Questions fo rour Clear Chiro, Smith

[Angele1]

Patience please

Hi everyone,
Please have some patience. I will have some answers for you later today!!
Thank you,
Dr. Jacqueline

[Pooka1]

Look, I never in a million years would have asked you those questions if I thought it would take up undue amounts of time. I realize you are running a business.

Let me limit the patient population data...

How about ONLY long term data, at least a year after the growth spurt has been documented to have ended. How many of your patients fall into that category? How many came in with a curve <30* versus >30*? How did they end up after the growth spurt compaared to the natural history? Now that has to be the $64,000 for most parents I would think.

So forget my questions about pre-growth spurt please. Just drop them out.

Please DO NOT bother posting any data that is "interim" (before the growth spurt ends or during treatment). Also definitely do NOT post any data that is taken within minutes of completing a treatment. Both categories are obviously completely irrelevant to evaluating the efficacy of Clear or any PT or bracing treatment for that matter.

Thanks.

[mariaf]

Please DO NOT bother posting any data that is "interim" (before the growth spurt ends or during treatment). Also definitely do NOT post any data that is taken within minutes of completing a treatment. Both categories are obviously completely irrelevant to evaluating the efficacy of Clear or any PT or bracing treatment for that matter.

Agree 100%. What matters is long term results. As for data taken within minutes of completing a treatment, that's like taking an x-ray immediately after one takes their brace off, rather than waiting the 24-48 hours most orthos require the patient to be brace-free beforehand. Dr. Betz once told me it takes at least that long for the spine to revert to its natural shape and that an x-ray within 24 hours of the brace coming off will not accurately reflect what the curve is doing.

[Pooka1]

Agree 100%. What matters is long term results. As for data taken within minutes of completing a treatment, that's like taking an x-ray immediately after one takes their brace off, rather than waiting the 24-48 hours most orthos require the patient to be brace-free beforehand. Dr. Betz once told me it takes at least that long for the spine to revert to its natural shape and that an x-ray within 24 hours of the brace coming off will not accurately reflect what the curve is doing.

That is apparently true of 23 hour/day braces and when articles don't say how long the patients are out of the brace I am very skeptical of the reported results unless it is a long-term follow up after all weaning has ceased.

But that said, our surgeon said that is not actually necessary with night-time braces. I'd like to hear the range of opinion on that. Did Dr. Betz address night-time braces?

[Pooka1]

Abbreviated list

Here's an abbreviated list of questions to hopefully save you time:

A. Radiographs:

1. How many radiographs do you typically take in the typical week-long treatment of a child? (A Number)
2. How many in a typical two-week treatment? (A number)

B. Long term: ONLY children who come in before or during the growth spurt and you treat until after the growth spurt. That should save you time.

1. How many children have you treated that made it through the growth spurt while in Clear treatment? (A Number)
2. What percentage started and ended <30* after the growth spurt? (A Percentage)
3. What percentage Started and ended <50* after the growth spurt? (A Percentage)

Don't bother trying to compare your results to natural history. I will do that with your numbers. This is will save you some time.

C. Scoliscore:

1. Do you recommend treatment for a Scoliscore <41? (Yes/No)
3. Do you recommend treatment for a Scoliscore >180? (Yes/No)
3. Do you recommend treatment no matter what the Scoliscore is? (Yes/No)

Thanks.

[mariaf]

But that said, our surgeon said that is not actually necessary with night-time braces. I'd like to hear the range of opinion on that. Did Dr. Betz address night-time braces?

Hi Sharon,

It is my understanding that Dr. Betz asks all patients to be OOB for at least 24 hours. So with nighttime brace wearers, they would probably not wear it the night before an x-ray. I think it's just what he uses as a guideline and he hasn't tweaked it for nighttime bracing as far as I know, although I definitely can understand that there might be a difference, in terms of necessity, as your surgeon pointed out.

[mariaf]

Hi everyone,
Please have some patience. I will have some answers for you later today!!
Thank you,
Dr. Jacqueline

Any luck with those answers yet? Please see Sharon's abbreviated list if that makes the task less daunting.

Again, no rocket science here - these are questions that a parent walking in off the street might ask - simple, basic questions to which one would think answers would be readily available. If I had posed similar, straight-forward questions to my son's doctor (and I e-mail him from time to time), based on prior experience I would say that I probably would have received a preliminary reply via his blackberry in a matter of hours.

Thanks in advance for your time on this and for the eagerly-awaited answers.

[Pooka1]

Any luck with those answers yet? Please see Sharon's abbreviated list if that makes the task less daunting.

Again, no rocket science here - these are questions that a parent walking in off the street might ask - simple, basic questions to which one would think answers would be readily available. If I had posed similar, straight-forward questions to my son's doctor (and I e-mail him from time to time), I would have probably gotten a preliminary reply via his blackberry in a matter of hours.

Yes exactly. I have asked any number of similar questions to our surgeon and he is right there with what his experience has been with patients, what the statistics are, what is known, what is not known, etc. etc. In other words, the state of the art knowledge in real time.

Is it possible that parents coming into Clear offices don't ask these types of questions? I almost can't believe that.

Hope, what did you ask the Clear types before you agreed to treatment? I'm very curious at this point what parent actually ask (and don't ask).

[leahdragonfly]

I am surprised too that these types of questions apparently can not be answered readily. I would think that if Clear were a viable treatment that the practitioners of it would feel obligated to inform the parents of this very basic information before treatment. Or maybe there is no type of informed consent with chiropractic treatment?? But I hate to think of parents subjecting their children to any treatment without even knowing the risks, benefits, and alternatives. Especially a treatment that costs thousands of dollars and exposes the child to a multitude of unjustified x-rays.

[Pooka1]

I'm wondering if we lost Smith.

[Pooka1]

Apparently Clear practitioners are sending their results to some central "research" person.

So Smith should have the numbers on post-growth spurt outcomes ALREADY in hand if she is participating. She said sh has being doing Clear for four years so she should have a largish number.

The rest of the questions would take a few seconds each to answer.

Maybe she can answer the number of radiographs questions and the Yes/No questions immediately since it is a total of a few seconds. If she hasn't assembled the post-growth spurt numbers to send them in a separate post on the next day or so.

In the bigger picture, I don't think Clear needs to pony up evidence to stay in business. I think they will keep their clinics full on fear of surgery alone. Look at the thread written by Still Hoping for some evidence of that.

[Pooka1]

I'm pretty sure Smith is gone.

She is posting elsewhere and not here now.

If someone asks about Clear I will post the link to this thread.

[mariaf]

Really makes you wonder about CLEAR. A lot of folks (myself included) were, understandably, very skeptical before. And now it seems that a few simple, straightforward questions cannot even be answered. Couple that with the excessive radiation exposure and the cost of treatment, and it's certainly not something I'd be running to pursue.

[Pooka1]

And the sad part is they will still fill their clinics through fear of surgery alone.

Clear is a business. I don't think I could write a business case to spend one penny on collecting evidence of efficacy when the customers don't walk in asking for that. The thread by Still Hoping is Exhibit A.

Smith is a shocking disappointment after she promised to answer the questions. It's a lack of intellectual honesty from a person who claimed to be evidence driven. She was so trying not to get kicked off when in the end she cowardly retreated rather than answer some straight-forward questions about her own work.

Her claim that she is concerned about the bunnies is nonsense.

[jrnyc]

sorry, but i bet ya' lost her, Sharon...didn't seem as if she was truly interested in providing answers...either there aren't any true ones, she knows the answers will sound like b.s., or she just doesn't care what folks on forum think of her, or of Clear...

jess