Federal Headache Guideline Panel Formed

Dr. John Triano will represent chiropractic profession

By Editorial Staff
'When you're lying awake with a dismal headache ...' Sir William Gilbert, "Iolanthe," 1882.

While the health care world is still assimilating the acute low back pain guidelines released at the end of 1994 by the Agency for Health Care Policy and Research (AHCPR), a new panel to establish clinical guidelines for the diagnosis and treatment of chronic headaches has been formed.

The headache panel will be co-chaired by MDs David Matchar and Douglas McCrory, both on the faculty of Duke University's Center for Health Policy Research and Education. Dr. Matchar is the director of the Center. Duke University has been chosen as the contractor to perform the administrative, panel support, and literature reviews.

The 18-member panel includes: three neurologists; three internists; two family medicine MDs; a pharmacist; an emergency medicine MD; a dentist; a psychologist; a psychiatrist; a radiologist (MD); a nurse; a social worker; a consumer; and a chiropractor.

The sole chiropractor in residence will be John Triano, DC, MA. Dr. Triano's experience goes back to establishing a quality assurance program at National College of Chiropractic. He was a member of the steering committee for the Mercy Guidelines conference, a member of the first RAND panel, and a member of the AHCPR's low back pain panel. Dr. Triano is a staff physician at the Texas Back Institute (TBI), in Plano, Texas; a clinical scientist at the Institute's research foundation, and is on the board of the Institute of Spine and Biomedical Research, which is affiliated with TBI.

The AHCPR has made an attempt to keep the panel isolated from the potential influence of headache pain drug manufacturers. Each panel member has agreed to abstain from any activities funded by pharmaceutical companies that sell headache drugs.

The panel's work will take approximately 18 months, time enough to examine all available research on headaches and to make their recommendations. It is hoped that enough viable chiropractic research on headaches has been produced to give the panel members a clear understanding of chiropractic's role in the treatment of headache.

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