A critique of "evidence-based medicine" (UK's NHS approves acupuncture)

Money quote:

It’s a phenomenon that’s very familiar to economists under the name “Goodhart’s Law”. Basically, Goodhart’s Law says that “any economic relationship which is used for policy purposes, ceases to be valid”.

Claims that conditions other than back pain and closely related discomfort can be treated by spinal manipulation are obviously bogus. That said, spinal manipulation has the same effect as cracking your knuckles, which does result in pain relief and increased range of motion[0].

There is also significant evidence for the efficacy of accupuncture for treating several conditions, including migranes[1], nausea/vomiting resulting from chemotherapy[2] and improving success rates in in-vitro fertilization[3]

Most of the objections seem to be centered around the fact that modern science has no explanation for how these things work. We don't even know what makes the noise when joints are cracked[4]. The scientific and medical communities tend to be understandably reluctant to accept things as true without plausible explanations for how they work. That said, it's probably harmful to deny patients treatments that have been demonstrated effective simply due to a lack of understanding the mechanism of action.

[0] http://www.jmptonline.org/article/S0161-4754(07)00059-0/abst...

[1] http://www.cochrane.org/reviews/en/ab001218.html

[2] http://www.cochrane.org/reviews/en/ab002285.html

[3] http://www.ncbi.nlm.nih.gov/pubmed/18258932

[4] http://en.wikipedia.org/wiki/Cracking_joints

This is slightly OT, but since the article seems to imply that chiropractic care is quackery, I have to ask: What do people have against chiropractors? Do most of them suck or something? I've only got experience with one family practice (mother/daughter), but my relief has been quite measurable and very significant at times.

Antidote: A few years ago, something strange happened in my back while standing for the morning SCRUM meeting and I could no longer stand without searing, intense pain. I was almost-literally carried into the chiropractic office by a coworker and came out walking and feeling like nothing had happened about 20 minutes later. It's not magical and obviously doesn't cure all ails, but to say it's junk seems to reek of improper study or prejudiced "debunkers."