CARE Program, Dept of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
CARE Program, Dept of Pedaitric, University of Alberta, Edmonton, Canada.
Complement Ther Med. 2019 Feb;42:27-32. doi: 10.1016/j.ctim.2018.10.022. Epub 2018 Oct 31.
Pediatric use of complementary medicine (CM) is common and offers numerous research questions about diverse therapies and conditions. Although research priorities for pediatric CM have been identified, there was a need to update in light of the rapid evolution of the field.
Building on previous work, we conducted an international, consensus-based 4-step modified Delphi process to develop and refine a pediatric CM research agenda, including on-line questionnaires and an in-person meeting. Participants included health care professionals, researchers, and educators.
We received 376 responses; participants included conventional and CM providers, researchers, educators, administrators, and policy-makers from 15 countries (Australia, Bangladesh, Belgium, Canada, China, Germany, India, Israel, Italy, New Zealand, Norway, Sri Lanka, The Netherlands, United Kingdom, and United States). While it was recognized that each region must set their own priorities based on use, access, and expertise, a "minimum set" for a pediatric CM research agenda was identified. After three rounds of surveys, participants identified the highest priorities for pediatric CM research as: (i) safety of CM therapies for infants, children, and adolescents; (ii) conditions for which CM use is highly prevalent and for which conventional medicine lacks safe, cost-effective therapies; iii) therapies/therapists to be examined for quality and reproducibility of interventions, comparative and cost effectiveness, dose, etc.; and iv) identification of relevant outcomes and outcome measurement tools.
The results of our study identify that "first do no harm" is the leading research priority for pediatric CM research, followed by more research on effectiveness of CM therapies for conditions not safely and effectively treated with conventional care. In order to improve pediatric health care, interdisciplinary collaborative approaches are needed between CM and conventional providers and researchers.
儿童补充医学（CM）的使用很常见，提出了许多关于不同疗法和病症的研究问题。尽管已经确定了儿科 CM 的研究重点，但鉴于该领域的快速发展，需要进行更新。
在以往工作的基础上，我们采用国际共识的 4 步改良 Delphi 流程来制定和完善儿科 CM 研究议程，包括在线问卷和现场会议。参与者包括医疗保健专业人员、研究人员和教育工作者。
我们收到了 376 份回复；参与者包括来自 15 个国家（澳大利亚、孟加拉国、比利时、加拿大、中国、德国、印度、以色列、意大利、新西兰、挪威、斯里兰卡、荷兰、英国和美国）的常规和 CM 提供者、研究人员、教育工作者、管理人员和政策制定者。虽然认识到每个地区都必须根据使用、获取和专业知识来确定自己的优先事项，但确定了儿科 CM 研究议程的“最低一套”。经过三轮调查，参与者确定了儿科 CM 研究的最高优先事项为：（i）CM 疗法对婴儿、儿童和青少年的安全性；（ii）CM 使用非常普遍且常规医学缺乏安全、经济有效的疗法的病症；（iii）对疗法/治疗师进行检查，以评估干预措施的质量和可重复性、比较和成本效益、剂量等；以及（iv）确定相关结果和结果测量工具。
我们的研究结果表明，“首先不造成伤害”是儿科 CM 研究的首要研究重点，其次是对 CM 疗法治疗常规护理无法安全有效治疗的病症的有效性进行更多研究。为了改善儿童的医疗保健，CM 和常规提供者和研究人员之间需要进行跨学科合作。
