Artikel
Complementary and alternative medicine in pediatrics: A systematic overview/synthesis of Cochrane Collaboration reviews
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Autoren
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S. Meyer
- Universitätsklinikum des Saarlandes, Klinik für Allgemeine Pädiatrie und Neonatologie, Homburg, Germany
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N. Schroeder
- Universitätsklinikum des Saarlandes, Homburg, Germany
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L. Gortner
- Universitätsklinikum des Saarlandes, Homburg, Germany
| Veröffentlicht: | 17. April 2013 |
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Gliederung
Text
Background: A high prevalence of complementary and alternative medicine (CAM) use has been documented in children with chronic illnesses. Conversely, evidence based medicine is considered an important contributor in providing the best quality of care.
Methods: We performed a systematic overview/synthesis of all Cochrane Reviews published between 1996 and 2012 in paediatrics, assessing the efficacy, clinical implications and limitations of CAM use in children. Main outcome variables: Percentage of reviews that concluded that a certain intervention provides a benefit, percentage of reviews that concluded that a certain intervention should not be performed, and percentage of studies that concluded that the current level of evidence is inconclusive.
Results: 163 reviews were enrolled - most often from the United Kingdom (36/163), Australia (30/163) and China (24/163). In only 7/163 of reviews a recommendation in favour of a certain intervention was given, 33/163 issued a conditional positive recommendation, while 14/163 reviews concluded that certain interventions should not be performed. One-hundred and nine reviews were inconclusive. The proportion of inconclusive reviews increased during 3, a priori defined time intervals (1995-2000: 16/29; 2001-2006: 37/54; and 2007-2012: 56/80). The 3 most common criticisms with regard to quality of enrolled studies were: more research needed (95/163), low methodological quality (65/163) and small number of study participants (52/163).
Conclusions: Given the disproportionate number of inconclusive reviews, there is an ongoing need for high quality research to assess a potential role of CAM in children. Unless the study of CAM is submitted to the same science-based standards as conventional therapies, CAM therapies risk being perpetually marginalised by mainstream medicine.
