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Background In March 2020, the World Health Organization elevated the coronavirus disease (COVID-19) epidemic to a pandemic and called for urgent and aggressive action worldwide. Public health experts have communicated clear and emphatic strategies to prevent the spread of COVID-19. Hygiene rules and social distancing practices have been implemented by entire populations, including ‘stay-at-home’ orders in many countries. The long-term health and economic consequences of the COVID-19 pandemic are not yet known. Main text During this time of crisis, some chiropractors made claims on social media that chiropractic treatment can prevent or impact COVID-19. The rationale for these claims is that spinal manipulation can impact the nervous system and thus improve immunity. These beliefs often stem from nineteenth-century chiropractic concepts. We are aware of no clinically relevant scientific evidence to support such statements. We explored the internet and social media to collect examples of misinformation from Europe, North America, Australia and New Zealand regarding the impact of chiropractic treatment on immune function. We discuss the potential harm resulting from these claims and explore the role of chiropractors, teaching institutions, accrediting agencies, and legislative bodies. Conclusions Members of the chiropractic profession share a collective responsibility to act in the best interests of patients and public health. We hope that all chiropractic stakeholders will view the COVID-19 pandemic as a call to action to eliminate the unethical and potentially dangerous claims made by chiropractors who practise outside the boundaries of scientific evidence.

Presents the findings of a systematic evaluation of websites for chiropractic clinics based in New Zealand in which unsubstantiated claims that chiropractic manipulation can treat or improve ADHD, allergies, bed wetting, colic, or ear infections, as well as any health testimonials used to promote their services, were advertised. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.

On the official register of chiropractors in New Zealand, the qualifications of each registrant are listed along with the 'honorific'.3 A simple cross reference and check between the list of registered chiropractors and those staff members of the New Zealand College would have allayed any fears that the authors had of chiropractors mis-representing themselves as medical practitioners, dentists, osteopaths, veterinarians or future Australian physiotherapists, who will have a Doctor of Physiotherapy degree from Melbourne University.

Acknowledges the failure of some chiropractors to comply with the Code of ethics and standards of Practice published by the New Zealand Chiropractic Board (NZCB), particularly in regard to the use of the term 'Doctor' by those who are not a registered medical practitioner. Touches on the implications for patients. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.

The information must not be misleading or inaccurate in any way.\" [...]I extracted the chiropractors' use of the title 'doctor' and the therapeutic claims made on the 10 websites. Langworthy et al recently showed that only 23% of UK chiropractors discuss serious risks of spinal manipulation with their patients before treating them.6 This lack of obtaining informed consent would constitute a further infringement on ethical guidelines.2 In the UK, chiropractors are independent primary healthcare professionals regulated by statute since the Chiropractors Act of 1994.

Both the New Zealand and the UK governments have got themselves into an impossible position by giving official recognition to chiropractic before the evidence was in. Since the conventional manipulative treatments are cheaper, and may be well be safer, and because they involve no quasi-religious ideas like \"subluxation\" or \"innate intelligence\", the only reasonable conclusion is that there is no need for chiropractic to exist at all. The term 'subluxation' has a colourful history and has been the subject of debate both within and outside the chiropractic profession.\\n Much of the evidence for the effects of subluxation increasingly comes from outside the chiropractic profession and is found in such varied fields as the basic sciences, medicine, psychology, biophysics and engineering, neurophysiology, and the relatively new field of psycho-neuro-immunology.2,3,9 It is only through inter-disciplinary co-operation that we can hope to further understand the complexities and interactions of the human organism as an integrated whole. [...]to address Colquhoun's statement that chiropractors \"do nothing that could not be done as well by medical practitioners and physiotherapists\" and \"what will governments do about that, I wonder?\", we recommend he read the New Zealand Government's thorough Report on the Commission of Inquiry into Chiropractic in 1979 to find out what has already been done and recommended.10 Simon Roughan Registered Chiropractor and Acting President of the New Zealand Chiropractors' Association Private practice, Christchurch, New Zealand References: 1.

