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Zhang X, Yang Z, Chen J, Zhang C, Zhang J. Implementation of the Admission Process of Patients Under the Public Crisis Situation of COVID-19 Pandemic: A Real-World Case Study. J Multidiscip Healthc 2023; 16:1905-1914. [PMID: 37465015 PMCID: PMC10351921 DOI: 10.2147/jmdh.s415678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023] Open
Abstract
Purpose To clarify the implementation of the admission process under the public crisis of COVID-19 pandemic. Methods A real-world study was conducted to collect data on the normal and public crisis situations at a tertiary hospital in China and understand the views of 18 head nurses on the necessity of the admission process in public crisis situations. Independent t-test and chi-square test were used to analyze the work data in two situations; Spearman correlation analysis was performed to determine the correlation of work data with two situations of process implementation, and differences between the head nurses' views of necessity of the admission process and actual implementation under public crisis situations were analyzed. Results Significant differences were observed in the working data between the normal and public crisis situations (P < 0.05), and the implementation of the admission process was not in place. The number of nurses on duty was positively correlated with each item of admission process (P < 0.05), the rest of work data were negatively correlated with each item in the admission process (P < 0.05), and there was a significant difference between the necessity of each item in the admission process and the actual implementation results (P < 0.05). Conclusion Public crisis leads to the lack of implementation of admission process, and the original admission process and quality control standards are not applicable during the public crisis situation.
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Affiliation(s)
- Xiaohong Zhang
- Nursing Department, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, People’s Republic of China
| | - Ziyan Yang
- College of Nursing, Shanxi Medical University, Taiyuan, People’s Republic of China
| | - Jiaqi Chen
- Nursing Department, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, People’s Republic of China
| | - Cuiling Zhang
- Department of Digestive Oncology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, People’s Republic of China
| | - Junyan Zhang
- Department of Clinical Epidemiology and Evidence-based Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, People’s Republic of China
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Acupuncture Case Registry Study: Rationale, Implementations, and Achievements. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:3860231. [DOI: 10.1155/2022/3860231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/10/2022] [Indexed: 11/22/2022]
Abstract
The acupuncture case registry study is focusing on acupuncture therapy data from patient cases. The main objective is to collect real-world data and integrate clinically meaningful outcome evaluation indicators to uncover and evaluate real-world acupuncture efficacy and safety, explore factors affecting acupuncture efficacy, and provide real-world evidence to complement RCTs. Since the International Acupuncture Case Registry data collection system’s establishment in 2017, 16 projects have been underway, including two acupuncture specialty therapies and 15 diseases. Data from 3404 patients included extensive information on the diagnosis and treatment of acupuncture and the evaluation of its efficacy. In order to serve as a guide for future studies, this article discusses the value of and rationale for establishing acupuncture case registry studies, how to distinguish them from patient registries, and crucial techniques for implementing registry studies in terms of applications, patient recruitment, costakeholder collaboration, data collection and management, study quality control, and ethics.
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Anderson BJ, Dudla S, Marantz PR, Kligler BE, Leininger BD, Evans R. Survey analysis to determine the impact of evidence informed practice education upon East Asian medicine faculty clinical instruction and students' skills, knowledge, attitudes and behaviors within a master's degree program. BMC MEDICAL EDUCATION 2021; 21:256. [PMID: 33947384 PMCID: PMC8094568 DOI: 10.1186/s12909-021-02690-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/23/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Between 2013 and 2018 Pacific College of Health and Science (formerly Pacific College of Oriental Medicine) trained faculty and developed curriculum in evidence informed practice (EIP), with support from a grant from the National Institutes of Health (NIH). A three-credit (45 h) Foundations of EIP course, and online EIP learning modules (developed as part of a previous NIH R25 award), were used for faculty and student training. In addition, EIP was incorporated into 73% of the East Asian medicine degree program. Clinical integration of EIP in the College clinic was enhanced by improving access to reference sources, including additional EIP-related questions to the patient intake forms, requiring the use of a patient-centered outcome instrument, and assessing students' clinical EIP competencies. METHODS Master's degree students' self-reported EIP skills, knowledge, attitudes and behaviors were assessed before and after taking the Foundations of EIP course using a 17-question paper-based survey with an additional open-ended comments section. The survey was administered in 29 courses across all three Pacific College campuses. Clinical faculty self-reported EIP instruction, focusing on the EIP content and instructional approaches that were utilized, was evaluated on the New York City campus using a paper-based survey before and after changes were made to enhance the clinical integration of EIP. RESULTS A total of 1181 completed EIP-course surveys consisting of 657 pre-EIP course surveys and 524 post-EIP course surveys were analyzed. There was a statistically significant improvement in students' EIP skills, knowledge and behaviors after completing the EIP course. Students' perception of the importance of EIP was high before and after the EIP course. Little change in Faculty's EIP-related clinical instruction was evident following the EIP-related changes that were made to the Clinic. CONCLUSION Our study suggests that the three-credit (45 h) EIP course was effective at improving the EIP skills, knowledge and behaviors of this group of East Asian medicine students who were undertaking a master's degree that qualified them for licensure in acupuncture in the US. These students also demonstrated a high level of recognition for the importance of research and EIP both before and after the course. Training faculty clinical supervisors and providing greater access to evidence sources in the College clinic did not appear to increase EIP instructional activity.
