Research: MELCHART and colleagues,

Listed in Issue 21


MELCHART and colleagues, Projekt Munchener Modell, Technische Universitat, Munich, Germany write that a scientific evaluation of complementary medical practices being used in healthcare is urgently required. They state that although randomised clinical trials are the primary tools used for such evaluation, they need not be the only tool. The authors propose that systematic clinical auditing could: 1) provide information regarding the epidemiology of complementary medical practices; 2) make more clearly intelligible the processes used in the daily practice of complementary methods; and 3) provide a preliminary estimation of outcomes. Systematic clinical auditing uses mainly observational studies of large cohorts of patients.



The authors conducted a pilot study to study the feasibility of using a systematic clinical audit for traditional Chinese medicine. 1597 patients admitted to the hospistal between February 1 1992 and August 31 1993 were included in the study. The patients characteristics, diagnoses and preventive and therapeutic treatments were recorded and patients rated the intensity of their main complaints upon admission, at discharge and at 2, 6 and 12 months after admission. About two thirds of the patients had chronic pain complaints, the most common diagnosis being migraine (n=224). Most patients received acupuncture and Chinese herbal therapy, 61% received tuina massage and 16% received qigong. The mean intensity of main complaints was 7.0 upon admission, 4.6 at discharge and 5.5, 12 months after admission. CONCLUSIONS: Systematic clinical auditing is a valuable tool for collecting basic information regarding structural characteristics, processes, and outcomes regarding complementary medicine and for the determination of representative and relevant questions for future randomised clinical trials.




Melchart D et al. Systematic clinical auditing in complementary medicine: rationale, concept, and a pilot study. Altern Ther Health Med. 3(1): 33-9. Jan 1997.

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