gullible consumer
Manual therapy is considered a safe and less painful method and has been increasingly used to alleviate chronic neck pain. However, there is controversy about the effectiveness of manipulation therapy on chronic neck pain. Therefore, this systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to determine the effectiveness of manipulative therapy for chronic neck pain.
A search of the literature was conducted on seven databases (PubMed, Cochrane Center Register of Controlled Trials, Embase, Medline, CNKI, WanFang, and SinoMed) from the establishment of the databases to May 2022. The review included RCTs on chronic neck pain managed with manipulative therapy compared with sham, exercise, and other physical therapies. The retrieved records were independently reviewed by two researchers. Further, the methodological quality was evaluated using the PEDro scale. All statistical analyses were performed using RevMan V.5.3 software. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment was used to evaluate the quality of the study results.
Seventeen RCTs, including 1190 participants, were included in this meta-analysis. Manipulative therapy showed better results regarding pain intensity and neck disability than the control group. Manipulative therapy was shown to relieve pain intensity (SMD = -0.83; 95% confidence interval [CI] = [-1.04 to -0.62]; p < 0.0001) and neck disability (MD = -3.65; 95% CI = [-5.67 to – 1.62]; p = 0.004). However, the studies had high heterogeneity, which could be explained by the type and control interventions. In addition, there were no significant differences in adverse events between the intervention and the control groups.
The authors concluded that manipulative therapy reduces the degree of chronic neck pain and neck disabilities.
Only a few days ago, we discussed another systematic review that drew quite a different conclusion: there was very low certainty evidence supporting cervical SMT as an intervention to reduce pain and improve disability in people with neck pain.
How can this be?
Systematic reviews are supposed to generate reliable evidence!
How can we explain the contradiction?
There are several differences between the two papers:
- One was published in a SCAM journal and the other one in a mainstream medical journal.
- One was authored by Chinese researchers, the other one by an international team.
- One included 17, the other one 23 RCTs.
- One assessed ‘manual/manipulative therapies’, the other one spinal manipulation/mobilization.
The most profound difference is that the review by the Chinese authors is mostly on Chimese massage [tuina], while the other paper is on chiropractic or osteopathic spinal manipulation/mobilization. A look at the Chinese authors’ affiliation is revealing:
- Department of Tuina and Spinal Diseases Research, The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, China.
- Department of Tuina and Spinal Diseases Research, The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, China; Department of Tuina, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China. Electronic address: [email protected].
- Department of Tuina and Spinal Diseases Research, The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, China; Department of Tuina, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China. Electronic address: [email protected].
What lesson can we learn from this confusion?
Perhaps that Tuina is effective for neck pain?
No!
What the abstract does not tell us is that the Tuina studies are of such poor quality that the conclusions drawn by the Chinese authors are not justified.
What we do learn – yet again – is that
- Chinese papers need to be taken with a large pintch of salt. In the present case, the searches underpinning the review and the evaluations of the included primary studies were clearly poorly conducted.
- Rubbish journals publish rubbish papers. How could the reviewers and the editors have missed the many flaws of this paper? The answer seems to be that they did not care. SCAM journals tend to publish any nonsense as long as the conclusion is positive.
Vaccine hesitancy has become a threat to public health, especially as it is a phenomenon that has also been observed among healthcare professionals. In this study, an international team of researchers analyzed the relationship between endorsement of so-called alternative medicine (SCAM) and vaccination attitudes and behaviors among healthcare professionals, using a cross-sectional sample of physicians with vaccination responsibilities from four European countries: Germany, Finland, Portugal, and France (total N = 2,787).
The results suggest that, in all the participating countries, SCAM endorsement is associated with lower frequency of vaccine recommendation, lower self-vaccination rates, and being more open to patients delaying vaccination, with these relationships being mediated by distrust in vaccines. A latent profile analysis revealed that a profile characterized by higher-than-average SCAM endorsement and lower-than-average confidence and recommendation of vaccines occurs, to some degree, among 19% of the total sample, although these percentages varied from one country to another: 23.72% in Germany, 17.83% in France, 9.77% in Finland, and 5.86% in Portugal.
The authors concluded that these results constitute a call to consider health care professionals’ attitudes toward SCAM as a factor that could hinder the implementation of immunization campaigns.
In my view, this is a very important paper. It shows what we on this blog have discussed often before: there is an association between SCAM and vaccination hesitancy. The big question is: what is the nature of this association. There are several possibilities:
- It could be coincidental. I think this is most unlikely; too many entirely different investigations have shown a link.
