Whole Systems Research Is Focus of Illuminating Roundtable Discussion in Journal of Alternative & Complementary Medicine.

NEW ROCHELLE, N.Y. -- The opportunities and methodological challenges inherent in a whole systems research approach to the study of complementary medicine were the focus of a roundtable discussion as part of the recent North American Research Conference on Complementary and Integrative Medicine, and the discussion was published in the November 2006 issue (Volume 12, Number 9) of The Journal of Alternative and Complementary Medicine, a peer-reviewed journal published by Mary Ann Liebert, Inc. (www.liebertpub.com). The Roundtable Discussion is available free online at www.liebertpub.com/acm.

George T. Lewith, MD, PhD, from the University of Southampton (UK), identified the most important methodologic issue facing whole systems research: "The big issue is getting whole systems research accepted as an entity in itself: Does it have any scientific validity at all?"

The discussion, moderated by Charles Elder, MD, MPH, from Kaiser Permanente Center for Health Research (Portland, OR), centered on the need to define more clearly the questions that studies should aim to answer and to describe in greater detail in published reports the methodologies used. This should include identifying the appropriate outcomes to measure, including conventional outcome measures that can serve as a basis for comparison.

Determining how to analyze within-patient data is another pivotal challenge. Researchers should also focus on pattern analysis and looking for patterns of outcomes. Additionally, the participants, including Mikel Aickin, PhD, Iris R. Bell, MD, PhD, and Cheryl Ritenbaugh, PhD, MPH, from the University of Arizona (Tucson), Vinjar FE[sup.1]nnebE[sup.1], MD, PhD, from the University of TromsE[sup.1] (Norway), and Marja Verhoef, PhD, from the University of Calgary (Canada), emphasized the importance of connecting with researchers in related disciplines and leveraging the opportunity to link up with the emerging area called complex systems science, or network science.

The discussion also revolved around whole systems clinical trial design and especially the methodological and ethical issues related to control groups and placebo interventions. Participants reinforced the need to educate the biomedical community and funding agencies about whole systems research.

"It is evident that the model of the double-blind randomized controlled cross-over clinical trial not only does not but cannot adequately evaluate the complexity of interaction inherent in complex systems," says Journal Editor Kim A. Jobst, M.A., D.M. "The need to be able to do this is of ever growing importance. The explorations of some of the greatest minds and most active researchers in the field of holistic integrated healthcare research and clinical delivery are contained in this Roundtable Discussion, which distills the essence of their deeply focused and serious debate on methodology, and makes available to all those interested in research, in clinical care delivery and in policy generation, some of their most recent and relevant conclusions. It is essential reading for anyone seriously interested in understanding whole systems thinking and research."

The Journal of Alternative and Complementary Medicine is a peer-reviewed journal published bimonthly in print and online that facilitates more effective communication and data collection and analysis, explores research methodologies and results, and stimulates inquiry and dialogue. The Journal includes observational, clinical, and scientific reports and commentary, and features clinical case reports intended to help healthcare professionals and scientists evaluate and integrate therapies into patient care protocols and research strategies. A complete table of contents and free sample issue may be viewed online at www.liebertpub.com/acm.

Mary Ann Liebert, Inc., is a privately, held, fully integrated media company known for establishing authoritative peer-reviewed journals in many promising areas of science and biomedical research, including Alternative & Complementary Therapies, Disease Management, and the Journal of Palliative Medicine. Its biotechnology trade magazine, Genetic Engineering News (GEN), was the first in its field and is today the industry's most widely read publication worldwide. A complete list of the firm's 60 journals, books, and newsmagazines is available at www.liebertpub.com.