Anyone know what Scoliosis Thoracalis is?

[Whisper]

Originally posted by: Mark R

Originally posted by: Whisper
Well, if the aim of the study was to examine the effectiveness of the treatment, then dropping those patients was probably the right thing to do, as they didn't adhere to the entire treatment protocol. However, what could've been done would be to compare their improvement (if any) to the adherence group; that'd go a long way in improving external validity.

On the contrary, if the treatment requires continued input in order to be effective, then its effectiveness depends on how many patients actually continue with it. For that reason, they cannot be excluded from the results.

For example, lets say there's a new pill for IBS, but it has a side effect of causing severe headaches. It completely relieves the IBS symptoms as long as you take it. However, no one can continue to take it for more than a few days because of the headaches. Is this an effective treatment? No. Because, no one will take it. It's therefore pointless recommending this treatment, if there is a better alternative.

This case series is difficult to interpret, because of the lack of a control group. As such, it lacks internal validity. The external validity can't be assessed, as the abstract provides insufficient information on the selection procedures.

Not necessarily. Leaving out those individuals who didn't adhere to the treatment regimen damages generalizability of the findings, definitely. However, if you're just interested in seeing how effective the treatment is, then you only need to examine the cases in which the treatment is followed 100%; otherwise, you're examining the effects of the treatment plus its realistic ability to be completed.

Although I guess with such a study, efficacy would be a better word to go with than effectiveness, to an extent, as you're assessing the ability of the treatment to improve the condition in an ideal environment. But when the treatment is newly-developed, you have to run such "perfect world" studies to determine efficacy before you can begin to go after effectiveness. Once the ability of the treatment to alleviate the condition has been shown in a controlled setting, then you can start to examine how realistic it would be to implement.

The lack of a control group is the key shortcoming, though, that's to be sure.

 

[z0mb13]

talked to the doctor, he said I had the scoliosis since I was little, so I shouldnt worry about it.. phew

 

[eits]

Originally posted by: z0mb13
talked to the doctor, he said I had the scoliosis since I was little, so I shouldnt worry about it.. phew

?? you shouldn't worry about it? i guess... not unless you want back pain later down the road.

 

[SirStev0]

Originally posted by: eits

Originally posted by: iliopsoas

Originally posted by: eits

I am a chiropractic quack. I think chiropractic back cracking cures everything.

Fixed.

when did i ever say chiropractic cured things? i've never said that and never will. your body cures itself.

please find me a post where i ever said that chiropractic cured everything, much less anything.

Always thought it funny when people call backcrackers quacks. Doctors never admit it but plenty of them go to them... My dad was in a pretty serious car wreck, his GP, who happened to be a friend of the family, suggested he go to his chiro.

Proof enough for me. And to be honest, not everything is fixable with a pill taken everyday. Painkillers only mask the pain while your body heals, they don't make it heal.

As a (hopefully) future doctor, I give you a nod eits. You will never hear me say a bad thing about a Chiropractor.

 

[SirStev0]

Originally posted by: AbAbber2k

Originally posted by: eits

Originally posted by: AbAbber2k

Originally posted by: eits
an acute herniated disc is more critical than scoliosis. an acute subluxated shoulder is also very important to treat because it could cause the patient pain during daily, personal, or work related activities, which is important. giving nsaids or cox2 inhibitors or whatever will never treat or correct the problem that's causing the symptoms... it just masks the symptoms.

'Serious' was poor word choice on my part. I definitely agree that chronic-pain causing conditions are more critical than something that might never cause pain, discomfort or restrict a persons daily life. And yes, we all know that there are a lot of prescription-happy doctors out there. My point was that TREATING scoliosis is a 'serious' matter because manipulation of the spine IS SERIOUS. Having someone hammer on your back every month/week, just so your spine is perfectly straight, could leave you in worse condition 20 years from now than you were when you first started.

