A critical appraisal of evidence and arguments used by australian chiropractors to promote therapeutic interventions

The Australian Health Practitioner Regulation Agency is currently dealing with over 600 complaints about chiropractors. Common allegations in these complaints are that chiropractic adjustments are promoted for pregnant women, infants and children despite the lack of good evidence to justify many of these interventions. The majority of chiropractors complained about appear to be caring practitioners who genuinely believe that the interventions they promote are effective. However, belief based on disproven dogma, the selective use of poor-quality evidence, and personal experience subject to bias is no longer an appropriate basis on which to promote and practice therapeutic interventions. Nor should treatments be justified solely on the basis of possible placebo effect. This paper provides a critical analysis of some of the evidence and arguments used by chiropractors to justify treatments that have been the subject of complaints. This analysis amplifies the recent statement on advertising by the Chiropractic Board of Australia. It should assist practitioners to understand the difference between the high-level evidence required by the Board and the low-level evidence used by some practitioners to justify their promotion and practice. It supports efforts by the Chiropractors' Association of Australia to encourage more research. (Chiropr J Australia 2016;44:234-245).