The evolving role of meta-analysis in CAM

Early on in this blog I defined terms used in clinical trials, including the “meta-analysis,” — a favorite statistical method that groups the results from the small studies that typify CAM research in order to arrive at more reliable conclusions on effectiveness.

As part of the growing recognition that CAM is here to stay, opinion leaders in the allopathic community are beginning to seriously debate the value of alternative methods to assess the value of CAM.

Ian Coulter in an article here, and referred to here, believes that “systematic reviews and syntheses [such as a meta-analysis] of evidence are a necessary but an insufficient method for making clinical decisions.”

On the other hand, he continues, “They represent an advance in reviewing evidence and as they evolve will continue to aid practice.” Dr. Coulter who is Director of Clinical Research and Integrative Medicine at the Samueli Institute in California concludes, “As the work continues around the issues of evaluating other forms of evidence, particularly for observation studies, their relevance will become even more significant.”

The MOOSE group agrees (I’m not kidding, it stands for Meta-analysis Of Observational Studies in Epidemiology). And in the most mainstream of allopathic medicine journals (The Journal of the American Medical Association), the MOOSE Group (although not referring to CAM specifically) has concluded “if a role for meta-analyses of observational studies in setting policy is to be achieved, standards of reporting must be maintained to allow proper evaluation of the quality and completeness of meta-analysis.”

To advance this effort they include an extensive checklist for authors, editors, and reviewers of meta-analyses of observational studies.

The bottom line?
This is good for CAM.

One problem with CAM research in general is that too few patients are included in any one study to permit reliable conclusions from the findings. It gives the appearance of slip-shod research, when often the real problem is lack of money to coordinate a larger clinical trial like those of pharmaceutical new drug trials.

By grouping small studies in a meta-analysis, more reliable results can be achieved. Now, the MOOSE group has provided a checklist of standards that will guide future authors who publish meta-analyses.

1/15/07 11:45 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.