After a long, long wait, the BCA published its list of 'evidence' on the Simon Singh case. There was one paper that no-one could find for a while that has finally emerged into public view, and it doesn't look good. For those of you who haven't been following the BCA-Simon Singh libel case, I recommend Sense About Science, who also run a petition that you should definitely sign; Jack Of Kent for the legal side; and the Lay Scientist and Gimpy for their ongoing coverage. This post investigates the conflicts of interest in the paper by Joan M Fallon D.C. F.I.C.C.P., and is taken from my regular blog at Blue-Genes. Click here to view the original (it's prettier).
The Lay Scientist has a great appraisal of the general quality of the BCA evidence. The Fallon paper that has just emerged was supposed to show "a strong correlation between the chiropractic adjustment and the resolution of otitis media for the children in this study", according to the BCA press release. A copy (google cached version) finally emerged on the 2nd July.
I figure that the leading bloggers of the bad science community will do the paper's criticism more justice than I would be able to (especially seeing as I don't currently have institutional access to journal articles). Gimpy has already pointed out that he was entirely correct when he judged it according to the abstract (the main point being the lack of a control group) and also pointed out some simple errors in data handling that demonstrate the clear lack of a rigorous approach to science.
I note that there's no statement about a conflict of interest - I guess the Journal of Clinical Chiropractic Pediatrics (JCCP) can't really have a conflict of interest statement, as it is a journal published by the International Chiropractors Association (ICA) Council on Chiropractic Pediatrics (CCP), one of whose stated goals is that "the Council endeavors to educate the public about the safety, efficacy,and appropriateness of chiropractic care from infants to adolescents." (grammatical error is not mine). The parent organisation, the ICA, was set up explicitly to lobby for the adoption of chiropractic - not exactly a balanced scientific organisation.
It all seems quite incestuous to me: according to this notice from the Palmer College of Chiropractic (where she got her Doctor of Chiropractic - D.C.) Fallon is a co-founder of the ICACCP who then published her landmark paper in her own journal. She was chair of the ICACCP at some point, although I don't know whether this was at the time that she did her 'study'. She is also listed as one of the most important sponsors of the ICACCP.
While I was looking around I found some reports that she had written a book called "The Textbook of Chiropractic and Pregnancy" (also mentioned in the Palmer College notice above) before writing the infamous paper. If true then that represents a possible further conflict of interest (although I guess the rules are a little stretched here). Interestingly, I couldn't find the book listed anywhere on the internet (although it recieved plenty of mentions on various chiropractic websites). It also isn't listed in the Cambridge University Library's catalogue which, to my knowledge, has a copy of close to every book published in English. I have sent them an email to check this, and will update as soon as I get a reply. The other book mentioned in the Palmer College notice was also mysteriously absent.
This brings me to another point: a PubMed search for "Joan Fallon" returns only one article titled "Could one of the most widely prescribed antibiotics amoxicillin/clavulanate "augmentin" be a risk factor for autism?". At the top of the page is a note saying that the article was commented upon later in the same journal. The title of the comment is "Antibiotic not linked to autism.". Unfortunately, I can't read any further because I don't have institutional access for the next two weeks.
Joan Fallon is frequently described as having done lots of important research in the field of chiropractic, although she seems to have moved to other areas recently, but her only PubMed result is something unrelated. Where on earth was all this research published?
I apologise for this ad hominem attack, but it strikes me that she may have published this paper in her own journal, further undermining the quality of its science.
JOAN M. FALLON, D.C., F.I.C.C.P. (1997). The Role of the Chiropractic Adjustment in the Care and Treatment of 332 Children with Otitis Media Journal of Clinical Chiropractic Pediatrics
*Update*
My apologies, it turns out that the textbook does exist: the Cambridge University Library doesn't have a copy because "the publishers, the International Chiropractors Association, is an American body, so we it is unlikely that we would have been able to acquire it under copyright.". Published in 1994 (three years before the study), this book would presumably have increased sales if more people think chiropractic works.
Comments
International Chiropractors Association Plagiarism of Mercy
July 4, 2009 by Anonymous, 20 weeks 4 days ago
Comment: 37705
You might be interested in my e-mail (below) describing the International Chiropractors Association's plagiarism of chiropractic guidelines it actually criticized years prior. Fallon was involved as was current ICA president Gary Walsemann who chaired the ICA's guidelines committee. The ICA continues to ignore this major ethical & intellectual violation. Perhaps some international scrutiny could get the ICA to move forward with an explanation/apology? I'll try sending you the PDF example of the plagiarism through your "Contact" link as I don't see how to attach it here. If you don't receive it, just e-mail me and I'll forward it to you.