I suppose what it comes down to is for patients to try and be a little more critical and not just blindly follow what their doctor tells them to do. In the case of chiropractitioners, make sure they're reputable... make sure they give you a thorough examination and don't just ask you to let them start crunching away at your bones. And in the case of general practitioners... don't be afraid to ask for alternatives to being drugged up or ask to be referred to a specialist. If they discount your concerns... find a new doctor.

There are quacks on both sides of the spectrum.

that's not true whatsoever... unless they adjusted into the concavity of the scoliosis...

disc problems cause lots of pain long-term because you lose disc integrity which throws you into djd. after a while, you'll end up with a compressed nerve and no way to restore disc space without surgery.

So you don't think regular spinal manipulation could potentially CAUSE things like reduction in disc integrity or wear on the vertebrae? ROFL. And all for a condition that might never produce distress for the patient.

Everytime you stand, bend over, sit down or do any other movement involving you back (basically everything) you are placing wear on the vertebrae. I seriously doubt chiropractic manipulation would ever put any unusual amount of stress or cause any damage that would not normally occur.

 

[SirStev0]

Originally posted by: Whisper

Originally posted by: eits

Originally posted by: AbAbber2k

Originally posted by: eits
edit: i'm getting my doctorate in chiropractic. i'm still in chiropractic school. it's med school, pretty much, but with a different name and some added courses to help you better understand how chiropractic works. we have the same courses and books as med schools, though... my school has the added bonus of having a two-trimester gross anatomy cadaver lab... we all get cadavers to dissect and study. pretty amazing when you actually see, cut out, and touch things you've learned/read/seen in books.

I actually recently graduated with my B.S. in Kinesiology. Anatomy, Biomechanics, Human Phys, Injury Prevention and related courses were standard fare. I also had a cadaver lab, but not nearly as hands on as I'm sure yours is. I've toyed with going back to school for Physical Therapy... Nursing wouldn't be too hard either. Medical school is a little ambitious for me though. The majority of what I've taken would definitely help me out but I just don't think it's my thing.

if you think you can make it through nursing school, you can make it through med school. go for it, man (that is, if you think that's what you're meant to do in life).

I'm not quite sure about that, as medical school is more demanding both in its content and time requirements than is a nursing program (don't get me wrong, I'm not degrading nursing in any way; nurses rock). But you could always give nursing a try, and if you like the work but would prefer a change in position, then try medical school afterwards.

That being said, nurses and doctors definitely have very different responsibilities, and I'm quite positive there are many RNs who would breeze through medical school, yet prefer the duties of a nurse to those of an MD.

I would never compare nursing to med school. My brother, who is currently in nursing school, does nothing compared to what I will do in medical school. Nurses learn with experience, doctors learn with theory. They are not the same.

 

[SirStev0]

I do not totally understand the entire hatred between Chiro's and doctors, but it is def find it absurd. I also find it disturbing about the tone the (I am assuming, since they atleast partially said it) med students have. I mean I get it, youre in med school; youre the balls. Lets be honest here though, a good deal of research is pretty questionable on all sides. The drug companies are out of control in america and our society is compliant. Look at Alzh. medicine that basically do nothing, depression drugs that are questionable at best (not to mention probably unsafe), and new diseases everyday that make less sense the the medications that supposebly treat them (see restless leg syndrome). Medications don't treat everything and maybe alternatives are effective. Asian theories were used for thousands of years and seem to do good. They involve a lot of questionable things. Look at their statistics for health, quite a difference from our rates.
I am quite tired of this med school boys club stuff, it is a little disheartening. Really not looking forward to a class of 150 as sholes with superiority complexes for the next few years.

