Concept: Research Resource for Systematic Review of Complementary and Integrative Health

Project Concept Review

Council Date: January 20, 2023

Program Director: Peter Murray, Ph.D.  

Background

One of the major challenges in interpreting clinical research data and utilizing evidence-based research in clinical practice, health policy, or research program decision making is the aggregation of study results by distinct groups of researchers, especially when methods or outcomes differ across studies. In 1992, an international group of scientists launched a process to systematically and objectively evaluate and update existing evidence, with a goal of facilitating health practice and health policy decision making. These scientists also conceived a means for timely dissemination of the existing evidence for the practice of medicine. This “Systematic Review” methodology consists of a painstaking process of searching all the published peer-reviewed research literature, defining inclusion criteria to identify the most appropriate studies, summarizing the study results in a systematic and unbiased manner, and disseminating the findings in a manuscript format describing the methods and summary results of the systematic analysis. Such manuscripts are usually published by medical journals or specialized review groups. The review of all controlled clinical trials published in the literature on a given topic and summarizing the results in a systematic and unbiased manner provide a “current best evidence” that may help guide health care practitioners, patients, health care policy, and research administration.

To answer the call for a “current best evidence” resource for practitioners, patients, and policymakers, the Cochrane Complementary Medicine Field was founded in 1996, by Dr. Brian Berman at the University of Maryland, Baltimore to establish a database of primary reports of complementary and integrative controlled trials, and to facilitate the conduct and dissemination of Cochrane systematic reviews of complementary and integrative therapies. In 2003, the National Center for Complementary and Integrative Health (NCCIH), then the National Center for Complementary and Alternative Medicine (NCCAM), funded the Cochrane Complementary Medicine Field to ensure the constancy of this research resource. The Cochrane Complementary Medicine Field has received continual funding from NCCIH from 2003 through 2023. The field of complementary and integrative health has benefited greatly from the numerous systematic reviews and meta-analyses published by the Cochrane Complementary Medicine Field. To date, the Cochrane Central Register of Controlled Trials (CENTRAL) includes over 101,000 complementary and integrative health–related controlled trials, and the Cochrane Complementary Medicine Field has published or supported the publication of nearly 1,000 systematic reviews.

Purpose of Proposed Initiative

This initiative will support a research resource for the continuation of a database of controlled trials of complementary and integrative health interventions, which are useful to those conducting systematic reviews. The research team will need to describe how to establish a database or convert an existing database, as well as how it will be maintained and kept current. The initiative will encourage increasing outreach, access, and availability of the database to a broader scientific community, the public, and policymakers. The resource should update multiple reviews with current evidence and conduct new systematic reviews each year focusing on topics that are of priority to NCCIH (NCCIH Strategic Plan 2021–2025), particularly topics related to whole person research that include multicomponent complementary and integrative health interventions. In the context of whole person health, topics should focus on the exploring the fundamental science of interconnected systems, investigating multicomponent interventions or therapeutic systems, and examining the impact of these interventions on multisystem or multiorgan outcomes. 

Objectives

The objectives to be met by this concept include but are not limited to the following:

• Maintain and keep current a research resource consisting of a database of primary reports of controlled trials across the spectrum of complementary and integrative health interventions that are useful and utilized by the scientific community to conduct systematic reviews and meta-analyses.
• Provide a description of the methods the team will use to determine which new and updated reviews will be conducted to assure that they fit with high priority topics to NCCIH, particularly multicomponent complementary and integrative health interventions.
• Describe plans to promote and ensure access and availability of the resource to the broader scientific community, consistent with the program goals of developing and providing resources for furthering systematic reviews and meta-analyses of clinically important complementary and integrative health interventions research.
• Enhance visibility of the resource and its products via outreach (knowledge translation) to the scientific community, the public, stakeholders, and policymakers interested in complementary and integrative health interventions.
• Work with the broader scientific community to further develop and enhance the methods of systematic review and meta-analyses for multicomponent interventions, trials that assess multiple outcomes, interventions that cannot be blinded in randomized trials, or interventions or systems of care delivery that have been evaluated in pragmatic trials. For example, an expert panel might be convened to further methods development in one or more of these areas..