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Affiliation(s)
- Belinda J Anderson
- Pace University, College of Health Professions, 163 Williams St, New York, NY, 10038, USA.
- Pacific College of Health and Science, 110 William St, New York, NY, 10038, USA.
- Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA.
| | - Saikaew Dudla
- Pacific College of Health and Science, 110 William St, New York, NY, 10038, USA
| | - Paul R Marantz
- Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
| | - Benjamin E Kligler
- Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
- United States Department of Veterans Affairs, Washington, D.C., USA
| | | | - Roni Evans
- University of Minnesota, Minneapolis, MN, 55455, USA
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Taylor G, Addie YO, Burchett J, Durkin C, Crawford P, Ledford CJW. "Miracle" or "Medicine": A Turning-Point Analysis of Patients' and Physicians' Shifting Views on Acupuncture. Med Acupunct 2020; 32:263-271. [PMID: 33101570 DOI: 10.1089/acu.2020.1428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Acupuncture is one of the most widely used treatments of complementary and alternative medicine (CAM) within the military's health system. The success of CAM integration is partially dependent on both providers' and patients' perceptions that acupuncture is health-promoting. The aim of this research was to identify turning points, or changes, across treatments that enhanced or inhibited physicians' and patients' perception of acupuncture as health-promoting. Materials and Methods: Using a retrospective-interview approach, interviews were conducted with 15 family medicine physicians practicing medical acupuncture in a family medicine setting and with 17 patients (N = 32). Turning points were separated into 2 groups (health-promoting or health-inhibiting). Similarities and differences between perspectives were noted. Results: Patients and physicians identified two changes that enhanced their perspective of acupuncture as health-promoting: (1) observed health changes and (2) pain-medicine/narcotic reduction/elimination. Patients identified their ability to fulfill personal or professional roles, whereas physicians identified (1) training experiences and (2) enhanced relationships with patients. Health-inhibiting changes in perspective were identified as logistical constraints/barriers by both parties, although their perspectives differed to some degree. Turning points that were viewed as health-inhibiting treatment were identified as clinical challenges by physicians and as a lack of consistency in care by patients. Conclusions: The insight from these findings can help identify areas where medical acupuncture can be improved to promote successful integration in conventional medicine settings, as well as how providers can tailor communication with patients about acupuncture.
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Affiliation(s)
- Greenberry Taylor
- Department of Journalism, University of Florida, Gainesville, FL, USA
| | - Yewande O Addie
- Department of Journalism, University of Florida, Gainesville, FL, USA
| | - Jason Burchett
- Nellis Family Medicine Residency Program, Mike O'Callaghan Military Medical Center, Nellis Air Force Base, NV, USA
| | - Christopher Durkin
- Nellis Family Medicine Residency Program, Mike O'Callaghan Military Medical Center, Nellis Air Force Base, NV, USA
| | - Paul Crawford
- Nellis Family Medicine Residency Program, Mike O'Callaghan Military Medical Center, Nellis Air Force Base, NV, USA.,Department of Family Medicine, F. Edward Hebert School of Medicine, Military Primary Care Research Network, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Christy J W Ledford
- Department of Family Medicine, F. Edward Hebert School of Medicine, Military Primary Care Research Network, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Ye H, Gao Y, Zhang Y, Cao Y, Zhao L, Wen L, Wen C. Study on intelligent syndrome differentiation neural network model of stomachache in traditional Chinese medicine based on the real world. Medicine (Baltimore) 2020; 99:e20316. [PMID: 32481403 DOI: 10.1097/md.0000000000020316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Stomachache is not only disease name of Traditional Chinese medicine (TCM) but also the clinical symptom. It is a common and multiple diseases. TCM has its particular advantage in clinical treatment of stomachache. Syndrome differentiation is an important concept in TCM practice. The therapeutic process is virtually a nonlinear mapping process from clinical symptom to syndrome diagnosis with processing and seeking rules from mass data. Artificial neutral network has strong learning ability for nonlinear relationship. Artificial neutral network has been widely used to TCM area where the multiple factors, multilevel, nonlinear problem accompanied by a large number of optimization exist.We present an original experimental method to apply the improved third-order convergence LM algorithm to intelligent syndrome differentiation for the first time, and compare the predicted ability of Levenberg-Marquardt (LM) algorithm and the improved third-order convergence LM algorithm in syndrome differentiation.In this study, 2436 cases of stomachache electronic medical data from hospital information system, and then the real world data were normalized and standardized. Afterwards, LM algorithm and the improved third-order convergence LM algorithm were used to build the Back Propagation (BP) neural network model for intelligent syndrome differentiation of stomachache on Matlab, respectively. Finally, the differentiation performance of the 2 models was tested and analyzed.The testing results showed that the improved third-order convergence LM algorithm model has better average prediction and diagnosis accuracy, especially in predicting "liver-stomach disharmony" and "stomach yang deficiency", is above 95%.By effectively using the self-learning and auto-update ability of the BP neural network, the intelligent syndrome differentiation model of TCM can fully approach the real side of syndrome differentiation, and shows excellent predicted ability of syndrome differentiation.