 

[Whisper]

Originally posted by: SirStev0
I do not totally understand the entire hatred between Chiro's and doctors, but it is def find it absurd. I also find it disturbing about the tone the (I am assuming, since they atleast partially said it) med students have. I mean I get it, youre in med school; youre the balls. Lets be honest here though, a good deal of research is pretty questionable on all sides. The drug companies are out of control in america and our society is compliant. Look at Alzh. medicine that basically do nothing, depression drugs that are questionable at best (not to mention probably unsafe), and new diseases everyday that make less sense the the medications that supposebly treat them (see restless leg syndrome). Medications don't treat everything and maybe alternatives are effective. Asian theories were used for thousands of years and seem to do good. They involve a lot of questionable things. Look at their statistics for health, quite a difference from our rates.
I am quite tired of this med school boys club stuff, it is a little disheartening. Really not looking forward to a class of 150 as sholes with superiority complexes for the next few years.

Actually, from what I know, restless leg syndrome is a fairly-verifiable condition. It basically has to do with a malfunction in the portion of your cerebellum that inhibits movement during sleep.

This same cerebellar area is the reason why many people have dreams in which it's difficult to walk/run/whatever.

 

[Whisper]

Originally posted by: SirStev0

Originally posted by: Whisper

Originally posted by: eits

Originally posted by: AbAbber2k

Originally posted by: eits
edit: i'm getting my doctorate in chiropractic. i'm still in chiropractic school. it's med school, pretty much, but with a different name and some added courses to help you better understand how chiropractic works. we have the same courses and books as med schools, though... my school has the added bonus of having a two-trimester gross anatomy cadaver lab... we all get cadavers to dissect and study. pretty amazing when you actually see, cut out, and touch things you've learned/read/seen in books.

I actually recently graduated with my B.S. in Kinesiology. Anatomy, Biomechanics, Human Phys, Injury Prevention and related courses were standard fare. I also had a cadaver lab, but not nearly as hands on as I'm sure yours is. I've toyed with going back to school for Physical Therapy... Nursing wouldn't be too hard either. Medical school is a little ambitious for me though. The majority of what I've taken would definitely help me out but I just don't think it's my thing.

if you think you can make it through nursing school, you can make it through med school. go for it, man (that is, if you think that's what you're meant to do in life).

I'm not quite sure about that, as medical school is more demanding both in its content and time requirements than is a nursing program (don't get me wrong, I'm not degrading nursing in any way; nurses rock). But you could always give nursing a try, and if you like the work but would prefer a change in position, then try medical school afterwards.

That being said, nurses and doctors definitely have very different responsibilities, and I'm quite positive there are many RNs who would breeze through medical school, yet prefer the duties of a nurse to those of an MD.

I would never compare nursing to med school. My brother, who is currently in nursing school, does nothing compared to what I will do in medical school. Nurses learn with experience, doctors learn with theory. They are not the same.

I wouldn't say that at all; it's a very gross generalization. It all is HEAVILY dependent on the nursing school, as they seem to be a bit less-comparable nationwide than accredited medical schools. I know quite a few nursing students in accelerated BSN programs that have workloads nearly equaling those of medical school students.

In actuality, nurses acquire more practical knowledge from their formal schooling than do MDs. Medical students learn the vast majority of their trade during their internship and residency. The first two years of med school provide the conceptual basis for this practical knowledge.

 

[SirStev0]

Originally posted by: Whisper

Originally posted by: SirStev0

Originally posted by: Whisper

Originally posted by: eits

Originally posted by: AbAbber2k

Originally posted by: eits
edit: i'm getting my doctorate in chiropractic. i'm still in chiropractic school. it's med school, pretty much, but with a different name and some added courses to help you better understand how chiropractic works. we have the same courses and books as med schools, though... my school has the added bonus of having a two-trimester gross anatomy cadaver lab... we all get cadavers to dissect and study. pretty amazing when you actually see, cut out, and touch things you've learned/read/seen in books.

I actually recently graduated with my B.S. in Kinesiology. Anatomy, Biomechanics, Human Phys, Injury Prevention and related courses were standard fare. I also had a cadaver lab, but not nearly as hands on as I'm sure yours is. I've toyed with going back to school for Physical Therapy... Nursing wouldn't be too hard either. Medical school is a little ambitious for me though. The majority of what I've taken would definitely help me out but I just don't think it's my thing.

if you think you can make it through nursing school, you can make it through med school. go for it, man (that is, if you think that's what you're meant to do in life).

