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European Journal of Integrative Medicine 5 (2013) 465–468
Editorial
Building the evidence for CAM—30 years on
As well as accepting original research articles, the
European Journal of Integrative Medicine are par-
ticularly interested in receiving submissions of
systematic reviews in the following areas – oncol-
ogy, multiple morbidity, integrative interventions,
health economics, safety, integrated health in
developing countries and policy.
In this final issue of 2013, there is a focus on the importance
of evidence in CAM? Evidence takes many different forms. It
can also vary greatly in its quality and how it is accepted by
the scientific community, regulators and health policy makers
and governments. Evidence based medicine has been defined
as – “the conscientious, explicit and judicious use of current
best evidence in making decisions about the care of individual
patients.” [1]. It has a key role in clinical decision-making and
consists of the now well-known hierarchy of evidence which is
based on the strength of the different research methodologies
used. The systematic review, being at the top of the evidence
tree, is regarded as the gold standard for assessing the effects of
treatments, followed by randomised controlled trials. However
at the bottom of the tree, which arguably is where most available
evidence sits, is clinical expert opinion and best practice. These
latter forms of often anecdotal qualitative evidence are how-
ever also important, because in the absence of clinical trial data,
expert opinion and best practice may be all that exists; many
conventional medicine interventions are delivered without the
underpinning evidence from randomised controlled trials [2].
The Research Council for Complementary Medicine
(RCCM) (www.rccm.org.uk), now into its 30th year, celebrated
with a conference entitled ‘From Hierarchy of Evidence to Good
Practice’ on the 25 September, 2013 at the Royal Society in
London. The RCCM is a UK charity with research and its dis-
semination as its key objective since its inception in 1983. This
high profile London venue was chosen because of The Royal
Society’s focus on science, having been instituted in the 1660s
to ‘recognize, promote, and support excellence in science and to
encourage the development and use of science for the benefit of
humanity’. The past, present and future of research evidence
in complementary and integrated medicine was delivered by
various speakers including Professor George Lewith (Univer-
sity of Southampton), Prof Sarah Stewart Brown (University
of Warwick), Dr Karen Pilkington (University of Westminster)
and Roger Newman-Turner (a founder member of the RCCM).
Of increasing importance is the engagement of practitioners in
research to build research capacity, as many research questions
emerge from clinical practice and, conversely, research should
inform practice. The evidence required for practice was pre-
sented at the conference by the UK’s Advertising Standards
Agency, and an informed debate was held with researchers
and practitioners. The RCCM conference demonstrated how the
evidence base for Complementary Medicine has substantially
developed over the last 30 years and how the RCCM has played
a vital role in education, research, and dissemination of research
on safety and effectiveness in complementary medicine in the
context of an integrated approach to health.
The RCCM was the brain child of Dr. Richard Tonkin (now
aged 98), who was a Consultant Physician at Westminster Hos-
pital. On his initiative and that of the co-founder, Harold Wicks,
who worked in communications, a council was assembled con-
sisting of distinguished medical experts, academics, writers,
CAM practitioners, and researchers to examine methodologies,
and facilitate research in the field. In the following few years
a series of conferences and workshops were held to develop
research awareness in the CAM professions and ‘CAM aware-
ness’ in the medical schools and universities.
In 1986 the RCCM instituted perhaps the first journal in this
field, Complementary Medical Research (a joint venture with
the British library) which later developed in 1993 into Comple-
mentary Therapies in Medicine (now another Elsevier journal).
One of the RCCM’s most significant achievements had been
attracting funding from the Department of Health to carry out
systematic review and appraisal of CAM interventions in key
NHS priority areas. Eighteen papers (12 systematic reviews and
6 papers on methods) were published in journals, 27 further
reviews were published on the RCCM’s database CAMEOL.
A total of 13 reviews were transferred to the National elec-
tronic Library on CAM which has now been subsumed into
the UK’s NHS Evidence service https://www.evidence.nhs.uk/.
1876-3820/$ – see front matter © 2013 Published by Elsevier GmbH.
http://dx.doi.org/10.1016/j.eujim.2013.10.003