Operational Definition of Complementary, Alternative, and Integrative Medicine Derived from a Systematic Search

Abstract

Background Identifying what therapies constitute complementary, alternative, and/or integrative medicine (CAIM) is complex for a multitude of reasons. An operational definition is dynamic, and changes based on both historical time period and geographical location whereby many jurisdictions may integrate or consider their traditional system(s) of medicine as conventional care. To date, only one operational definition of “complementary and alternative medicine” has been proposed, by Cochrane researchers in 2011. This definition is not only several years old but also did not use systematic methods to compile the therapies. Furthermore, it did not capture the concept “integrative medicine”, which is an increasingly popular aspect of the use of complementary therapies in practice. An updated operational definition reflective of CAIM is warranted given the rapidly increasing body of CAIM research literature published each year. Methods Four peer-reviewed or otherwise quality-assessed information resource types were used to inform the development of the operational definition: peer-reviewed articles resulting from searches across seven academic databases; the “aims and scope” webpages of peer-reviewed CAIM journals; CAIM entries found in online encyclopedias, and highly-ranked websites identified through searches of CAIM-related terms on HONcode. Screening of eligible resources, and data extraction of CAIM therapies across them, were each conducted independently and in duplicate. CAIM therapies across eligible sources were deduplicated. Results A total of 101 eligible resources were identified: peer-reviewed articles (n = 19), journal “aims and scope” webpages (n = 22), encyclopedia entries (n = 11), HONcode-searched websites (n = 49). Six hundred four unique CAIM terms were included in this operational definition of CAIM. Conclusions This updated operational definition is the first to be informed by systematic methods, and could support the harmonization of CAIM-related research through the provision of a standard of classification, as well as support improved collaboration between different research groups.

Prevalence of Use of Traditional, Complementary and Alternative Medicine by the General Population: A Systematic Review of National Studies Published from 2010 to 2019

“…More recently, the term 'integrative medicine' (IM) has been introduced to describe the combined use of 'conventional' and traditional, complementary and alternative medicine (TCAM) approaches in a patient-focused manner to achieve positive health outcomes for individual patients [3]. In 2022, researchers established an operational definition for 'complementary, alternative and integrative medicine' (CAIM); the definition included 604 TCAM therapies, an update from the 259 that were listed on the Cochrane Complementary Medicine website [4]. The World Health Organization's (WHO's) global report on traditional and complementary medicine 2019 used the term 'traditional and complementary medicine (T&CM)' to 'merge the terms traditional medicine and complementary medicine, encompassing products, practices and practitioners' [2].…”

The Provision of Complementary, Alternative, and Integrative Medicine Information and Services: A Review of World Leading Oncology Hospital Websites

“…These ndings indicate that while oncology hospitals provided CAIM services to patients, it is less common that hospitals denote such services as part of a larger treatment regimen that is CAIM. This discrepancy could exist due to the lack of a standardized operational de nition of CAIM as well as its categories and therapies, and due to cultural and geographical differences worldwide 24 . While some studies have attempted to create operational de nitions of CAIM, they have not been largely adopted by healthcare practitioners and researchers, thereby resulting in non-uniform information on these websites 24,25 .…”

A Bibliographic Database Search Strategy Informed by an Operational Definition of Complementary, Alternative, and Integrative Medicine

“…Prior to this, Wieland et al ( 2011) developed an operational de nition of CAM consisting of 70 therapies and the Cochrane Complementary Medicine website ampli ed this by listing 259 CAIM therapy terms [10]. Our previously reported study represents the largest operational de nition of CAIM created to date, with 604 CAIM therapy terms and their respective synonyms; in addition, it is the only systematically and transparently developed operational de nition of its kind [47]. The present study is the rst to present a comprehensive keyword search strategy to identify CAIM studies in the literature for systematic searches.…”

“…We have previously reported the rst operational de nition of CAIM informed by a systematic search, which serves as the basis for the present study [47]. Brie y, the CAIM operational de nition was derived from four types of quality-assessed media types: 1) peer-reviewed articles from the MEDLINE, EMBASE, AMED, PsycINFO, CINAHL, Scopus and Web of Science databases; 2) the "Aims and Scopes" of peer-reviewed CAIM journals; 3) CAIM entries in highly accessed online encyclopaedias; and 4) websites resulting from Health On the Net Code of Conduct (HONcode) searches.…”