- It could mean that people start endorsing SCAM because they are critical about vaccination.
- It could be that people are critical about vaccination because they are proponents of SCAM.
- Finally, it could be that some people have a mind-set that renders them simultaneously hesitant about vaccination and fans of SCAM.
This study, like most of the other investigationson this subject, was not desighned to find out which possibility is most likely. I suspect that the latter two explanations apply both to some extend. The authors of this study argue that that, “from a theoretical point of view, this situation may be explicable by reasons that are both implicit (i.e., CAM would fit better with certain worldviews and ideological standpoints that conflict with the epistemology and values that underlies scientific knowledge) and explicit (i.e., some CAM techniques are doctrinally opposed to the use of vaccines). Although we have outlined these potential explanations for the observed relationships, more research is needed to better understand the underlying mechanisms”.
I was asked by NATURE to provide a comment on the WHO Traditional Medicine Global Summit: Towards health and well-being for all which is about to take place in India:
The First WHO Traditional Medicine Global Summit will take place on 17 and 18 August 2023 in Gandhinagar, Gujarat, India. It will be held alongside the G20 health ministerial meeting, to mobilize political commitment and evidence-based action on traditional medicine, which is a first port of call for millions of people worldwide to address their health and well-being needs.
The Global Summit will be co-hosted by WHO and the Government of India, which holds the presidency of the G20 in 2023. It will be a platform for all stakeholders, including traditional medicine workers, users and communities, national policymakers, international organizations, academics, private sector and civil society organizations, to share best practices and game-changing evidence, data and innovation on the contribution of traditional medicine to health and sustainable development.
For centuries, traditional and complementary medicine has been an integral resource for health in households and communities. It has been at the frontiers of medicine and science laying the foundation for conventional medical texts. Around 40% of pharmaceutical products today have a natural product basis, and landmark drugs derive from traditional medicine, including aspirin, artemisinin, and childhood cancer treatments. New research, including on genomics and artificial intelligence are entering the field, and there are growing industries for herbal medicines, natural products, health, wellness and related travel. Currently, 170 Member States reported to WHO on the use of traditional medicine and have requested evidence and data to inform policies, standards and regulation for its safe, cost-effective and equitable use.
In response to this increased global interest and demand, WHO, with the support of the Government of India, established in March 2022 the WHO Global Centre for Traditional Medicine as a knowledge hub with a mission to catalyse ancient wisdom and modern science for the health and well-being of people and the planet. The WHO Traditional Medicine Centre scales up WHO’s existing capacity in traditional medicine and supplements the core WHO functions of governance, norms and country support carried out across the six regional Offices and Headquarters.
The Centre focuses on partnership, evidence, data, biodiversity and innovation to optimize the contribution of traditional medicine to global health, universal health coverage, and sustainable development, and is also guided by respect for local heritages, resources and rights.
A cross-regional expert panel will advise on the Summit’s theme, format, topics and issues to address. All updates will be posted here and on the forthcoming webpages for the First WHO Traditional Medicine Global Summit.
In case you are interested, the programme can be seen here.
And my comment? I am afraid, it was not very encouraging. I doubt that Nature will publish it in full. So, allow me to show you my unabridged comment:
The increasing demand for fertility treatments has led to the rise of private clinics offering so-called alternative medicine (SCAM) treatments. Even King Charles has recently joined in with this situalion. One of the most frequently offered SCAM infertility treatment is acupuncture. However, there is no good evidence to support the effectiveness of acupuncture in treating infertility.
This study evaluated the scope of information provided by SCAM fertility clinics in the UK. A content analysis was conducted on 200 websites of SCAM fertility clinics in the UK that offer acupuncture as a treatment for infertility. Of the 48 clinics that met the eligibility criteria, the majority of the websites did not provide sufficient information on:
- the efficacy,
- the risks,
- the success rates
of acupuncture for infertility.
The authors concluded that this situation has the potential to infringe on patient autonomy, provide false hope and reduce the chances of pregnancy ever being achieved as fertility declines during the time course of ineffective acupuncture treatment.
The authors are keen to point out that their investigation has certain limitations. The study only analysed the information provided on the clinics’ websites and did not assess the quality of the treatment provided by the clinics.
Therefore, the study’s fndings cannot be generalized to the quality of the acupuncture treatment provided by the clinics.
