Landmark Papers in CAM Research
The articles, reviews and critiques selected below represent work by some of the leading researchers in the field of CAM and integrative medicine. The list is intended to give a sense of the scope of research topics and is organized consistent with the five topics areas highlighted in the National Center for Complementary and Alternative Medicine (NCCAM) Strategic Plan. A description of each of the five areas is included. The ‘Additional References’ section focuses on current issues and approaches to CAM and integrative medicine research.
1. Whole Medical Systems
“Whole medical systems are built upon complete systems of theory and practice. Often, these systems have evolved apart from and earlier than the conventional medical approach used in the United States. Examples of whole medical systems that have developed in Western cultures include homeopathic medicine and naturopathic medicine. Examples of systems that have developed in non–Western cultures include traditional traditional Chinese medicine and Ayurveda.” (1)
Whole systems research
- Bell IR, Koithan M. Models for the study of whole systems. Integr Cancer Ther. 2006 Dec;5(4):293–307.
- Ritenbaugh C, Hammerschlag R, Calabrese C, Mist S, Aickin M, Sutherland E, Leben J, Debar L, Elder C, Dworkin SF. A pilot whole systems clinical trial of traditional Chinese medicine and naturopathic medicine for the treatment of temporomandibular disorders. J Altern Complement Med. 2008 Jun;14(5):475–87.
- Verhoef MJ, Lewith G, Ritenbaugh C, Boon H, Fleishman S, Leis A. Complementary and alternative medicine whole systems research: beyond identification of inadequacies of the RCT. Complement Ther Med. 2005 Sep;13(3):206–12.
- Walach H, Falkenberg T, Fønnebø V, Lewith G, Jonas WB. Circular instead of hierarchical: methodological principles for the evaluation of complex interventions. BMC Med Res Methodol. 2006 Jun 24;6:29.
Traditional Chinese Medicine/Acupuncture
- Berman BM, Lao L, Langenberg P, et al. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Annals of Internal Medicine. 2004;141(12):901–910.
- Cummings M. Modellvorhaben Akupunktur–a summary of the ART, ARC and GERAC trials. Acupunct Med. 2009;27(1):26–30.
- Shang A, Huwiler K, Nartey L, et al. Placebo–controlled trials of Chinese herbal medicine and conventional medicine comparative study. International Journal of Epidemiology. 2007;36(5):1086–1092.
- Thomas KJ, MacPherson H, Thorpe L, Brazier J, Fitter M, Campbell MJ, Roman M, Walters SJ, Nicholl J. Randomised controlled trial of a short course of traditional acupuncture compared with usual care for persistent non–specific low back pain. BMJ 2006;333(7569):623.
- Standish LJ, Calabrese C, Snider P. The naturopathic medical research agenda: the future and foundation of naturopathic medical science. Journal of Alternative and Complementary Medicine. 2006;12(3):341–345.
- Szczurko O, Cooley K, Mills EJ, Zhou Q, Perri D, Seely D. Naturopathic treatment of rotator cuff tendinitis among Canadian postal workers: a randomized controlled trial. Arthritis Rheum. 2009 Aug 15;61(8):1037–45.
- Bell IR, Lweis DAI, Brooks AJ, et al. Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo. Rheumatology, 2004a;43:577–582.
- Ernst E, Kaptchuk TJ. Homeopathy revisited. Archives of Internal Medicine. 1996;156(19):2162–2164.
- Jacobs J, Herman P, Heron K, Olsen S, Vaughters L. Homeopathy for menopausal symptoms in breast cancer survivors: a preliminary randomized controlled trial. J Alt Comp Med. 2005;11:21–27.
- Walach H, Jonas WB, Ives J, van Wijk R, Weingärtner O. Research on homeopathy: state of the art. J Altern Complement Med. 2005 Oct;11(5):813–29.
- Kaptchuk TJ, and Linde K. A critical overview of homeopathy. Annals of Internal Medicine. 2003;138(5):393–399.
- Patwardhan B, Bodeker G. Ayurvedic genomics: establishing a genetic basis for mind-body typologies. J Altern Complement Med. 2008 Jun;14(5):571–6.
- Sharma H, Chandola HM, Singh G, Basisht G. Utilization of Ayurveda in health care: an approach for prevention, health promotion, and treatment of disease. Part 1–Ayurveda, the science of life. J Altern Complement Med. 13(9):1011-9, 2007 Nov.
