In recent years, many systematic reviews of CAM therapies have been conducted and efforts are under way to synthesize and summarize as comprehensively as possible the evidence available from these reviews.

One way in which data are synthesized is through systematic reviews of reviews, which provide an overview of a therapy’s effectiveness across all conditions. It is important to note that those preparing the summary must be aware of and acknowledge or adjust for the fact that some studies may appear in more than one review of a given topic.

Reviews of reviews use comprehensive searches, strict inclusion criteria, and data extraction with pretested forms. These reviews of reviews summarize the basic information from individual reviews, including conditions, interventions, methodological features, and results, as well as present the number of studies reviewed and the reviewers’ own conclusions (Linde et al., 2001a,c,d).

AHRQ, the leading federal agency concerned with research on health care quality, efficiency, effectiveness, and safety, prepares evidence reports and technology assessments that provide information on the clinical efficacies of medical interventions on the basis of systematic reviews and, when appropriate, meta-analyses. Many AHRQ evidence reports relate to CAM interventions (Table 5-4).

An NIH consensus statement is prepared by a panel of experts who review key questions and data about various therapies before an audience that comprises other experts in various medical fields. The panel, working with this audience of experts, addresses a predefined question and reaches conclusions on the basis of both the scientific data presented to the panel and data from the relevant literature gathered from MEDLINE. In 1997, NIH produced a consensus statement on acupuncture and concluded that, despite equivocal results in many studies, acupuncture is clearly effective for postoperative dental care and the prevention of nausea and vomiting in adults after surgery and chemotherapy and is possibly effective for many other conditions (National Institutes of Health, 1998). Nevertheless, poor study designs, inadequate sample sizes, and other problems invalidated the

Front Matter (R1-R22)

Executive Summary (1-12)

1 Introduction (13-33)

2 Prevalence, Cost, and Patterns of CAM Use (34-73)

3 Contemporary Approaches to Evidence of Treatment Effectiveness: A Context for CAM Research (74-107)

4 Need for Innovative Designs in Research on CAM and Conventional Medicine (108-128)

5 State of Emerging Evidence on CAM (129-167)

6 An Ethical Framework for CAM Research, Practice, and Policy (168-195)

7 Integration of CAM and Conventional Medicine (196-225)

8 Educational Programs in CAM (226-252)

9 Dietary Supplements (253-277)

10 Conclusion (278-282)

Appendix A: CAM Therapies, Practices, and Systems (283-292)

Appendix B: Consortium of Academic Health Centers for Integrative Medicine (293-294)

Appendix C: Table 1-1 List of Abbreviations (295-295)

Appendix D: Liaison Panel Organizations (296-297)

Appendix E: Model Guidelines for the Use of Complementary and Alternative Therapies in Medical Practice (298-306)

Appendix F: National Center for Complementary and Alternative Medicine Research Centers (307-309)

Appendix G: Public Meetings (310-318)

Appendix H: Committee Biosketches (319-326)

Index (327-338)