among reliable sources. We should edit according to the sources. Reference number nine has quotes that should be removed. The text should explain what type of ideas (pseudo-scientific) that are barriers to chiropractic and not in a footnote. QuackGuru 19:39, 16 August 2008 (UTC)[reply]

The part about ideas is still vague. Me thinks the reader will be left in the dark about the kind of ideas that are barriers to chiropractic. This should first be explained in the text and not in the footnote. QuackGuru 17:53, 17 August 2008 (UTC)[reply]

I don't see inappropiate vagueness here. The text accurately summarizes what the source says; the source gives one example, and the lead does too. The footnote doesn't give any more examples than the source does. (I think the quote in the footnote is unnecessary, but it's not a big deal either way.) This is the lead, after all: it's supposed to briefly summarize the source. The lead shouldn't go into a lot of detail. Eubulides (talk) 21:02, 18 August 2008 (UTC)[reply]

I know this is late, but the quote happens to be exact. It is a perfect reproduction of the conclusion, including the word "conclusion" itself. You can't follow the source more closely than quoting its conclusion. -- Fyslee / talk 20:23, 22 August 2008 (UTC)[reply]

This edit introduced a qualifier "in one study" that is not needed within the context in the lead. The body already explains the fact that it's one study; it's not necessary to emphasize that in the lead. The study shows that an overwhelming majority of those surveyed reject the CAM label for chiropractic. It was just a survey, of course, but in that particular context the phrase "in one study" makes it look like the overwhelming consensus is that chiropractic is CAM, and that there's just one leeetle study that contradicts the consensus; but this is an inaccurate summary of the situation. Let's remove that phrase from the lead.

The edit's log message said "only one study of a limited group (did it include both straight and mixer schools?)". The people surveyed included "all D.C. faculty at 3 institutions and all the practitioners in a PBRN [chiropractic practice-based research network] database, and the institutions were in 3 widely diverse geographic areas. In terms of the representativeness of the philosophical position of the respondents, NUHS and SCUHS are considered to be on the liberal end of the spectrum of chiropractic philosophy, and Cleveland is considered to be on the conservative side of the spectrum, although not at the extreme end. Thus our sample may represent some bias toward a more liberal philosophy." So it's safe to say that this was a survey of mainstream chiropractic, and not the fringe straights. However, even if all straights think chiropractic is CAM (an extremely unlikely hypothesis), this would not overturn the conclusion that most chiropractors dispute the characterization of chiropractic as CAM. Eubulides (talk) 19:48, 16 August 2008 (UTC)[reply]

This further set of edits (again, made without discussion in advance) simply makes this worse in this regard. This is the lead! It is not the place to get bogged down in details like that, and to give a misleading summary of the details to boot. I made this change to solve the problem in a much more succinct way (basically, changing "most" to an inarguable "many"). The lead should summarize the body: it shouldn't contain details that are not in the body. Eubulides (talk) 07:28, 17 August 2008 (UTC)[reply]

You are reading far more into my qualifier than is implied, and than would necessarily be understood by others. Let's avoid hyperbole here. Just make sure that the impression isn't given that the survey participants consider chiropractic to be mainstream. On the contrary. Only "20% of practitioners and 6% of faculty considered chiropractic mainstream medicine." The study is only one study, with a poor reply rate, covering only part of the profession, the liberal part at that. It is very unrepresentative. It would be improper to extrapolate the results to the whole profession. The "fringe" is not a small percentage and is part of the whole. It has a much greater influence than its numbers would imply. That (degree of "influence") is from a RS. A truly representative survey would have included all schools and types of chiropractors. It is just "one study", which implies nothing more than that one shouldn't put more confidence in it than it is worth. Yes, it "would not overturn the conclusion that most [of the surveyed] chiropractors dispute the characterization of chiropractic as CAM." Yet IM is part of CAM! One can't read more into it than that. Extrapolation would be improper. To balance what's now included, maybe we should include the part that says that only "20% of practitioners and 6% of faculty considered chiropractic mainstream medicine." And that's liberal chiros speaking! That is a staggering minority. -- Fyslee / talk 06:42, 17 August 2008 (UTC)[reply]

Thanks for the comment. You've pointed out that it was possible to misread the old version as implying that most chiropractors think chiropractic is mainstream. This was a misreading I hadn't thought of. Does the current version (with "many" instead of "most") sufficiently forestall this problem? Eubulides (talk) 07:28, 17 August 2008 (UTC)[reply]

My main point (with adding "one study"), which I didn't make very clearly, is about attribution. "Many" is certainly an improvement. Since this is in the lead, we can't elaborate much, so I suggest that in the second instance where this study is being used as a ref, we include the "20% of practitioners....." part mentioned above. That way no one will misunderstand. -- Fyslee / talk 07:35, 17 August 2008 (UTC)[reply]

OK, thanks, then I propose that in Chiropractic #Utilization and satisfaction rates we replace this:

A 2008 survey stated that 69% of DC chiropractors disagree with the categorization of chiropractic as CAM, with 27% having some preference for the term "integrated medicine."

with this:

A 2008 study reported that 31% of surveyed chiropractors categorized chiropractic as CAM, 27% as integrated medicine, and 12% as mainstream medicine.

