Is complementary and alternative medicine (CAM) evidence-based medicine? CAM has been defined as a group of diverse medical and health systems, practices and products that are not presently considered part of conventional medicine (NCCAM, 2009). CAM includes but is not limited to Chinese Medicine, Ayuverdic Medicine, homeopathy, spinal-manipulative medical practices as well as mind/body Practices. Evidence-based medicine consists of an approach and/or attempt by professionals (social workers, therapists, health providers) to integrate clinical expertise with the best available external clinical evidence from systematic research (Sackett, et al, 1996). The level of clinical expertise for CAM interventions varies depending on discipline, licensure and regulatory bodies. CAM practices are evaluated in the same way that other interventions in the field of psychology, social work and medicine are evaluated. In evidence-based medicine, there is a standard and hierarchy. The gold standard for scientific evidence is the systematic review of several double-blind, randomized controlled trials (RCT). The next level of scientific evidence consists of quasi-experimental studies, open clinical trials, systematic observations, and unsystematic observations. It is also important to take into account number of studies, treatment effects, the importance of outcomes, the generalizability of studies, and other factors (Drake et al, 2003, p. 812). Problems inherent in conducting gold standard CAM interventions include the consideration of individualized treatment plans, difficulty associated with the creation of control groups, and blinding or double blinding researchers and participants (Satterfield et al & Baranowsky, 2009). Verhoef, Casebeer and Hilsden (2002) argue that an effective evaluation of CAM interventions need to include qualitative research designs that assess the understanding, significance and beliefs patients hold about the treatment and expectations of the outcome. Despite these difficulties thousands of RCT evaluating the effectiveness of CAM treatments in general and for specific diseases have been conducted (NCCAM, 2009).
Drake, R.E., Latimer, E.A., Leff, H.S., McHugo, G.J., & Burns, B.J. (2004). What is evidence? Child and Adolescent Psychiatric Clinics of North America, 13(4), 717-728. doi: 10.1016/j.chc.2004.05.005.
NCCAM (2009). What is complementary and alternative Medicine? http://nccam.nih.gov/health/whatiscam/ (March 12, 2011)
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Satterfield, , J. M., Spring, B., Brownson, R. C., Mullen, E. J., Newhouse, R. P., Walker, B. B., & Whitlock, E. P. (2009). Toward a Transdisciplinary Model of Evidence-Based Practice. Milbank Quarterly, 87(2), 368-390. doi:10.1111/j.1468-0009.2009.00561.x
Verhoef, M. J., Casebeer, A. L., & Hilsden, R. J. (2002). Assessing Efficacy of Complementary Medicine: Adding Qualitative Research Methods to the "Gold Standard". Journal of Alternative & Complementary Medicine, 8(3), 275-281. doi:10.1089/10755530260127961