title: Complementary therapy systems and their integrative evaluation.
abstract: Complementary and alternative medicine (CAM) is becoming an integral part of modern medicine. Complementary and alternative medicine therapy systems include natural medicinal products, nonpharmacological treatments, and counselling on health and lifestyle issues. Complementary and alternative medicine concepts are often elaborate, transcending biophysical models and employing the principles of salutogenesis. Evaluations of CAM therapy systems need to be integrative and cover the dimensions of: (1) therapeutic professionalism; (2) patient perspective and public demand; (3) conceptuality; (4) safety, effectiveness, and costs. Complex research strategies are required, which reverse the phases of conventional drug assessment. The predominant use of randomized trials would introduce structural bias and create an artificial picture. Important are evaluations of the whole system in real-world conditions, and surveys on component evaluations. Systemic CAM assessments should consist of a broad array of high-quality research methods: well-conducted randomized and nonrandomized studies, cohort studies, qualitative research, high-quality case reports and case series, studies on patient perspective, safety analyses, economic analyses, etc. Good clinical judgement, a core epistemic element of medicine based on nonstochastic principles, should also be integrated and could reflect routine patient care.
authors.affiliation: Institute for Applied Epistemology and Medical Methodology, Freiburg, Germany. gunver.kienle@ifaemm.de
authors.forename: Gunver Sophia
authors.initials: GS
authors.lastname: Kienle
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Albonico
authors.forename: Lorenz
authors.initials: L
authors.lastname: Fischer
authors.forename: Martin
authors.initials: M
authors.lastname: Frei-Erb
authors.forename: Harald J
authors.initials: HJ
authors.lastname: Hamre
authors.forename: Peter
authors.initials: P
authors.lastname: Heusser
authors.forename: Peter F
authors.initials: PF
authors.lastname: Matthiessen
authors.forename: Adrian
authors.initials: A
authors.lastname: Renfer
authors.forename: Helmut
authors.initials: H
authors.lastname: Kiene
mesh_terms: D035843:Biomedical Research / Q000379:methods / Q000592:standards*; D002986:Clinical Trials as Topic / Q000592:standards*; D000529:Complementary Therapies / Q000592:standards*; D019317:Evidence-Based Medicine; D006801:Humans; D055048:Integrative Medicine