The "12%" is the combination of the "20%" and "6%" figures you mentioned above (the combination was done by the source, of course). I doubt whether it's necessary for us to break it down into practicing DCs vs. faculty chiropractors. Please notice that I am taking the liberty of proposing other minor changes as well, e.g., normalizing to positive figures like 31% rather than negative ones like 69% (which the source also does, of course), and removing unnecessary quote marks and adding a wikilink to Integrated medicine. Eubulides (talk) 09:16, 17 August 2008 (UTC)[reply]

This is looking better. I do suspect a typo above. That 12% should be 26%. I don't have the whole study available. May we get a link to it? The figures above still don't add up: 26% + 31% + 27% ? What is the real breakdown? -- Fyslee / talk 14:28, 17 August 2008 (UTC)[reply]

It's not a typo. 6% of the 71 faculty and 20% of the 61 practitioners in the survey considered chiropractic to be mainstream medicine; this averages out to be 12% (the "12%" was computed by the source). Aside from the 31%, 27%, and 12% mentioned in the proposed sentence, the study reported 14% "not CAM" but with no alternative suggested; 7% Any, depending on practitioner; 5% Its own category; 2% Primary care providers; 2% Categorize by level of education; and 2% no opinion. Responses do not total 100% due to "missing values and rounding". The only link I can provide to the article is what is on Chiropractic now; the article is copyrighted and I don't have the rights to reproduce it. Eubulides (talk) 21:02, 18 August 2008 (UTC)[reply]

Aha! That explains it. Thanks for the info. -- Fyslee / talk 01:27, 19 August 2008 (UTC)[reply]

No further comment, so I installed that change. Eubulides (talk) 21:32, 21 August 2008 (UTC)[reply]

One thing I have noticed is that the manner in which quotes are formatted is sometimes different in the same articles many places here at Wikipedia. That used to apply here as well. This is an unfortunate way in which editorial POV can creep into an article. An editor can insert a quote and make it more noticeable than other quotes. It may even happen with no ulterior motives than personal preference for a certain method of formatting, but it's still not right. Some quotes are indented in the simple and normal ":" or "*" manners and others are indented and formatted using the <blockquote> or {{quote}} template formats. I have undone such formatting (the last two) in several places where I have found it. I am currently proposing to do this at Quackwatch, but will wait for comments before doing anything.

I think all quotes should use the simple wiki markup ":" or "*" methods of indenting, unless there is some special reason not related to editorial POV for doing otherwise. It isn't proper to highlight some quotes in big quote boxes, while others are kept more obscure, sometimes even hidden as part of the inline text, even though the quotes are several lines long. I think MOS allows both methods, but I find it to be misused at times, and would rather avoid making POV differences. -- Fyslee / talk 04:14, 18 August 2008 (UTC)[reply]

Any responses on this? If not, I'll proceed as suggested. -- Fyslee / talk 01:29, 19 August 2008 (UTC)[reply]

The only extended quote I noticed in Chiropractic was the one in Chiropractic #Vertebral subluxation, which already uses the ":" style, with the extended quote in double-quotes. So I don't see what change you're proposing here. Eubulides (talk) 07:29, 19 August 2008 (UTC)[reply]

There are some problems with the Holism bullet in Chiropractic #Philosophy:

• It contains words like "appreciates" and "recognizes" that convey approval of the chiropractic worldview; this runs afoul of WP:NPOV.
• It contains two direct quotes from the source, but doesn't put these quotes in quote marks. The quotes are "appreciates multifactorial nature of influences (structural, chemical, and psychological) on the nervous system" and "recognizing dynamics between lifestyle, environment, and health" (for the latter, the source says "recognizes" rather than "recognizing" but the difference is trivial).
• Its use of the word "treats" is confusing, as it can easily be misunderstood to be referring to treatment, as in medical treatment.
• It uses "patient", which WP:MEDMOS #Audience frowns on.

The two quotes are from a public-domain source, so it's legal to quote them without using quote marks, but it's not polite. Also, the quotes don't really fit that well in this context and they are too long; they can be compactly summarized instead. So I propose fixing the problem by replacing the holism bullet with the following: