Financial Support for Research Training and Career Development in Complementary and Alternative Medicine from the National Institutes of Health

How can meta-research be used to evaluate and improve the quality of research in the field of traditional, complementary, and integrative medicine?

The field of traditional, complementary, and integrative medicine (TCIM) has garnered increasing attention due to its holistic approach to health and well-being. While the quantity of published research about TCIM has increased exponentially, critics have argued that the field faces challenges related to methodological rigour, reproducibility, and overall quality. This article proposes meta-research as one approach to evaluating and improving the quality of TCIM research. Meta-research, also known as research about research, can be defined as "the study of research itself: its methods, reporting, reproducibility, evaluation, and incentives". By systematically evaluating methodological rigour, identifying biases, and promoting transparency, meta-research can enhance the reliability and credibility of TCIM research. Specific topics of interest that are discussed in this article include the following: 1) study design and research methodology, 2) reporting of research, 3) research ethics, integrity, and misconduct, 4) replicability and reproducibility, 5) peer review and journal editorial practices, 6) research funding: grants and awards, and 7) hiring, promotion, and tenure. For each topic, we provide case examples to illustrate meta-research applications in TCIM. We argue that meta-research initiatives can contribute to maintaining public trust, safeguarding research integrity, and advancing evidence based TCIM practice, while challenges include navigating methodological complexities, biases, and disparities in funding and academic recognition. Future directions involve tailored research methodologies, interdisciplinary collaboration, policy implications, and capacity building in meta-research.

The Needs and Priorities for Government Grants for Traditional Korean Medicine: Comparing the Public and Traditional Korean Medicine Doctors

This study was conducted to compare the need for research and development (R&D) of Traditional Korean Medicine (TKM) perceived by the public and Traditional Korean Medicine doctor (KMD) in. Survey data from 2462 people and KMD were utilized for this study. Overall, 25.10% of the public and 90.91% of KMD answered that government grants for TKM R&D were "extremely necessary." The majority of respondents reported that grants were needed "for the advancement of science and technology in TKM" (public, 46.28%; KMD, 34.08%). Research regarding herbal medicine was the top priority of TKM R&D in both groups. However, "research facilities and training for researchers (27.85%)" was a close second priority of the public, but not KMD. Moreover, the public believed that safety from adverse effects and toxicity was a more important area of R&D in each discipline, but KMD did not find these to be important. The public and KMD generally agreed on the need for government grants for TKM R&D, but the public was more interested in safety than KMD. Therefore, government policy decision makers must consider opinions of both the public and KMD when planning government grants.

The RCCM 2009 Survey: Mapping Doctoral and Postdoctoral CAM Research in the United Kingdom

Complementary and Alternative Medicine (CAM) is widely available in the UK and used frequently by the public, but there is little high quality research to sustain its continued use and potential integration into the NHS. There is, therefore, a need to develop rigorous research in this area. One essential way forward is to train and develop more CAM researchers so that we can enhance academic capacity and provide the evidence upon which to base strategic healthcare decisions. This UK survey identified 80 research active postgraduates registered for MPhils/PhDs in 21 universities and were either current students or had completed their postgraduate degree during the recent UK Research Assessment Exercise (RAE) 2001–2008. The single largest postgraduate degree funder was the university where the students registered (26/80). Thirty-two projects involved randomized controlled trials and 33 used qualitative research methods. The UK RAE also indicates a significant growth of postdoctoral and tenured research activity over this period (in 2001 there were three full time equivalents; in 2008 there were 15.5) with a considerable improvement in research quality. This mapping exercise suggests that considerable effort is currently being invested in developing UK CAM research capacity and thus inform decision making in this area. However, in comparative international terms UK funding is very limited. As in the USA and Australia, a centralized and strategic approach by the National Institute of Health Research to this currently uncoordinated and underfunded activity may benefit CAM research in the UK.

