Human variability in health and disease cannot be controlled. Therefore the controlled clinical trial is seriously flawed in testing a drug or a chiropractic adjustment. Health care is a unique occurrence and must be individualized. What works for one person will not work in the same way for another. That is one difference between chiropractic and medicine. Each person must be analyzed for their unique subluxation pattern and their adjustment will be unique for their needs. No two spines are alike, no two people have identical joints, nervous systems or structural systems. No two people have identical subluxations.
Controlled Clinical Trials:
While Chiropractic is more accepted than it used to be there are still skeptical people. There has been the false belief that if we do enough studies the medical profession, the government and the people who make drugs and have influence will accept Chiropractic. That is fantasy. That approach has been tried and has been discredited in the laboratory of life.
Homeopathic Doctors began CCTs (Controlled Clinical Trials) in the 1960s so the medical profession would change their opinions of homeopathy. After 100 trials it did not change, so why do some chiropractors feel that if chiropractors will only do more CCTs we’ll get “accepted”. That attitude all but destroyed Osteopathy and Homoeopathy earlier in this century.
Homeopaths are medical doctors. They graduate medical school, take the same courses, get the same degrees. They are in the “club” – not like Doctors of Chiropractic. However, Homeopaths have a different medical philosophy than their allopathic brethren – a philosophy that is more aligned with chiropractic in their respect for the wisdom of the body, the dangers of suppressing symptoms and the enhancement of natural resistance to disease.
Clinical Trials Don’t Work:
Why? Because for a CCT to be valid you have to have a group of people who are similar. That’s impossible to find as the famous nutritionist Roger
While healthy young men of the same height and weight may resemble one another in their overall oxygen consumption, specific chemical reactions may take place five or ten times as fast in one individual as in another. Each individual would, if subjected to the same stress and given the same food, exhibit a highly distinctive metabolic pattern. In our experience with control in young men we have never found one who exhibited a pattern which was free from distinctive variations from the average.[i]
We are just too different. As Harris Coulter in his “Controlled Clinical Trial” states: “If every individual has a different set of fingerprints, would everyone have the same riboflavin requirements?”[ii] We may also add, why should everyone metabolize drugs the same way, react to their environment the same way or get sick the same way? Look at some of the things that make us chemically different:
- Sex – men and women have different body chemistry and different blood composition.
- Age – different ages have different chemistry and nutritional needs.
- Ethnic background – will affect how drugs are metabolized.
- Time of year – metabolism under goes variation from season to season.
- Time of day – metabolism undergoes variation from day to night.
- Place – body temperature is different in different latitudes.
- Past immunologic history. As Coulter writes: “Each individual possesses a unique set of antibodies, representing the history of his or her lifetime exposure to the environment.”
- Emotional Stress – metabolism is affected by emotional stress.
- Genes are never the same in two people, so proteins are different.
- Other variables include height, weight, diet and past drug use etc.
As an example, if you could somehow test a drug on 25 fifty year old white women of the same ethnic background, of similar height, weight, personality and body-type from the same place, who have similar immunologic histories, do the drug findings from this CCT relate to you, me and your neighbors? Answer? No!
The basis of the “Controlled Clinical Trial” sounds very impressive. You get a group of homogenous people suffering from the same condition or with no condition at all, you give them a drug and you see what happens. This information is then printed on drug inserts, in drug ads, in the Physicians’ Desk Reference and other publications as Side Effects, Contraindications, Adverse Reactions, Indications, and so on. The implication is that physicians will know what will happen when they give the drug to patients. The reality however is that there is no way of knowing.
These tests are very expensive. The FDA makes drug companies spend over $300 million to get a drug to market and yet you still cannot predict how people will react.
More than half the prescription drugs approved by the Food and Drug Administration (FDA) between 1976 and 1985 caused serious side effects that later caused the drugs to be either relabeled or removed from the market.[iii]
Coulter also brings up the salient point that Homoeopathy, as well as Chiropractic, is NOT suited to be judged by the Controlled Clinical Trial since a purely homogenous group of individuals (with or without the exact same disease, another impossibility) is needed to perform a proper CCT. Such a group does not exist since human variability is so great. But Homeopaths and Chiropractors do not treat diseases and homeopathic philosophy, along with acupuncture and other vitalistic schools of healing do not even recognize individual diseases.
[i] Roger J. Williams cited in Controlled Clinical Trial by Harris Coulter, Ph.D. p.216.
[ii] I am indebted to Harris Coulter, Ph.D. and his two wonderful books, which every D.C. should have: The Controlled Clinical Trial and Divided Legacy Vol. 4.
[iii] M. Caldwell, Serious Side Effects linked too many drugs. Washington Post, May 28, 1990.