Bruce Weisbein, D.C.
Cedar Rapids, Iowa, USA
www.mychiroinfo.com
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Re: ICA's Plagiarism of Mercy
Drs. [name removed] and Maltby,
You both asked for some information on the ICA's plagiarism of the Mercy Guidelines. Attached is a scan of p. 71 from the ICA's Guidelines and p. 161 of the Mercy Guidelines. Start with "Collaborative Care" on the ICA page (from the Child Care chapter) and compare to the Mercy page. Do you see the plagiarism? Everywhere I underlined in red is text I found to be identical to Mercy, and there are at least 94 pages of plagiarized text. As you compare both works, you'll see omissions and modifications... presumably for political reasons. After all, the ICA does claim to be the first to REJECT Mercy! Notice on the ICA page, Joan Fallon et al use a Mercy paragraph that begins, "Firstly,..." but fail to follow it with the "secondly" and "thirdly" paragraphs. Oops! As well, the ICA's plagiarized "List of Subtopics" is never followed-up in the remainder of the Child Care chapter. Oops! The ICA's plagiarism of the references is also amusing in that where the ICA omitted paragraphs from Mercy, it neglected to also omit the references cited in those paragraphs... so the ICA listed references that refer to nothing in the text. In one Mercy paragraph, that the ICA plagiarized completely, there is a numeric reference to the ACA Code of Ethics; you guessed it, the ICA actually had the audacity to remove this particular reference despite plagiarizing the entire paragraph. The ICA even reprinted Mercy's erroneous use of an apostrophe after "Chiropractors" in "International Chiropractors Association" in a reference (although I always thought there should be an apostrophe there, it's possessive, isn't it?).
Some background: In 2001, I was composing a rebuttal letter to an insurance company for denying a service. In quoting numerous authoritative references, I noticed when I was quoting the ICA guidelines the text was identical to the quote from Mercy. Over the next several months, while eating breakfast every morning, I would read both documents together and underline ICA text that was identical to Mercy. I burned-out at 94 pages of plagiarized text. I confronted ICA Executive Director Ron Hendrickson and ICA guidelines committee Chair Gary Walsemann, and both continue to deny any wrongdoing (Bob Hoffman, who is credited with "bringing ICA's landmark Recommended Clinical Prodocols and Guidelines for the Practice of Chiropractic to their completion" was no longer ICA president when I caught the ICA infraction). They further rationalized that the ICA legitimately purchased the publication rights to the guidelines from the 1997 "Guidelines and Practice Parameters for Chiropractic in the State of Florida." The FCA/FCS as co-publishers of the Florida guidelines are likely responsible for the original plagiarism and apparently the ICA unwittingly used a plagiarized document to "create" its "own" guidelines... apparently unaware they would be plagiarizing Mercy which they "rejected" eight years prior. Oh, the irony!
Aside from the plagiarism issue, the ICA's use of the Florida guidelines is wrong on many levels, but mainly because there is no disclosure by the ICA of its original source for its guidelines and the ICA still promotes these guidelines as a work that they created through a consensus process. They really pulled-one over on the entire chiropractic profession.
Amazingly, Joan Fallon still claims that her Child Care chapter is original despite the obvious plagiarism on the single page I attached for you to see. ICA guideline co-author Chris Kent was even fooled by the ICA when in a JMPT letter to the editor he criticized some of Mercy guidelines that were plagiarized in the ICA guidelines. Also in JMPT, Cates et al compared the ICA guidelines to Mercy, but they never actually noticed the plagiarism, which raises a serious question about the scientific objectivity of their review (ICA scored lower than Mercy) and the peer-review process for publication of their paper.
Below are some of my comments to others from a few years ago... when I was a member of the ICA. I eventually terminated my membership over embarrassment with what the ICA did.
So, why would this come up now?
[name removed] mentioned the Iowa Chiropractic Society reviewing the ICA's new guidelines. The ICA has never fessed-up to their plagiarism of Mercy, and they have yet to make a public apology to the entire profession (internationally, of course). I believe that before any organization consumes time, effort, and money to review (and give any degree of credibility) to the ICA's new guidelines, every organization should demand from the ICA a full explanation and apology to Aspen Publishers, the Mercy authors, and the international chiropractic profession. The ICA should also explain how plagiarism was avoided in the production of its new guidelines.
