Response to Licciardone

Abstract

The main aim of our review [1] was to assess the effectiveness of osteopathic manipulative therapy (OMT) for musculoskeletal pain. The aim of the review by Licciardone et al. [2] was to evaluate the effectiveness of OMT for low back pain (LBP). Thus, discrepant conclusions are not surprising. Both reviews were designed to answer different research questions, required different search strategy, and arrived at different conclusions.We were unable to run a formal meta-analysis due to heterogeneity of the data and therefore we could not perform a subgroup analysis of LBP. Perhaps this should be stated clearly in the text.The trial of Cleary and Fox [3] was excluded as it was predominantly focused on menopausal symptoms and hormone levels. The study by Hoehler et al. reported an immediate relief, but there were no differences between groups at discharge [4]. It was only included for the safety information, but it was unclear who administered spinal manipulation, it was excluded from the main analysis. We do not believe that comparing the quality of one set of studies with another one, as Licciardone seems to suggest, generates meaningful information.Others rated the systematic review by Licciardone as having major flaws [5]. We would hope that when our review is submitted to a similarly independent evaluation, it might fare better.