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Affiliation(s)
- Hua Ye
- College of Medical Information Engineering
| | - Yuan Gao
- College of Medical Information Engineering
| | - Ye Zhang
- College of Medical Information Engineering
| | - Yue Cao
- College of Medical Information Engineering
| | - Liang Zhao
- College of Medical Information Engineering
| | - Li Wen
- College of Basic medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Ho RS, Wong CH, Wu JC, Wong SY, Chung VC. Non-specific effects of acupuncture and sham acupuncture in clinical trials from the patient's perspective: a systematic review of qualitative evidence. Acupunct Med 2020; 39:3-19. [PMID: 32375500 DOI: 10.1177/0964528420920299] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Previous clinical trials have demonstrated that both acupuncture and sham acupuncture exert significant, non-specific effects on treatment outcomes when compared to no-treatment controls. A recently developed framework (mechanisms in orthodox and complementary and alternative medicine-MOCAM) suggests that the non-specific effects of acupuncture originate from multiple domains (e.g. patient characteristics, acupuncturist skill/technique, the patient-acupuncturist relationship, and the acupuncture environment). However, it remains to be determined precisely how these domains influence the non-specific effects of treatment among patients receiving acupuncture and sham acupuncture in clinical trials. Therefore, we conducted a systematic review to synthesize existing qualitative evidence on how trial participants randomized to acupuncture and sham acupuncture groups experience non-specific effects, regardless of the types of medical condition investigated. METHODS This systematic review included primary qualitative studies embedded in randomized controlled trials designed to investigate acupuncture or sham acupuncture interventions. Eligible studies published in English were derived from a search of five international databases. The methodological quality of included studies was evaluated using the Critical Appraisal Skills Programme (CASP) tool. Using a framework synthesis approach, the identified MOCAM framework was adapted based on the synthesis of the available qualitative evidence. RESULTS A total of 20 studies of high methodological quality were included. Our proposed model indicated that the effects of acupuncture may be increased by maintaining a professional status, applying a holistic treatment approach, practicing empathy, and providing patients with an appropriate explanation of the theory behind acupuncture and sham acupuncture. From the patient's perspective, the efficacy of treatment can be increased by following the lifestyle modification advice provided by acupuncturists, maintaining a positive attitude toward treatment efficacy, actively engaging with acupuncturists during consultation, and making behavioral changes based on experience gained during the trial. CONCLUSION The results of this study may provide a basis for improving and standardizing key components of non-specific effects in acupuncture treatment, and for improving the isolation of specific effects in future clinical trials involving acupuncture and sham acupuncture.
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Affiliation(s)
- Robin St Ho
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Charlene Hl Wong
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Justin Cy Wu
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Samuel Ys Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Vincent Ch Chung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.,School of Chinese Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
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Ijaz N. Research-related attitudes among Chinese medicine students at a Canadian college: a mixed-methods study. Integr Med Res 2019; 8:264-270. [PMID: 31799116 PMCID: PMC6881630 DOI: 10.1016/j.imr.2019.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/03/2019] [Accepted: 10/06/2019] [Indexed: 11/29/2022] Open
Abstract
Background Previous studies have suggested that American Chinese medicine students' research interest declines as their training progresses. Many students further express low confidence in the congruence ('model validity') of bioscientific research methods in relation to the Chinese medicine paradigm. However, prior research has not assessed the impacts of research-related coursework on student perspectives in this regard. Methods First-, second- and third-year Chinese medicine students were surveyed regarding their research-related views. Final year students were re-surveyed after completing the research course. Qualitative analyses of the participating students' coursework were also undertaken. Results Over 80% of all participants showed high research interest and engagement, and viewed research as both relevant to clinical practice and important for the profession's socioeconomic legitimation. Male students were significantly more likely to view scientific evidence as improving the quality of Chinese medicine care (p = 0.021). A view that conventional research methods have low model validity for Chinese medicine interventions was higher among third year students than those in their first or second years of study (p = 0.001). Research coursework appeared to increase self-assessed research interest and skill. Concern regarding model validity was strongly evident in student coursework. Conclusion Research-related curricular interventions in the Chinese medicine field should directly address model validity, as it is of significant interest to a majority of students.
