Developing Patient-Centered Measures for Outcomes of CAM Therapies

在补充和替代医学（CAM）中，许多疗法或药物针对整体 人，重点是生命力，气，普拉纳，或类似的概念。这与生物医学形成鲜明对比， 重点是特定的疾病，器官，症状或机制（药物）。现代CAM研究通常 研究用生物医学术语定义的患者人群，并适当使用定义的结局指标 与生物医学条件有关。然而，结果适合于理解CAM 系统，在整个人的水平上评估变化（例如能量，福祉）。往往缺乏。 此外，有证据表明，一些接受CAM疗法的个体，特别是那些 可能被认为具有能量或精神成分（例如顺势疗法，能量或精神 治疗，针灸），报告什么可以被称为变革的经验，如描述的W.R.米勒和 他人CAM研究人员还没有工具来衡量基于以下实证研究的结果： CAM客户体验整个人的成果或变革的经验。本申请提出 实现两个目标-确定与CAM疗法相关的重要的整体结果， 建议在CAM研究中进行一致性评估，并开发和验证测量 在没有可用项目的情况下，这些工具可以用于这些方面，例如转型变革。 具体目标是（1）重新分析CAM患者的五个现有定性数据集和两个现有定性数据集。 与通过CAM疗法经历的结果相关的从业者，识别整体 参与者自然语言中的个人经验，用于开发新的问卷项目; (2)使用这些结果开发（编译）CAM全人结果问卷，包括项目 从现有问卷中确定的量表，以最好地评估最常见的CAM结局，以及 根据定性数据，根据需要增加新项目;（3）在适当的情况下， 根据种族多样性和CAM经验选择人口。在这个项目中，来自四个美国和 一个独立进行同行评审CAM研究的加拿大机构联合收割机， 定性数据集和独特的CAM研究经验与适当的顾问，以制定一个 在CAM和非CAM环境中具有潜在广泛适用性的结果工具。

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..