Nonetheless the paper touches on very important issues: far too many health clinics that offer SCAM for this or that indication operate way outside the ethically (and legally) acceptable norm. They advertise their services without making it clear that they are neither effective nor safe. Desperate consumers thus fall for their promises. In the case of infertility, this might result merely in frustration and loss of (often substantial amounts of) money. In the case of serious disease, such as cancer, this often results in premature death.
It is time, I think, that this entire sector is regualted in a way that it does not endanger the well-being, health, or life of consumers.
Spiritual healing has been defined as the direct interaction between one individual (the healer) and a patient, with the intention of improving the patient’s condition or curing the illness. Treatment can occur through personal, direct contact between healer and patient or at a (sometimes large) distance. Spiritual healers, who are usually not medically qualified, believe that the therapeutic effect results from the channelling of ‘energy’ from an undefined source via the healer to the patient. The main problem with this concept is that there is no evidence that this energy actually exists. Therefore, the assumptions on which spiritual healing is based lack plausibility.
The central claim of healers is that they promote or facilitate self-healing and wellbeing, both of which could be relevant to patients with any type of condition. An article by enthusiasts of spiritual healing explains: “All conditions can be treated by spiritual healing—but not all people. Some people are more receptive than others to this treatment, due to a number of factors such as karma and mental outlook. As such the results of healing can vary a great deal. If the patient has faith in the technique and the healer, this will of course aid the healing process, but is not necessary; this is not faith healing as practiced in some religions—it is based instead on spiritual energy. This being the case, it is possible for a skeptic to receive healing and benefit from it.”
The evidence from clinical trials of spiritual healing is contradictory. Many studies have serious flaws, and the most reliable trials fail to show effects beyond placebo. Research papers often fail to differentiate between different types of paranormal healing. One Cochrane, for instance, review “found inconclusive evidence that interventions with spiritual or religious components for adults in the terminal phase of a disease may or may not enhance well-being. Such interventions are under-evaluated. All five studies identified were undertaken in the same country, and in the multi-disciplinary palliative care interventions it is unclear if all participants received support from a chaplain or a spiritual counsellor. Moreover, it is unclear in all the studies whether the participants in the comparative groups received spiritual or religious support, or both, as part of routine care or from elsewhere. The paucity of quality research indicates a need for more rigorous studies.”
Many people believe that spiritual healing is harmless. Sadly, this is not the case. The BBC’s ‘Women’s Hour’ reported on 9 August this year about serious abuses of spiritual healers. Here you can find the published test of the broadcast:
Spiritual healing is extremely popular in many countries in the Middle East and North Africa. But the practice is unregulated and that means women are vulnerable to sexual exploitation. An investigation by BBC News Arabic has uncovered allegations of widespread sexual abuse by healers in Sudan and Morocco. Clare McDonnell is joined by the BBC’s Hanan Razek and Senior Women’s Rights Researcher at Human Rights Watch, Rothna Begum, to discuss.
And here you can listen to the actual broadcast. Briefly, what it reveales is deeply shocking:
- Spiritual healing is extremely popular in Sudan and Morocco.
- Healers charge hefty sums and healing is big business.
- Anyone regardless of background or training can call themselves a healer.
- There is no regulation whatsoever.
- Healers claim to cure illnesses, expell evil spirits, help with emotional problems, etc.
- For the programme, the BBC asked 80 women who had received healing.
- They accused 60 different healers of sexual transgression, including rape.
- Undercover recording revealed a healer placing his hand on a woman’s abdomen and then putting a finger “all the way down”.
- The police refuses to investigate if a women complains.
- The authorities refuse to take notice of the problem.
- A minister was quoted stating that there is no need for regulation.
- Another one said that the political athmosphere is not allowing to investigate the issue.
______________________
The references for the evidence cited above can be found here.
Online misinformation is disproportionality created and spread by people with extreme political attitudes, especially among the far-right. There is a debate in the literature about why people spread misinformation and what should be done about it. According to the purely cognitive account, people largely spread misinformation because they are lazy, not biased. According to a motivational account, people are also motivated to believe and spread misinformation for ideological and partisan reasons. To better understand the psychological and neurocognitive processes that underlie misinformation sharing among the far-right, an international team of researchers conducted a cross-cultural experiment with conservatives and far-right partisans in the Unites States and Spain (N = 1,609) and a neuroimaging study with far-right partisans in Spain (N = 36).
