- Robust Evidence in Integrative Medicine: Innovations, Challenges, and Future Directions
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Ye-Seul Lee, Myeong Soo Lee, David Moher, In-Hyuk Ha, Jian-Ping Liu, Terje Alræk, Stephen Birch, Tae-Hun Kim, Yoon Jae Lee, Juan V.A. Franco, Jeremy Y. Ng, Holger Cramer
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Perspect Integr Med. 2024;3(3):162-167. Published online October 23, 2024
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DOI: https://doi.org/10.56986/pim.2024.10.005
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 - Integrative Medicine (IM), which includes therapies such as acupuncture, herbal medicine, yoga, and meditation, is gaining attention for managing chronic pain conditions. However, concerns about the quality of evidence supporting the use of these interventions persist. The 5th Annual Jaseng Academic conference 2024, in Seoul, South Korea, themed "Robust Evidence in Integrative Medicine: Innovations, Challenges, and Future Directions," addressed these concerns by focusing on advancements in study design, evidence synthesis, and open science practices. This conference proceeding summarizes key insights from the conference, emphasizing the role of pragmatic randomized controlled trials (pRCTs) in evaluating real-world effectiveness, and addressing the complexities involved in IM research such as sham controls. The integration of IM therapies into comprehensive pain management strategies (particularly in Korea), supported by government-backed research and policy initiatives was also discussed. Advancements in methodologies were addressed, such as bibliometric analysis, evidence mapping, and the development of clinical practice guidelines (CPGs) for integrative therapies. These methodologies offer valuable insights but face challenges due to the heterogeneity of IM interventions, and potential synergistic or antagonistic effects when combined with conventional medicine. Finally, the potential of open science to enhance transparency, reporting, and reproducibility in IM was explored, emphasizing the increased role of adherence to reporting guidelines (CONSORT and PRISMA). The future of IM research is built upon the continued efforts of refined study designs, rigorous evidence synthesis, and the integration of open science principles, for a robust and more credible evidence base.
- Evidence Map of Acupuncture: Where We Stand and Where We Should Go
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Tae-Hun Kim, Jung Won Kang
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Perspect Integr Med. 2024;3(2):106-113. Published online June 21, 2024
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DOI: https://doi.org/10.56986/pim.2024.06.006
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 - Background
Evidence mapping presents the current status of evidence on a specific field. The "Evidence Map of Acupuncture" published in 2014 gave an overall picture of the evidence on acupuncture treatments for various conditions/diseases. In this study, evidence in 2024 for the effect of acupuncture was reassessed.
Methods
The systematic reviews (SRs) on acupuncture for the 43 conditions/diseases where evidence was previously unclear or potentially effective in the "Evidence Map of Acupuncture" 2014 were searched in the PubMed and the Cochrane Library, and included SRs up to February, 2024. The Grading of Recommendations, Assessment, Development, and Evaluations assessment in the included SRs was used for assessing the confidence level in the evidence of each condition.
Results
When compared with the results of the "Evidence Map of Acupuncture" 2014, the average number of randomized controlled trials included in a SR increased from 11 to 19.5 by 2024. However, the confidence level showed an overall decrease. The reasons for unclear evidence were mainly methodological limitations such as poor research design, small sample size and small number of studies, and the results of the 2024 reassessment did not show a significant difference in the reasons compared with the "Evidence Map of Acupuncture" 2014.
Discussion
To improve clinical evidence for acupuncture, simple repetition and increasing the number of new randomized controlled trials does not seem to be effective. To reduce redundancy, large scaled studies should be conducted, and a new critical appraisal tool for acupuncture is needed to avoid unfair evaluation of risk of bias in acupuncture research.
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Citations
Citations to this article as recorded by  - Robust Evidence in Integrative Medicine: Innovations, Challenges, and Future Directions
Ye-Seul Lee, Myeong Soo Lee, David Moher, In-Hyuk Ha, Jian-Ping Liu, Terje Alræk, Stephen Birch, Tae-Hun Kim, Yoon Jae Lee, Juan V.A. Franco, Jeremy Y. Ng, Holger Cramer
Perspectives on Integrative Medicine.2024; 3(3): 162. CrossRef
- Does the Chinese Literature Indicate Larger Effect Sizes? This Might Indeed be the Case
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Tae-Hun Kim, Jung Won Kang
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Perspect Integr Med. 2023;2(3):202-203. Published online October 23, 2023
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DOI: https://doi.org/10.56986/pim.2023.10.009
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- This letter discusses concerns in a currently published meta-epidemiological study on commonly observed large effect sizes in the Chinese literature, focusing on potential selection bias and analysis methods. Researchers should be cautious when conducting systematic reviews that include the literature from specific countries or regions. Regardless of the country, the key issue is to enhance future research quality.
- Shoulder Pain and the Potential Role of Acupuncture: A Narrative Review of Clinical Practice and Treatment Guidelines
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Stephen Birch, Myeong Soo Lee, Tae-Hun Kim, Terje Alraek
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Perspect Integr Med. 2022;1(1):3-9. Published online September 22, 2022
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DOI: https://doi.org/10.56986/pim.2022.09.002
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6,153
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- The potential use of acupuncture for shoulder pain of various etiologies and whether clinicians make recommendations about the use of acupuncture was examined. Shoulder pain is a common clinical problem. What is the level of evidence and how often is acupuncture recommended for shoulder pain? A manual and database (PubMed) search of review articles of related clinical trials and guidelines was performed. The evidence for effectiveness of acupuncture treatment of different types of shoulder pain was weak. However, there are some studies, with a weak to moderate level of evidence, on shoulder pain (across nine subtypes of shoulder pain). Acupuncture is safe and may be a cost-effective treatment for shoulder pain. There were 131 statements recommending the use of acupuncture for shoulder pain across 12 subtypes of shoulder pain. The most common statements were for non-specific ‘shoulder pain.’ There were 11 statements against the use of acupuncture for shoulder pain and three subtypes of shoulder pain. The level of evidence in studies of acupuncture treatment for shoulder pain is low, therefore, further research is needed. Recommendations for the use of acupuncture for shoulder pain are increasing but lag behind those for other pain problems such as low back pain.
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Citations
Citations to this article as recorded by - “Are we there yet?” – Green shoots of progress in acupuncture implementation in healthcare
Sandro Graca, Matthias Huemer, Beverley de Valois, Bobbee Vang, Lara McClure
European Journal of Integrative Medicine.2024; 69: 102371. CrossRef - Health Care Utilization for Common Shoulder Disorders: Analysis of the 2010–2019 National Patient Sample Data from the Health Insurance Review and Assessment Service in Korea
Jin-Young Kang, Doori Kim, Huijun Kim, In-Hyuk Ha, Yoon Jae Lee
Medicina.2024; 60(5): 744. CrossRef - A Review of Key Research and Engagement in 2022
John McDonald, Sandro Graca, Claudia Citkovitz, Lisa Taylor-Swanson
Journal of Integrative and Complementary Medicine.2023; 29(8): 455. CrossRef
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