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Affiliation(s)
- Nadine Ijaz
- Humber College, Faculty of Health Sciences and Wellness, Room M13, 205 Humber College Blvd., Toronto, ON M9W 5L7, Canada
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8
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He Y, May BH, Zhang AL, Guo X, Liu Y, Qu Y, Chang X, Lu CJ, Xue CC, Zhang H. Acupuncture for cancer pain: protocol for a pilot pragmatic randomised controlled trial. BMJ Open 2019; 9:e025564. [PMID: 31289059 PMCID: PMC6629396 DOI: 10.1136/bmjopen-2018-025564] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Although acupuncture has been recommended for alleviating cancer pain by clinical guidelines, the level of the supporting evidence needs to be improved. A pragmatic randomised controlled trial (pRCT) in a hospital setting would provide real-world assessments of the overall clinical effects of acupuncture. This pilot trial aims to explore the feasibility and provide data for sample size calculations for a pRCT evaluating the effectiveness of acupuncture as an adjunctive therapy to routine medical care for cancer pain. METHODS AND ANALYSIS Thirty patients with cancer admitted to the oncology department with moderate or severe pain will be recruited. Participants will be randomised at a ratio of 1:1 to the adjunctive acupuncture group or a control group which receives routine pain management without acupuncture. The standardised section of the acupuncture protocol will be developed based on the results of reviews of the literature, recommendations in clinical guidelines and interviews with clinical experts. The acupuncturist will be allowed to tailor the protocol according to the individual situation of each participant. Primary outcomes relevant to the feasibility of conducting a fully powered trial include: numbers and proportions of participants recruited, screened, consented and randomised; numbers and reasons for withdrawals and dropouts; numbers and types of adverse events; feasibility of implementing the trial procedures; evaluation of the comprehensiveness and ease-of-use of the case report form. Secondary outcomes are clinical measurements of the effectiveness of the treatment that are intended for use in the full-scale trial. Analysis of feasibility will be descriptive and pain intensity measures will be analysed using mixed-effects regression. ETHICS AND DISSEMINATION Ethics approval was obtained from the Institutional Ethics Committee of Guangdong Provincial Hospital of Chinese Medicine (approval no: Z2017-184-01) and RMIT University Human Research Ethics Committee (reference no: 21361). Results will be disseminated in a peer-reviewed journal, and trial participants will be informed via email and/or phone calls. TRIAL REGISTRATION NUMBER ChiCTR1800017023.
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Affiliation(s)
- Yihan He
- Guangdong Provincial Hospital of Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangdong Provincial Academy of Chinese Medical Science, Guangzhou, Guangdong, China
- China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Brian H May
- China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Anthony Lin Zhang
- China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Xinfeng Guo
- Guangdong Provincial Hospital of Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangdong Provincial Academy of Chinese Medical Science, Guangzhou, Guangdong, China
- China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yihong Liu
- Guangdong Provincial Hospital of Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangdong Provincial Academy of Chinese Medical Science, Guangzhou, Guangdong, China
- China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yanchun Qu
- Guangdong Provincial Hospital of Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangdong Provincial Academy of Chinese Medical Science, Guangzhou, Guangdong, China
- China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xuesong Chang
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Chuan-jian Lu
- Guangdong Provincial Hospital of Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangdong Provincial Academy of Chinese Medical Science, Guangzhou, Guangdong, China
- China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Charlie Changli Xue
- Guangdong Provincial Hospital of Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangdong Provincial Academy of Chinese Medical Science, Guangzhou, Guangdong, China
- China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Haibo Zhang
- Guangdong Provincial Hospital of Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangdong Provincial Academy of Chinese Medical Science, Guangzhou, Guangdong, China
- China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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Schloss J, McIntyre E, Steel A, Bradley R, Harnett J, Reid R, Hawrelak J, Goldenberg J, Van De Venter C, Cooley K. Lessons from Outside and Within: Exploring Advancements in Methodology for Naturopathic Medicine Clinical Research. J Altern Complement Med 2019; 25:135-140. [PMID: 30785314 PMCID: PMC6424155 DOI: 10.1089/acm.2018.0403] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Introduction: Naturopathy is a mixture of both traditional and complementary medicine. It incorporates a broad set of health care practices that may or may not be traditional to that country or conventional medicine and are not fully integrated into the dominant health care system. Research required to evaluate or substantiate naturopathic medicine may not fall under the testing of randomized clinical trials, which opens up discussions on what is the best practice for research in naturopathic medicine. Discussion: Not only do advances in health research methodology offer important opportunities to progress naturopathic research, there are also areas where the unique characteristics of naturopathic philosophy and practice can impact other areas of health research. Some of the new advances in health research methodology involve whole-system research, pragmatic trials, template for intervention description and replication protocols for complex interventions, patient-centered care models, and the pragmatic-explanatory continuum indicator summary tool for designing pragmatic trials. Discussion and critique of these health-related methodologies shows that these research methods are more suited for the philosophy and treatment options that naturopathy is based on. Conclusions: Successful implementation of naturopathic research methodologies, and translation and dissemination of research will require a substantial paradigm shift in which naturopathic practitioners adopt a greater level of responsibility for developing an evidence base for naturopathic medicine.
