Psychooncology Research Unit, Department of Oncology, Aarhus University Hospital, and Department of Psychology, University of Aarhus, Jens Chr. Skous Vej 4, 8000 Aarhus C, Denmark.
Cancers (Basel). 2011 Feb 23;3(1):773-88. doi: 10.3390/cancers3010773.
In spite of lacking evidence for effects on cancer progression itself, an increasing number of cancer patients use various types of complementary and alternative medicine (CAM). There is disagreement between CAM practitioners, researchers and clinical oncologists, as to how evidence concerning effects of CAM can and should be produced, and how the existing evidence should be interpreted. This represents a considerable challenge for oncologists; both in terms of patient needs for an informed dialogue regarding CAM, and because some types of CAM may interact with standard treatments. There is a need for insight into which kinds of CAM may work, for whom they work, what the possible effects and side-effects are, and in what ways such effects may come about. The present article presents a framework for evaluating effects of CAM by suggesting a taxonomy of different levels of evidence related to different types of research questions and discussing the relevance of different research methodologies for different types of effects.
尽管缺乏关于癌症进展本身的影响的证据，但越来越多的癌症患者使用各种类型的补充和替代医学（CAM）。CAM 从业者、研究人员和临床肿瘤学家之间存在分歧，即关于 CAM 效果的证据应该如何以及应该如何产生，以及如何解释现有的证据。这对肿瘤学家来说是一个相当大的挑战；既要考虑到患者对有关 CAM 的知情对话的需求，也要考虑到某些类型的 CAM 可能会与标准治疗相互作用。我们需要了解哪些类型的 CAM 可能有效，对谁有效，可能的效果和副作用是什么，以及这些效果可能通过何种方式产生。本文通过提出一个评估 CAM 效果的框架，建议对与不同类型的研究问题相关的不同证据水平进行分类，并讨论不同的研究方法对于不同类型的效果的相关性，为这一问题提供了一种解决方案。
