title: Overview of the Publications From the Anthroposophic Medicine Outcomes Study (AMOS): A Whole System Evaluation Study.
abstract: Anthroposophic medicine is a physician-provided complementary therapy system that was founded by Rudolf Steiner and Ita Wegman. Anthroposophic therapy includes special medicinal products, artistic therapies, eurythmy movement exercises, and special physical therapies. The Anthroposophic Medicine Outcomes Study (AMOS) was a prospective observational multicenter study of 1631 outpatients starting anthroposophic therapy for anxiety disorders, asthma, attention deficit hyperactivity disorder, depression, low back pain, migraine, and other chronic indications under routine conditions in Germany. AMOS INCORPORATED TWO FEATURES PROPOSED FOR THE EVALUATION OF INTEGRATIVE THERAPY SYSTEMS: (1) a sequential approach, starting with the whole therapy system (use, safety, outcomes, perceived benefit), addressing comparative effectiveness and proceeding to the major system components (physician counseling, anthroposophic medicinal products, art therapy, eurythmy therapy, rhythmical massage therapy) and (2) a mix of different research methods to build an information synthesis, including pre-post analyses, prospective comparative analyses, economic analyses, and safety analyses of individual patient data. AMOS fostered two methodological innovations for the analysis of single-arm therapy studies (combined bias suppression, systematic outcome comparison with corresponding cohorts in other studies) and the first depression cost analysis worldwide comparing primary care patients treated for depression vs depressed patients treated for another disorder vs nondepressed patients. A total of 21 peer-reviewed publications from AMOS have resulted. This article provides an overview of the main research questions, methods, and findings from these publications: anthroposophic treatment was safe and was associated with clinically relevant improvements in symptoms and quality of life without cost increase; improvements were found in all age, diagnosis, and therapy modality groups and were retained at 48-month follow-up; nonrespondent bias, natural recovery, regression to the mean, and adjunctive therapies together could explain a maximum of 37% of the improvement.
authors.affiliation: Institute for Applied Epistemology and Medical Methodology at the University of Witten-Herdecke, Freiburg, Germany (Dr Hamre).
authors.forename: Harald Johan
authors.initials: HJ
authors.lastname: Hamre
authors.affiliation: Institute for Applied Epistemology and Medical Methodology at the University of Witten-Herdecke, Freiburg, Germany (Dr Kienle).
authors.forename: Helmut
authors.initials: H
authors.lastname: Kiene
authors.affiliation: Institute Hiscia, Society for Cancer Research, Arlesheim, Switzerland (Dr Ziegler).
authors.forename: Renatus
authors.initials: R
authors.lastname: Ziegler
authors.affiliation: Clinical Research Dr Tröger, Freiburg, Germany (Dr Tröger).
authors.forename: Wilfried
authors.initials: W
authors.lastname: Tröger
authors.affiliation: Community Hospital Havelhöhe, Berlin, Germany (Dr Meinecke).
authors.forename: Christoph
authors.initials: C
authors.lastname: Meinecke
authors.affiliation: Albert-Fraenkel-Centrum, Badenweiler, Germany (Dr Schnürer).
authors.forename: Christof
authors.initials: C
authors.lastname: Schnürer
authors.affiliation: Ita Wegman Therapeutikum, Dortmund, Germany (Dr Vögler). Dr Vögler was the contact person for the Anthroposophic Medicine Outcomes Study (AMOS) in the Physicians' Association for Anthroposophical Medicine in Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Vögler
authors.affiliation: Institute for Applied Epistemology and Medical Methodology at the University of Witten-Herdecke, Freiburg, Germany (Ms Glockmann).
authors.forename: Anja
authors.initials: A
authors.lastname: Glockmann
authors.affiliation: Institute for Applied Epistemology and Medical Methodology at the University of Witten-Herdecke, Freiburg, Germany (Dr Kiene).
authors.forename: Gunver Sophia
authors.initials: GS
authors.lastname: Kienle
keywords: Anthroposophic medicine; art therapy; drug therapy; eurythmy therapy; observational studies; review; rhythmical massage therapy; whole system evaluation
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