This study prompted the following response from Anthony L. Rosner, Ph.D., the Director of Research for the Foundation for Chiropractic Education and Research (FCER).
There were also these responses from the academic and research community. This study raises serious issues with the design of a truly inert placebo, as well as issues for the design of future randomized trials for "manual", "manipulative", or "physical medicine" types of trials. This is discussed in length in the Problems with Placebos Page
A casual reading of the Balon and Aker study, published in the October 8, 1998 issue of The New England Journal of Medicine suggests that chiropractic spinal manipulation provides no benefit to patients. What is overlooked are the facts that the design of the study is such that the outcome is all but guaranteed in advance and the benefits of chiropractic manipulation in the management of asthma (suggested in several previously published case studies and clinical trials) are obscured and therefore judged to be nonexistent. At a time when public interest in the application of alternative medicine is rising, it is regrettable that a study with such deep flaws should have found its way to the lead position in such a prominent journal.
Balon J, Aker PD, Crowther ER, et al. N Engl J Med. 1998 (Oct 8);339 (15): 1013-1020