Developing Patient-Centered Measures for Outcomes of CAM Therapies

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Within complementary and alternative medicine (CAM), many therapies or medicines target the whole person, with focus on vital force, qi, prana, or similar concepts. This contrasts with biomedicine, where the focus is on specific diseases, organs, symptoms, or mechanisms (drugs). Modern CAM research often studies patient populations defined in biomedical terms, and appropriately uses outcome measures defined in relation to biomedical conditions. However, outcomes appropriate to the understanding of the CAM systems, evaluating changes at the level of the whole person (e.g. energy, well-being.) are often lacking. Further, there is evidence that some individuals receiving CAM therapies, especially those therapies that might be considered to have an energetic or spiritual component (e.g. homeopathy, energy or spiritual healing, acupuncture), report what can be called transformative experiences, as described by W.R.Miller and others. CAM researchers have not had tools to measure outcomes that are based on empirical studies of CAM clients experiencing whole person outcomes or transformative experiences. This application proposes to accomplish two goals - identifying important whole person outcomes associated with CAMtherapies to propose for consistent evaluation in CAM research, and developing and validating a measurement instrument for those dimensions without available items, such as transformative change. The specific aims are (1) to reanalyze five existing qualitative data sets on CAM patients and two on practitioners relating to outcomes experienced through CAM therapies, identifying descriptors of whole person experiences in participants' natural language, to use in the development of new questionnaire items; (2) to use these results to develop (compile) a CAM whole person outcomes questionnaire, including items and scales from existing questionnaires identified to best evaluate the most common CAM outcomes, and new items as needed based on the qualitative data; and (3) to rigorously evaluate this tool in appropriate populations chosen for ethnic diversity and CAM experiences. In this project, scientists from four US and one Canadian institution who have independently conducted peer-reviewed CAM research combine their qualitative data sets and unique CAM research experiences with appropriate consultants to develop an outcomes instrument with potential broad applicability in CAM and non-CAM settings..