Perspectives on Integrative Medicine

Protocols

Artificial Intelligence in the Editorial and Peer Review Process: A Protocol for a Cross-Sectional Survey of Traditional, Complementary, and Integrative Medicine Journal Editors’ Perceptions: Jeremy Y. Ng, Daivat Bhavsar, Neha Dhanvanthry, Myeong Soo Lee, Ye-Seul Lee, Tanuja M. Nesari, Thomas Ostermann, Claudia M. Witt, Linda Zhong, Holger Cramer; Perspect Integr Med. 2025;4(2):121-124. Published online June 23, 2025; DOI: https://doi.org/10.56986/pim.2025.06.008

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Graphical Abstract Abstract PDF Supplementary Material: This research protocol outlines a cross-sectional survey study, aimed at editors from traditional, complementary, and integrative medicine (TCIM) journals, regarding their perceptions of the use of artificial intelligence (AI) in the editorial and peer review process. The survey will be sent to editors-in-chief, associate editors, and editorial board members of TCIM journals (100-150). The research involves purposive sampling via manual collection of contact details from TCIM journal websites. The survey will include sections on demographics, current use and familiarity with AI, perceived benefits and challenges, ethical concerns, and the outlook for AI in publishing. Data collection will be conducted online using SurveyMonkey whereby email invitations and follow-up reminders will be sent to potential respondents. Quantitative data will be analyzed using descriptive statistics, and for qualitative data, thematic analyses will be employed. This protocol study aimed to devise a survey which could provide insight into the acceptance and potential barriers to AI adoption in TCIM publishing from an editor’s perspective. The results of which may later guide the development of AI tools in a way that aligns with the needs and values of the TCIM research community.

A Study Protocol for Developing a Consensus-Based Reporting Guideline for Case Reports on Acupuncture-Related Adverse Events: Tae-Hun Kim, Ye-Seul Lee, Jung-Won Kang, Myeong Soo Lee, Lin Ang, Jeremy Y. Ng, Stephen Birch, Terje Alræk, Lin Yu, Yuting Duan, Zhirui Xu; Perspect Integr Med. 2025;4(2):117-120. Published online June 23, 2025; DOI: https://doi.org/10.56986/pim.2025.06.007

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Graphical Abstract Abstract PDF Supplementary Material: Case reports play a crucial role in identifying safety concerns related to new or rare complications and adverse events (AEs) associated with therapeutic interventions. Although acupuncture is generally considered safe when performed by trained professionals, the increasing number of case reports reporting acupuncture-related AEs has raised public safety concerns. A recent systematic review of case reports from 2010 to 2023 determined that many reports lacked the essential details necessary for assessing AE causality, treatment appropriateness, and contributing risk factors. These omissions may result in misinformation, and exaggerate the potential harm of acupuncture. The CAse REport guidelines (13 items) provide general guidance to improve the clarity, completeness, and transparency of case report findings, but they do not address the unique clinical features and factors specific to acupuncture-related AEs such as defective needles, practitioner malpractice, or patient-related factors. These limitations may hinder the educational value of such reports in preventing acupuncture-related AEs. To address this gap, a consensus-based reporting guideline tailored to acupuncture-related AEs is necessary to enhance the quality, transparency, and reliability of case reports, which will ultimately contribute to improved patient care. This article outlines a protocol, and approaches, for developing a reporting guideline for acupuncture-related AEs in case reports.

Short Communication

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; Perspect Integr Med. 2024;3(3):162-167. Published online October 23, 2024; DOI: https://doi.org/10.56986/pim.2024.10.005

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Graphical Abstract Abstract PDF: 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.

Original Article

Acupuncture Needles and the Risk of Lymphedema After Breast Cancer Surgery: A Retrospective National Cohort Study: Ye-Seul Lee, Yucheol Lim, Jiyoon Yeo; Perspect Integr Med. 2024;3(1):29-36. Published online February 22, 2024; DOI: https://doi.org/10.56986/pim.2024.02.004

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Graphical Abstract Abstract PDF Supplementary Material

Background
Controversies remain over the impact of using needles on breast cancer patients after surgery due to risk of breast cancer-related lymphedema (BCRL). While recent literature suggests that vascular access during the postsurgical stage does not affect the risk of BCRL, the impact of acupuncture on the risk of BCRL during the postsurgical stage has not been studied.
Methods
This study included 35,153 patients from 2011 to 2013 who were newly diagnosed with breast cancer in a population-based cohort from the Korean National Health Insurance Service database. All patients received breast surgery, and the treatment group received acupuncture for more than 3 sessions in the 3-6 months post-surgery. The control group did not receive acupuncture. The incidence rate ratio, Kaplan-Meier curve, and Cox proportional hazards models were used to compare the risk of BCRL, and death between groups.
Results
About 5.8% of the study population received acupuncture during the 3-6 months post-surgery treatment window. After propensity score matching, the acupuncture treatment group did not show an increased risk of BCRL (IRR 1.017, 95% CI 0.868-1.193; unadjusted HR 1.018, 95% CI 0.868-1.193). This risk was robust in all multivariate Cox proportional hazards models.
Conclusion
An association of BCRL with acupuncture was not observed. Patients who received acupuncture to manage symptoms such as pain during the 3-6 months postsurgical stage did not have a higher risk of developing BCRL. Breast cancer patients who seek acupuncture to alleviate post-surgery symptoms such as pain, can receive acupuncture without concerns for potential risk of BCRL.

