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Thursday, 18 June 2009

The BCA's Worst Day

Today has not been a good day for the British Chiropractic Association.

The last gasp of their increasingly wonky media strategy - the release of the "plethora" after fifteen months - has been discredited in less than a single day.

If you have not looked at the Blogs already, see the legendary David Colquhoun's easy demolition of the claims for colic and the incomparable Gimpy on the BCA having no evidence that chiropractic can help with ear infections. And then look at the deeply scathing blogpost at Ministry of Truth.

[Add: Evidence Matters subjects the BCA's claims on asthma to devastating bombardment.]

No wonder Phil Plait in America is just shaking his head at the inanity of the BCA.

And this humiliation is in the wider context of the Quacklash of activists and bloggers, hundreds of complaints to Tradings Standards, the strange (and possibly legally unsound) maneuvering by the General Chiropractic Council, and of course the wonderful Sense About Science campaign, which now has over 10,000 signatures.

But it was a point picked up by another Blogger which means that this case could yet take a more interesting turn.

The Lay Scientist Blog noticed a most curious discrepancy.

The BCA quote a Cochrane Review (no less) as saying:

"There was weak evidence to support the use of [chiropractic]."

But according to the Lay Scientist, the original statement is:

"There was weak evidence to support the use of hypnosis, psychotherapy, acupuncture and chiropractic but it was provided in each case by single small trials, some of dubious methodological rigour."

(Emphasis added.)

If this is correct, there can be no doubt that (a) such deletions would be deliberate and (b) the edited quotation would be likely to give a different impression to the original.

However, I will leave you to draw your own conclusion as to what the motives could have been behind this apparent "sexing-up" of the original quotation. I just hope that this dossier took more than 45 minutes to compile.

That said, and more gravely, I do not think those responsible for this editing - and for approving this statement for publication - can now be looking forward to any cross-examination on how this discrepancy came about, regardless of whether Simon Singh wins his appeal on meaning.

Generally, it is obvious there is now no good way out for the BCA in this awful litigation.

Their least bad outcome would be to drop the case now, relying on their "vindication" at the preliminary hearing, and suffering the current ridicule.

Their worst outcome would be to lose the case.

I have always maintained that this case should never have been brought; but it is simply not for me to call on the BCA to drop it.

Though, of course, it is never too late to make a good decision.

16 comments:

Tony Lloyd said...

Jack, what are the rules about costs in a libel action? I'm thinking about a possible "Heresiarch ruling" by the judge. When Whistler (the painter) sued Ruskin (the critic) for libel Whilster won. He was awarded damages of one farthing.

Now it strikes me that if the BCA were libelled they weren't libelled very much. They wouldn't have been libelled at all if Simon Singh had said "there is a paltry amount of crap evidence" and "they might not be deliberately pushing false remedies, but they're hardly looking after the interests of the public".

With the offer of free space in the Grauniad to reply could the judge rule that the BCA had already been offered more than adequate compensation? What would happen to the costs if that was decided?

Whistler, for the record, went bankrupt.

TK said...

Is chiropractic a good treatment for shooting yourself in the foot?

pvandck said...

TK said...
"Is chiropractic a good treatment for shooting yourself in the foot?"

If you wring the sufferer's neck hard enough it probably is.

Niklas said...

It's wonderful to read these blog posts; the internet has again proved of great benefit to science (it was invented for scientific collaboration, after all!).

But I first noticed the BCA's "evidence" in a letter they wrote to the BMJ in response to Evan Harris' editorial: http://www.bmj.com/cgi/eletters/338/jun03_1/b2254

All the bloggers who have written posts critiquing the BCA's evidence should write to the BMJ and summarise their posts there (they can reply to Richard Brown's letter on through the link above). These criticisms must reach the scientific press.

Kenneth said...

Jack of Kent, you wrote:

"Their least bad outcome would be to drop the case now, relying on their "vindication" at the preliminary hearing, and suffering the current ridicule.

Their worst outcome would be to lose the case."

Why is the least bad outcome for the BCA dropping the case? Is it not possible that the BCA could still win in court? If Simon Singh were to loose his appeal, wouldn't the earlier ruling on the meaning of "bogus" still make this difficult for him, despite the terrible weakness of the evidence the BCA have cited? Although today has been a good day for critics of the BCA, I don't see why it affects the legal issues. Hopefully I'm missing something.

Anonymous said...

How much is a "jot"?

Yamato said...

"Is chiropractic a good treatment for shooting yourself in the foot?"

I think this time they have shooted themselves in the head.

Some time ago my opinion was also that the best option for the BCA would be to drop the case. Now I tend to think that it is their only option for their survival...

Le Canard Noir said...

As with any sort of bad news, it is best to try to get it all out in one go instead of letting it rumble for ages and constantly be on the 'front pages'. There must surely be a good case for them to drop now and take the hit. Maybe they think the internal ramifications would be too huge, but the alternatives now look more and more like the inevitable extinction of the BCA.

Andy said...

