JAOA • Vol 106 • No 9 • September 2006 • 529-
Editor's Response
Gilbert E. D'Alonzo, Jr, DO
Drs Hershey and Winner were shown this letter and declined to comment.
Dr Vasquez, a first-year osteopathic medical student, states that studies
using such alternatives as spinal manipulation, coenzyme Q10, riboflavin,
feverfew, Petasites hybridus, vitamin D, cobalamin,
5-hydroxytryptophan, and combination fatty acid therapy need to be replicated
in children. The implication is that such studies have not been done in
children. Therefore, had Drs Hershey and Winner mentioned these interventions,
they would have been asked to document their efficacy for use in children with
published studies. Without such documentation, they would have been referring
to off-label treatment, thus failing to adhere to the topic of this
JAOA supplement: "evidence-based medicine" in the
treatment of patients with headache. One of the tenets of osteopathic medicine
states: "The practice of medicine should be based on sound medical
principles. Only therapies proven clinically beneficial in improving patient
outcome should be recommended" (see
http://www.osteopathic.org/index.cfm?PageID=ost_tenet).
In addition, Dr Vasquez's reference 10 was published in February 2005 and
therefore would not have been available to Drs Hershey and Winner via a
literature search at the time they wrote their article (between the last week
of January 2005 and the end of February 2005).