I'm not quite sure about that, as medical school is more demanding both in its content and time requirements than is a nursing program (don't get me wrong, I'm not degrading nursing in any way; nurses rock). But you could always give nursing a try, and if you like the work but would prefer a change in position, then try medical school afterwards.

That being said, nurses and doctors definitely have very different responsibilities, and I'm quite positive there are many RNs who would breeze through medical school, yet prefer the duties of a nurse to those of an MD.

I would never compare nursing to med school. My brother, who is currently in nursing school, does nothing compared to what I will do in medical school. Nurses learn with experience, doctors learn with theory. They are not the same.

I wouldn't say that at all; it's a very gross generalization. It all is HEAVILY dependent on the nursing school, as they seem to be a bit less-comparable nationwide than accredited medical schools. I know quite a few nursing students in accelerated BSN programs that have workloads nearly equaling those of medical school students.

In actuality, nurses acquire more practical knowledge from their formal schooling than do MDs. Medical students learn the vast majority of their trade during their internship and residency. The first two years of med school provide the conceptual basis for this practical knowledge.

I really do not think we disagreed, you basically (actually almost exactly) said my feelings on the matter. I was basically making the claim that nurses are not as involved in the theory as doctors are expected. Nursing is much more practical. Doctors learn theory first then go on to hands on training (which is essentially where they learn most about actually being a doctor). Nursing is also a very very large group. There are nurses who are essentially ass-wipers (I can say that because my brother is very proud of this title) all the way up to nurses who have responsiblities on the same level or even possibly above some doctors.

 

[SirStev0]

Originally posted by: Whisper

Originally posted by: SirStev0
I do not totally understand the entire hatred between Chiro's and doctors, but it is def find it absurd. I also find it disturbing about the tone the (I am assuming, since they atleast partially said it) med students have. I mean I get it, youre in med school; youre the balls. Lets be honest here though, a good deal of research is pretty questionable on all sides. The drug companies are out of control in america and our society is compliant. Look at Alzh. medicine that basically do nothing, depression drugs that are questionable at best (not to mention probably unsafe), and new diseases everyday that make less sense the the medications that supposebly treat them (see restless leg syndrome). Medications don't treat everything and maybe alternatives are effective. Asian theories were used for thousands of years and seem to do good. They involve a lot of questionable things. Look at their statistics for health, quite a difference from our rates.
I am quite tired of this med school boys club stuff, it is a little disheartening. Really not looking forward to a class of 150 as sholes with superiority complexes for the next few years.

Actually, from what I know, restless leg syndrome is a fairly-verifiable condition. It basically has to do with a malfunction in the portion of your cerebellum that inhibits movement during sleep.

This same cerebellar area is the reason why many people have dreams in which it's difficult to walk/run/whatever.

I would love to actually find the study on that disease, because all the tv ads make me die laughing. The problem with drug company "studies" are that they are bullsht. They spend almost half the money they claim they use for research on advertising things. Results are questionable. The companies control the studies, the researchers, the trials, basically everything. Half the FDA are in the drug companies pockets and the other half own stock in one of the companies.

There was a very good expose by a researcher who worked for years as a drug company dog. I have to dig it out from my text books from years past to remember the name, but it was something along the lines of "Private interests of scientific research". It was an amazing read and quite the eye opener.
One of the more interesting stories was about a major and commonly used Alzheimer's drug. The research was presented in such a way that it seemed that patients who took the drug regained cognitive power. Using statistics play and sweet graphs they advertised the hell out of the drug. One graph showed this very nice steep linear increase in cognative power; however you actually looked at the entire graph of all the information and not just one focused in part you would see a straight line. They were only reporting on four parts of a 30 part scale. This is a major drug company and a very common drug for people with this horrible disease.

They sell us this tripe and we take a big old bite.

