Council on Chiropractic Guidelines and Practice Parameters, and FCER Testify at Public Hearing
ARLINGTON, Virginia -- On October 31, 1995, members of the chronic headache panel of the Agency for Health Care Policy and Research (AHCPR) held its only public meeting. The meeting was an opportunity for various organizations to give their input to the panel before the group develops the practice guidelines for the treatment of headaches.
Six organizations were scheduled to present their information:
- Council on Chiropractic Guidelines and Practice Parameters (CCGPP): presenter, Donald Petersen Jr., editor/publisher of Dynamic Chiropractic.
- Foundation for Chiropractic Education and Research (FCER): presenter, George McCelland, DC.
- Migraine Awareness Group: A National Understanding for Migraineurs (MAGNUM): presenter, Michael Coleman, Terry Miller.
- American Physical Therapy Association (APTA): presenter, Arthur Nelson, PhD, PT.
- American Osteopathic Association (AOA): presenter, Mitchell Elkiss, DO.
- American Psychological Association (APA): presenter, Russ Newman, PhD, JD.
Presenters were limited to 10 minutes, and another 10 minutes for questions and answers.
The Council on Chiropractic Guidelines and Practice Parameters was the first organization to present. The Council provided over 200 studies that support the effectiveness of chiropractic manipulation for all types of headaches. The CCGPP has representation from every major chiropractic organization in the United States:
American Chiropractic Association
Association of Chiropractic Colleges
Congress of Chiropractic State Associations
Consortium for Chiropractic Research
Council on Chiropractic Education
Foundation for the Advancement of Chiropractic Tenets & Science Foundation for Chiropractic Education and Research
Federation of Chiropractic Licensing Boards
International Chiropractors Association
National Association of Chiropractic Attorneys
National Institute for Chiropractic Research
The Foundation for Chiropractic Education and Research was the second organization to present. FCER President George "Mac" McClelland Jr., DC, gave the panel a more in-depth understanding of the literature and did an excellent job handling a number of tough questions.
The chiropractic profession was well served by both presentations. Recognizing the AHCPR panel's criteria requiring quality evidence, both organizations provided extensive references from the scientific literature.
Chiropractic is represented in the AHCPR headache panel by John Triano, DC, MS. This representation was not enjoyed by the osteopaths or the physical therapists. Dr. Triano spoke up twice during the question and answer period to address issues regarding chiropractic research.
MAGNUM founder Michael John Coleman related personal concerns for migraine sufferers. While Mr. Coleman presented some interesting information, he was mostly unable to support his statements with documentation.
For an unknown reason, the representative from the American Physical Therapy Association never showed up. This could not have helped their position, considering the fact that there isn't any physical therapy representation on the headache panel.
Mitchell Elkiss, DO, of the American Osteopathic Association (AOA), boldly told the panel that osteopathy was the best form of treatment for headaches, based on their multi-therapeutic approach. This point was apparently lost on the panel. The AOA's position probably would have been better received had they had any documentation to demonstrate their claims of superior effectiveness.
The American Psychological Association representative, Russ Newman, PhD, JD, spoke last, providing some data and complaining of the lack of inclusion for the treatment of headache in most health care plans.
The AHCPR headache panel will take into account the information provided at the public hearing as they begin to develop the first draft of the headache practice guidelines.
Chiropractic was reasonably well prepared to demonstrate why we should be included. A special thanks should go to Howard Vernon, DC, FCCS(C), and many other chiropractic researchers for their efforts. Dr. Vernon's presentation at the Chiropractic Centennial celebration in Washington, DC provided an excellent review of the literature for chiropractic's inclusion in the treatment of headache.
We will now have to wait approximately 18 months to read the headache guidelines produced by the panel. These guidelines could open new doors for the profession. The decision rests on the quality and quantity of our research.
