Subjects used a variety of CAM therapies to cope with their diseases and rigors of treatment and clinical trials. Further research is needed to identify CAM therapies that may be used as adjunct treatments during clinical trials.

Data from the surveys of the Harvard team, led by David Eisenberg, M.D., are frequently used as a summary first paragraph introduction to the status of complementary and alternative medicine (CAM) in the United States. However, there is now a substantial body of literature on various facets of CAM use. Six national surveys to date are briefly discussed and summarized in a table. Some surveys have been conducted at a regional level. Three are summarized but there are too few data yet to draw any conclusions. Eighteen more exploratory surveys of specific subpopulations are presented to help draw a clearer picture of income, ethnic, and age groups. The search strategy is provided. The changing terminology in the field, the development of the CAM survey, and some common shortcomings are also addressed.

The second part of this series on surveys of complementary and alternative medicine (CAM) in the United States provides a "point-of-information" summary of the studies on patients with cancer and their use of CAM therapies. Surveys of patients with cancer were the precursors of the recent wave of studies on CAM prevalence and use. Three tables summarize the findings from a total of 18 surveys categorized by Childhood Cancer, Adult Cancer, and Breast Cancer studies.

A series of 16 independent studies of the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) community and their use of alternative and complementary therapies over the past 10 years helps document the changes that have occurred. The earlier studies are characterized by political activism, lack of confidence in conventional therapies, and widespread use of alternative pharmacological therapies and unapproved drug use. The improvement of conventional treatment since the mid-1990s has been accompanied by a greater emphasis on complementary therapies used in conjunction with conventional drug therapy. Mind-body or psycho-spiritual therapies that help the patient cope with stress and adjust to life-threatening illness are the most popular.

This fourth review in the series covers eight recent U.S. surveys on complementary and alternative medicine (CAM) use by patients with rheumatologic and other autoimmune conditions, and summarizes seven studies of other disease categories. Regarding the previous reviews, the acronym CAM is used unless it is possible to refine the concepts. This reflects the problem that most survey questionnaires do not differentiate between adjunct or complementary therapies and alternative approaches to treatment.