Dear WDDTY: Your news item on chiropractic was written implying that WDDTY is antichiropractic globally. I take exception to my profession being compared to one survey in one American state where the whole structure of the medical system is more commercially based. This report is also isolated in its opinion. The UK's Medical Research Council's clinical trial published in the BMJ in 1990 found chiropractic to be 'more effective' than hospital outpatient treatment for low back pain, particularly for those with chronic or severe pain. In a follow-up report published in 1995, those same patients reported a very significantly lower recurrence of back pain post chiropractic, as compared with the hospital treatment. In Ontario, Canada, an economist, Profes-sor Manga, was commissioned by the government to look at treatment of low back pain, and chiropractic was found to be safer, more effective, and therefore more cost-effective than medical management, and patient satisfaction was much greater. - Patricia Waite, Natural Health Care, Dundee.

Dear WDDTY: Dr Anthony Rosner, Director of Research for the Foundation for Chiropractic Education and Research, has isolated 11 points of error in the minor study you report on and has labelled the conclusions as misleading. For instance, the effects of the severity of illness are virtually ignored, the degree of recovery does not receive adequate attention, and some of the results cited raised concerns about statistical methodology. There is also considerable published evidence of the effectiveness of chiropractic treatment of migraine and headache ((J Am Chiro Assoc, 1978; 12: 363-7; Aust NZ J Med, 1978; 8: 589-93; JMPT, 1982; 5: 109-12; MJPT, 18 (3): 148-54; JMPT, 1994; 6: 369-75).

WDDTY replies. We are well aware of the scientific evidence supporting the effectiveness of chiropractic (see particularly our back pain issue, vol 4 no 8, which highlighted both the Manga report and the 1990 Lancet study, and also vol I no 8 on the BMJ 1990 study). Thank you for highlighting the flaws in the most recent study, which we'd reported tongue in cheek. See also Case Study, p 10.