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Which Research Is Needed to Support Clinical Decision-making on Integrative medicine?——Can Comparative Effectiveness Research Close the Gap?

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Chinese Journal of Integrative medicine 2012年第10期18卷 723-729页

作者： claudia m.witt 黄文静 Lixing Lao Berman Bm Charit University medical Center Institute for Social MedicineEpidemiology and Health Economics University of maryland School of medicine Center for Integrative Medicine Chengdu University of Traditional Chinese medicine The Institute for Integrative Health

In clinical research on complementary and integrative medicine, experts and scientists have often pursued a research agenda in spite of an incomplete understanding of the needs of end users. Consequently, the majority of previous clinical trials have mainly assessed the efficacy of interventions. Scant data is available on their effectiveness. Comparative effectiveness research （CER） promises to support decision makers by generating evidence that compares the benefits and harms of the best care options. This evidence, more generalizable than the evidence generated by traditional randomized controlled trials （RCTs）, is better suited to inform real-world care decisions. An emphasis on CER supports the development of the evidence base for clinical and policy decision-making. Whereas in most areas of complementary and integrative medicine data on comparative effectiveness is scarce, available acupuncture research already contributes to CER evidence. This paper wil introduce CER and make suggestions for future research.

关键词： comparative effectiveness research decision making integrative medicine Chinese medicine acupuncture

我们需要什么研究来支持将结合医学运用于临床的决策?--效益比较研究可以填补其间的沟壑吗?

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中国中西医结合杂志 2013年第8期33卷 1030-1035页

作者： claudia m.witt 黄文静劳力行 Brian m.Berman 德国柏林医科大学社会医学、流行病学及卫生经济学研究所德国柏林10117 马里兰大学医学院结合医学中心美国巴尔的摩21201 成都中医药大学针灸推拿学院成都610075 结合卫生研究所美国巴尔的摩21231

在补充和结合医学临床研究中,专家和科研工作者往往片面地追求研究纲领而没有充分考虑到最终服务对象,即患者的需求。因此,以往大多数的临床研究都集中在评价治疗措施的效力,却缺乏关于其临床效果的研究数据。效益比较研究(comparative ... 详细信息

在补充和结合医学临床研究中,专家和科研工作者往往片面地追求研究纲领而没有充分考虑到最终服务对象,即患者的需求。因此,以往大多数的临床研究都集中在评价治疗措施的效力,却缺乏关于其临床效果的研究数据。效益比较研究(comparative effectivenesresearch,CER)旨在通过提供对可能的最佳治疗方案利弊的比较证据,使决策者能明智选择最佳治疗方案。这种证据,较之传统意义上的RCT研究证据更普遍,更适用于对实际医疗方案的决策。重视CER将为临床循证医学的发展及政策制定提供支持。诚然,在补充和结合医学的大多数领域中,CER的数据还很匮乏,针灸研究已为CER提供了一定的证据。笔者将重点介绍CER,并对将来的研究方向提供建议。

关键词：效益比较研究决策结合医学中医针刺

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西方国家藏医临床研究综述

中国藏学 2014年第2期 163-167页

作者： K.Philip Reuter Thorolf E.R.Weiβ huhn claudia m.witt 罗辉中国藏学研究中心藏医药研究所

本文通过全面检索各医学文献数据库中收录的以英文、德文、芬兰文或西班牙文发表的临床研究文献,对西方国家近40年来开展的医临床研究进行了系统综述。结果显示:这些研究在类型和规模、试验条件、治疗措施、结局测量指标和研究质量方面... 详细信息

本文通过全面检索各医学文献数据库中收录的以英文、德文、芬兰文或西班牙文发表的临床研究文献,对西方国家近40年来开展的医临床研究进行了系统综述。结果显示:这些研究在类型和规模、试验条件、治疗措施、结局测量指标和研究质量方面具有很大的异质性。本检索分析后认为,目前西方开展的藏医临床研究数量少,研究的方法和结果各异,今后还需要开展高质量、大样本的临床试验,进一步探索藏医药的疗效。