Background A Bayesian approach may be useful in the study of possible treatment-related rare serious adverse events, particularly when there are strongly held opinions in the absence of good quality previous data. We demonstrate the application of a Bayesian analysis by integrating expert opinions with population-based epidemiologic data to investigate the association between chiropractic care and acute lumbar disc herniation (LDH) with early surgery. Methods Experts’ opinions were used to derive probability distributions of the incidence rate ratio (IRR) for acute LDH requiring early surgery associated with chiropractic care. A ‘community of priors’ (enthusiastic, neutral, and skeptical) was built by dividing the experts into three groups according to their perceived mean prior IRR. The likelihood was formed from the results of a population-based epidemiologic study comparing the relative incidence of acute LDH with early surgery after chiropractic care versus primary medical care, with sensitive and specific outcome case definitions and surgery occurring within 8- and 12-week time windows after acute LDH. The robustness of results to the community of priors and specific versus sensitive case definitions was assessed. Results The most enthusiastic 25% of experts had a prior IRR of 0.42 (95% credible interval [CrI], 0.03 to 1.27), while the most skeptical 25% of experts had a prior IRR of 1.66 (95% CrI, 0.55 to 4.25). The Bayesian posterior estimates across priors and outcome definitions ranged from an IRR of 0.39 (95% CrI, 0.21 to 0.68) to an IRR of 1.40 (95% CrI, 0.52 to 2.55). With a sensitive definition of the outcome, the analysis produced results that confirmed prior enthusiasts’ beliefs and that were precise enough to shift prior beliefs of skeptics. With a specific definition of the outcome, the results were not strong enough to overcome prior skepticism. Conclusion A Bayesian analysis integrating expert beliefs highlighted the value of eliciting informative priors to better understand how new evidence ought to update prior existing beliefs. Clinical epidemiologists are encouraged to integrate informative and expert opinions representing the end-user community of priors in Bayesian analyses, particularly when there are strongly held opinions in the absence of definitive scientific evidence.

Background Accreditation of healthcare provider training programs ensures graduate competency and provides a means for programs to improve. Accreditation consistency assures the public that healthcare providers have similar basic training across world regions. Currently, it is unknown if chiropractic accrediting agencies have congruent standards globally. Therefore, the purpose of this study was to investigate similarities and differences in student competencies and program standards among four chiropractic accreditation agencies worldwide. Methods A quantitative content analysis was performed on accreditation standards from regional international accreditation agencies responsible for accrediting the majority of the world’s chiropractic degree programs. Agencies included the Council on Chiropractic Education (United States), the European Council on Chiropractic Education (Europe, United Kingdom, South Africa), the Council on Chiropractic Education Australasia (Australia, New Zealand, Malaysia), and the Council on Chiropractic Education Canada (Canada). The contents of the accrediting standards were coded using a standardized coding list. A modified Delphi technique was used by 21 international experts from December 1, 2023, to April 18, 2024. After four rounds of consideration to achieve consensus, the contents were analyzed for frequency and congruence of coded items across the accrediting agencies’ standards. A two-way analysis of variance was conducted to identify if there were any differences among the accreditation agencies. Results Neither student competencies [ F (3,8) = 0.007, p  > .05] nor program standards [ F (3,4) = 0.002, p  > .05] differed significantly across the accrediting agencies. The statistical relationships between accreditation agencies and coding frequencies remained stable across all coded items, with no single code exhibiting differential performance depending on the accrediting body. The overall model showed R 2  = 0.96 for student competencies and R 2  = 0.87 for program standards; thus, the models’ predictions align with the observed data. Conclusions The study findings demonstrate congruence for student competencies and program standards among chiropractic accreditation agencies across multiple geographic regions. The patterns of content were stable and consistent across the four accrediting agencies, with no evidence of differential effects among the agencies. In addition, this study provides essential details and standardized codes for agencies’ documents, which may facilitate dialogue and comprehension among agencies, educators, regulators, governing officials, and other stakeholders in chiropractic education. Study registration The study protocol was prospectively registered with Open Science Framework on November 30, 2023 https://doi.org/10.17605/OSF.IO/259WC .

