{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T07:29:17Z","timestamp":1761204557462,"version":"build-2065373602"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Syst Rev"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      A recent meta-analysis by Posadzki et al. synthesized randomized controlled trials to evaluate the effectiveness and safety of spinal manipulative therapy (SMT) for migraines. Considering\n                      <jats:italic>Systematic Reviews<\/jats:italic>\n                      recognizes several methodological guidelines and reporting standards, our Letter highlights deviations from best practice methodologies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main findings<\/jats:title>\n                    <jats:p>We detail issues with the search strategy, application of selection criteria, inclusion of data, and outcome reporting and analysis. We partially replicated the authors\u2019 search across three of their seven databases, which identified 1845 more articles than they reported. Finally, the authors\u2019 interpretations appear to conflate mild and transient adverse effects with serious ones and minimize potentially meaningful benefits of SMT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The methodological limitations in the meta-analysis by Posadzki et al. raise concerns about its reliability and reproducibility. Accordingly, we advise against relying on this study to guide clinical decision-making. Clinicians, patients, and stakeholders should interpret its conclusions cautiously when evaluating the appropriateness of SMT for migraine management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13643-025-02849-5","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T07:25:58Z","timestamp":1761204358000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Critical limitations compromise the conclusions of a recent meta-analysis regarding spinal manipulation and migraine: a commentary"],"prefix":"10.1186","volume":"14","author":[{"given":"Robert J.","family":"Trager","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc A.","family":"Bronson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clinton J.","family":"Daniels","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen M.","family":"Perle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"2849_CR1","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1186\/s13643-024-02719-6","volume":"13","author":"P Posadzki","year":"2024","unstructured":"Posadzki P, Klimek AT, Ernst E. Spinal manipulations for migraine: an updated systematic review and meta-analysis of randomized clinical trials. Syst Rev. 2024;13:296.","journal-title":"Syst Rev"},{"key":"2849_CR2","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1186\/s13643-023-02255-9","volume":"12","author":"K Kolaski","year":"2023","unstructured":"Kolaski K, Logan LR, Ioannidis JPA. Guidance to best tools and practices for systematic reviews. Syst Rev. 2023;12:96.","journal-title":"Syst Rev"},{"key":"2849_CR3","first-page":"685","volume":"38","author":"K MacLure","year":"2016","unstructured":"MacLure K, Paudyal V, Stewart D. Reviewing the literature, how systematic is systematic? Int J Clin Pharm. 2016;38:685\u201394.","journal-title":"Int J Clin Pharm"},{"key":"2849_CR4","unstructured":"Higgins J, Thomas J, Chandler J, Cumpston M, Li T, Page M, et al. Cochrane Handbook for Systematic Reviews of Interventions version 6.5 (updated August 2024). 2024 [cited 2024 Dec 18]. 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Available from: https:\/\/figshare.com\/articles\/dataset\/Repository_data_for_Commentary\/28057199\/1."},{"key":"2849_CR8","doi-asserted-by":"publisher","unstructured":"Odell J, Branney J, Hunnisett A. Effectiveness of manual therapy as an adjunct to care as normal in female chronic migraine patients. A Randomised Controlled Trial [Internet]. 2022 [cited 2024 Dec 18]. Available from: https:\/\/doi.org\/10.21203\/rs.3.rs-2291690\/v1.","DOI":"10.21203\/rs.3.rs-2291690\/v1"},{"key":"2849_CR9","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1159\/000496032","volume":"26","author":"L Nie","year":"2019","unstructured":"Nie L, Cheng J, Wen Y, Li J. The effectiveness of acupuncture combined with tuina therapy in patients with migraine. 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Trager discloses that he has earned royalties from authoring a textbook on the topic of sciatica that discusses the application of SMT for low back disorders, and that he serves as an unpaid Scientific Commission member of the 501c3 non-profit Clinical Compass. Clinton J. Daniels serves as the Scientific Commission Chair for Clinical Compass, and consults on the Washington State Health Technology Clinical Committee. Stephen M. Perle discloses that he has earned honoraria for teaching continuing education and legal consultation.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"200"}}