Far-right partisans in Spain and U.S. Republicans who highly identify with Trump were more likely to share misinformation than center-right voters and other Republicans, especially when the misinformation was related to sacred values (e.g., immigration). Sacred values predicted misinformation sharing above and beyond familiarity, attitude strength, and salience of the issue. Moreover, far-right partisans were unresponsive to fact-checking and accuracy nudges. At a neural level, this group showed increased activity in brain regions implicated in mentalizing and norm compliance in response to posts with sacred values.
The authors concluded that these results suggest that the two components of political devotion – identity fusion and sacred values – play a key role in misinformation sharing, highlighting the identity-affirming dimension of misinformation sharing. We discuss the need for motivational and identity-based interventions to help curb misinformation for high-risk partisan groups.
People who have followed the discussions on this blog closely could be forgiven in assuming that right-wing political devotion also plays an important role in spreading misinformation about healthcare (e.g. vaccination) and so-called alternative medicine (SCAM). It would be good, if someone could test this hypothesis more directly.
PS
Just as I had finished writing this post, I came across a quote given yesterday by Ben Habib on GBN:
“I’m very reluctant to put my destiny in the hands of scientists. You know, unbridled authority given to faux knowledge.”
QED
We discussed the 2015 Australian NHMRC report on homeopathy many times before, e.g.:
- Homeopathy: the 2015 NHMRC report and its criticism re-analysed
- HOMEOPATHY: the NHMRC report revisited
- Ombudsman investigates ‘flawed’ homeopathic study
- The final verdict on homeopathy: it’s a placebo
In a nutshell, the report was an hugely influential analysis of the effectiveness of homeopathy which came to squarely negative conclusions. Thus it was celebrated as a thorough and conclusive piece evidence demonstrating the madness of homeopathy. Unsurprisingly, homeopaths did not like it at all and produced various criticisms claiming that it was neither thorough nor conclusive.
Now the final evaluation of what has been going on was finally published (ISSUED BY THE COMMONWEALTH OMBUDSMAN, IAIN ANDERSON, ON 4 AUGUST 2023):
The Office of the Commonwealth Ombudsman (the Office) has finalised an investigation relating to the National Health and Medical Research Council’s (NHMRC) review of the evidence for the effectiveness of homeopathy, conducted between 2010 and 2015. We commenced this investigation in September 2017 in response to concerns raised with us about how the NHMRC review had proceeded.
The Office conducts its investigations in private, and the Ombudsman generally does not make a public statement in the absence of a formal report. In the circumstances of this matter, including that the then-Ombudsman released a public statement on 4 June 2021 which acknowledged the Office was investigating, we believe it is important to share publicly the information we can, now that the investigation is complete.
Our investigation was finalised in July 2023. We acknowledge the length of time the investigation has taken. This is in part due to the extensive efforts the Office made to source independent scientific expertise to advise us on some detailed and specific questions of scientific methodology that were raised with our Office, including some that were only brought to our attention as our investigation progressed. Despite our best efforts, it was not possible to engage an expert (or experts) to provide independent advice to our Office on this subject. In the absence of independent, expert scientific expertise we have not been able to conclusively determine those matters of scientific methodology. This did not prevent our Office from forming a view on other aspects of the matter.
Our investigation did not result in any adverse findings about the review or the NHMRC. When finalising investigations, we may offer comments and suggestions to an agency about areas for future improvement. In this instance, we offered comments and suggestions to the NHMRC about how it records and publicly explains decisions about its activities. The NHMRC also independently made several improvements to its processes during the course of our investigation.
________________
In essence, this means that the conclusions of the report stand:
Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness. People who are considering whether to use homeopathy should first get advice from a registered health practitioner. Those who use homeopathy should tell their health practitioner and should keep taking any prescribed treatments.
Thus the matter is closed – that is closed for rational thinkers. For irrationalists, the matter will no doubt continue to be a stone of contention. No, homeopath will be able to accept these conclusions simply because a member of a cult ceases to be a cultist once he/she accepts the criticism agaist the cult.
There is evidence that, in the US, Republican-leaning counties have had higher COVID-19 death rates than Democratic-leaning counties and similar evidence of an association between political party affiliation and attitudes regarding COVID-19 vaccination. This investigation assessed political party affiliation and mortality rates for individuals during the initial 22 months of the COVID-19 pandemic.
A cross-sectional comparison of excess mortality between registered Republican and Democratic voters between March 2020 and December 2021 adjusted for age and state of voter registration was conducted. Voter and mortality data from Florida and Ohio in 2017 linked to mortality records for January 1, 2018, to December 31, 2021, were used in data analysis. The main outcome measure was the excess weekly death rates during the COVID-19 pandemic adjusted for age, county, party affiliation, and seasonality.