Kenneth,

I can't speak for Jack but I think the point is that every day that this drags on just gets worse for the BCA. The industry has already lost so much with very few people even coming out of the woodwork to speak up for chiro.

From where I sit, a win just looks like some money in the BCA's pockets. It's hard to see that any credibility would accompany it though since the win will only be on the exceedingly technical question of whether "happily promoting bogus treatments" is defamatory.

It will do nothing to change the evidence, or lack thereof, that's on trial outside the courtroom.

Tony Lloyd said...

Anonymous asked what a "jot" was.

It's one of these: i

The word comes from a corruption of "ioata", the Greek for "i".

In a non-legal sense I would take Simon Singh's "not a jot" to mean there was either:

1. Absolutely none (which is untrue)
2. A negligible amount (which, going on what the other bloggers are saying is true. The "evidence" is so slim, so bad and so circumstantial that it can be completely discounted.)

Strictly speaking a negligible amount is still an amount, but to press the point would be overly pedantic. There is no material difference between an amount that can be ignored and one that doesn't exist (you treat both as if they didn't exist).

Of course, the law and lawyers might disagree!

Alan the Chemist said...

It seems the evidence is weak. Certainly my paediatrician colleague thinks so.

I think so too, some of the studies might just warrant further research.

Simon said "not a jot", which suggests none or negligible.

Weak would be more than that. What do the legals think?

Anonymous said...

A definition

not a jot or tittle, not a bit; not at all: The world situation matters not a jot or tittle to him.

evidence that can be taken together to suggest a trend would be considered to be more than a jot.

Mong H Tan, PhD said...

If I'm not mistaken, the rule of this libel case is: The loser will assume all the costs!

It looks like Singh is fully prepared to fight on, to the costs of exceeding £1m!? And, that is a very big "jot" to me!

Besides, just a curiosity: Can other (non-BCA) chiropractors, initiate a class-action lawsuit against Singh, since his persistent campaigns against chiropractic, must have had adverse effects on their ongoing paramedical businesses!?

Best wishes, Mong 6/19/9usct3:17p.

sceptic said...

@Kenneth
I suspect the reason JackOfKent describes dropping the case as the least bad outcome is because it would bring all this negative attention to an end (well, reduce it a bit anyway).

They aren't going to make a meaningful amount of money out of this. They are suing Simon Singh over an interpretation of his words that he didn't intend so it's not as if they are going to get a meaningful retraction out of him.

They have shown their evidence for the claims that he was attacking and been laughed at for it's weakness. I'm amazed they were so foolish as to do this.

The longer this goes on the longer they will keep shooting themselves in the foot. What can they hope to gain from a victory.

Even if they win Simon can walk straight out of court and write an article on what idiots they are and how feeble the evidence is for chiropractic and quote the BCA's own studies to back this up.

Doubtless there's a book in it for Simon Singh as well who, what with all the attention, will hopefully not be out of pocket for too long.

In the short term the lawyers will win, in the long term Simon will win, the BCA can only lose harder the longer it goes on.

DCPeri said...

A good summary of the current state of chiropractic research (pitiful though it may be compared to far more generously funded research) may be found at http://www.icabestpractices.org/chapter-docs.html

DCPeri said...

Having been a close observer in not one, but two, attempts by the chiropractic profession to develop its research arm, I can state categorically that the reason chiropractic has weak research, is because chiropractic is systematically excluded from science academia and biomedical research funding.

The first series of events occured in the late 1980's through the early 1990's, when the Foundation for Chiropractic Education and Research funded a series of fellowships to financially assist Masters-degree-holding scientists to achieve their PhD, with their research foci on chiropractic. The concept was to achieve a "critical mass" of credible researchers so that chiropractic-focused research centers could be founded. What happened instead was, after writing chiropractic-oriented dissertations, the fledgling chiropractic researchers found that they could not get hired, published, or funded if any aspect of their applications or papers referenced chiropractic in any way, and that they were socially ostracized in academia if they discussed their interest in chiropractic. Unsurprisingly, all these researchers are working in other areas now.

The second experience was at Florida State University, which has a well-established reputation for biomedical research. FSU established a College of Medicine in 2000, one of whose stated missions was to improve training of young physicians in alternative medicine. The Florida Chiropractic Association raised $1M in "seed money" from its membership and lobbied heavily until money was budgeted by the legislature to include a College of Chiropractic at FSU. This looked set to proceed in 2003-2004.
At that time, the medical school's final accreditation was pending, and suddenly the medical school's clinical director, an irascible orthopedist who hates chiropractors virulently, announced that he would resign if a chiropractic school were founded at FSU. He arm-twisted approximately 1/3 of the medical staff of the school to go along with him. An administrative hearing was held; the Florida Medical Association and the American Medical Association both spent hundreds of thousands of dollars getting career "experts" in "quackery" to testify.

So, chiropractic is not scientific because it doesn't have large-scale, university-based research to back it up. But, it has lower quality research because it is "not scientific" enough to be the subject of serious academic research.