关键词：西方藏医药研究状况

STANDARDIZED *** ACUPUNCTURE FOR CHRONIC LOW BACK PAIN — A RANDOmIZED CONTROLLED TRIAL

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Journal of Integrative medicine 2014年第3期 224-225页

作者： Daniel Pach Xiaoli Yang-Strobel Rainer Lüdtke Lüdtke Stephanie Roll Katja Icke Benno Brinkhaus claudia m.witt Institute for Social medicine Epidemiology and Health EconomicsCharité-Universittsmedizin Berlin Karl and Veronica Carstens Foundation 3. Center for Integrative medicine University of Maryland School of Medicine

Background: Chinese medical diagnoses and treatment recommendations for specific patients with chronic low back pain vary widely across practitioners.A comparison of individualized treatment with a thoughtfully developed standardized approach is useful to determine which, if either, is ***: We aimed to compare the effectiveness of standardized and individualized acupuncture treatment in patients with chronic low back ***: We performed a single-centre randomized controlled single-blind trial in a general medical practice in Germany run by a Chinese born medical doctor trained in Western and Chinese medicine.150 outpatients with chronic low back pain were randomly allocated to two groups(78 standardized acupuncture and 72 individualized acupuncture).Patients received either standardized acupuncture or individualized *** encompassed between 10 to 15 treatments based on individual symptoms with two treatments per *** main outcome measure was the area under the curve(AUC), summarizing eight weeks of daily rated pain severity measured with a visual analogue scale(0 mm=no pain, 100 mm=worst imaginable pain).Results: No significant differences between groups were observed for the AUC(individualized acupuncture mean:1768.7 [95% CI, 1460.4; 2077.1]; standardized acupuncture 1482.9 [1177.2; 1788.7]; group difference, 285.8 [-33.9; 605.5] P=0.080).Conclusion: In this single-centre trial individualized acupuncture was not superior to standardized acupuncture for patients suffering from chronic *** a next step a multi-centre non-inferiority study should be performed to investigate whether standardized acupuncture treatment for chronic low back pain might be applicable in a broader usual care setting.

关键词： AUC STANDARDIZED VS.INDIVIDUALIZED ACUPUNCTURE FOR CHRONIC LOW BACK PAIN A RANDOmIZED CONTROLLED TRIAL

DEVELOPmENT OF A STANDARDIZED ACUPUNCTURE FOR FATIGUE IN WESTERN PATIENTS WITH mULTIPLE SCLEROSIS

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Journal of Integrative medicine 2014年第3期 273-273页

作者： Ying-hui Chang Daniel Pach Judith Bellmann-Strobl Friedemann Paul Xue-min Shi claudia m witt Institute for Social medicine Epidemiology and Health EconomicsCharité – Universittsmedizin Berlin NeuroCure Clinical Research Center Charité – Universittsmedizin Berlin First Teaching Hospital of Tianjin University of Traditional Chinese medicine Center for Integrative medicine University of Maryland School of Medicine

Background: Fatigue is the most common clinical symptom of patients with multiple sclerosis(mS) and strongly influences their quality of *** Tianjin, China, Xingnao Kaiqiao(XNKQ)acupuncture is widely used to treat *** is a standard acupuncture therapy developed by Shi Xuemin with a strict set of points and standard quantitative *** retention time is about 15 min for each session, which is usually applied five times a week over at least four *** acupuncture aims to alert the spirit, refresh and regulate the *** "mind" here not only refers to mental, conscious and thinking activities, but also manifests the function of zang-fu organs and ***: Our aim was to improve that the intervention could be applied as a standardized acupuncture in a randomized controlled trial in the West(***: NCT01864707,trial performed in Germany).The trial compared usual care plus acupuncture with usual care only for fatigue in Western mS patients in an outpatient ***: A consensus was achieved involving Chinese acupuncture experts, Western mS experts, and research methodologists in an onsite group of discussions and email ***: A XNKQ-based prescription for fatigue is based on the following assumption: regulate and harmonize zang-fu organs, reinforce the function of liver and kidney, and improve the motor *** is applied twice a week over twelve weeks and consists of 19 points and 34 needles(0.25 mm × 40 mm stainless steel disposable).For each point a standardized manual manipulation which reflects the manipulation also used in China is *** retention time is 15 min per ***: A standardized acupuncture for fatigue in mS patients who are suitable for a clinical trial in the West can be developed.

