THERE are 5 articles in this issue relating to the rapidly growing area of complementary and alternative medicine (CAM). It is clear in the literature in this area that the demand for this service greatly exceeds the science on health services research as well as evidence on efficacy. It is worth restating that more specifically there is very little health services research that deals with costs, utilization, financing, quality, and outcomes of CAM. The research analysis on the integration of CAM with conventional or mainline medicine is focused on efficacy. Obviously, I do not mean to question the emphasis on efficacy but we need much more health services research. It is in this context that we look at 5 articles in the CAM area in this journal. The articles in this mini series add to the health services research literature as it might relate to the management of ambulatory care management. Some of the articles also focus on evidenced-based literature and practice.
The first article provided by Makowski examines the assessment of "Local Market and Organizational Readiness for the Integration of Complementary and Alternative Medicine Into Ambulatory Care Centers." In this article, Dr Makowski looks at some of the national trends of the phenomenon of CAM growth and provides a framework for the strategic analysis of market factors, thereby enabling ambulatory care centers to inform organizational developments in this area.
The second article is the "Use of Complementary and Alternative Medicine by the Adult Membership of a Large Northern California HMO, 1999." In this article, Gordon and Lin investigate the prevalence of use of 15 CAM modalities by adult members in 1999, how the prevalence varied by age group and gender, and which CAM modalities were increasing in popularity.
The third article provided by Pelletier examines "Mind-Body Medicine in Ambulatory Care: An Evidence-Based Assessment." The focus of the article is on the evidence underlying the clinical efficiency of mind-body interventions focusing on the point that such therapies link changes with both the inside, ie, psychological, attitudinal changes in orientation, and the outside environment. Literature reviews are conducted on electronic searches of NLM sources and the Cochrane Library databases.
The fourth article by Meenan and colleagues speaks directly to the health services research issue outlined above by "Applying Techniques of Economic Evaluation to Complementary and Alternative Medicine." The purpose of this article is to facilitate the application of these techniques to CAM interventions. A goal of the article is to increase the utilization of the economic evaluation technique by researchers, practitioners of CAM, policy analysts, and others so that cost and quality improvement issues can be directly addressed.
In the final article, Ben-Arye and colleagues take a global view of the use of CAM practice for patients with cancer. The article is entitled "Approaching Complementary and Alternative Medicine Use in Patients With Cancer: Questions and Challenges." The focus is on a step process suggested for primary care physicians in the management of cancer patients.