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Affiliation(s)
- Janet Schloss
- 1 Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Faculty of Health, Ultimo, Australia.,2 Office of Research, Endeavour College of Natural Health, Fortitude Valley, Australia
| | - Erica McIntyre
- 1 Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Faculty of Health, Ultimo, Australia
| | - Amie Steel
- 1 Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Faculty of Health, Ultimo, Australia.,2 Office of Research, Endeavour College of Natural Health, Fortitude Valley, Australia
| | - Ryan Bradley
- 1 Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Faculty of Health, Ultimo, Australia.,3 Helfgott Research Institute, National University of Natural Medicine, Portland, OR
| | - Joanna Harnett
- 1 Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Faculty of Health, Ultimo, Australia.,4 Faculty of Pharmacy, University of Sydney, Sydney, Australia
| | - Rebecca Reid
- 1 Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Faculty of Health, Ultimo, Australia.,2 Office of Research, Endeavour College of Natural Health, Fortitude Valley, Australia
| | - Jason Hawrelak
- 1 Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Faculty of Health, Ultimo, Australia.,5 College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Joshua Goldenberg
- 1 Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Faculty of Health, Ultimo, Australia.,6 Department of Naturopathy, Bastyr University, Kenmore, WA USA
| | - Claudine Van De Venter
- 1 Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Faculty of Health, Ultimo, Australia.,7 Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Kieran Cooley
- 1 Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Faculty of Health, Ultimo, Australia.,8 Office of Research, Canadian College of Naturopathic Medicine, North York, Canada
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10
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Anderson BJ, Jurawanichkul S, Kligler BE, Marantz PR, Evans R. Interdisciplinary Relationship Models for Complementary and Integrative Health: Perspectives of Chinese Medicine Practitioners in the United States. J Altern Complement Med 2019; 25:288-295. [PMID: 30523704 PMCID: PMC6437621 DOI: 10.1089/acm.2018.0268] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The combination of biomedicine and traditional and complementary medicine (T&CM) is often referred to as integrative medicine. However, the degree to which the medical disciplines are integrated varies between medical settings, and it is believed by some to be impossible due to epistemological and paradigmatic differences. Clinicians' perspectives are important determinants of how different medical disciplines are used together. This study explores the perspectives of experienced Chinese medicine practitioners when asked about the most ethical model (opposition, integration, or pluralism) for the relationship between biomedicine and T&CM. DESIGN Thirty-one Chinese medicine practitioners, undertaking a doctoral upgrade program at the Pacific College of Oriental Medicine, participated in this study. Participants were asked to read a publication discussing three models (opposition, integration, and pluralism) for the relationship between biomedicine and T&CM and then discuss, via an online forum within Moodle learning management system, the most ethical model. An inductive content analysis of the forum posts was undertaken to identify common themes, followed by member checking. RESULTS The data were found to contain six major and six minor themes. There was a clear preference for pluralism. The Chinese medicine practitioners expressed reservations about the integrative model, and, above all, cared about the quality of patient care. Much dialogue occurred around issues related to a power imbalance within health care, and possible cooptation issues. Paradigmatic differences and a lack of compatibility between biomedical research models and the practice of Chinese medicine were seen as problematic to the validity of research findings. Interprofessional education was viewed as critical for the development of respect, shared patient care, and referrals between clinicians from different disciplines. CONCLUSIONS This study provides insight into the issues associated with combining biomedicine and T&CM that are perceived by Chinese medicine practitioners. Such insights are important for the development and management of clinical settings that provide complementary and integrative health care, especially as the provision of insurance coverage for T&CM increases.
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Affiliation(s)
- Belinda J. Anderson
- Pacific College of Oriental Medicine, New York, NY
- Albert Einstein College of Medicine, Bronx, NY
| | | | | | | | - Roni Evans
- University of Minnesota, Minneapolis, MN
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11
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Standard Protocol Items for Clinical Trials with Traditional Chinese Medicine 2018: Recommendations, Explanation and Elaboration (SPIRIT-TCM Extension 2018). Chin J Integr Med 2018; 25:71-79. [PMID: 30484022 DOI: 10.1007/s11655-018-2999-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2018] [Indexed: 12/20/2022]
Abstract
Traditional Chinese Medicine (TCM) is one of the oldest systems of medicine. More and more attention has been paid to TCM application, but the variable quality of clinical trials with TCM impedes its widespread acceptance. The Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 Statement has established guidelines for designing clinical trials to ensure that the trial results are accurate and reliable. However, there are difficulties when applying SPIRIT 2013 Statement to trials with TCM, due to the unique theory and the characteristic of TCM intervention. An Extension to the original SPIRIT was developed to ensure the quality of trial design with TCM. As Chinese herbal formulae, acupuncture and moxibustion are common and representative interventions in TCM practice, the executive working group determined that the SPIRIT-TCM Extension focus on these three interventions. Extension was developed through initiation, 3 rounds of Delphi consensus survey, and finalizing expert meeting. Seven items from the SPIRIT 2013 Statement were modified, namely, "title", "background and rationale", "objectives", "eligibility criteria", "interventions", "outcomes", and "data collection methods". The Extension includes the introduction of the concept of TCM pattern and 3 major TCM interventions, with examples and explanations. The SPIRIT-TCM Extension 2018 provides suggestion for investigators in designing high quality TCM clinical trials. It is expected that wide dissemination and application of this extension ensure continuous improvement of TCM trial quality throughout the world.
