Mirtz Timothy A, Morgan Lon, Wyatt Lawrence H, Greene Leon
University of South Dakota, Vermillion, South Dakota, USA.
Chiropr Osteopat. 2009 Dec 2;17:13. doi: 10.1186/1746-1340-17-13.
Chiropractors claim to locate, analyze and diagnose a putative spinal lesion known as subluxation and apply the mode of spinal manipulation (adjustment) for the correction of this lesion.
The purpose of this examination is to review the current evidence on the epidemiology of the subluxation construct and to evaluate the subluxation by applying epidemiologic criteria for it's significance as a causal factor.
The databases of PubMed, Cinahl, and Mantis were searched for studies using the keywords subluxation, epidemiology, manipulation, dose-response, temporality, odds ratio, relative risk, biological plausibility, coherence, and analogy.
The criteria for causation in epidemiology are strength (strength of association), consistency, specificity, temporality (temporal sequence), dose response, experimental evidence, biological plausibility, coherence, and analogy. Applied to the subluxation all of these criteria remain for the most part unfulfilled.
There is a significant lack of evidence to fulfill the basic criteria of causation. This lack of crucial supportive epidemiologic evidence prohibits the accurate promulgation of the chiropractic subluxation.
脊椎按摩师声称能够定位、分析和诊断一种被称为半脱位的假定脊柱病变，并采用脊柱推拿（调整）方式来矫正这种病变。
本次审查的目的是回顾当前关于半脱位概念流行病学的证据，并通过应用流行病学标准评估半脱位作为致病因素的重要性。
在PubMed、Cinahl和Mantis数据库中检索使用关键词半脱位、流行病学、推拿、剂量反应、时间顺序、比值比、相对风险、生物学合理性、连贯性和类推法的研究。
流行病学中的因果关系标准包括强度（关联强度）、一致性、特异性、时间顺序（时间序列）、剂量反应、实验证据、生物学合理性、连贯性和类推法。应用于半脱位时，这些标准大多未得到满足。
严重缺乏满足因果关系基本标准的证据。这种关键支持性流行病学证据的缺乏阻碍了脊椎按摩疗法半脱位的准确传播。