 

[Whisper]

Originally posted by: SirStev0

Originally posted by: Whisper

Originally posted by: SirStev0

Originally posted by: Whisper

Originally posted by: eits

Originally posted by: AbAbber2k

Originally posted by: eits
edit: i'm getting my doctorate in chiropractic. i'm still in chiropractic school. it's med school, pretty much, but with a different name and some added courses to help you better understand how chiropractic works. we have the same courses and books as med schools, though... my school has the added bonus of having a two-trimester gross anatomy cadaver lab... we all get cadavers to dissect and study. pretty amazing when you actually see, cut out, and touch things you've learned/read/seen in books.

I actually recently graduated with my B.S. in Kinesiology. Anatomy, Biomechanics, Human Phys, Injury Prevention and related courses were standard fare. I also had a cadaver lab, but not nearly as hands on as I'm sure yours is. I've toyed with going back to school for Physical Therapy... Nursing wouldn't be too hard either. Medical school is a little ambitious for me though. The majority of what I've taken would definitely help me out but I just don't think it's my thing.

if you think you can make it through nursing school, you can make it through med school. go for it, man (that is, if you think that's what you're meant to do in life).

I'm not quite sure about that, as medical school is more demanding both in its content and time requirements than is a nursing program (don't get me wrong, I'm not degrading nursing in any way; nurses rock). But you could always give nursing a try, and if you like the work but would prefer a change in position, then try medical school afterwards.

That being said, nurses and doctors definitely have very different responsibilities, and I'm quite positive there are many RNs who would breeze through medical school, yet prefer the duties of a nurse to those of an MD.

I would never compare nursing to med school. My brother, who is currently in nursing school, does nothing compared to what I will do in medical school. Nurses learn with experience, doctors learn with theory. They are not the same.

I wouldn't say that at all; it's a very gross generalization. It all is HEAVILY dependent on the nursing school, as they seem to be a bit less-comparable nationwide than accredited medical schools. I know quite a few nursing students in accelerated BSN programs that have workloads nearly equaling those of medical school students.

In actuality, nurses acquire more practical knowledge from their formal schooling than do MDs. Medical students learn the vast majority of their trade during their internship and residency. The first two years of med school provide the conceptual basis for this practical knowledge.

I really do not think we disagreed, you basically (actually almost exactly) said my feelings on the matter. I was basically making the claim that nurses are not as involved in the theory as doctors are expected. Nursing is much more practical. Doctors learn theory first then go on to hands on training (which is essentially where they learn most about actually being a doctor). Nursing is also a very very large group. There are nurses who are essentially ass-wipers (I can say that because my brother is very proud of this title) all the way up to nurses who have responsiblities on the same level or even possibly above some doctors.

Well, my main disagreement was with your statement that nursing school isn't at all comparable to medical school in terms of difficulty, when in fact at many institutions it can be equally rigorous.

But no, nurses generally aren't given the depth of knowledge to which medical doctors are privy. Using my own field as an example, it's similar to comparing a master's degree in counseling or psychometrics to a doctorate in clinical psychology; both types of professional perform some of the same tasks, but the degree of understanding and depth of knowledge is a key difference.

 

[SirStev0]

I still would say Medical School is harder. Nurses (as far as I know, I will actually be looking into this in hopes that I am not currently putting my foot in my mouth) do not take things like organic chemistry, advanced biology and microbiology, biochemistry, biomechanics, etc. This are very difficult classes. I would not doubt that many nurses would be able to take these classes (in other words I am not saying they are any less intelligent), however they do need to be able to have an understand of these theories. These are all classes that are taken prior to med school in order to prepare ones self for the next step up.

 

[Whisper]

Originally posted by: SirStev0
I still would say Medical School is harder. Nurses (as far as I know, I will actually be looking into this in hopes that I am not currently putting my foot in my mouth) do not take things like organic chemistry, advanced biology and microbiology, biochemistry, biomechanics, etc. This are very difficult classes. I would not doubt that many nurses would be able to take these classes (in other words I am not saying they are any less intelligent), however they do need to be able to have an understand of these theories. These are all classes that are taken prior to med school in order to prepare ones self for the next step up.

