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Complementary and Alternative Medicine in the United States [Kietas viršelis]

  • Formatas: Hardback, 360 pages, aukštis x plotis: 229x152 mm
  • Išleidimo metai: 13-May-2005
  • Leidėjas: National Academies Press
  • ISBN-10: 0309092701
  • ISBN-13: 9780309092708
Kitos knygos pagal šią temą:
  • Formatas: Hardback, 360 pages, aukštis x plotis: 229x152 mm
  • Išleidimo metai: 13-May-2005
  • Leidėjas: National Academies Press
  • ISBN-10: 0309092701
  • ISBN-13: 9780309092708
Kitos knygos pagal šią temą:
Integration of complementary and alternative medicine therapies (CAM) with conventional medicine is occurring in hospitals and physicians offices, health maintenance organizations (HMOs) are covering CAM therapies, insurance coverage for CAM is increasing, and integrative medicine centers and clinics are being established, many with close ties to medical schools and teaching hospitals. In determining what care to provide, the goal should be comprehensive care that uses the best scientific evidence available regarding benefits and harm, encourages a focus on healing, recognizes the importance of compassion and caring, emphasizes the centrality of relationship-based care, encourages patients to share in decision making about therapeutic options, and promotes choices in care that can include complementary therapies where appropriate.



Numerous approaches to delivering integrative medicine have evolved. Complementary and Alternative Medicine in the United States identifies an urgent need for health systems research that focuses on identifying the elements of these models, the outcomes of care delivered in these models, and whether these models are cost-effective when compared to conventional practice settings.



It outlines areas of research in convention and CAM therapies, ways of integrating these therapies, development of curriculum that provides further education to health professionals, and an amendment of the Dietary Supplement Health and Education Act to improve quality, accurate labeling, research into use of supplements, incentives for privately funded research into their efficacy, and consumer protection against all potential hazards.

Table of Contents



Front Matter Executive Summary 1 Introduction 2 Prevalence, Cost, and Patterns of CAM Use 3 Contemporary Approaches to Evidence of Treatment Effectiveness: A Context for CAM Research 4 Need for Innovative Designs in Research on CAM and Conventional Medicine 5 State of Emerging Evidence on CAM 6 An Ethical Framework for CAM Research, Practice, and Policy 7 Integration of CAM and Conventional Medicine 8 Educational Programs in CAM 9 Dietary Supplements 10 Conclusion Appendix A: CAM Therapies, Practices, and Systems Appendix B: Consortium of Academic Health Centers for Integrative Medicine Appendix C: Table 1-1 List of Abbreviations Appendix D: Liaison Panel Organizations Appendix E: Model Guidelines for the Use of Complementary and Alternative Therapies in Medical Practice Appendix F: National Center for Complementary and Alternative Medicine Research Centers Appendix G: Public Meetings Appendix H: Committee Biosketches Index
Executive Summary 1(1)
Toward Common Research Ground
2(2)
A New Position on Dietary Supplements
4(1)
Filling the Gaps
5(1)
Integrating CAM and Conventional Medicine
6(2)
Educating for Improved Care
8(2)
Knowns and Unknowns About CAM Use
10(3)
Introduction
13(21)
Context
14(2)
Definition of CAM
16(4)
Recent Milestones in the History of CAM
20(3)
CAM Activities at NIH and AHRQ
23(8)
Report Contents
31(3)
Prevalence, Cost, and Patterns of CAM Use
34(40)
Overall Use
34(7)
Use by Population Subgroups
41(4)
Types of Illness
45(1)
Frequency of Use
46(1)
Long-Term Trends in CAM Use
47(2)
Cost-Effectiveness
49(1)
What Motivates People to Use CAM
50(8)
Accessing Information About CAM
58(2)
How the American Public Uses CAM Modalities
60(3)
Characteristics of CAM Therapies Provided by Licensed Acupuncturists, Chiropractors, Massage Therapists, and Naturopaths
63(1)
Conclusions and Recommendations
64(10)
Contemporary Approaches to Evidence of Treatment Effectiveness: A Context for CAM Research
74(34)
A Brief Account of the Development of Treatment Effectiveness Research
74(5)
Basic Features of Contemporary Clinical Effectiveness Research
79(6)
Contemporary Issues in Study Design and Analysis
85(9)
Levels of Evidence
94(5)
Applying Contemporary Research Methods to CAM
99(9)
Need for Innovative Designs in Research on CAM and Conventional Medicine
108(21)
Characteristics of CAM Treatments and Modalities
108(3)
Innovative Study Designs to Assess Treatment Effectiveness of CAM
111(8)
Use of Both Traditional and Innovative Study Designs to Create a Rich Body of Knowledge
119(1)
Relationship Between Basic Research and Clinical Research
120(2)
Conceptual Models to Guide Research
122(1)
Conclusions and Recommendations
123(6)
State of Emerging Evidence on CAM
129(39)
Sources of Information on High-Quality Evidence
130(16)
Gaps in Evidence
146(5)
A Research Framework
151(10)
Conclusions and Recommendations
161(7)
An Ethical Framework for CAM Research, Practice, and Policy
168(28)
Value Commitments That Inform This
Chapter
168(6)
Value Judgments in Defining CAM
174(1)
Ethical Issues in CAM Research
174(5)
Ethical Issues in the Integration of CAM Therapies into Conventional Medical Practice
179(4)
Related Legal and Regulatory Issues
183(13)
Integration of CAM and Conventional Medicine
196(30)
From Idea to Practice
196(5)
Growing Integration of CAM
201(7)
Why Is Integration Occurring?
208(1)
Integrative Medicine
209(4)
Advising Patients
213(2)
Health Care Institutions
215(2)
Approaches to Integration
217(3)
Conclusions and Recommendations
220(6)
Educational Programs in CAM
226(27)
CAM in Health Professions Education
226(11)
Educating CAM Practitioners
237(5)
Lessons from Other Fields
242(4)
Practice Guidelines
246(2)
Conclusions and Recommendations
248(5)
Dietary Supplements
253(25)
Dietary Supplement Use in the United States
253(4)
Regulation of Dietary Supplements
257(8)
Product Quality and Safety
265(5)
Safety
270(2)
Research on Dietary Supplements
272(2)
Conclusions and Recommendations
274(4)
Conclusion
278(49)
APPENDIXES
A CAM Therapies, Practices, and Systems
283(10)
B Consortium of Academic Health Centers for Integrative Medicine
293(2)
C Table 1-1 List of Abbreviations
295(1)
D Liaison Panel Organizations
296(2)
E Model Guidelines for the Use of Complementary and Alternative Therapies in Medical Practice
298(9)
F National Center for Complementary and Alternative Medicine Research Centers
307(3)
G Public Meetings
310(9)
H Committee Biosketches
319(8)
Index 327
Committee on the Use of Complementary and Alternative Medicine by the American Public