On the Global Summit: do critiques of evidence hierarchies favour chiropractic?

The Global Summit systematic review claims that spinal manipulation therapy is not effective in preventing any non-musculoskeletal disorders. But a breakaway group has challenged their findings, in part based on my arguments regarding evidence hierarchies. Are they correct? Does my critique undermine the Global Summit review? If so, does the evidence base favour chiropractic?

Minding the Gaps: Statistical Misrepresentation in Attainment Gap Research

Political interests configure the stories we tell with data. Closing the gap in attainment between disadvantaged students and their advantaged contemporaries is pivotal to an agenda to use education as a positive social force. But both the measurement and representation of this gap is politicised, skewed and open to manipulation. This paper shows how two organisations with inverse aims represent—and misrepresent—their measure of the attainment gap to portray diametric trajectories in the pursuit of equal attainment.

Conversion Therapy: Evidence is Irrelevant

Pressure mounts upon equalities minister Kemi Badenoch to resign over the UK government’s failure to ban conversion therapies. Attention has focused on the government’s failure to publish research commissioned in 2018. But evidence about whether conversion therapy works is irrelevant: conversion therapy is not a medical intervention.

A Ghost of Progress – How Hierarchies Become Fixtures

I have written extensively on hierarchies of evidence in evidence-based medicine. The origin story of hierarchies of evidence is a little contentious. Several sources in EBM cite Campbell and Stanley’s 1963 classic “Experimental and Quasi-experimental Designs for Research” as containing the first hierarchy, or at least the germ of the …

The Dismal Disease: Temozolomide and the Interaction of Evidence

“I think the challenge is really that we still, not only in glioblastoma, but in oncology at large, treat the majority of patients with a one-size-fits-all approach.” — Roger Stupp    Blockbuster drugs are rare. To be a blockbuster, a drug must shift over $1bn worth in one year. There …

Machine Evidence: Trial by AI

Take a look at the following snippets from descriptions of clinical trials, thinking about how you’d rate the quality and strength of the evidence that comes from each: 1: We conducted a clinical trial in which erythropoietin (EPO) administration was administered daily to patients with severe acne resulting in clinically significant …

The Authority of Evidence-Based Medicine

In the early part of the 20th century, the philosopher Ludwig Wittgenstein sought to demonstrate that metaphysical claims are meaningless. Statements which couldn’t be proven true in some way—through logic or evidence—weren’t even false, they had no meaning at all. But he ran up against a problematic irony. His book, …