关键词： mS DEVELOPmENT OF A STANDARDIZED ACUPUNCTURE FOR FATIGUE IN WESTERN PATIENTS WITH mULTIPLE SCLEROSIS

利用经济学评价证据支持针灸医疗保险报销决策:现有证据及挑战

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英国医学杂志中文版 2022年第6期25卷 315-319页

作者：李洪超金雪晶 Patricia m Herman claudia m witt 陈英耀岗卫娟景向红宋坪杨龙会 Dan Ollendorf 张渊 Gordon Guyatt 黄璐琦张誉清(文/译) 王欣恬中国药科大学国际医药商学院中国药科大学药物经济学评价研究中心北京中医药大学循证医学中心 RAND Corporation USA Institute for Complementary and Integrative medicine University Hospital Zurich and University of ZurichZurichSwitzerland 复旦大学公共卫生学院复旦大学国家卫生委员会卫生技术评估重点实验室中国中医科学院针灸研究所中国中医药循证医学研究中心中国医学科学院 Center for the Evaluation of Value and Risk in Health Institute for Clinical Research and Health Policy StudiesTufts Medical CenterUSA 加拿大麦克马斯特大学健康研究方法、证据与影响学系 Department of medicine Faculty of Health SciencesMcMaster UniversityHamiltonONCanada 中国中医科学院广安门医院中加整合医学循证医学研究合作中心宁波诺丁汉大学宁波诺丁汉GRADE中心

李洪超和同事们探索了在针灸医疗保险报销决策过程中引入经济学评价证据的全球挑战。医疗保险报销决策的过程本质上是复杂的。除了安全性和有效性,社会、经济、政治、地理、制度等非医学因素通常也会对决策制订产生重要的影响。

关键词：经济学评价医疗保险非医学因素报销决策评价证据针灸全球挑战证据支持

DIFFERENTIAL CEREBRAL RESPONSE TO SOmATOSENSORY STImULATION OF AN ACUPUNCTURE POINT VERSUS TWO NONACUPUNCTURE POINTS mEASURED WITH fmRI

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Journal of Integrative medicine 2014年第3期 219-219页

作者： Daniel Pach Till Nierhaus Wenjing Huang Xiangyu Long Vitaly Napadow Stephanie Roll Fanrong Liang Burkhard Pleger Arno Villringer claudia m.witt Institute for Social medicine Epidemiologyand Health EconomicsCharité-Universittsmedizin Berlin mind-Brain Institute and Berlin School of mind and Brain Charité-Universittsmedizin Berlin and Humboldt-University max Planck Institute for Human Cognitive and Brain Sciences Chengdu University of Traditional Chinese medicine Athinoula A.martinos Center for Biomedical Imaging Department of RadiologyMassachusetts General Hospital 6. Department of RadiologyLogan College of Chiropractic 7. Center for Integrative MedicineUniversity of Maryland School of Medicine

Objective: To evaluate whether different point locations chosen for a somatosensory stimulation with acupuncture needles differently change the brain activity in healthy ***: We used event-related fmRI, and resting-state functional connectivity fmRI to assess neural responses to standardized manual needle stimulation of the acupuncture point ST36(lower leg) and two control point locations(CP1 same dermatome, and CP2 different dermatome) that are not *** responses were expected to differ for stimulation in two different dermatomes(CP2 different from ST36 & CP1), or stimulation at the acupuncture point versus the control *** scans all healthy subjects(n=22) received manual needle stimulation at all 3 points in a randomized *** needle stimulation consisted of 6-minute intermittent penetrating needle manipulation on one *** sensation was measured by the massachusetts General Hospital Acupuncture Sensation Scale(mASS) and correlated with fmRI ***: The fmRI analysis found that insula and S2 activation was more pronounced with ST36 stimulation, and there was increased S2 connectivity to thalamus and brainstem following ST36 *** in needle sensation between ST36 ***1 and ST36 ***2 were statistically significant(pairwise t-test, P=0.009 and P=0.005, respectively).No correlation was found when exploring the relationship between the mASS index and the β values of the fmRI BOLD ***: Our results suggest that stimulation at acupoints may modulate somatosensory and saliency processing regions more readily.