Many nursing programs have some of the same undergrad pre-reqs as medical school; I'll ask a friend of mine who went through Duke's accelerate BSN program what she had to take, but I believe at the very least it included bio, chem, and biochem. Not sure about orgo, physics, and calc, but I'll check.

Also, much of what you learn in undergrad, especially organic chemistry, won't be used very often in medical school unless you plan on going entirely into biomedical research. It all really depends on what you plan on doing, but I've heard from multiple surgeons (and yes, I know the pitfalls of anecdotal evidence) that your second undergrad semester of o. chem is the last exposure most physicians will have to that particular slant on the information.

 

[Whisper]

Originally posted by: SirStev0

Originally posted by: Whisper

Originally posted by: SirStev0
I do not totally understand the entire hatred between Chiro's and doctors, but it is def find it absurd. I also find it disturbing about the tone the (I am assuming, since they atleast partially said it) med students have. I mean I get it, youre in med school; youre the balls. Lets be honest here though, a good deal of research is pretty questionable on all sides. The drug companies are out of control in america and our society is compliant. Look at Alzh. medicine that basically do nothing, depression drugs that are questionable at best (not to mention probably unsafe), and new diseases everyday that make less sense the the medications that supposebly treat them (see restless leg syndrome). Medications don't treat everything and maybe alternatives are effective. Asian theories were used for thousands of years and seem to do good. They involve a lot of questionable things. Look at their statistics for health, quite a difference from our rates.
I am quite tired of this med school boys club stuff, it is a little disheartening. Really not looking forward to a class of 150 as sholes with superiority complexes for the next few years.

Actually, from what I know, restless leg syndrome is a fairly-verifiable condition. It basically has to do with a malfunction in the portion of your cerebellum that inhibits movement during sleep.

This same cerebellar area is the reason why many people have dreams in which it's difficult to walk/run/whatever.

I would love to actually find the study on that disease, because all the tv ads make me die laughing. The problem with drug company "studies" are that they are bullsht. They spend almost half the money they claim they use for research on advertising things. Results are questionable. The companies control the studies, the researchers, the trials, basically everything. Half the FDA are in the drug companies pockets and the other half own stock in one of the companies.

There was a very good expose by a researcher who worked for years as a drug company dog. I have to dig it out from my text books from years past to remember the name, but it was something along the lines of "Private interests of scientific research". It was an amazing read and quite the eye opener.
One of the more interesting stories was about a major and commonly used Alzheimer's drug. The research was presented in such a way that it seemed that patients who took the drug regained cognitive power. Using statistics play and sweet graphs they advertised the hell out of the drug. One graph showed this very nice steep linear increase in cognative power; however you actually looked at the entire graph of all the information and not just one focused in part you would see a straight line. They were only reporting on four parts of a 30 part scale. This is a major drug company and a very common drug for people with this horrible disease.

They sell us this tripe and we take a big old bite.

Oh trust me, I know quite well the pains drug companies will go through to support positive efficacy studies of their medications. There's a huge push in both the medical and psychological fields to force researchers to disclose their sources of funding in all studies, especially those related to drug trials. Many scientists currently practice such disclosure, but there are definitely instances in which it's not done.

And yes, statistics can be abused quite well by practiced and knowledgeable individuals, which is why they spend so much time drilling proper usage into us doctoral students. Not that I'm suggesting any professional would falsify his or her results, but as you've pointed out, even minor effects can be made to look huge depending on the method of reporting results. This is why critical review of journal articles is so important.

As for restless leg syndrome, I don't have any articles on hand, but I'll see if I can dig anything up at some point. I'm pretty sure it's a well-validated and accepted condition, but just as with any diagnosis, the opportunity for abuse is there.