- Sharma H, Chandola HM, Singh G, Basisht G. Utilization of Ayurveda in health care: an approach for prevention, health promotion, and treatment of disease. Part 2–Ayurveda in primary health care. J Altern Complement Med. 13(10):1135-50, 2007 Dec.
- Singh BB, Vinjamury SP, Der–Martirosian C, et al. Ayurvedic and collateral herbal treatments for hyperlipidemia: a systematic review of randomized controlled trials and quasi–experimental designs. Alternative Therapies in Health and Medicine. 2007;13(4):22–28.
2. Mind-Body Medicine
“Mind-body medicine uses a variety of techniques designed to enhance the mind’s capacity to affect bodily function and symptoms. Some techniques that were considered CAM in the past have become mainstream (for example, patient support groups and cognitive–behavioral therapy). Other mind–body techniques are still considered CAM, including meditation, prayer, mental healing, and therapies that use creative outlets such as art, music, or dance.” (1)
- Astin JA, Shapiro SL, Eisenberg DM, Forys KL. Mind–body medicine: state of the science, implications for practice. J Am Board Fam Pract. 2003;16(2):131-47.
- Galvin JA, Benson H, Deckro GR, Fricchione GL, Dusek JA. The relaxation response: reducing stress and improving cognition in healthy aging adults. Complement Ther Clin Pract. 2006 Aug;12(3):186–91. Epub 2006 Jun 5.
- Folkman S. The case for positive emotions in the stress process. Anxiety Stress Coping. 2008 Jan;21(1):3–14.
- Caspi O, Burleson KO. Methodological challenges in meditation research. Advances in Mind–Body Medicine. 2005;21(1):4–11.
- Davidson RJ, Kabat–Zinn J, Schumacher J, et al. Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine. 2003;65(4):564–570.
- Davidson RJ, Lutz A. Buddha’s brain: neuroplasticity and meditation. IEEE Signal Processing. 2007;25(1):171–174.
- Dossey L. Healing research: What we know and don’t know. Subtle En En Med 2008;19(1):9-27.
- Larson DB. Spirituality’s potential relevance to physical and emotional health: a brief review of quantitative research. J Psychol Theol. 2003;31:137–51
- Targ EF, Levine EG. The efficacy of a mind–body–spirit group for women with breast cancer: a randomized controlled trial. Gen Hosp Psych. 2002; 24(4):238–248
- Chesney MA, Chambers DB, Taylor JM, Johnson LM, Folkman S. Coping effectiveness training for men living with HIV: results from a randomized clinical trial testing a group–based intervention. Psychosom Med. 2003 Nov-Dec;65(6):1038–46.
- Rainforth MV, Schneider RH, Nidich SI, Gaylord–King C, Salerno JW, Anderson JW. Stress reduction programs in patients with elevated blood pressure: a systematic review and meta–analysis. Curr Hypertens Rep. 2007;9(6):520–528
- Roffe I, Schmidt K, Ernst E. A systematic review of guided imagery as an adjuvant cancer therapy. Psychooncology. 2005;14(8)607–617
Therapies that use creative outlets
- Maratos AS, Gold C, Wang X, Crawford MJ. Music therapy for depression. Cochrane Database Syst Rev. 2008;(1):CD004517
- Pennebaker, James W and Beall, Sandra K. Confronting a Traumatic Event: Toward an Understanding of Inhibition and Disease. Journal of Abnormal Psychology, 95, pp. 274–81.
- Smith S, Anderson–Hanley C, Langrock A, Compas B. The effects of journaling for women with newly diagnosed breast cancer. Psychooncology. 2005 Dec;14(12):1075–82.
3. Biologically-Based Practices
“Biologically based practices in CAM use substances found in nature, such as herbs, foods, and vitamins. Some examples include dietary supplements, herbal products, and the use of other so–called natural but as yet scientifically unproven therapies (for example, using shark cartilage to treat cancer).” (1)
- Bensoussan A, Talley NJ, Hing M, Menzies R, Guo A, Ngu M. Treatment of irritable bowel syndrome with Chinese herbal medicine: a randomized controlled trial. JAMA 1998;280(18):1585–1589.
