Monday, April 20, 2009

Chiroquackery #1?

I love Consumers Union and their magazine Consumer Reports. They are a great, not-for-profit, unbiased organization fighting for consumer protection and they independently test the quality of various merchandise. But, they have a terrible habit of using surveys to rate things that cannot be directly tested in their labs. So, the results come up completely misleading. In this month's issue they made the claim that the best treatment for back pain was going to a chiropractor (59% were happy), followed by going to a physical therapist, in third place was acupuncture and way down in the bottom was going to a physician (a mere 34% happy). They sent surveys to a lot of people, but with a vague topic like back pain, basing your ratings by only asking "How satisfied were you with your treatment?" can only result in a meaningless outcome. They have no controls about severity of pain, underlying disease, number of visits or compliance with the prescribed treatment. Also, maybe people who have already made the decision to go to an acupuncturist or chiropractor are more likely to report having a satisfactory experience no matter what the outcome. Maybe people who see anyone once a week for a year will feel better than someone who, at most, sees someone a few times a year for their pain. The efficacy of pain treatment is extraordinarily difficult to measure. A simple survey is far from adequate. Consumers Union should know better (after all, they've got a team of statisticians). They are a very influential organization and this report is giving undeserving ammo to quacks (who are already pimping it) and terribly misleading their readers. Stick with crashing cars and breaking washing machines!

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