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Practice-Based Research in Complementary Medicine: Could N-of-1 Trials Become the New Gold Standard?

Complementary medicines and therapies are popular forms of healthcare with a long history of traditional use. Yet, despite increasing consumer demand, there is an ongoing exclusion of complementary medicines from mainstream healthcare systems. A lack of evidence is often cited as justification. Unti...

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Autores principales: Bradbury, Joanne, Avila, Cathy, Grace, Sandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151123/
https://www.ncbi.nlm.nih.gov/pubmed/31936355
http://dx.doi.org/10.3390/healthcare8010015
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author Bradbury, Joanne
Avila, Cathy
Grace, Sandra
author_facet Bradbury, Joanne
Avila, Cathy
Grace, Sandra
author_sort Bradbury, Joanne
collection PubMed
description Complementary medicines and therapies are popular forms of healthcare with a long history of traditional use. Yet, despite increasing consumer demand, there is an ongoing exclusion of complementary medicines from mainstream healthcare systems. A lack of evidence is often cited as justification. Until recently, high-quality evidence of treatment efficacy was defined as findings from well-conducted systematic reviews and meta-analyses of randomized controlled trials. In a recent and welcome move by the Oxford Centre for Evidence-Based Practice, however, the N-of-1 trial design has also been elevated to the highest level of evidence for treatment efficacy of an individual, placing this research design on par with the meta-analysis. N-of-1 trial designs are experimental research methods that can be implemented in clinical practice. They incorporate much of the rigor of group clinical trials, but are designed for individual patients. Individualizing treatment interventions and outcomes in research designs is consistent with the movement towards patient-centered care and aligns well with the principles of holism as practiced by naturopaths and many other complementary medicine practitioners. This paper explores whether rigorously designed and conducted N-of-1 trials could become a new ‘gold standard’ for demonstrating treatment efficacy for complementary medicine interventions in individual patients in clinical practice.
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spelling pubmed-71511232020-04-20 Practice-Based Research in Complementary Medicine: Could N-of-1 Trials Become the New Gold Standard? Bradbury, Joanne Avila, Cathy Grace, Sandra Healthcare (Basel) Opinion Complementary medicines and therapies are popular forms of healthcare with a long history of traditional use. Yet, despite increasing consumer demand, there is an ongoing exclusion of complementary medicines from mainstream healthcare systems. A lack of evidence is often cited as justification. Until recently, high-quality evidence of treatment efficacy was defined as findings from well-conducted systematic reviews and meta-analyses of randomized controlled trials. In a recent and welcome move by the Oxford Centre for Evidence-Based Practice, however, the N-of-1 trial design has also been elevated to the highest level of evidence for treatment efficacy of an individual, placing this research design on par with the meta-analysis. N-of-1 trial designs are experimental research methods that can be implemented in clinical practice. They incorporate much of the rigor of group clinical trials, but are designed for individual patients. Individualizing treatment interventions and outcomes in research designs is consistent with the movement towards patient-centered care and aligns well with the principles of holism as practiced by naturopaths and many other complementary medicine practitioners. This paper explores whether rigorously designed and conducted N-of-1 trials could become a new ‘gold standard’ for demonstrating treatment efficacy for complementary medicine interventions in individual patients in clinical practice. MDPI 2020-01-08 /pmc/articles/PMC7151123/ /pubmed/31936355 http://dx.doi.org/10.3390/healthcare8010015 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Opinion
Bradbury, Joanne
Avila, Cathy
Grace, Sandra
Practice-Based Research in Complementary Medicine: Could N-of-1 Trials Become the New Gold Standard?
title Practice-Based Research in Complementary Medicine: Could N-of-1 Trials Become the New Gold Standard?
title_full Practice-Based Research in Complementary Medicine: Could N-of-1 Trials Become the New Gold Standard?
title_fullStr Practice-Based Research in Complementary Medicine: Could N-of-1 Trials Become the New Gold Standard?
title_full_unstemmed Practice-Based Research in Complementary Medicine: Could N-of-1 Trials Become the New Gold Standard?
title_short Practice-Based Research in Complementary Medicine: Could N-of-1 Trials Become the New Gold Standard?
title_sort practice-based research in complementary medicine: could n-of-1 trials become the new gold standard?
topic Opinion
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151123/
https://www.ncbi.nlm.nih.gov/pubmed/31936355
http://dx.doi.org/10.3390/healthcare8010015
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