- Boon H, Hirschkorn K, Griener G, Cali M. The ethics of dietary supplements and natural health products in pharmacy practice: a systematic documentary analysis. Int J Pharm Pract. 2009 Feb;17(1):31–8.
- Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006 Feb 23;354(8):795–808.
- The Coronary Drug Project Research Group. Clofibrate and niacin in coronary heart disease. JAMA. 231 (1975), pp. 360–381.
- Davis VL, Jayo MJ, Ho A, Kotlarczyk MP, Hardy ML, Foster WG, Hughes CL. Black cohosh increases metastatic mammary cancer in transgenic mice expressing c-erbB2. Cancer Res. 2008 Oct 15;68(20):8377–83.
- Einbond LS, Wen-Cai Y, He K, Wu HA, Cruz E, Roller M, Kronenberg F. Growth inhibitory activity of extracts and compounds from Cimicifuga species on human breast cancer cells. Phytomedicine. 2008 Jun;15(6-7):504–11. Epub 2007 Nov 5.
- Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico. Dietary supplementation with n–3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet. 1999 Aug 7;354(9177):447-55.
- Hypericum Depression Trial Study Group. Effect of Hypericum perforatum (St John’s wort) in major depressive disorder: a randomized controlled trial. JAMA. 2002 Apr 10;287(14):1807–14.
- Piscitelli SC, Burstein AH, Chaitt D, Alfaro RM, Falloon J. Indinavir concentrations and St John’s wort. Lancet. 2000 Feb 12;355(9203):547–8.
- Turner RB, Bauer R, Woelkart K, Hulsey TC, Gangemi JD. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. N Engl J Med. 2005 Jul 28;353(4):341–8.
4. Manipulative and Body-Based Practices
“Manipulative and body–based practices in CAM are based on manipulation and/or movement of one or more parts of the body. Some examples include chiropractic or osteopathic manipulation, and massage.” (1)
- Cherkin DC, Sherman KJ, Deyo RA, et al. A review of the evidence for the effectiveness, safety, and cost of acupuncture, massage therapy, and spinal manipulation for back pain. Annals of Internal Medicine. 2003;138(11):898–907.
- Liptan GL. Fascia: A missing link in our understanding of the pathology of fibromyalgia. J Bodyw Mov Ther 2010;14(1):3–12.
Chiropractic, Osteopathic Manipulation
- Bronfort G, Haas M, Evans R, Leiniger B, Triano J. Effectiveness of manual therapies: the UK evidence report Chiropractic & Osteopathy 2010, 18:3doi:10.1186/1746–1340–18–3
- Haldeman S, Underwood M. Commentary on the United Kingdom evidence report about the effectiveness of manual therapies Chiropractic & Osteopathy 2010, 18:4doi:10.1186/1746–1340–18–4
- Kaptchuk TJ, Eisenberg DM. Chiropractic: origins, controversies, and contributions. Archives of Internal Medicine. 1998;158(20):2215–2224.
- Senstad O, Leboeuf-Yde C, Borchgrevink C. Frequency and characteristics of side effects of spinal manipulative therapy. Spine. 1997;22(4):435–440.
- Corbin L. Safety and efficacy of massage therapy for patients with cancer. Cancer Control: Journal of the Moffitt Cancer Center. 2005;12(3):158–164.
- Sherman KJ, Cherkin DC, Hawkes RJ, et al. Randomized trial of therapeutic massage for chronic neck pain. Clinical Journal of Pain. 2009;25(3):233–238.
- Field T. Massage therapy effects. American Psychologist. 1998;53(12):1270–1281.
- Furlan AD, Imamura M, Dryden T, et al. Massage for low-back pain. Cochrane Database of Systematic Reviews. 2008;(4):CD001929. Accessed on November 25, 2008.
5. Energy Medicine
“Energy therapies involve the use of energy fields. They are of two types, biofield therapies and bioelectromagnetic-based therapies.” (1)
- Jonas WB, Crawford CC. Science and spiritual healing: a critical review of spiritual healing, “energy” medicine, and intentionality. Alternat Therap. 2003;9(2):56–61
“Biofield therapies are intended to affect energy fields that purportedly surround and penetrate the human body. The existence of such fields has not yet been scientifically proven. Some forms of energy therapy manipulate biofields by applying pressure and/or manipulating the body by placing the hands in, or through, these fields. Examples include qi gong, Reiki, and Therapeutic Touch.” (1)
- Rubik B. The biofield hypothesis: its biophysical basis and role in medicine. J Altern Complement Med. 2002 Dec;8(6):703–17.
