Confessions of a Quackbuster

This blog deals with healthcare consumer protection, and is therefore about quackery, healthfraud, chiropractic, and other forms of so-Called "Alternative" Medicine (sCAM).

Tuesday, May 17, 2005

Serious pseudoscience (FSU chiropractic school)

Serious pseudoscience
A US university has been considering establishing a school of chiropractic. We should find out if it works first

Edzard Ernst
Tuesday February 1, 2005

Guardian

Imagine a British university deciding to open a department of tarot studies, a crop-circle laboratory or a college of palm reading. One would expect a formidable row, with scientists opposing such a move and administrators with opportunistic pragmatism pointing towards the potential for making money. This is roughly what happened in Florida recently.

Last March, the Florida State legislature, whose president happens to be a chiropractor, offered the Florida State University (FSU) in Tallahassee $60m (£33m) to establish a school of chiropractic. The plan was to offer a five-year "Doctor of Chiropractic" degree - a courageous step, it seems, because no other public US university has such a course. And few universities could afford to reject that sort of money these days.

But many academics at FSU disagree. "Having a chiropractic programme would seriously undermine the scientific tradition of any institution," said Raymond Bellamy, director of orthopaedic surgery at FSU. He also called chiropractic "gobbledygook" and "pseudoscience", suggesting that it was "no better than the placebo effect".

Independent experts confirmed that "a comprehensive picture [in support of chiropractic theory] has not emerged". Reassured by such assessments, some 500 staff and 40 FSU professors signed a petition against the proposal.

The chiropractors, of course, did their best to defend their corner. "In the last 10 years, $20m has been put into chiropractic research from the federal government and $4 to $5m from the profession itself," said John Triano, a chiropractor at the Texas Back Institute. No doubt, there is plenty of research; yet the trouble seems to be that it has demonstrated so little. Whenever the clinical evidence for or against chiropractic is systematically reviewed, the bottom line is that there is no convincing data to show that it works.

This issue was deferred from one committee to the next. Finally, it was up to the Florida Board of Governors to decide. Last week this panel voted 11:3 to defeat the proposal for a school of chiropractic. One commentator said: "Scientific method has won over propaganda, promotion and financial interests."

From a safe distance, I find this story highly entertaining and it reminds me of my own professional past. When my chair was created, several top British universities were approached. None wanted to touch the substantial (yet, nowhere near as large as the US funds) endowment that came with the proposed chair. Finally Exeter had the "courage" to accept it. When I arrived, about 12 years ago, I had no idea that I had just planted myself in an ant's nest of intrigue, controversy and back-stabbing.

And how have I managed to win over my numerous opponents? Well, perhaps I haven't - the controversies about what I should do and how I should tackle my task continue. By and large I ignore them. From the beginning my plan was to focus on science, not politics. Surely, applying the rules of science to any healthcare field, however controversial, can only be a good thing.

And perhaps this is what the mud-wrestling chaps in Tallahassee should have considered: forget about a "Doctor of Chiropractic" degree - that's nonsense - and use that money not for training therapists (that is done thousand fold outside academia) but for applying top-quality science to chiropractic. At least we would eventually know whether this treatment does more good than harm.

· Edzard Ernst is professor of complementary medicine at the Peninsula medicine school at the universities of Exeter and Plymouth.

Guardian Unlimited © Guardian Newspapers Limited 2005

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