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WORKSHOP Thursday, May 25, 11:00-12:30
Methodological Challenges of Preparing Systematic Reviews
of Randomized Controlled Trials in CAM
Speakers: Eric Manheimer, MS, Anne Nedrow, MD
There is a great need to collect, synthesize,
and disseminate high quality information in complementary and alternative
medicine (CAM). Yet systematic reviewers in CAM face many challenges
because of the special characteristics of CAM therapies and trials:
- CAM trial reports are often not published
in English and often not indexed on MEDLINE;
- CAM trials are frequently heterogeneous in
intervention, control, and outcome, and therefore difficult to quantitatively
synthesize in meta-analyses;
- CAM therapies may not be familiar to Western-trained
researchers, who may be inadequately trained to assess treatment adequacy
or evaluate whether seemingly dissimilar therapies (e.g. laser acupuncture
and Chinese acupuncture) should be lumped together or evaluated separately;
and
- CAM therapies are often not ideally suited
to evaluation by double-blind controlled trials, because double-blinding
is difficult to implement in acupuncture, massage, and other CAM modalities
involving manipulation by the therapist.
Using the example of acupuncture, this workshop
will examine some of the issues and challenges that can be encountered
in preparing CAM systematic reviews, and some strategies for addressing
these challenges. Topics to be covered include evaluating title adequacy
of raised question, conducting literature searches, determining intervention
and control classification, defining treatment adequacy, scoring quality,
and reporting results.
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