Objective To explore differences in palpatory acuity between two independent student cohorts from 2015 to 2024, and to assess the potential effect of pedagogical changes in the teaching of palpation skills that emphasize sensory awareness over anatomical identification at the New Zealand College of Chiropractic (NZCC). Methods This study was a comparative cross-sectional study using two independent student cohorts. In 2015, palpatory acuity was assessed in 199 chiropractic students (42.5% female, mean: 25.8 ± 7.4 years) from 4 different cohorts. In 2024, 154 students (54.5% female, mean: 23.6 ± 5.6 years) over 4 cohorts were assessed. Palpatory acuity was measured by the participant’s ability to accurately locate a 0.1 mm nylon monofilament under a variable number of 80gsm white copying paper sheets while blindfolded. Unpaired Wilcoxon rank sum tests were used to assess differences between timepoints (2015 and 2024) and year groups. Results The 2024 group (mean: 67.8 ± 22.5 pages) demonstrated significantly higher palpatory acuity compared with the 2015 group (mean: 31.1 ± 22.4 pages, p  < .001). All cohorts in 2024 outperformed their 2015 counterparts ( p  < .001). In both groups, acuity improved notably between cohorts in years 2 and 3 but showed minimal further gains in the final year. In the 2015 group, year 3 (mean: 38.0 ± 24.4) and year 4 (mean: 37.5 ± 20.1) students outperformed year 1 (mean: 25.1 ± 19.8, p  = .028–0.040) and year 2 students (mean: 26.3 ± 22.6, p  = .039–0.040). In the 2024 group, year 3 students (mean: 81.7 ± 15.2) performed significantly better than year 1 (mean: 59.8 ± 22.5, p  < .001) and year 2 students (mean: 70.6 ± 17.5, p  = .023). Discussion These findings suggest that emphasizing sensory experience in palpation training may enhance student performance. Educators may consider integrating more structured haptic exercises early in curricula, while future research should explore longitudinal outcomes and the neural mechanisms underlying skill acquisition to guide further educational reform. Conclusion Curricular and pedagogical changes at NZCC were linked to significantly greater palpatory acuity in students. Palpatory acuity appears to improve early-to-midway through training (regardless of the method used to teach it), with limited gains thereafter. Practical experience and repetition contribute to improving acuity, but this study highlights the value of sensory-focused practice in curriculum design for chiropractic education.

The world’s elderly population is growing at a rapid pace. This has led to an increase in demand on the health and welfare systems due to age-related disorders, with musculoskeletal complaints driving the need for rehabilitation services. However, there are concerns about health services’ ability to meet this demand. While chiropractic care is gaining recognition for its benefits in treating older adults with musculoskeletal disorders, there is limited scientific literature on chiropractors’ role and experiences in this area. To bridge this gap, we interviewed 21 chiropractors in Great Britain, the Netherlands, Norway, and Sweden. Inductive qualitative content analysis was used to analyse the interviews, and despite differences in integration and regulation between the countries, several common facilitators and barriers in caring for and managing older patients with musculoskeletal complaints emerged. While participants expressed optimism about future collaborations with other healthcare professionals and the integration of chiropractic into national healthcare systems, they also highlighted significant concerns regarding the existing healthcare infrastructure. The participants also felt that chiropractors, with their non-surgical and holistic approach, were well-positioned to be the primary point of contact for older patients. However, there were some common barriers, such as the affordability of care, limited integration of chiropractic, and the need to prioritise musculoskeletal complaints within public healthcare. Our findings suggest that chiropractors experience their clinical competencies as an underutilised resource in the available healthcare systems and that they could contribute to and potentially reduce the escalating burden of musculoskeletal complaints and associated costs among older patients. Additionally, our findings highlight the desire among the participants to foster collaboration among healthcare professionals and integrate chiropractic into the national public healthcare system. Integrating chiropractors as allied health professionals was also perceived to improve coordinated, patient-centred healthcare for older adults.