Researching complementary and alternative treatments - the gatekeepers are not at home

Persistent Link:
http://hdl.handle.net/10150/610042
Title:
Researching complementary and alternative treatments - the gatekeepers are not at home
Author:
Fonnebo, Vinjar; Grimsgaard, Sameline; Walach, Harald; Ritenbaugh, Cheryl; Norheim, Arne; MacPherson, Hugh; Lewith, George; Launso, Laila; Koithan, Mary; Falkenberg, Torkel; Boon, Heather; Aickin, Mikel
Affiliation:
National Research Center in Complementary and Alternative Medicine, Faculty of Medicine, University of Tromsø, N-9037 TROMSØ, Norway; Clinical Research Center, University Hospital of North Norway, N-9038 TROMSØ, Norway; School of Social Sciences & Samueli Institute, University of Northampton, Boughton Green Rd, Northampton NN2 7AL, UK; Department of Family & Community Medicine, University of Arizona, 1450 North Cherry Avenue, Tucson, AZ 85719, USA; Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK; Complementary Medicine Research Unit, Primary Medical Care, Aldermoor Health Centre, Aldermoor Close, Southampton SO16 5ST, UK; Program in Integrative Medicine, University of Arizona, PO Box 245153, Tucson, AZ 85724-5153, USA; Center for Studies of Complementary Medicine, Department of Nursing and the division of International Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Alfred Nobels Allé 23, S-141 83 Huddinge, Sweden; Leslie Dan Faculty of Pharmacy, University of Toronto, 19 Russell Street Toronto, Ontario, M5S 2S2, Canada
Issue Date:
2007
Publisher:
BioMed Central
Citation:
BMC Medical Research Methodology 2007, 7:7 doi:10.1186/1471-2288-7-7
Journal:
BMC Medical Research Methodology
Rights:
© 2007 Fønnebø et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)
Collection Information:
This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.
Abstract:
BACKGROUND:To explore the strengths and weaknesses of conventional biomedical research strategies and methods as applied to complementary and alternative medicine (CAM), and to suggest a new research framework for assessing these treatment modalities.DISCUSSION:There appears to be a gap between published studies showing little or no efficacy of CAM, and reports of substantial clinical benefit from patients and CAM practitioners. This "gap" might be partially due to the current focus on placebo-controlled randomized trials, which are appropriately designed to answer questions about the efficacy and safety of pharmaceutical agents. In an attempt to fit this assessment strategy, complex CAM treatment approaches have been dissected into standardized and often simplified treatment methods, and outcomes have been limited.Unlike conventional medicine, CAM has no regulatory or financial gatekeeper controlling their therapeutic "agents" before they are marketed. Treatments may thus be in widespread use before researchers know of their existence. In addition, the treatments are often provided as an integrated 'whole system' of care, without careful consideration of the safety issue.We propose a five-phase strategy for assessing CAM built on the acknowledgement of the inherent, unique aspects of CAM treatments and their regulatory status in most Western countries. These phases comprise:1. Context, paradigms, philosophical understanding and utilization2. Safety status3. Comparative effectiveness.4. Component efficacy5. Biological mechanisms.SUMMARY:Using the proposed strategy will generate evidence relevant to clinical practice, while acknowledging the absence of regulatory and financial gatekeepers for CAM. It will also emphasize the important but subtle differences between CAM and conventional medical practice.
EISSN:
1471-2288
DOI:
10.1186/1471-2288-7-7
Version:
Final published version
Additional Links:
http://www.biomedcentral.com/1471-2288/7/7