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Sibbritt D, Peng W, Lauche R, Ferguson C, Frawley J, Adams J. Efficacy of acupuncture for lifestyle risk factors for stroke: A systematic review. PLoS One 2018; 13:e0206288. [PMID: 30365567 PMCID: PMC6203376 DOI: 10.1371/journal.pone.0206288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 10/10/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Modifications to lifestyle risk factors for stroke may help prevent stroke events. This systematic review aimed to identify and summarise the evidence of acupuncture interventions for those people with lifestyle risk factors for stroke, including alcohol-dependence, smoking-dependence, hypertension, and obesity. METHODS MEDLINE, CINAHL/EBSCO, SCOPUS, and Cochrane Database were searched from January 1996 to December 2016. Only randomised controlled trials (RCTs) with empirical research findings were included. PRISMA guidelines were followed and risk of bias was assessed via the Cochrane Collaboration risk of bias assessment tool. The systematic review reported in this paper has been registered on the PROSPERO (#CRD42017060490). RESULTS A total of 59 RCTs (5,650 participants) examining the use of acupuncture in treating lifestyle risk factors for stroke met the inclusion criteria. The seven RCTs focusing on alcohol-dependence showed substantial heterogeneity regarding intervention details. No evidence from meta-analysis has been found regarding post-intervention or long-term effect on blood pressure control for acupuncture compared to sham intervention. Relative to sham acupuncture, individuals receiving auricular acupressure for smoking-dependence reported lower numbers of consumed cigarettes per day (two RCTs, mean difference (MD) = -2.75 cigarettes/day; 95% confidence interval (CI) = -5.33, -0.17; p = 0.04). Compared to sham acupuncture those receiving acupuncture for obesity reported lower waist circumference (five RCTs, MD = -2.79 cm; 95% CI: -4.13, -1.46; p<0.001). Overall, only few trials were considered of low risk of bias for smoking-dependence and obesity, and as such none of the significant effects in favour of acupuncture interventions were robust against potential selection, performance, and detection bias. CONCLUSIONS This review found no convincing evidence for effects of acupuncture interventions for improving lifestyle risk factors for stroke.
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Affiliation(s)
- David Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Wenbo Peng
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Caleb Ferguson
- Nursing Research Centre, Western Sydney University & Western Sydney Local Health District, Blacktown Clinical & Research School, Blacktown Hospital, Sydney, New South Wales, Australia
| | - Jane Frawley
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Sousa IMCD, Hortale VA, Bodstein RCDA. Medicina Tradicional Complementar e Integrativa: desafios para construir um modelo de avaliação do cuidado. CIENCIA & SAUDE COLETIVA 2018; 23:3403-3412. [DOI: 10.1590/1413-812320182310.23792016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 10/08/2016] [Indexed: 11/22/2022] Open
Abstract
Resumo A complexidade e a diversidade do que se propõe sob a lógica da Medicina Tradicional Complementar e Integrativa (MTCI) constituem um desafio para os interessados em evidências de sua efetividade. Seu crescimento, oferta e uso justificam a necessidade de construir referenciais metodológicos mais complexos e mais adequados para explicitar a singularidade do cuidado e a diversidade de suas técnicas. Este artigo, partindo de uma revisão narrativa da literatura, visa contribuir para a construção de um modelo de avaliação que, centrado na compreensão da singularidade e nas diversas dimensões do cuidado, busca refletir sobre os desafios de se buscar evidências do êxito terapêutico. O modelo proposto tem como base as abordagens qualitativas em saúde em que experiências dos agentes envolvidos (profissionais e usuários) no processo terapêutico ganham centralidade. Avaliar a efetividade do cuidado significa reconhecer a cadeia de processos interligados e suas diversas dimensões: acolhimento, diálogo, diagnóstico, ação e resultados alcançados.
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Alvim DT, Ferreira AS. Pragmatic Combinations of Acupuncture Points for Lateral Epicondylalgia are Unreliable in the Physiotherapy Setting. J Acupunct Meridian Stud 2018; 11:367-374. [PMID: 30092365 DOI: 10.1016/j.jams.2018.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 07/16/2018] [Accepted: 07/30/2018] [Indexed: 01/07/2023] Open
Abstract
This study describes the reliability of pragmatic combinations of acupuncture points for lateral epicondylalgia (LE) as prescribed by physiotherapists who were experts in acupuncture. Raters (n = 14; 33-59 years) independently prescribed acupuncture points for 30 simulated human patients with LE who were surveyed via a printed questionnaire. The frequency and cooccurrence of acupuncture points prescribed for patients with lateral epicondylitis were assessed. Absolute agreement and Light's kappa (κLight) with 95% confidence interval (CI) were used to quantify the interrater agreement. Raters prescribed 103 unique acupuncture points in different combinations with a median (min-max) of 5 (0-11) acupuncture points. The most prescribed acupuncture point was LI-11 (297 of 420; 71%), and the most common cooccurring acupuncture points were LI-11 and LI-4 (160 of 420; 38%). The absolute agreement for prescribing the acupuncture points ranged from 70% (point GB-20) to 0% (points LI-10, SP-6, LI-11, GB-34, LI-12, and LI-4). Point LR-3 showed the highest interrater reliability for prescribing the acupuncture points [κLight = 0.112, 95% CI = (0.055-0.194)], whereas point LI-4 showed the lowest reliability [κLight = -0.003, 95% CI = (-0.024 to 0.024)]. These findings suggest that pragmatic prescriptions of acupuncture points for LE are unreliable among physiotherapists who are experts in acupuncture. Explicit, high-level evidence-based rules for prescribing and teaching combinations of acupuncture points for LE are warranted.