 

[eits]

Originally posted by: SirStev0

Originally posted by: Whisper

Originally posted by: eits

Originally posted by: AbAbber2k

Originally posted by: eits
edit: i'm getting my doctorate in chiropractic. i'm still in chiropractic school. it's med school, pretty much, but with a different name and some added courses to help you better understand how chiropractic works. we have the same courses and books as med schools, though... my school has the added bonus of having a two-trimester gross anatomy cadaver lab... we all get cadavers to dissect and study. pretty amazing when you actually see, cut out, and touch things you've learned/read/seen in books.

I actually recently graduated with my B.S. in Kinesiology. Anatomy, Biomechanics, Human Phys, Injury Prevention and related courses were standard fare. I also had a cadaver lab, but not nearly as hands on as I'm sure yours is. I've toyed with going back to school for Physical Therapy... Nursing wouldn't be too hard either. Medical school is a little ambitious for me though. The majority of what I've taken would definitely help me out but I just don't think it's my thing.

if you think you can make it through nursing school, you can make it through med school. go for it, man (that is, if you think that's what you're meant to do in life).

I'm not quite sure about that, as medical school is more demanding both in its content and time requirements than is a nursing program (don't get me wrong, I'm not degrading nursing in any way; nurses rock). But you could always give nursing a try, and if you like the work but would prefer a change in position, then try medical school afterwards.

That being said, nurses and doctors definitely have very different responsibilities, and I'm quite positive there are many RNs who would breeze through medical school, yet prefer the duties of a nurse to those of an MD.

I would never compare nursing to med school. My brother, who is currently in nursing school, does nothing compared to what I will do in medical school. Nurses learn with experience, doctors learn with theory. They are not the same.

i think you might have that backwards... doctors learn with experience. nurses to, too, but not as much... they rely a lot on what they've learned in school.

 

[eits]

Originally posted by: SirStev0
I do not totally understand the entire hatred between Chiro's and doctors, but it is def find it absurd. I also find it disturbing about the tone the (I am assuming, since they atleast partially said it) med students have. I mean I get it, youre in med school; youre the balls. Lets be honest here though, a good deal of research is pretty questionable on all sides. The drug companies are out of control in america and our society is compliant. Look at Alzh. medicine that basically do nothing, depression drugs that are questionable at best (not to mention probably unsafe), and new diseases everyday that make less sense the the medications that supposebly treat them (see restless leg syndrome). Medications don't treat everything and maybe alternatives are effective. Asian theories were used for thousands of years and seem to do good. They involve a lot of questionable things. Look at their statistics for health, quite a difference from our rates.
I am quite tired of this med school boys club stuff, it is a little disheartening. Really not looking forward to a class of 150 as sholes with superiority complexes for the next few years.

mds hated dcs for a long time because they viewed they did not like the fact that dcs had a more vitalistic approach to healthcare. they said it was unscientific and should be eradicated. so, they set off on an agenda to contain and eliminate chiropractic altogether by propaganda. dcs didn't take too kindly to the fact that the ama trying to kill off the profession. however, that was AGES ago. nowadays, more and more mds are referring out to dcs for certain things and vice versa. it's not nearly as bad as it used to be. it's gotten a lot better, especially with more insurances covering chiropractic care.

i personally restless leg syndrome is caused by lumbar subluxation, which could be brought on by crappy mattresses. my ex has rls and i've been adjusting her low back with very favorable results. she doesn't have NEARLY the crawling discomfort and restlessness in her legs anymore. her mattress is abysmal...

 

[Mark R]

Originally posted by: Whisper
Not necessarily. Leaving out those individuals who didn't adhere to the treatment regimen damages generalizability of the findings, definitely. However, if you're just interested in seeing how effective the treatment is, then you only need to examine the cases in which the treatment is followed 100%; otherwise, you're examining the effects of the treatment plus its realistic ability to be completed.

This issue is most relevant to clinical trials, rather than the short case series, in this example. At any rate, it's a bit of an omission that there is no discussion of the clinical progress of those who dropped out - at least, they could have said there was no data available. However, the concept of 'intention to treat' analysis is an important part of trial design - you should be able to find a good discussion in any contemporary book on clinical trial design or clinical statistics.

