Sir

Your News story “Survey questions safety of alternative medicine” (Nature 436, 898; 200510.1038/436898b) quotes Edzard Ernst as saying that complementary and alternative medicine (CAM) organizations are not doing enough to monitor adverse reactions. It also reports that chiropractic treatments sometimes have serious side-effects.

The British Chiropractic Association (BCA) is currently undertaking a large-scale observational study (sample size of over 50,000) to document patient outcomes after cervical spine manipulation. Final data analysis is expected in 2006, and we hope to publish the results in peer-reviewed journals.

The BCA has also, in conjunction with the Anglo-European Chiropractic College, set up a chiropractic reporting and learning system; more than 1,200 practitioners who are members of the BCA have recently received an information pack to enable them to participate in the scheme. Resulting data will be analysed at the Anglo-European Chiropractic College and outcomes will be relayed to the profession, through our newsletter, journal and website, so practitioners may learn from the experience of others.

The intention is that the scheme will, if successful, be offered to other chiropractic associations within Europe in 2006.