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Affiliation(s)
- Danielle T Alvim
- Laboratory of Computational Simulation and Modeling in Rehabilitation, Postgraduate Program in Rehabilitation Sciences, Augusto Motta University Center, Praça das Nações, 34, Bonsucesso, Rio de Janeiro, RJ, 21041-010, Brazil; Research Laboratory of Exercise Sciences, Physical Education Center Admiral Adalberto Nunes, Brazilian Navy, Av. Brasil, 10590, Penha, Rio de Janeiro, RJ, 21012-350, Brazil
| | - Arthur S Ferreira
- Laboratory of Computational Simulation and Modeling in Rehabilitation, Postgraduate Program in Rehabilitation Sciences, Augusto Motta University Center, Praça das Nações, 34, Bonsucesso, Rio de Janeiro, RJ, 21041-010, Brazil; Salgado de Oliveira University, Rua Marechal Deodoro 263, Centro, Niterói, RJ, 24030-060, Brazil.
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Fisher CL, Ledford CJW, Moss DA, Crawford P. Physician Communication to Enhance Patient Acupuncture Engagement in Family Medicine. JOURNAL OF HEALTH COMMUNICATION 2018; 23:422-429. [PMID: 29630471 DOI: 10.1080/10810730.2018.1458924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Integrating complementary therapies (acupuncture) into conventional medicine has garnered recent support. Given the health benefits, low cost, and minimal risks, the military has advocated for acupuncture and begun training family medicine physicians. Little is known about the role of physician communication in patients' acupuncture engagement (uptake and adherence) in conventional medicine settings. We interviewed physicians (N = 15) and patients (N = 17) to capture physician communication they perceived affected treatment engagement. Data for each group were thematically analyzed. Physicians and patients prioritized different communication approaches and associated strategies. Physicians identified four approaches that enhance treatment engagement: (1) using shared decision-making (e.g., treatment options); (2) not being pushy (e.g., in tone); (3) carefully choosing language (e.g., Eastern versus Western terms); and (4) explaining treatment outcomes (e.g., efficacy). Patients also prioritized explaining treatment outcomes but differently (e.g., timing clarity), with two additional approaches: (5) talking with the same physician (e.g., continuity) and (6) being responsive to patient (e.g., flexibility). Findings highlight how physicians and patients prioritize patient-centered communication differently and how it is embedded within a unique, complex therapy. Data showcase authentic narratives that could be translated into physician communication skills training to promote treatment engagement in integrative care.
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Affiliation(s)
- Carla L Fisher
- a College of Journalism & Communications, STEM Translational Communication Center, UF Health Cancer Center; UF Health Center for Arts in Medicine , University of Florida , Gainesville , FL , USA
| | - Christy J W Ledford
- b Department of Family Medicine, F. Edward Hebert School of Medicine, Military Primary Care Research Network , Uniformed Services University of the Health Sciences , Bethesda , MD , USA
| | - David A Moss
- c Nellis Family Medicine Residency Program , Mike O'Callaghan Military Medical Center , Nellis Air Force Base , NV , USA
| | - Paul Crawford
- b Department of Family Medicine, F. Edward Hebert School of Medicine, Military Primary Care Research Network , Uniformed Services University of the Health Sciences , Bethesda , MD , USA
- c Nellis Family Medicine Residency Program , Mike O'Callaghan Military Medical Center , Nellis Air Force Base , NV , USA
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International patient registry on acupuncture therapy for premature ovarian insufficiency: Challenges and opportunities. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2018. [DOI: 10.1016/j.wjam.2018.03.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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de Almeida Andrade F, Schlechta Portella CF. Research methods in complementary and alternative medicine: an integrative review. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2017; 16:6-13. [PMID: 29397095 DOI: 10.1016/j.joim.2017.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/01/2017] [Indexed: 11/18/2022]
Abstract
The scientific literature presents a modest amount of evidence in the use of complementary and alternative medicine (CAM). On the other hand, in practice, relevant results are common. The debates among CAM practitioners about the quality and execution of scientific research are important. Therefore, the aim of this review is to gather, synthesize and describe the differentiated methodological models that encompass the complexity of therapeutic interventions. The process of bringing evidence-based medicine into clinical practice in CAM is essential for the growth and strengthening of complementary medicines worldwide.
