Lachance L, Zick S, Hawthorne V, Brien S, Hyland ME, Lewith G, Verhoef M, Warber S.

Delphi process for developing a common epidemiologic core for complementary and alternative medicine (CAM) prevalence.

The University of Michigan, School of Public Health, 109 South Observatory St, Ann Arbor, MI 48109-2029. lauriel@umich.edu

A number of useful surveys of the prevalence of CAM use have been conducted in both the US and elsewhere and the outcomes have underlined the difficulty of comparing variables in one survey with another. There is a clear need for surveys to collect data more fully in accord with standard epidemiological principles.

METHODS: The primary aim of this project was to obtain a consensus among a broad based sample of CAM researchers, practitioners and users with respect to a core list of CAM. Members of the newly formed International Society for Complementary Medicine Research (ISCMR) agreed to take part. A Delphi study was conducted to identify an agreed upon core list of treatments, methods and usage for the development of further questionnaires. Respondents were asked to rate the importance of a list of practitioner based CAM therapies and a list of self-care CAM modalities. Respondents were also asked to add and rate CAM therapies for consideration in the next round. Therapies were rated on a scale of 1=very important, 2=somewhat important, and 3=not important. First round responses with a mean ³ 2.0 were removed from the list for the second Delphi round. Overall and therapy-specific comments were also collected and fed back to the participants.

RESULTS: The first round of the Delphi process has been completed. Preliminary results from the 69 respondents (50% response rate) show the most agreement with acupuncture (mean=1.0, SD=0.17); Traditional Chinese Medicine (mean=1.1, SD=0.24); and homeopathy (mean=1.1, SD=0.38) among the practitioner-based CAM therapies. Opinions were more widespread for the self-medication list, with most agreement on herbal supplements (mean=1.2, SD= 0.47); homeopathy (mean=1.3, SD=0.63); and nutritional therapy (mean=1.3, SD=0.55). Agreement existed across countries for CAM practitioner-based therapies, however, the UK also included osteopathy and chiropractic; Canada included chiropractic; European countries included Anthroposophical Medicine; and the US included naturopathy in the top rankings (mean ³ 1.1). Agreements also existed across countries for self-care CAM with the inclusion of yoga in the UK and Traditional Chinese Medicine in the US (mean ³ 1.3).

CONCLUSIONS: The second round of this Delphi process is underway. Results from the second round as well as a possible third round will be analyzed and reported. Final results from the Delphi process will then be refined into an acceptable standardized survey instrument for general use in studies of the prevalence of CAM use at different times and across national boundaries.

 

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