Between January 1, 2018, and December 31, 2021, there were 538 159 individuals in Ohio and Florida who died at the age of 25 years or older in the study sample. The median age at death was 78 years (IQR, 71-89 years). Overall, the excess death rate for Republican voters was 2.8 percentage points, or 15%, higher than the excess death rate for Democratic voters (95% prediction interval [PI], 1.6-3.7 percentage points). After May 1, 2021, when vaccines were available to all adults, the excess death rate gap between Republican and Democratic voters widened from −0.9 percentage points (95% PI, −2.5 to 0.3 percentage points) to 7.7 percentage points (95% PI, 6.0-9.3 percentage points) in the adjusted analysis; the excess death rate among Republican voters was 43% higher than the excess death rate among Democratic voters. The gap in excess death rates between Republican and Democratic voters was larger in counties with lower vaccination rates and was primarily noted in voters residing in Ohio.
The authors concluded that, in this cross-sectional study, an association was observed between political party affiliation and excess deaths in Ohio and Florida after COVID-19 vaccines were available to all adults. These findings suggest that differences in vaccination attitudes and reported uptake between Republican and Democratic voters may have been factors in the severity and trajectory of the pandemic in the US.
In light of what has been discussed repeatedly, these findings are in my view most impressive and seem to speak for themselves. The authors are nevertheless prudent and stress that their study has several limitations which mean that we ought to interpret their results with caution.
- First, there are plausible alternative explanations for the difference in excess death rates by political party affiliation beyond the explanatory role of vaccines discussed herein.
- Second, the mortality data, although detailed and recent, only included approximately 83.5% of deaths in the US and did not include the cause of death. Although overall excess death patterns in our data are similar to those in other reliable sources, such as the Centers for Disease Control and Prevention National Center for Health Statistics data, it is possible that the deaths that our study data did not include may disproportionately occur among individuals registered with a particular political party, potentially biasing our results. In addition, the completeness of the mortality data may vary across states or time, potentially biasing our estimates of excess death rates.
- Third, all excess death models rely on fundamentally untestable assumptions to construct the baseline number of deaths one would expect in the absence of the COVID-19 pandemic.
- Fourth, because no information on individual vaccination status was available, analyses of the association between vaccination rates and excess deaths relied on county-level vaccination rates.
- Fifth, the study was based on data from 2 states with readily obtainable historical voter registration information (Florida and Ohio); hence, the results may not generalize to other states.
We have discussed the Miracle Mineral Solution (MMS) before. Now it has been making headlines again. It has been reported that a Miami federal jury convicted a father and his three sons of selling a toxic bleach solution as a “miracle” medical cure out of a fake Florida church’s website to thousands of consumers across the US. Mark Grenon, 65, and sons Jonathan, 37, Joseph, 35, and Jordan, 29, chose to represent themselves in their two-day trial in Miami federal court. But they said nothing during the trial as if they were silently protesting the proceeding. Only after the 12-person jury hit them with a quick verdict did one of the Grenons speak up. “We will be appealing,” Joseph Grenon said.
During the trial and closing arguments, prosecutors portrayed the four defendants as con men who used a phony religious front on a website, the Genesis II Church of Health and Healing, to sell $1 million worth of their “Miracle Mineral Solution” a cure for 95% of the world’s known diseases, from AIDS to the coronavirus. “This whole Miracle Mineral Solution scheme was built on deception and dishonesty,” the prosecutor said during his closing argument, telling jurors that the Grenons “created a fake church to make it harder for the Food and Drug Administration and government to stop them from selling snake oil.” But, “this was no church,” he argued. “This was a scam for money — an old-fashioned scam.” The jury found the four defendants — all wearing beige inmate uniforms, ponytails, and flowing beards — guilty of conspiring to defraud the U.S. government and FDA, which regulates the food and drug industry, by distributing an unapproved and misbranded drug, Miracle Mineral Solution (MMS). That conviction carries up to five years in prison.
During the trial, the prosecutor said the Grenons called themselves “bishops” and peddled MMS as “sacraments” to consumers in South Florida and other parts of the US in exchange for a “donation” to the Genesis church, before the FDA cracked down on the family in 2020.
The Grenons were charged that April with conspiring to defraud the U.S. government after the outbreak of the COVID-19 pandemic when they defied FDA and court orders to stop distributing the toxic MMS substance. Their criminal case was the first pandemic-related enforcement action in Florida. In public warnings, FDA said it received several reports of hospitalizations and life-threatening conditions as people drank the dangerous substance.