- Hartwell, B, Brewitt, B. The Efficacy of Reiki Hands On Healing: Improvements in Adrenal, Spleen and Nervous Function as Quantified by Electro-Dermal Screening. Alternative Therapies Magazine, 1997; 3(4): 89.\
- Miles P, True G. Reiki-review of a biofield therapy history, theory, practice, and research. Alternative Therapies in Health and Medicine. 2003;9(2):62–72.
- Lee MS, Pittler MH, Ernst E. External qigong for pain conditions: a systematic review of randomized clinical trials. J Pain 2007;8(11):827–831.
- Rogers CE, Larkey LK, Keller C. A review of clinical trials of tai chi and qigong in older adults. West J Nurs Res 2009;31(2):245–279.
Taiji (Tai Chi)
- Song R, Roberts BL, Lee E-O,Lam P, Bae S–C. A randomized study of the effects of Tai Chi on muscle strength, bone mineral density, and fear of falling in women with osteoarthritis. J Altern Complement Med 2010;16(3):227–233.
- Wayne PM, Krebs DE, Wolf SL, Gill–Body KM, Scarborough D, McGibbon CA, et al. Can Tai Chi improve vestibulopathic postural control? Archives of Physical and Medicine & Rehabilitation. 2004;85:142–152.
- Yeh GY, Wang C, Wayne PM, Phillips R. Tai chi exercise for patients with cardiovascular conditions and risk factors: A SYSTEMATIC REVIEW. J Cardiopulm Rehabil Prev 2009;29(3):152–60.
- Kiernan J. The experience of therapeutic touch in the lives of five postpartum women. MCN Am J Matern Child Nurs. 2002; 27(1):47–53
- Manville JA, Bowen JE, Benham G. Effect of healing touch on stress perception and biological correlates. Holistic Nurs Pract. 2008;22(2):103–110
- Meehan TC. Therapeutic touch and postoperative pain: a Rogerian research study. Nurs Sci Quart. 1993;6(2):69-78
- Movaffaghi Z, Hsanpoor M, Farsi M, et al. Effects of therapeutic touch on blood hemoglobin and hematocrit level. J Holist Nurs. 2006;24(1):41–48
- Bower JE, Woolery A, Sternlieb B, et al. Yoga for cancer patients and survivors. Cancer Control. 2005;12(3):165–171.
- Khalsa SBS. Yoga as a therapeutic intervention: a bibliometric analysis of published research studies. Indian Journal of Physiology and Pharmacology. 2004;48(3):269–285.
- Pilkington K, Kirkwood G, Rampes H, Richardson J. Yoga for depression: the research evidence. J Affect Disord. 2005;89(1-3):13–24
- McCraty R, Atkinson M, Bradley RT. Electrophysiological evidence of intuition: part 1. The surprising role of the heart. J Altern Complement Med 2004;10(1):133–43.
“Bioelectromagnetic–based therapies involve the unconventional use of electromagnetic fields, such as pulsed fields, magnetic fields, or alternating–current or direct–current fields.” (1)
- Colbert AP, Wahbeh H, Harling N, Connelly E, Schiffke HC, Forsten C, Gregory WL, Markov MS, Souder JJ, Elmer P, King V. Static magnetic field therapy: a critical review of treatment parameters. Evid Based Complement Alternat Med 2009 Jun;6(2):133–9.
- Ahn AC, Colbert AP, Anderson BJ, Martinsen OG, Hammerschlag R, Cina S, Wayne PM, Langevin HM. Electrical properties of acupuncture points and meridians: a systematic review. Bioelectromagnetics. 2008 May;29(4):245–56.
Additional References for CAM Research
Issues in CAM research
- Fonnebo¸ V, Grimsgaard S, Walach H, Ritenbaugh C, Norheim AJ, MacPherson H, Lewith G, Launso¸ L, Koithan M, Falkenberg T, Boon H, Aickin M. Researching complementary and alternative treatments–the gatekeepers are not at home. BMC Med Res Methodol. 2007; 11(7):7.