'Intention-to-treat' analysis is regarded as the gold standard because it is free from bias but, as you point out, has the side effect of diluting the effect of the treatment. As a result, the results from this analysis are valid, but conservative - i.e. it errs on the side of caution before recommending a treatment.

The problem with 'per protocol' or 'treatment received' analysis, perfect-world as you put it, is that it can introduce serious bias, and compromise the internal validity of the study. E.g. did patients drop out because of side effects, because their symptoms weren't bad enough, or because they were too bad?

The use, therefore, of 'treatment received' analysis is not ideal, and needs justifying - e.g. there were a very large number of drop-outs which would make the ITT analysis too insensitive.

 

[Mark R]

Originally posted by: Whisper
Actually, from what I know, restless leg syndrome is a fairly-verifiable condition. It basically has to do with a malfunction in the portion of your cerebellum that inhibits movement during sleep.

There's no doubt that RLS exists - there are numerous medical reports about it stretching back several centuries.

There's now evidence (autopsy, Dopamine-PET scans and other) linking RLS to abnormalities in the basal ganglia in the brain (these circuits are used for activating and choosing movements), and good evidence that RLS has a strong genetic component.

Research on RLS first got a boost when doctors treating Parkinson's disese recognised that both conditions had peculiar movement effects, and subsequently found that drugs for Parkinson's disease were effective at reducing the severity of RLS.

Until fairly recently, most drugs for parkinson's disease had unacceptable side effects - even barely acceptable given the severity of Parkinson's disease. however, the latest generation of Parkinson's meds are hugely better in terms of side-effects. A number of people, including the drug companies, realised that these much better drugs could be used for RLS.

These meds are still patent protected, and can be sold at very high price. After a number of trials confirming that they worked acceptably, the drug companies have been trying hard to market these drugs, while they still can - once the patent expires, anyone can make and sell the drug for as low a price as they can.

The, more politically correct, reason for the advertising barrage, is because some studies have suggested that a large number of people with the condition, don't realise that anything can be done about it, and think that it's just them. You can argue that if a condition causes so little trouble that people don't seek medical help, then it doesn't need treatment - but then it is a bit of a weird condition and many people may not recognise it, even though it causes them significant trouble.

 

[eits]

Originally posted by: Mark R

Originally posted by: Whisper
Actually, from what I know, restless leg syndrome is a fairly-verifiable condition. It basically has to do with a malfunction in the portion of your cerebellum that inhibits movement during sleep.

There's no doubt that RLS exists - there are numerous medical reports about it stretching back several centuries.

There's now evidence (autopsy, Dopamine-PET scans and other) linking RLS to abnormalities in the basal ganglia in the brain (these circuits are used for activating and choosing movements), and good evidence that RLS has a strong genetic component.

Research on RLS first got a boost when doctors treating Parkinson's disese recognised that both conditions had peculiar movement effects, and subsequently found that drugs for Parkinson's disease were effective at reducing the severity of RLS.

Until fairly recently, most drugs for parkinson's disease had unacceptable side effects - even barely acceptable given the severity of Parkinson's disease. however, the latest generation of Parkinson's meds are hugely better in terms of side-effects. A number of people, including the drug companies, realised that these much better drugs could be used for RLS.

These meds are still patent protected, and can be sold at very high price. After a number of trials confirming that they worked acceptably, the drug companies have been trying hard to market these drugs, while they still can - once the patent expires, anyone can make and sell the drug for as low a price as they can.

The, more politically correct, reason for the advertising barrage, is because some studies have suggested that a large number of people with the condition, don't realise that anything can be done about it, and think that it's just them. You can argue that if a condition causes so little trouble that people don't seek medical help, then it doesn't need treatment - but then it is a bit of a weird condition and many people may not recognise it, even though it causes them significant trouble.

can you post the sources of where you got your info? i'd like to read through it.