As numerous of my posts have demonstrated, chiropractic manipulations can cause severe adverse effects, including deaths. Several hundred have been documented in the medical literature. When discussing this fact with chiropractors, we either see denial or we hear the argument that such events are but extreme rarities. To the latter, I usually respond that, in the absence of a monitoring system, nobody can tell how often serious adverse events happen. The resply often is this:
You are mistaken because the Royal College of Chiropractors’ UK-based Chiropractic Patient Incident Reporting and Learning System (CPiRLS) monitors such events adequately.
I have heard this so often that it is time, I feel, to have a look at CPiRLS. Here is what it says on the website:
CPiRLS is a secure website which allows chiropractors to view, submit and comment on patient safety incidents.
Access to CPiRLS
CPiRLS is currently open to all UK-based chiropractors, all ECU members and members of the Chiropractic and Osteopathic College of Australasia. To access the secure area of the CPiRLS website, please click the icon below and insert the relevant CPiRLS username and password when prompted.
In the UK, these can normally be found on your Royal College of Chiropractors’ membership card unless the details are changed mid-year. Alternatively, email email@example.com from your usual email address and we will forward the details.
Alternatively, in the UK and overseas, secure access details can be obtained from your professional association.
National associations and organisations wishing to use CPiRLS, or obtain trial access to the full site for evaluation purposes, should contact The Royal College of Chiropractors at firstname.lastname@example.org
Please click the icon below to visit the CPiRLS site.
Yes, you understood correctly. The public cannot access CPiRLS! When I click on the icon, I get this:
Welcome to CPiRLS
CPiRLS, The Chiropractic Patient Incident Reporting and Learning System – is an online reporting and learning forum that enables chiropractors to share and comment on patient safety incidents.
The essential details of submitted reports are published on this website for all chiropractors to view and add comments. A CPiRLS team identifies trends among submitted reports in order to provide feedback for the profession. Sharing information in this way helps to ensure the whole profession learns from the collective experience in the interests of patients.
All chiropractors are encouraged to adopt incident reporting as part of a blame-free culture of safety, and a routine risk management tool.
CPiRLS is secure and anonymous. There is no known way that anyone reporting can be identified, nor do those running the system seek to identify you. For this security to be effective, you require a password to participate.
Please note that reporting to CPiRLS is NOT a substitute for the reporting of patient safety incidents to your professional association and/or indemnity insurers.
So, how useful is CPiRLS?
Can we get any information from CPiRLS about the incidence of adverse effects?
Do we know how many strokes or deaths have been reported?
Can chiropractors get reliable information from CPiRLS about the incidence of adverse effects?
No, because reporting is not mandatory and the number of reports cannot relate to incidence.
Are chiropractors likely to report adverse effects?
No, because they have no incentive and might even feel that it would give their profession a bad name.
Is CPiRLS transparent?
Is CPiRLS akin to postmarketing surveillance as it exists in conventional medicine?
How useful is CPiRLS?
I think I let my readers answer this question.