Letters to the Editor: Spinal Manipulative Therapy for Adolescent Idiopathic Scoliosis: A Systematic Review

Abstract

We read with interest the recently published systematic review on the effects of spinal manipulation for adolescent idiopathic scoliosis.1.Théroux J Stomski N Losco CD Khadra C Labelle H Le May S Spinal manipulative therapy for adolescent idiopathic scoliosis: a systematic review.J Manipulative Physiol Ther. 2017; 40: 452-458Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar There appears to be a discrepancy between the risk of bias assessment text and Table 2 regarding Rowe et al.2.Rowe DE Feise RJ Crowther ER et al.Chiropractic manipulation in adolescent idiopathic scoliosis: a pilot study.Chiropr Osteopat. 2006; 14: 15Crossref PubMed Scopus (27) Google Scholar The text appears mostly correct, but the table appears mostly incorrect. In the text, the authors state that in the randomized clinical trial by Rowe et al, there is a low risk of bias for selection, performance, and attrition. But they incorrectly state that there is an unclear risk of detection bias. We indeed did blind the outcome assessors. Here is a quote from our published paper: “In this study, strict measurement protocols were used and intra- and inter-examiner reliability was measured using two independent orthopedic surgeons blinded to treatment allocation.”2.Rowe DE Feise RJ Crowther ER et al.Chiropractic manipulation in adolescent idiopathic scoliosis: a pilot study.Chiropr Osteopat. 2006; 14: 15Crossref PubMed Scopus (27) Google Scholar Detection bias is a failure to blind the outcome assessor(s) to the treatment group allocation. We not only blinded our orthopedic surgeons as they assessed the spinal radiographs for the primary outcome, but also made their assessments independent. We suggest that Table 2 is incorrect regarding risk of bias for selection, performance, attrition, detection, and other source of bias. Spinal Manipulative Therapy for Adolescent Idiopathic Scoliosis: A Systematic ReviewJournal of Manipulative & Physiological TherapeuticsVol. 40Issue 6PreviewThe purpose of this study was to perform a systematic review of clinical trials of spinal manipulative therapy for adolescent idiopathic scoliosis. Full-Text PDF Response to Letter to Editor: “Spinal Manipulative Therapy for Adolescent Idiopathic Scoliosis: A Systematic Review”Journal of Manipulative & Physiological TherapeuticsVol. 42Issue 5PreviewWe welcome the comments that Feise and colleagues have made about our systematic review.1 We had noted that Rowe et al2 had examined intrarater and inter-rater reliability with blinded assessors. Intrarater and inter-rater reliability are commonly assessed through analyzing a subset of the data.3 As such, it was unclear whether blinded assessors had evaluated all outcomes, and hence the reason behind our attribution of an unclear rating for detection bias for the Rowe et al study. We appreciate the clarification that Feise and colleagues have provided. Full-Text PDF