A general record of my ongoing battle with all forms of nonsense.

Tuesday, 6 October 2009

General Chiropractic Council to Change Patient Information Leaflet

My complaint to the Advertising Standards Authority about the General Chiropractic Council’s Patient Information Leaflet has now gone through the ASA’s process.

The ASA has managed to deal with my complaint as an “Informally Resolved Complaint” rather than pushing it through to a formal adjudication.

This is a very interesting outcome.

What this means is that the General Chiropractic Council has withdrawn the claims as soon as they were approached and asked the ASA’s guidance in how they can make their advertising comply. There is an important point to note here: if the General Chiropractic Council believed they had the evidence to back up the efficacy of using chiropractic as a treatment for asthma, headaches, migraine and infant colic – then they simply could have produced it.

The ASA would have assessed this for them free of charge and either upheld the complaint asking them to remove the advertising, or not upheld the complaint. There is only one reason for backing off from the complaints: the GCC must have appreciated that that they simply do not currently have the evidence.

This is a significant change, and has huge implications for the circa 600 complaints currently being handled by the GCC.

By backing off and removing their claims before the ASA investigates, the GCC is acknowledging that even their loosely worded, slightly ambiguous leaflet (text below) is in breach of ASA guidelines.

There is some evidence, though more research is needed, that you may see an improvement in some types of:
• asthma
• headaches, including migraine
• infant colic.

If the GCC believes this loosely worded text to be in breach of ASA guidelines, then they must also believe that every complaint made to the GCC surrounding this subject is valid.

Am I being too optimistic in anticipating a vast number of guilty verdicts against chiropractors in the forthcoming months?

It also brings up a second potentially interesting outcome. If you’ve been following this blog, you will be aware of the letter that the GCC sent to Trading Standards in defence of their members. The advice given in that letter includes the exact text within the patient information leaflet that I complained about.

Will the GCC now follow that letter up with another saying that they are now withdrawing that claim? I will be putting that question to them.

Perhaps I'm being a bit optimistic – especially considering that more than a week after agreeing to informally resolve the complaint, the patient information leaflet remains on their website in its original form.

I am now beginning work on my second ASA complaint about the same Patient Information Leaflet.

While you're in the mood for chiro woo, I highly recommend Zeno's post on his recent ASA complaint - published at the same time.


Alice said...


"Though more research is needed" - they clearly haven't read "Bad Science". Good old Ben Goldacre points out that this phrase is effectively banned from the BMJ - you need to say WHAT research, and how, what is already known and what specifically still needs testing. It's no good just doing more and more of the same trials until you get a result you want.

Silly question, but is that bit about more research being needed part of what they say publicly? Well at least that might encourage the public to think about, and possibly take part in, research. There is no better way to learn about such things than to do them.

Anyway, well done!

Anonymous said...

Your complaint assumes that there was some intent on deceiving the public by the GCC. This is not the case. There are many different standards of research, the question is, can you always apply the highest standard to what you are specifically looking for? The ASA in THEIR judgement will only allow research that is the absolute highest standard (randomized clinical trials), however as this is the most expensive form of research, AND the fact that this type of study cannot be utilized with every type of treatment or condition, then what EVERY health care profession does is fall back onto the next best form of research available in making a decision on treatment. This does not mean it is not valid or stringent, it means that you must make a decision on efficacy based on what research IS available (double blind, cohort, case studies etc). Because of the narrow view the ASA takes on research to support advertising, the GCC had to remove the advertising, even though there is research (although not RCT) to support the claims. So the fact that the GCC did not produce the research had more to do with the fact that it was not RCT, rather than anything else. Note that medical doctors also follow the same process of elimination when treating patients. They start with the most researched RCT treatment first, and then fall back on other standards of research if there is no RCT available for the condition they are treating. They will not, as many might extrapolate from the chiropractic experience here, deny treatment because there are no RCT's to prove their choice of treatment might work. There was never any deception intended, just a change in the ASA requirement. There are loads of good research (albeit not RCT level) that justifies treatments based on the simple fact that "this is the bulk of what we know now". There is misunderstanding of the issues here that the lay public do not fully understand, and so many are left to draw the wrong conclusions. I hope this clarifies things.