Thursday, 15 September 2016

Ken Harvey debunks ‘evidence’ used in chiropractic advertisements

SPHPM Adjunct Associate Professor Ken Harvey has recently turned his attention to Australian chiropractors and their promotion of therapeutic interventions, publishing an article this month in the Chiropractic Journal of Australia critically appraising the evidence and arguments used by Australian chiropractors to promote therapeutic interventions. He hopes the article will clarify for practitioners the difference between high-level and low-level evidence used by some practitioners in the industry to promote certain therapeutic interventions.

"Chiropractors have sought and gained the right to call themselves “doctor” and some aggressively promote themselves as alternative primary health care practitioners. However, significant elements of the profession have refused to accept regulatory measures that protect patients of other registered health professionals,” said Associate Professor Harvey.

In the article he explains why personal accounts of practitioner’s experience in treating conditions like ear infections and bed-wetting with chiropractic is unsound evidence, and how that impacts on patient safety and best practice.

“In short, personal experience is easy, convincing and often wrong, while blinded, placebo-controlled clinical trial are laborious, complex and costly, however the latter are crucial as the plural of anecdote is not evidence,” he said.

Associate Professor Harvey was the lead author on a submission of 10 representative complaints to the Australian Health Practitioner Regulation Agency (AHPRA) about chiropractic clinic websites that made claims likely to harm consumers.

The analysis, assisted by colleague Mr Malcolm Vickers and two SPHPM Summer Research Scholarship Students Amy Yan and Ned Latham, was published in January in the Medical Journal of Australia. It highlighted the failings of the Chiropractic Board of Australia (CBA) in taking action on misleading advertising claims by chiropractors. This led to the CBA putting chiropractors who spruik spinal manipulation to treat infections, diseases and conditions such as autism and asthma on notice.

In response to the representative complaints made to AHPRA, the CBA sent out a strongly-worded statement sent to all 5000 registered chiropractors, warning those who advertise unproven benefits for children, pregnant mothers and unborn babies, could be prosecuted.

“The Australian Health Practitioner Regulation Agency is currently dealing with over 600 complaints about chiropractors. Common allegations in these complaints are that chiropractic adjustments are promoted for pregnant women, infants and children despite the lack of good evidence to justify many of these interventions,” said Associate Professor Harvey.

“This latest article in the Chiropractic Journal of Australia provides a critical analysis of some of the evidence and arguments used by chiropractors to justify treatments that have been the subject of complaints.

“I hope that this analysis will amplify the recent statement on advertising by the CBA and assist practitioners to understand the difference between the high-level evidence required by the Board and the lower-level evidence used by some practitioners to justify their promotion and practice.”

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