for those evaluations. In effect, research committees at drug companies and National Institutes of Health study sections perform this function by deciding which proposals shall receive funding. The committee suggests that the following criteria (also discussed in Chapter 4) be used when CAM interventions are considered for testing. Clearly, no intervention will meet all criteria, and a therapy should not be excluded from consideration because it does not meet any one particular criterion, for example, biological plausibility.

• A biologically plausible mechanism exists for the intervention, with recognition that the science base on which plausibility is judged is a work in progress.

• Research could plausibly lead to the discovery of biological mechanisms of disease or treatment effect.

• The condition is highly prevalent (e.g., diabetes mellitus).

• The condition causes a heavy burden of suffering.

• The potential benefit is great.

• Some evidence already exists that the intervention is effective.

• Some evidence that there are safety concerns exists.

• The research design is feasible and likely to yield an unambiguous result.

• The target condition or the intervention is important enough to have been detected by existing population surveillance mechanisms.

Next in the evaluation part of the cycle is the conduct of preliminary studies to establish feasibility. One example of this process is the Phase I and Phase II trials required by the Food and Drug Administration for new drugs. These studies evaluate whether the intervention does what it claims to and characterizes adverse effects.

If the intervention meets the challenges imposed by the Phase I and II trials, it becomes a candidate for adoption as a medical practice and moves to the next challenge: clinical trials to test its effects with larger numbers of patients.

Several things happen during the acceptance phase of the translation cycle. Once research results are available, dissemination begins. Researchers publish their findings in peer-reviewed journals and make presentations at scientific meetings. This step requires a careful peer-review process and competent researchers to evaluate the evidence and recommend the findings for publication or presentation. The articles may be published in CAM-related journals (e.g., Journal of Complementary and Alternative Medicine)

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)