Chiropractic Immunity Hit Piece Published in JAMA - Several Canadian Organizations & the WFC Behind It

In what is an obvious follow-up and blatant attack on conservative, traditional chiropractic a team of the usual suspects of Subluxation Deniers have had a hit piece on chiropractic and immunity published in JAMA Network Open. The conclusions from the extremely narrow and methodologically flawed paper are:

"No clinical evidence from high- or acceptable-quality RCTs was found to support or refute claims that SMT is efficacious or effective in preventing or improving infectious diseases."

According to the authors the meaning of their finding is:

"Claims that spinal manipulative therapy is associated with changes in the immune system are premature and further clinical studies should be completed."

Even a casual observer will notice that the "meaning" they concoct is not consistent with their conclusions and shows that just because its in JAMA does not mean it was properly peer reviewed. 

According to JAMA Network Open - the Journal is ". . . an international, peer-reviewed, open access, general medical journal that publishes research on clinical care, innovation in health care, health policy, and global health across all health disciplines and countries for clinicians, investigators, and policy makers."

As was the case with the initial attack on chiropractic at the beginning of the COVID pandemic by the World Federation of Chiropractic, American Chiropractic Association and Parker University, the key audience for this paper are policy makers and the chief goal of the paper is to tighten the muzzle already placed on chiropractors in regards to free speech and the application of evidence informed practice. Its intention is to substitute the autonomy of the doctor patient relationship for compelled speech and forced restriction on the care of patients to musculoskeletal disorders. Those efforts last year led to widespread attacks on chiropractors by regulatory boards who adopted the WFC/ACA/Parker stance who went after chiropractors for making any claims regarding immunity.  

CLICK HERE for more on that story 

Their narrative is easily deconstructed since those who practice in a vitalistic, salutogenic model are not looking to alter disease specific outcomes or prevent disease. The reality is that the researchers involved in this charade and their methods are akin to the fraud that occurred with PCR testing amplification and is another case study on how the Deniers openly commit research sleight of hand. The authors purposely limited their "systematic review" to 13 studies by allowing only randomized clinical trials and cohort studies to be included. Then using the Deniers favorite tactic of employing Weasel Words they further "appraised" those studies and came up with studies they determined to be ". . . evidence with high and acceptable quality." High" and "acceptable quality" being the Weasel Words necessary to get the result they wanted.

In contrast to the WFC supported hit piece, The Foundation for Vertebral Subluxation recently published a Best Practices/Practice Guidelines document on the role of chiropractic in immune function.

CLICK HERE for more on that story

The Best Practices document from the Foundation is part of a multi-pronged project to address questions related to the role of chiropractic care in immune function. The project has multiple parts including the completion of a scoping review of chiropractic, immunity and biomarkers, a comprehensive, integrative review of the scientific literature on chiropractic and immunity, the development of research protocols, feasibility studies, development of a prospective longitudinal health outcomes study, and the development of policy and best practice statements for practitioners and patients in an evidence informed framework.

CLICK HERE to review the project outline

The Foundation is utilizing an evidence informed approach using a broad data set as opposed to the narrow confines used by the Deniers and accomplished through the use of ill-defined terms and Weasel Words.  According to Amy Haas DC, Ph.D, a Research Fellow with the Foundation who is also in private practice: "The view utilized by the Foundation is showing that the effects from the chiropractic adjustment extend far beyond musculoskeletal and are more biologically consistent with an affect on the neuroendocrine immune super system as a whole."

Indeed the Best Practices Recommendation from the FVS includes:

A growing body of evidence supports our understanding of the role of the nervous system in immune system function. Basic science studies and clinical reports in the scientific literature provide supportive evidence of the beneficial effects of chiropractic care in improving function, including immune system function and quality of life. 

This approach by the Foundation for Vertebral Subluxation has established the current reality of clinical practice in an evidence informed framework and according to Haas "establishes a foundational outline for more research rather than slamming the door on practicing chiropractors and their patients." Haas continued: “Research supported biological plausibility will create possibilities for the improvement of human health, while this recent article’s selective use of data simply attempts to limit clinical application of Chiropractic, and promotes a narrow “conclusion” - one that in the end will be overturned by exploration and emerging evidence. Because that’s how science works. It doesn’t slam doors, it asks questions.”

The narrative being used by the Deniers within chiropractic to trample on the autonomy of the doctor/patient relationship goes like this:

The evidence for chiropractic is limited to a small group of musculoskeletal pain syndromes. Acceptable, credible and best evidence is defined as randomized controlled clinical trials (RCT's) conducted by independent parties multiple times and yielding the same results. These studies must be completely free from bias. Patient reported outcome studies are not acceptable. Individual case reports, no matter the number of them, are not acceptable. Basic science research is not acceptable. Non human animal studies are not acceptable. The clinical expertise and experience of the doctor does not matter. The wishes of the patient do not matter.     

In effect they have dismantled the model of evidence informed practice so that the only aspect of the model that is allowed to be considered is research evidence - and that research must be high level research i.e. RCT's. The role of the doctor has been removed along with the wishes of the patient and their clinical state and circumstances.

The regulatory nidus for this tactic by the Deniers is in Canada and Australia where this nonsense took root and has grown like weeds. In Canada this policy is known as APPENDIX N.

CLICK HERE for more on APPENDIX N 

It should come as no surprise then that the following regulatory boards, trade associations, Universities and malpractice insurance providers gave the financial support for the construction of this flawed policy document:

• College of Chiropractors of British Columbia
• Canadian Chiropractic Research Foundation
• World Federation of Chiropractic
• Canadian Chiropractic Protective Association
• Canadian Chiropractic Association
• Ontario Chiropractic Association
• Ontario Tech University
• The Canada Research Chairs program

The College of Chiropractors of British Columbia are once again at the heart of his cancer spreading through the profession. Having adopted "APPENDIX N", the CCBC then quickly set out to attack chiropractors on their role in caring for women and children stating chiropractic has no beneficial effect on fetal development or position, no beneficial effect on labour or birth, no beneficial effect on hormone function or postpartum depression.

CLICK HERE for that story

Once they had accomplished their goal of stopping the chiropractic care of pregnant women for anything other than back pain, the CCBC then set their sights on banning the use of x-rays for subluxation analysis. That ban has caused an international scandal as chiropractors from across the province of British Columbia Canada filed for an injunction in the British Columbia Supreme Court on Wednesday March 10, 2021 to reverse the decision. The filing of the injunction is being supported by nearly 4500 people around the world who have signed a petition in support of patients rights to have their doctor make health care recommendations without the intrusion of the government.

CLICK HERE for more on that

The money trail in the x-ray debacle will prove to be interesting and appears as though a real scandal has developed between the CCBC Board, Ontario Tech University, the Canada Research Chairs Program, the Canadian Chiropractic Research Foundation, the World Federation of Chiropractic and the Canadian Memorial Chiropractic College (CMCC). The funding for the sham x-ray study was provided by the College of Chiropractors of British Columbia to Ontario Tech. Additional funding came from the Canada Research Chairs program and the Canadian Chiropractic Research Foundation.

Notice that the same group of usual funding suspects are also involved in this latest debacle on immunity. Perhaps the JAMA Editors are unaware of this scandal and the use of their journal to perpetuate it.