Chiropractic claims in the English-speaking world.
BACKGROUND
Some chiropractors and their associations claim that chiropractic is effective for conditions that lack sound supporting evidence or scientific rationale. This study therefore sought to determine the frequency of World Wide Web claims of chiropractors and their associations to treat, asthma, headache/migraine, infant colic, colic, ear infection/earache/otitis media, neck pain, whiplash (not supported by sound evidence), and lower back pain (supported by some evidence).


METHODS
A review of 200 chiropractor websites and 9 chiropractic associations' World Wide Web claims in Australia, Canada, New Zealand, the United Kingdom, and the United States was conducted between 1 October 2008 and 26 November 2008. The outcome measure was claims (either direct or indirect) regarding the eight reviewed conditions, made in the context of chiropractic treatment.


RESULTS
We found evidence that 190 (95%) chiropractor websites made unsubstantiated claims regarding at least one of the conditions. When colic and infant colic data were collapsed into one heading, there was evidence that 76 (38%) chiropractor websites made unsubstantiated claims about all the conditions not supported by sound evidence. Fifty-six (28%) websites and 4 of the 9 (44%) associations made claims about lower back pain, whereas 179 (90%) websites and all 9 associations made unsubstantiated claims about headache/migraine. Unsubstantiated claims were made about asthma, ear infection/earache/otitis media, neck pain,


CONCLUSIONS
The majority of chiropractors and their associations in the English-speaking world seem to make therapeutic claims that are not supported by sound evidence, whilst only 28% of chiropractor websites promote lower back pain, which is supported by some evidence. We suggest the ubiquity of the unsubstantiated claims constitutes an ethical and public health issue.
Ernst
Edzard
E
Complementary Medicine, Peninsula Medical School, University of Exeter, Exeter, England.
Gilbey
Andrew
A
D001249:Asthma / Q000628:therapy; D001315:Australia; D001416:Back Pain / Q000628:therapy; D002170:Canada; D002684:Chiropractic; D003085:Colic / Q000628:therapy; D008192:Deception; D004992:Ethics, Medical; D019317:Evidence-Based Medicine; D006261:Headache / Q000628:therapy; D006801:Humans; D007223:Infant; D020407:Internet; D008389:Marketing of Health Services; D008881:Migraine Disorders / Q000628:therapy; D019547:Neck Pain / Q000628:therapy; D009520:New Zealand; D010033:Otitis Media / Q000628:therapy; D006113:United Kingdom; D014481:United States; D014911:Whiplash Injuries / Q000628:therapy