Bruce Weisbein, D.C.
======================
(2002)
That's exactly what the ICA should have
done back in October when Dr. Walsemann was notified
of this serious problem. I do, in fact, understand
the ICA's position on this, but I think that you are
incorrect. Why? The ICA's guidelines (2000) contain
at least 91 pages of text verbatim from Mercy (1992).
The "Guidelines and Practice Parameters for
Chiropractic in the State of Florida" bear a copyright
date of 1997. Even the disclaimer contains plagiarism
from Mercy! Now can you see why others and I feel
that the ICA has committed a huge offense?
As an ICA member, I thank you for beginning to take
the appropriate actions.
=====================================
(2005)
I'd like to express my concern about the election of
Dr. Gary Walsemann to any leadership position in the
ICA. Dr. Welsemann's actions in his role as
Chairperson of the ICA Committee that plagiarized
nearly 100 pages of its Protocols and Guidelines from
the Mercy Guidelines were not only reprehensible but
likely illegal, and he has exposed the ICA to damaging
and costly legal action... and significantly lowered
this member's ICA pride. I urge you to give the ICA
membership the opportunity to OPPOSE the election of
Dr. Walsemann to any leadership position of the ICA
until he can issue the appropriate apology,
explanation, and remedy for the ICA's plagiarism of
the Mercy Guidelines.
======================================
(2005)
I faxed a sample page with plagiarized text underlined,
and for your convenience I also faxed the pages from
Mercy. As a member of the ICA, I'll admit I'm
certainly embarrassed at the ICA's copyright
violation, but worse, I'm ashamed that my association
hasn't admitted its ironic wrong-doing (I alerted the
ICA in 2001) and the ICA still proclaims that it was
the first reject Mercy. Even Kent was fooled as his
letter to editor of JMPT criticizes several Mercy
recommendations that the ICA actually plagiarized as
well. Since the ICA is ignoring this member, perhaps
you could encourage the appropriate profession-wide
apology from the ICA for its plagiarism. This sample
has also been sent to Drs. Fallon and Haldeman.
======================================
(2005)
I am an ICA member, since approximately 1991. The
ICA's plagiarism of Mercy appears to pose several
problems:
1. Violation of Aspen's copyright. Nearly 100 pages
of ICA's guidelines contain verbatim or slightly
altered text plagiarized text from Mercy. The
alterations appear to be for the purpose of suiting
the conservative ICA membership. Even errors in
Mercy's references were plagiarized by the ICA. In
fact, even Mercy variations to reference to the ICA
were plagiarized by the ICA.
2. Principle. The ICA fooled the entire chiropractic
profession in to believing the ICA authored/produced
an original guideline document. There is even a
reference to an apparently fictitious concensus
process in the ICA guidelines. Of course, no cretit
to Mercy is cited.
3. Contradiction. The ICA claims to be the first to
reject Mercy, but eight years later the ICA
plagiarizes nearly 100 pages of Mercy and attempts to
pass it off as its own! Can you see the irony?
4. Scientific Integrity. In JMPT, Cates et al
evaluated the ICA guidelines and even compared scores
to Mercy... but they never noticed that the ICA
guidelines were largely plagiarized from Mercy. This
raises the question, Did Cates et al actually read
either the ICA Guidelines or Mercy? Is there a major
flaw in JMPT's peer review process if the peer
reviewer didn't catch this either? Even Christopher
Kent (listed as an ICA guideline contributor)
apparently didn't realize that the Mercy recommendations
he criticized in a letter to the editor in JMPT were
also plagiarized into a document he co-authored.
Those are all the issues I can think of. I'm planning
to be in Santa Ana in June; if Dr. Haldeman would like
to see my copy of the ICA guidelines with the nearly
100 pages of underlined plagiarized text, I can
certainly make time to pay him a visit.
Relevant book review
July 3, 2009 by Fred Bortz, 20 weeks 5 days ago
Comment: 37684
I reviewed Trick or Treatment: The Undeniable Facts About Alternative Medicine, Singh's book with Edzard Ernst, M.D., quite favorably for some major metropolitan newspapers.
See my review at http://www.scienceshelf.com/TrickorTreatment.htm .
Fred Bortz
Science Books for Young Readers
and
Science Book Reviews