In an editorial for the June 11, 2008 edition of JAMA, Eugenia Chan, MD, MPH discusses the importance of reliable, evidence-based information about CAM.
In an editorial for the June 11, 2008 issue of JAMA1, Eugenia Chan, MD, MPH discusses the importance of reliable, evidence-based research findings on CAM therapies. By 2002, the prevalence of CAM use by adults had increased to up to 68%. Since then, physicians have been trying to keep up with the exponential increase in CAM use among their patients and are eager to seek reliable, evidence-based research in the form of randomized controlled trials (RCTs). Interventions pose unique challenges to rigorous RCT methodology for CAM, including: therapies whose outcomes are subjective (general well-being, level of energy), dependent upon the skill of the practitioner (therapeutic touch, psychotherapy), tailored to an individual (homeopathy, TCM), used simultaneously (meditation, aromatherapy, herbs), or combined with secular trends in lifestyle (diet, exercise, yoga, massage) which may attenuate or magnify treatment effects. Citing findings from 2005 IOM2, 2008 JAMA3 and 2004 Journal of Complementary Medicine4 studies, Chan suggests that some of these challenges could be addressed by using alternative study designs.
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1 – Chan, Eugenia. Quality of Efficacy Research in Complementary and Alternative Medicine. JAMA. 2008;299(22):2685-2686.
2 – Institute of Medicine. Complementary and Alternative Medicine in the United States. Washington, DC: National Academies Press; 2005.
3 – Weber, Wendy et al. Hypericum perforatum (St John’s Wort) for Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Randomized Controlled Trial. JAMA. 2008;299(22):2633-2641.
4 – Caspi O, Bell IR. One size does not fit all: aptitude x treatment interaction (ATI) as a conceptual framework for complementary and alternative medicine outcome research. J Altern Complement Med. 2004;10(3):580-586.