Full metadata record

DC FieldValue Language
dc.contributor.authorFonnebo, Vinjaren
dc.contributor.authorGrimsgaard, Samelineen
dc.contributor.authorWalach, Haralden
dc.contributor.authorRitenbaugh, Cherylen
dc.contributor.authorNorheim, Arneen
dc.contributor.authorMacPherson, Hughen
dc.contributor.authorLewith, Georgeen
dc.contributor.authorLaunso, Lailaen
dc.contributor.authorKoithan, Maryen
dc.contributor.authorFalkenberg, Torkelen
dc.contributor.authorBoon, Heatheren
dc.contributor.authorAickin, Mikelen
dc.date.accessioned2016-05-20T08:57:14Z-
dc.date.available2016-05-20T08:57:14Z-
dc.date.issued2007en
dc.identifier.citationBMC Medical Research Methodology 2007, 7:7 doi:10.1186/1471-2288-7-7en
dc.identifier.doi10.1186/1471-2288-7-7en
dc.identifier.urihttp://hdl.handle.net/10150/610042-
dc.description.abstractBACKGROUND:To explore the strengths and weaknesses of conventional biomedical research strategies and methods as applied to complementary and alternative medicine (CAM), and to suggest a new research framework for assessing these treatment modalities.DISCUSSION:There appears to be a gap between published studies showing little or no efficacy of CAM, and reports of substantial clinical benefit from patients and CAM practitioners. This "gap" might be partially due to the current focus on placebo-controlled randomized trials, which are appropriately designed to answer questions about the efficacy and safety of pharmaceutical agents. In an attempt to fit this assessment strategy, complex CAM treatment approaches have been dissected into standardized and often simplified treatment methods, and outcomes have been limited.Unlike conventional medicine, CAM has no regulatory or financial gatekeeper controlling their therapeutic "agents" before they are marketed. Treatments may thus be in widespread use before researchers know of their existence. In addition, the treatments are often provided as an integrated 'whole system' of care, without careful consideration of the safety issue.We propose a five-phase strategy for assessing CAM built on the acknowledgement of the inherent, unique aspects of CAM treatments and their regulatory status in most Western countries. These phases comprise:1. Context, paradigms, philosophical understanding and utilization2. Safety status3. Comparative effectiveness.4. Component efficacy5. Biological mechanisms.SUMMARY:Using the proposed strategy will generate evidence relevant to clinical practice, while acknowledging the absence of regulatory and financial gatekeepers for CAM. It will also emphasize the important but subtle differences between CAM and conventional medical practice.en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.biomedcentral.com/1471-2288/7/7en
dc.rights© 2007 Fønnebø et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)en
dc.titleResearching complementary and alternative treatments - the gatekeepers are not at homeen
dc.typeArticleen
dc.identifier.eissn1471-2288en
dc.contributor.departmentNational Research Center in Complementary and Alternative Medicine, Faculty of Medicine, University of Tromsø, N-9037 TROMSØ, Norwayen
dc.contributor.departmentClinical Research Center, University Hospital of North Norway, N-9038 TROMSØ, Norwayen
dc.contributor.departmentSchool of Social Sciences & Samueli Institute, University of Northampton, Boughton Green Rd, Northampton NN2 7AL, UKen
dc.contributor.departmentDepartment of Family & Community Medicine, University of Arizona, 1450 North Cherry Avenue, Tucson, AZ 85719, USAen
dc.contributor.departmentDepartment of Health Sciences, University of York, Heslington, York YO10 5DD, UKen
dc.contributor.departmentComplementary Medicine Research Unit, Primary Medical Care, Aldermoor Health Centre, Aldermoor Close, Southampton SO16 5ST, UKen
dc.contributor.departmentProgram in Integrative Medicine, University of Arizona, PO Box 245153, Tucson, AZ 85724-5153, USAen
dc.contributor.departmentCenter for Studies of Complementary Medicine, Department of Nursing and the division of International Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Alfred Nobels Allé 23, S-141 83 Huddinge, Swedenen
dc.contributor.departmentLeslie Dan Faculty of Pharmacy, University of Toronto, 19 Russell Street Toronto, Ontario, M5S 2S2, Canadaen
dc.identifier.journalBMC Medical Research Methodologyen
dc.description.collectioninformationThis item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
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