- Hammerschlag R, Zwickey H. Evidence-based complementary and alternative medicine: back to basics. J Altern Complement Med. 2006 May;12(4):349–50.
- Zollman C, MacPherson H. The challenges of interpreting and applying the evidence for CAM and Integrated Medicine. J Holistic Healthcare, 2009; 6(1): 16–21.
- Aickin M. The importance of early phase research. J Altern Complement Med. 2007 May;13(4):447–50.
- Coulter ID, Khorsan R. Is health services research the Holy Grail of complementary and alternative medicine research? Altern Ther Health Med. 2008 Jul–Aug;14(4):40–5. Review.
- Horn SD, Gassaway J. Practice–based evidence study design for comparative effectiveness research. Med Care 2007;45(10 Suppl 2):S50–7
- MacPherson H. “Pragmatic clinical trials”. Complementary Therapies in Medicine. 2004; 12: 134–140
- Nahin RL. Use of the best case series to evaluate complementary and alternative therapies for cancer: a systematic review. Semin Oncol. 2002 Dec;29(6):552–62.
- Finniss DG, Kaptchuk TJ, Miller F, Benedetti F. Biological, clinical, and ethical advances of placebo effects. Lancet. 2010 Feb 20;375(9715):686–95.
- Kaptchuk TJ, Kelley JM, Conboy LA, et al. Components of the Placebo Effect: A Randomized Controlled Trial in Irritable Bowel Syndrome. BMJ. Online publication April 2008.
- Moerman DE, Jonas WB. Deconstructing the placebo effect and finding the meaning response. Ann Intern Med. 2002 Mar 19;136(6):471–6.
- Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report. 2008 Dec 10;(12):1–23.
- Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med. 1993 Jan 28;328(4):246–52.
- Nahin RL, Barnes PM, Stussman BJ, Bloom B. Costs of complementary and alternative medicine (CAM) and frequency of visits to CAM practitioners: United States, 2007. Natl Health Stat Report. 2009 Jul 30;(18):1–14.
- Nahin RL, Pontzer CH, Chesney MA. Racing toward the integration of complementary and alternative medicine: a marathon or a sprint? Health Aff (Millwood). 2005 Jul–Aug;24(4):991–3.
- Walji R, Boon H, Barnes J, Austin Z, Welsh S, Baker GR. Consumers of natural health products: natural-born pharmacovigilantes? BMC Complement Altern Med. 2010 Feb 25;10:8.
- Koithan M, Verhoef M, Bell IR, White M, Mulkins A, Ritenbaugh C. The process of whole person healing: “unstuckness” and beyond. J Altern Complement Med. 2007 Jul–Aug;13(6):659–68.
- Verhoef MJ, Vanderheyden LC, Dryden T, Mallory D, Ware MA. Evaluating complementary and alternative medicine interventions: in search of appropriate patient-centered outcome measures. BMC Complement Altern Med 2006;6:6–38.
During the past decade, education programs in integrative medicine have been established at allopathic medical schools around the country. CAM and allopathic practitioners have collaborated to set up independent integrative medicine clinics. They have also established conferences, both public and professional, to address the emerging fields that integrative medicine has proliferated.
The Consortium of Academic Health Centers for Integrative Medicine, a collaboration of 44 highly esteemed academic medical centers, defines integrative medicine as: "The practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing.” (2)
- Heber D. An integrative view of obesity. Am J Clin Nutr. 2010 Jan;91(1):280S-283S. Epub 2009 Nov 18.
- McDonough–Means SI, Kreitzer MJ, Bell IR. Fostering a healing presence and investigating its mediators. J Altern Complement Med 2004;10 Suppl 1:S25–41.
- Rakel DP, Hoeft TJ, Barrett BP, Chewning BA, Craig BM, Niu M. Practitioner empathy and the duration of the common cold. Fam Med. 2009 Jul-Aug;41(7):494–501.
- What is CAM? National Center for Complementary and Alternative Medicine (NCCAM) web site. http://nccam.nih.gov/ Accessed on March 10, 2010
- Definition of Integrative Medicine Developed and Adopted by The Consortium, May 2004
Edited May 2009 and November 2009 Consortium for Integrative Medicine Web Site. http://www.imconsortium.org/ Accessed March 26, 2010