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Current Research: Integrative Medicine
Notes:
CAM Therapies 2017
September 18-19, 2017 Charlotte, USA
5th International Meeting on
Complementary and Alternative Medicine & Therapies
The quantity and quality of complementary and alternative medicine clinical practice
guidelines on herbal medicines, acupuncture and spinal manipulation: Systematic review
and assessment using AGREE II
Anna R Gagliardi, Jeremy Y Ng and Laurel Liang
Toronto General Hospital Research Institute, Canada
Background: Complementary and alternative medicine (CAM) use is often not disclosed by patients, and can
be unfamiliar to health care professionals. This may lead to underuse of beneficial CAM therapies, and overuse
of other CAM therapies with little proven benefit or known contraindications. No prior research has thoroughly
evaluated the credibility of knowledge-based resources. The purpose of this research was to assess the quantity
and quality of CAM guidelines.
Methods: A systematic review was conducted to identify CAM guidelines. MEDLINE, EMBASE and CINAHL
were searched in January 2016 from 2003 to 2015. The National Guideline Clearinghouse, National Center for
Complementary and Integrative Health web site, and two CAM journals were also searched. Eligible guidelines
published in English language by non-profit agencies on herbal medicine, acupuncture, or spinal manipulation
for adults with any condition was assessed with the Appraisal of Guidelines, Research and Evaluation II (AGREE
II) instrument.
Results: From 3,126 unique search results, 17 guidelines (two herbal medicines, three acupuncture, four spinal
manipulations, and eight mixed CAM therapies) published in 2003 or later and relevant to several clinical
conditions were eligible. Scaled domain percentages from highest to lowest were clarity of presentation (85.3%),
scope and purpose (83.3%), rigour of development (61.2%), editorial independence (60.1%), stakeholder
involvement (52.0%) and applicability (20.7%). Quality varied within and across guidelines. None of the 17
guidelines were recommended by both appraisers; 14 were recommended as yes or yes with modifications.
Conclusions: Guidelines that scored well could be used by patients and health care professionals as the basis for
discussion about the use of these CAM therapies. In future updates, guidelines that achieved variable or lower
scores could be improved according to specifications in the AGREE II instrument, and with insight from a large
number of resources that are available to support guideline development and implementation. Future research
should identify CAM therapies other than those reviewed here for which guidelines are available. Research is
also needed on the safety and effectiveness of CAM therapies.
Biography
Anna R Gagliardi is a Scientist at Toronto General Hospital Research Institute (TGHRI) and working as an Associate Professor in the Department of Surgery at
Institute of Health Policy, Management & Evaluation; and Institute of Medical Science, University of Toronto. She is a Chair at Implementation Working Group,
Guidelines International Network.