Objective：To assess the evidence of the use and efficacy for complementary and alternative medicine（CAM） in inflammatory bowel disease（IBD）. Methods：A systematic literature search in MEDLINE was performed for ra...Objective：To assess the evidence of the use and efficacy for complementary and alternative medicine（CAM） in inflammatory bowel disease（IBD）. Methods：A systematic literature search in MEDLINE was performed for randomized controlled trials（RCTs） in Crohn＇s disease and ulcerative colitis.Moreover,a selective literature search for health services research studies on the use of CAM in patients with IBD was performed.Results：Health services research studies showed a high use of CAM in adult and pediatric patients with IBD worldwide.In contrast to the high use among IBD patients,there was a lack of high-quality data for many of the used CAM methods.Although most of the studies showed positive results,the methodological quality of most studies was rather low;therefore,the results had to be interpreted with caution.While there were many studies for probiotics and fish oil,RCTs for the highly used method homeopathy, for most herbal products,and for traditional Chinese medicine methods apart from acupuncture RCTs were completely lacking.Conclusions：The lack of high-quality studies might be the consequence of the problems associated with the funding of clinical trials involving CAM.However,having the high user rates in mind,high-quality studies assessing efficacy and safety of those methods are urgently needed.Furthermore,there is a need for better representation of CAM in undergraduate and postgraduate medical education.展开更多
Globally,cancer care delivery is marked by inequalities,where some economic,demographic,and sociocultural groups have worse outcomes than others.In this review,we sought to identify patient-facing interventions design...Globally,cancer care delivery is marked by inequalities,where some economic,demographic,and sociocultural groups have worse outcomes than others.In this review,we sought to identify patient-facing interventions designed to reduce disparities in cancer care in both high-and low-income countries.We found two broad categories of interventions that have been studied in the current literature:Patient navigation and telehealth.Navigation has the strongest evidence base for reducing disparities,primarily in cancer screening.Improved outcomes with navigation interventions have been seen in both high-and low-income countries.Telehealth interventions remain an active area of exploration,primarily in high income countries,with the best evidence being for the remote delivery of palliative care.Ongoing research is needed to identify the most efficacious,costeffective,and scalable interventions to reduce barriers to the receipt of cancer care globally.展开更多
文摘Objective：To assess the evidence of the use and efficacy for complementary and alternative medicine（CAM） in inflammatory bowel disease（IBD）. Methods：A systematic literature search in MEDLINE was performed for randomized controlled trials（RCTs） in Crohn＇s disease and ulcerative colitis.Moreover,a selective literature search for health services research studies on the use of CAM in patients with IBD was performed.Results：Health services research studies showed a high use of CAM in adult and pediatric patients with IBD worldwide.In contrast to the high use among IBD patients,there was a lack of high-quality data for many of the used CAM methods.Although most of the studies showed positive results,the methodological quality of most studies was rather low;therefore,the results had to be interpreted with caution.While there were many studies for probiotics and fish oil,RCTs for the highly used method homeopathy, for most herbal products,and for traditional Chinese medicine methods apart from acupuncture RCTs were completely lacking.Conclusions：The lack of high-quality studies might be the consequence of the problems associated with the funding of clinical trials involving CAM.However,having the high user rates in mind,high-quality studies assessing efficacy and safety of those methods are urgently needed.Furthermore,there is a need for better representation of CAM in undergraduate and postgraduate medical education.
文摘Globally,cancer care delivery is marked by inequalities,where some economic,demographic,and sociocultural groups have worse outcomes than others.In this review,we sought to identify patient-facing interventions designed to reduce disparities in cancer care in both high-and low-income countries.We found two broad categories of interventions that have been studied in the current literature:Patient navigation and telehealth.Navigation has the strongest evidence base for reducing disparities,primarily in cancer screening.Improved outcomes with navigation interventions have been seen in both high-and low-income countries.Telehealth interventions remain an active area of exploration,primarily in high income countries,with the best evidence being for the remote delivery of palliative care.Ongoing research is needed to identify the most efficacious,costeffective,and scalable interventions to reduce barriers to the receipt of cancer care globally.