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Yue J, Liu M, Li J, Wang Y, Hung ES, Tong X, Sun Z, Zhang Q, Golianu B. Acupuncture for the Treatment of Hiccups following Stroke: A Systematic Review and Meta-Analysis. Acupunct Med 2017; 35:2-8. [DOI: 10.1136/acupmed-2015-011024] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2016] [Indexed: 11/04/2022]
Abstract
Objectives To assess the effectiveness and safety of acupuncture for hiccups following stroke. Methods Medline, Embase, CENTRAL, CINAHL, and four Chinese medical databases were searched from their inception to 1 June 2015. The dataset included randomised controlled trials (RCTs) with no language restrictions that compared acupuncture as an adjunct to medical treatment (effectiveness) or acupuncture versus medical treatment (comparative effectiveness) in stroke patients with hiccups. The Cochrane risk of bias tool was used to assess the methodological quality of the trials. Results Out of 436 potentially relevant studies, five met the inclusion criteria. When acupuncture was compared with other interventions (as sole or adjunctive treatment), meta-analysis revealed a significant difference in favour of cessation of hiccups within a specified time period (CHWST) following intervention when used as an adjunct (risk ratio (RR) 1.59, 95% CI 1.16 to 2.19, I2=0%), but not when used alone (RR 1.40, 95% CI 0.79 to 2.47, I2=65%, ie, high heterogeneity). No safety information was reported in these studies. Conclusions Our systematic review and meta-analysis suggests that acupuncture may be an effective treatment for patients suffering from hiccups following stroke when used as an adjunct to medical treatment. However, due to the limited number of RCTs and poor methodology quality, we cannot reach a definitive conclusion, hence further large, rigorously designed trials are needed.
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Affiliation(s)
- Jinhuan Yue
- Department of Acupuncture and Moxibustion, College of Acupuncture and Moxibustion, Heilongjiang University of Chinese Medicine, Harbin, China
- Department of Anesthesia, Stanford University, Stanford, California, USA
| | - Ming Liu
- College of Basic Medical Sciences, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jun Li
- Department of Personnel, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yuming Wang
- Department of Rehabilitation, Chinese Medicine Hospital of Daqing, Daqing, China
| | - E-Sing Hung
- Department of Education, Five Branches University, California, USA
| | - Xin Tong
- Department of Medical Clinic, Atlantic Institute of Oriental Medicine, Florida, USA
| | - Zhongren Sun
- Department of Acupuncture and Moxibustion, College of Acupuncture and Moxibustion, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Qinhong Zhang
- Department of Acupuncture and Moxibustion, College of Acupuncture and Moxibustion, Heilongjiang University of Chinese Medicine, Harbin, China
- Department of Anesthesia, Stanford University, Stanford, California, USA
| | - Brenda Golianu
- Department of Anesthesia, Stanford University, Stanford, California, USA
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Wu X, Zheng C, Xu X, Ding P, Xiong F, Tian M, Wang Y, Dong H, Zhang M, Wang W, Xu S, Xie M, Huang G. Electroacupuncture for Functional Constipation: A Multicenter, Randomized, Control Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2017; 2017:1428943. [PMID: 28250788 PMCID: PMC5307003 DOI: 10.1155/2017/1428943] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 10/26/2016] [Accepted: 11/30/2016] [Indexed: 12/17/2022]
Abstract
Background and Aim. To investigate the efficacy and safety of electroacupuncture (EA) with different current intensities for functional constipation (FC) and to assess whether the effects of EA with different current intensities are superior to the mosapride. Methods. Patients with FC were randomly divided into low current intensity group (LCI), high current intensity group (HCI), and mosapride group (MC). The primary outcome was three or more spontaneous bowel movements (SBMs) per week and an increase of one or more SBMs from baseline during at least 3 of the 4 weeks. Results. The primary outcome was reached by 53.45%, 66.15%, and 52.24% of the patients who received LCI, HCI, and mosapride, respectively. EA can significantly improve the weekly SBMs and stool consistency and reduce straining severity (p < 0.0001, all). HCI improved the quality of life better than mosapride (p < 0.05) and reduced the proportion of severe constipation more than LCI and mosapride (p < 0.05, both). Conclusions. EA is effective and safe at both current intensities for FC; therapeutic effects of LCI and HCI are not superior to mosapride. EA is superior to mosapride in improving patients' life quality and satisfaction level of treatment; EA has fewer adverse events than mosapride.
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Affiliation(s)
- Xiao Wu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430030, China
| | - Cuihong Zheng
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430030, China
| | - Xiaohu Xu
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430030, China
| | - Pei Ding
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430030, China
| | - Fan Xiong
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430030, China
| | - Man Tian
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430030, China
| | - Ying Wang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430030, China
| | - Haoxu Dong
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430030, China
| | - Mingmin Zhang
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430030, China
| | - Wei Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430030, China
| | - Shabei Xu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430030, China
| | - Minjie Xie
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430030, China
| | - Guangying Huang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430030, China
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Abstract
Atrial fibrillation (AF) is the most common arrhythmia and it is an independent risk for serious events. Acupuncture has been growing in popularity in the West, and there are reports of its benefits in treating AF. We report a 57-year-old man who was admitted after having an allergic reaction to amiodarone administered to treat paroxysmal AF with fast ventricular response. Cardioversion with intravenous propafenone was uneventful. Before an attempt of electric cardioversion, he was treated with acupuncture as additional therapy to peroral propafenone. After acupuncture treatment consisting of 10 treatments during 30 days period, both immediate cardioversion to sinus rhythm and no paroxysmal AF during 30 days period were recorded.
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Affiliation(s)
- Dario Dilber
- Department of Cardiology, County Hospital Čakovec, Čakovec, Croatia. E-mail.
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