Let’s play a game! After my little blurb, I’ve posted something seen in a presentation made by a medical student, on chiropractic. In the comments post all the ways in which the student’s comment is wrong.
Some background: At my med school, there is a senior elective class where one can independently study and research an area of health care that isn’t covered in detail in our curriculum. This student chose chiropractic. Specifically he chose “Evidence based medicine applied to chiropractic.”
Disappointingly the presenter was not up on how to read or understand evidence based medicine. It’s disappointing because the student in question is an “honors” level student, and will be going on to do his residency at Mayo clinic, in a very competitive speciality.
Among other things, he took Cochrane reviews, and called them biased. He didn’t identify any particular bias. He just picked the author of the Cochrane review and said that this author was against chiropractic. Throughout the presentation he had scattered statistics that “proved” the usefulness of chiropractic.
The worst part of all this, is that his presentation was supposedly reviewed by a clinical professor BEFORE the presentation. I’m hoping that the doctor in question was just busy, because if not, some attending at my school has some ‘splainin to do.
At any rate, I’ve presented the text of the worst slide below. In the comments, post why you think he’s wrong. If possible pop a reference on, but there are multiple right answers that don’t require any research at all!
Chiropractic is, hands down, safer than conventional therapy!
- The rate of the worst complication (vertebrobasilar artery dissection) is at best 1 in 10000.
- Compare this to a 0.4% mortality rate with chronic NSAID use.
There are lots of ways in which this is wrong, pick your favorite.
Hint: More than one of the reasons this is wrong are completely independent of the accuracy of the statistics he provides. That is, the rate of vertebral artery dissection really could be 1 in 10000 (which I doubt, but research to follow with my answers tomorrow) and he’d still be wrong.
Answer to follow tomorrow, with a little bit of research blogging thrown in for good measure.
Totally slipped my mind when I initially posted this. There is also a highly entertaining post over at Science Based Medicine on Chiropractic.
If you end up reading through the comments you’ll see that not all doctors understand anything at all about science.
This is probably going to be hard to pick out without the context of the presentation around it. I’m looking for problems with the actual comparison of the rates given. This is not an apples to apples comparison, and he should have known better.