Citations

Citations to this article as recorded by

Sarcomatoid squamous cell carcinoma arising in a post-acupuncture keloid scar: a case report and literature review
Minwoo Park, Sug Won Kim, Jiye Kim
Archives of Craniofacial Surgery.2025; 26(4): 160. CrossRef

Guideline

ACURATE: A Guide for Reporting Sham Controls in Trials Using Acupuncture: Ye-Seul Lee, Song-Yi Kim, Hyangsook Lee, Younbyoung Chae, Myeong Soo Lee; Perspect Integr Med. 2023;2(2):100-106. Published online June 23, 2023; DOI: https://doi.org/10.56986/pim.2023.06.004

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Abstract PDF

This paper presents the Acupuncture Controls gUideline for Reporting humAn Trials and Experiments (ACURATE) checklist, an extension of The Consolidated Standards for Reporting of Trials (CONSORT) and to be used along with STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) when both real and sham acupuncture needles are used in the study. This checklist focuses on a clear depiction of sham needling procedures to enhance replicability and enable a precise appraisal. We encourage researchers to use ACURATE in trials and reviews involving sham acupuncture to assist reporting of sham acupuncture procedures and the related components.

Citations

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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

Review Article

Minimum Clinically Important Difference for Nonsurgical Interventions for Spinal Diseases: Choosing the Appropriate Values for an Integrative Medical Approach: Ye-Seul Lee, Sungmin Lee, Yoon Jae Lee, In-Hyuk Ha; Perspect Integr Med. 2023;2(2):86-99. Published online June 23, 2023; DOI: https://doi.org/10.56986/pim.2023.06.003

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5 Citations

Graphical Abstract Abstract PDF Supplementary Material

The minimal clinically important difference (MCID) plays a crucial role in the design and interpretation of clinical trials, as it helps in distinguishing between statistically significant and clinically meaningful outcomes. This scoping review aims to collate and appraise the current research concerning the validation of MCIDs for surgical and nonsurgical measures for spine disorders. Two databases of MEDLINE (PubMed and EMBASE) were searched. There were 1,590 studies retrieved and 79 were selected as eligible for review. Measurement tools such as the Oswestry Disability Index, Neck Disability Index, Numeric Rating Scale, and Visual Analogue Scale were assessed by regions and interventions. A total of 24 studies identified MCIDs on nonsurgical interventions, and 55 studies identified MCIDs on surgical interventions. The range of MCIDs varied greatly depending on study population, specific interventions, calculation methods, and outcomes. This scoping review emphasizes the complexity and variability in determining MCIDs for musculoskeletal or neurodegenerative spinal diseases, influenced by several factors including the intervention type, measurement tool, patient characteristics, and disease severity. Given the wide range of reported MCIDs, it is crucial to consider the specific context when interpreting these values in clinical and research settings. To select an appropriate MCID value for comparison in a clinical trial, careful consideration of the patient group, intervention, assessment tools, and primary outcomes is necessary to ensure that the chosen MCID aligns with the research question at hand.

Citations

Citations to this article as recorded by

Efficacy and safety of musculoskeletal manipulations in elderly population with musculoskeletal disorders: a systematic review
Donatella Bagagiolo, Michela Persiani, Luca Cicchitti, Luca Vismara, Irene Bruini, Alessandro Mauro, Francesca Buffone
BMJ Open.2025; 15(6): e088655. CrossRef
Predicting nonsurgical treatment outcomes in lumbar disc herniation: leveraging sparse electronic health records for patient phenotyping
Ye-Seul Lee, Yoon Jae Lee, In-Hyuk Ha
International Journal of Medical Informatics.2025; 204: 106056. CrossRef
Minimal Clinically Important Difference in Patients with Acute Neck Pain Undergoing Conservative Treatment with Korean Medicine
Ji Sun Kim, Eunsan Kim, Seungwon Shin, In-Hyuk Ha, Yoon Jae Lee
Journal of Pain Research.2025; Volume 18: 3709. CrossRef
Minimum clinically important difference and substantial clinical benefit in patients with chronic temporomandibular disorders
Jaemin Son, Eun‐San Kim, Yoon Jae Lee, Nam‐Woo Lee, In‐Hyuk Ha
Journal of Oral Rehabilitation.2024; 51(8): 1468. CrossRef
Safety and effectiveness of integrative Korean medicine for the management of patients sustaining injuries in traffic accidents during pregnancy: A retrospective chart review and questionnaire survey
Dahyun Kyung, Kyoung Sun Park, Ji-Eun Koo, Sujin Kim, Jiwon Park, Jun-Hyo Bae, Jieun Bae, Suna Kim, Yoon Jae Lee, In-Hyuk Ha
Medicine.2024; 103(21): e38250. CrossRef

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