Looking for a person-centered medicine: non conventional medicine in the conventional European and italian setting

In Italy, the use of non conventional medicines (NCMs) is spreading among people as in the rest of Europe. Sales of alternative remedies are growing, and likewise the number of medical doctors (MDs) who practise NCM/complementary and alternative medicine (CAM). However, in Italy as in other countries of the European Union, at the present time the juridical/legal status of NCM/CAM is not well established, mainly due to the lack of any national law regulating NCM/CAM professional training, practice and public supply and the absence of government-promoted scientific research in this field. This is an obstacle to safeguarding the patient's interests and freedom of choice, especially now that dissatisfaction with biomedicine is inclining more and more people to look for a holistic and patient-centered form of medicine.

Attitudes and interests toward research among students at two colleges of acupuncture and Oriental medicine

BACKGROUND

Collaborative input from clinicians of acupuncture and Oriental medicine (AOM) is required for sound AOM research, and AOM training institutions have begun to include research education into their curriculum. However, few attempts have been made to systematically evaluate AOM practitioners' perspectives on the value of research to their profession.

METHODS

We conducted surveys of AOM students at two institutions that have begun to integrate research training into their curriculum, the New England School of Acupuncture and the Oregon College of Oriental Medicine. Surveys were conducted to assess current attitudes regarding the value of research and to serve as a reference point for documenting the impact of ongoing research training programs on these attitudes. Surveys at both institutions were independently developed and administered but shared seven questions that were phrased very similarly. This paper summarizes responses to these questions.

RESULTS

Surveys at both institutions suggest interest in research among AOM students is high in first-year students; students in later years showed a lower level of interest, but the cross-sectional design of this survey does not allow any temporal effects to be inferred. Results also indicate that AOM students believe research is highly relevant to how both the public and the health insurance industry view their system of healthcare but not highly relevant to their own clinical practice of AOM. The belief that research is of limited relevance to clinical practice was associated with widespread belief that scientific methods may not be consistent with the principles of AOM.

CONCLUSIONS

Results of these surveys provide important preliminary information about attitudes of AOM students toward research, and thus the value and future specific needs of research training programs targeting this population. Repeated implementation of validated versions of our surveys are needed to confirm the trends we report and to evaluate the impact of research training programs already in place on AOM students' attitudes toward research.

Do chiropractors identify with complementary and alternative medicine? Results of a survey

OBJECTIVES

Chiropractic in the United States exhibits characteristics of both mainstream health care and complementary and alternative medicine (CAM). The purpose of this project was to investigate the opinions of a sample of chiropractic faculty and practitioners on the appropriate classification of their profession, in terms of CAM versus mainstream.

DESIGN

This was a descriptive study conducted by means of an electronically administered survey to a sample of chiropractic college faculty and practicing chiropractors.

SAMPLE POPULATION

The faculty sample consisted of all faculty members holding Doctor of Chiropractic (D.C.) degrees at 4 chiropractic colleges, 2 in the Midwest and 2 in southern California. The practitioner sample consisted of all 108 participants, located in 32 states in the United States, in a chiropractic practice-based research network.

SURVEY INSTRUMENT

The survey instrument was based on one used with permission from its authors, who had developed and used it to gather information about respondents' concepts and definitions of health and disease, in order to compare the broad categories of practitioners-mainstream medicine, integrated medicine (IM), and CAM.

RESULTS

Of 191 D.C. faculty invited to participate, 71 (37%) completed the survey. Of the 108 practicing D.C.s invited to participate, 61 (57%) completed the survey. Of the total sample of 132, 69% did not agree that chiropractic should be categorized as CAM. Twenty-seven percent (27%) of 132 thought that chiropractors should be classified as IM; 20% of practitioners and 6% of faculty considered chiropractic mainstream medicine.

CONCLUSIONS

The majority (69%) of the chiropractors in this sample rejected being characterized as CAM practitioners, showing some preference for the term IM (27%).