MMS is a chemical solution containing sodium chlorite that, when mixed with water and a citric acid “activator,” turns into chlorine dioxide, a powerful bleach typically used for industrial water treatment or bleaching textiles, pulp, and paper. During the trial, a FDA agent testified about three Grenon-produced videos that pitched the solution as a cure for cancer, lung cancer, and COVID-19, among other deadly diseases. “We are trying to create a world without disease,” Mark Grenon said in one video, pitching the MMS substance. “It’s been proven to be tremendously effective in curing cancer.” Another video, dated March 8, 2020, was titled: “The coronavirus is curable. Do you believe it? You better!”
Prosecutors said the Grenon family’s religious front, the Genesis II Church of Health and Healing, sold tens of thousands of MMS orders in violation of federal law since 2010. It was in that year that Mark Grenon claims to have founded the organization with a man named Jim Humble in a plan to avoid governmental regulation and arrest as they promoted MMS as a miracle cure. Humble, a man who has dabbled in Scientology and professed to be a billion-year-old god, began promoting the substance as early as 2006 in self-published works after he claimed to have discovered its medical properties while on a gold-mining expedition in South America. After Humble supposedly stepped away from the organization in 2017, Grenon continued to manufacture, promote and sell MMS with his three sons.
The Grenons’ open defiance of a court order ultimately led to criminal charges and a federal raid on the family’s Bradenton home, where federal investigators say they found loaded guns, nearly 10,000 pounds of sodium chlorite powder, and thousands of bottles of MMS.
The World Federation of Chiropractic (WFC) has recently launched a new Global Patient Safety (GPS) initiative:
Unanimously approved by the WFC Board at its May meeting, the project will be overseen by the Research Committee and involve the establishment of an expert task force. Planned projects will include a scoping review, identification of best practices in incident reporting and learning, risk management in chiropractic practice and knowledge translation activities.
In recent years, patient safety has increasingly been in the spotlight as health systems strive to reduce unnecessary incidents and iatrogenic injury.
“With adverse events having the potential to impact trust and confidence in the chiropractic profession, it is important that we do as much as possible to inform ourselves in relation to the risks and benefits of chiropractic treatments and related activities,” said Prof. Richard Brown DC, LL.M, WFC Secretary- General.
“While we know that serious adverse events are rare, patients with multiple co-morbidities and known risk factors require special attention. The WFC GPS Task Force will highlight key areas of patient safety to support chiropractors, build and strengthen the existing safety culture and help to meet the expectations of patients and the public.”
Chiropractors use a package of interventions in their treatment of patients, including hands-on care, adjunct therapies, health promotion, advice and exercise prescription. The process of shared decision-making involves consideration by the chiropractor of the suitability and safety of each intervention. In addition to direct patient care, chiropractors also have a duty to consider the safety of their offices and clinics.
A WHO resolution on patient safety, passed in 2019 at the World Health Assembly, made a commitment to take global action in tackling avoidable harm.
Its subsequent publication, Global Action on Patient Safety, set out goals and targets to reduce morbidity from healthcare related incidents.
Chair of the Task Force and Research Committee vice-chair, Dr Katie Pohlman DC, PhD, said: “With the current global focus on patient safety, I’m proud to be leading this WFC Task Force, which will support the chiropractic profession but, most importantly, work to minimize adverse events and protect patients.
“The creation of an open, transparent culture of patient safety is key to maintaining trust and credibility. The Task Force is looking forward to adding to the body of knowledge and advancing safe, evidence-based, people-centered practice.”
The WFC GPS Task Force will report to Research Committee Chair, Assoc. Prof Sidney Rubinstein. It will include members of the existing Research Committee as well as external experts.
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At first, most people will think: WHAT A GOOD IDEA!
After a bit of reflection, however, some might ponder: WHY ONLY NOW AND NOT DECADES AGO?
And after reading the above text carefully, skeptics might feel that the exercise can already be classified as a PR gimmick that will not generate the needed information:
- The WFC has yet again failed to establish a monitoring system of adverse effects; without it ‘patient safety’ is not achievable.
- They claim that “we know that serious adverse events are rare”. How do they know this? And if they already are convinced of this, the new task force is bound to be a pure ‘white wash’.
- They think an “existing safety culture” exists in chiropractic. This is wishful thinking and far from reality.
- They speak of the “expectations of patients and the public” but ignore the need for a monitoring system accessible to the public.
