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Implementing a research agenda for complementary and alternative medicine.

Jonathan D Berman1, Stephen E Straus

  • 1National Center for Complementary and Alternative Medicine, National Institutes of Health, Bethesda, Maryland 20892, USA. Bermanjo@mail.nih.gov

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|January 30, 2004
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Summary

Complementary and alternative medicine (CAM) lacks proven safety and efficacy, despite popularity. Further research is crucial to determine which CAM therapies are safe and effective for public health.

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Area of Science:

  • Integrative Medicine
  • Evidence-Based Practice
  • Public Health

Background:

  • Complementary and alternative medicine (CAM) encompasses diverse interventions often used without prior safety and efficacy demonstration.
  • CAM therapies are broadly categorized into biologically based, manipulative, mind-body, energy therapies, and alternative systems.

Purpose of the Study:

  • To evaluate the current evidence base for the safety and efficacy of CAM interventions.
  • To highlight the need for a structured research agenda to assess CAM's therapeutic index.

Main Methods:

  • Review of existing evidence on individual CAM modalities.
  • Analysis of anecdotal reports and small clinical trials.
  • Assessment of safety concerns, including toxicity and drug interactions.

Main Results:

  • Evidence for CAM efficacy is largely anecdotal, though some small trials show positive results.
  • Some CAM modalities show encouraging data, while others are demonstrably ineffective.
  • CAM interventions may pose safety risks, particularly botanical agents, due to toxicity or adulterants.

Conclusions:

  • A significant research gap exists regarding the safety and efficacy of most CAM interventions.
  • Rigorous investigation is required to establish the therapeutic index of CAM practices.
  • Public health requires a defined research agenda to standardize and validate CAM therapies.