Research methodology: Evaluating complementary and alternative therapies

Complementary and alternative medicine (CAM) represents an opportunity to expand tools for assisting patients with health care issues, retain or increase market share by proactively responding to consumers, and increase our understanding of interventions outside of conventional medicine. CAM research is a flourishing area that is currently receiving a new focus as a result of the creation of recognized CAM research centers in university settings worldwide. Several botanical products, complex CAM interventions and individual approaches are now being tested with rigorous and well-controlled research. Adequate execution of clinical trials, however, represents a major challenge, particularly in medical fields such as pediatrics and CAM therapies such as acupuncture and herbal medicine. The scientific community, industry, and consumers are joining efforts to provide reliable and objective information about the efficacy and safety of CAM therapies. Medical journals are publishing CAM-related issues regularly and there is concern about quality of clinical trials, reliability of results, placebo effect, and publication bias. The number of CAM clinical trials continues to grow although it is still very low compared with conventional medicine trials. There are major research methodology issues that need to be considered in CAM research that have not been completely and thoroughly evaluated. Nevertheless, ideas have been proposed and innovative projects are ongoing. The conduct of CAM research requires the commitment of the scientific community as well as substantial funding from governmental institutions and the pharmaceutical industry.