Share with a friendDEVELOPMENT OF COMPLEMENTARY THERAPY ASSESSMENTS
Complementary and alternative therapies are a growing part of health care in America. The National Institutes of Health National Center for Complementary and Alternative Medicine has defined complementary and alternative medicine (CAM) as covering "a broad range of healing philosophies (schools of thought), approaches, and therapies that mainstream Western (conventional) medicine does not commonly use, accept, study, understand, or make available. A few of the many CAM practices include the use of acupuncture, herbs, homeopathy, therapeutic massage, and traditional oriental medicine to promote well-being or treat health conditions."[43] Americans spend an estimated $14 billion a year on alternative treatments. Mainstream medicine is recognizing a need to learn more about alternative therapies and to determine their true value, and most medical schools in the United States offer courses in alternative therapies. The editors of the Journal of the American Medical Association announced that publishing research on alternative therapies will be one of its priorities. More scrutiny and scientific objectivity is being applied to determine whether evidence supporting their effectiveness exists.
In the fall of 1998, the Board of Trustees appointed a Task Force on Complementary Therapy to evaluate complementary therapies in eye care and develop an opinion on their safety and effectiveness, based on available scientific evidence, in order to inform ophthalmologists and their patients. A scientifically grounded analysis of the data will help ophthalmologists and patients evaluate the research and thus make more rational decisions on appropriate treatment choices.
The Academy believes that complementary therapies should be evaluated similarly to traditional medicine: evidence of safety, efficacy, and effectiveness should be demonstrated.[44] Many therapies used in conventional medical practice also have not been as rigorously tested as they should be. Given the large numbers of patients affected and the health care expenditures involved, it is important that data and scientific information be used to base all treatment recommendations. In this way, we can encourage high-quality, rigorous research on complementary therapies.[45]
Ideally, a study of efficacy compares a treatment to a placebo or another treatment, using a double-masked controlled trial and well-defined protocol. Reports should describe enrollment procedures, eligibility criteria, clinical characteristics of the patients, methods for diagnosis, randomization method, definition of treatment, control conditions, and length of treatment. They should also use standardized outcomes and appropriate statistical analyses.
The goal of these assessments is to provide objective information of complementary therapies and provide a scientific basis for physicians to advise their patients, when asked.
To accomplish these goals, the assessments, in general, are intended to do the following:
· Describe the scientific rationale or mechanism for action for the complementary therapy.
· Describe the methods and basis for collecting evidence.
· Describe the relevant evidence.
· Summarize the benefits and risks of the complementary therapy.
· Pose questions for future research inquiry.
· Summarize the evidence on safety and effectiveness.
· American Occupational Therapy Association, Inc. at http://www.aota.org/
· International Dyslexia Association at http://www.interdys.org/
· International Council on Developmental and Learning Disorders at www.icdl.com
· ICDL Clinical Practice Guidelines . Redefining the Standards of Care for Infants, Children, and Families with Special Needs. Available at http://icdl.com/ICDLguidelines/toc.htm.
· Joint Statement of the American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus, and the American Academy of Ophthalmology.
· Learning Disabilities, Dyslexia, and Vision: A Subject Review (RE9825). Available at http://www.aap.org/
· National Center for Learning Disabilities at http://www.ncld.org/
· National Institute of Child Health and Human Development at http://www.nichd.nih.gov/
· NICHD Report of the National Reading Panel. Teaching Children to Read: An Evidence-Based Assessment of the Scientific Research Literature on Reading and Its Implications for Reading Instructions. Available at www.nichd.nih.gov/publications/nrppubskey.cfm.
· Schwab Foundation for Learning at www.schwablearning.org
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