Listed in Issue 22


PRACTICE AND POLICY GUIDELINES PANEL, National Institutes of Health Office of Alternative Medicine (NIHOAM) estimate that 1 out of every 3 Americans uses some form of complementary and alternative medicine (CAM) such as acupuncture, homoeopathy and herbal medicine . The NIHOAM convened in 1995 an expert panel to examine the role of clinical practice guidelines in CAM.




The panel concluded that CAM practices are currently unsuitable for the development of evidence-based practice guidelines, partly due to lack of relevant outcomes data from well-designed clinical trials. Moreover there are challenging methodological problems when notions of standardisation and appropriateness are applied to CAM, which uses many different treatment practices and encourages highly individualised care. CAM disciplines have fundamental differences, which are even more striking when compared with those used by Western medicine, in how target conditions are defined, causes of disease, interventions and outcome measures of effectiveness.


The panel made a series of recommendations regarding strategies to strengthen the evidence base for future guideline development in CAM and to better meet the current information needs of clinicians, patients and guideline developers seeking information regarding CAM treatments.


Clinical practice guidelines in complementary and alternative medicine. An analysis of opportunities and obstacles. Practice and Policy Guidelines Panel, National Institutes of Health Office of Alternative Medicine. Arch Fam Med 6(2): 149-54. Mar-Apr 1997.

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