HEALTH SERVICE RESEARCH POSTER PRESENTATION ABSTRACTS
Please note: All posters will be displayed in
Salons 10-12.
FRIDAY, 10:15-11:00 AM
Adams D, Cramer K, Vanderjagt L, Vohra S.
Systematic review of pediatric clinical trials of traditional
Chinese medicine interventions.
University of Alberta denise.adams@ualberta.ca
BACKGROUND: It is estimated that over 25% of
the world population uses traditional Chinese medicine (TCM), however,
the efficacy and safety of TCM modalities for many medical conditions
remain unknown. Current knowledge of the state of pediatric research
of TCM interventions is limited. This systematic review seeks to fill
this gap in knowledge.
OBJECTIVE: To identify and categorize pediatric
clinical trials of TCM interventions published in English.
METHODS: The following databases were searched
using predefined search strategies: MEDLINE, EMBASE, CENTRAL and the
Chalmers Research Group PedCAM database. Search results were independently
screened by two reviewers for potentially relevant articles. These were
then reviewed using the following inclusion/exclusion criteria: randomized
or quasi-randomized controlled trials; populations including children
18 or younger; interventions described as traditional Chinese medicine,
or Chinese medicine; and presence of a control group receiving sham,
placebo, conventional Western medicine or standard care. Publications
available in English were retrieved and the following data extracted
and tabulated: date, country, population age, condition treated, intervention,
type of control, sample size, and treatment results. Quality was assessed
using Jadad scores and allocation concealment.
RESULTS: A total of 80 publications, including
9 381 participants, met inclusion criteria. Sample size ranged from
12 to 1158 with a mean of 117. In 36 trials the upper age limit was
18. In 32 trials the lower age limit was 14 and included adults. 47
trials investigated acupuncture, 26 investigated herbal products, 5
investigated combined acupuncture and herbal products, 1 investigated
moxibustion and 1 investigated massage. Trial sites included: China
(42), UK (6), US (6), Australia (3), Austria (3), Canada (3), Taiwan
(3), Germany (2), Israel (2), and Hong Kong (1). 48 different medical
categories were investigated including nausea/vomiting, asthma, pain,
headache, hepatitis, epilepsy, and depression. 12/48 conditions have
been investigated by more than one clinical trial. 65% of the trials
found TCM significantly improved the outcome when compared to control.
40% of trials received a Jadad score of 3 or more. 10% of trials reported
adequate allocation concealment methods.
CONCLUSION: Controlled clinical trials of TCM
in pediatric populations are being conducted. Overall, trial results
indicate TCM may be effective in treating a variety of conditions. Caution
must be used in the interpretation of trial results due to methodological
flaws, lack of validated outcome measures, heterogeneous populations,
and incomplete reporting of data. Meta-analysis of multiple trials may
be difficult due to limited availability of multiple trial data for
most conditions, variation in trial parameters such as population, intervention,
and control. Limitations: Limitations of this review include exclusion
of non-English publications and restriction of searches to 4 databases.
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