关键词： fmRI DIFFERENTIAL CEREBRAL RESPONSE TO SOmATOSENSORY STImULATION OF AN ACUPUNCTURE POINT VERSUS TWO NONACUPUNCTURE POINTS mEASURED WITH fmRI ST

如何设计高质量针刺临床研究:基于证据的专家共识

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英国医学杂志中文版 2022年第6期25卷 325-337页

作者：张誉清焦睿珉 claudia m witt 劳力行刘建平 Lehana Thabane Karen J Sherman mike Cummings Dawn P Richards Eun-Kyung Anna Kim Tae-Hun Kim myeong Soo Lee michael E Wechsler Benno Brinkhaus Jun J mao Caroline A Smith 岗卫娟刘保延刘志顺刘岩郑晖吴佳霓 AloBSO Carrasco-Labra mohit Bhandari Philip J Devereaux 景向红 Gordon Guyatt 中国中医科学院针灸研究所中国中医科学院广安门医院中加整合医学循证医学研究合作中心 Department of Health Research methods Evidenceand ImpactMcMaster UniversityHamiltonONCanada 宁波诺丁汉大学宁波诺丁汉GRADE中心中国中医药循证医学中心 Institute for Complementary and Integrative medicine University Hospital Zurich and University of ZurichZurichSwitzerland Virginia University of Integrative medicine FairfaxVAUSA 北京中医药大学循证医学中心北京中医药大学国际循证中医药研究院 Department of medicine Faculty of Health SciencesMcMaster UniversityHamiltonONCanada Kaiser Permanente Washington Health Research Institute Seattle WAUSA Department of Epidemiology University of WashingtonSeattle WAUSA British medical Acupuncture Society LondonUK Patient and Public Engagement Clinical Trials OntarioTorontoONCanada Department of Western medicine Virginia University of Integrative MedicineFairfaxVAUSA Korean medicine Clinical Trial Center SeoulRepublic of Korea Korean medicine Hospital SeoulRepublic of Korea Kyung Hee University SeoulRepublic of Korea Clinical medicine Division Korea Institute of Oriental MedicineDaejeonRepublic of Korea Korean Convergence medicine University of Science and TechnologyDaejeonRepublic of Korea National Jewish Health DenverCOUSA Institute of Social medicine Epidemiology and Health EconomicsCharitéUniversit?ts medizin BerlinFreie Universit?t Berlin and Humboldt-Universittzu BerlinBerlinGermany Integrative medicine Service Memorial Sloan Kettering Cancer CenterBendheim Integrative Medicine CenterNew YorkNY USA Translational Health Research Institute Western Sydney UniversityPenrithNew South WalesAustralia 中国中医科学院中国中医科学院广安门医院北京中医药大学东直门医院中医内科学教育部重点实验室成都中医药大学针灸推拿学院/第三附属医院 Center for Integrative Global Oral Health School of Dental MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA

本针刺随机对照试验(Randomised controlled trials, RCT)专家共识是基于目前针刺试验面临的最普遍、最关键问题,由临床医生、研究人员、从事针灸和外科的临床试验专家、统计专家、临床流行病学和方法学专家以及患者组成的国际临床研究... 详细信息

本针刺随机对照试验(Randomised controlled trials, RCT)专家共识是基于目前针刺试验面临的最普遍、最关键问题,由临床医生、研究人员、从事针灸和外科的临床试验专家、统计专家、临床流行病学和方法学专家以及患者组成的国际临床研究小组联合制订。该共识将有助于临床试验资助者、注册者以及期刊编辑等评估针刺RCT方案及研究结果的相关性、重要性和质量。

关键词：临床流行病学针刺试验临床试验临床医生专家共识随机对照试验资助者期刊编辑

Crystal structure evolution of complex metal aluminum hydrides upon hydrogen release

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Journal of Energy Chemistry 2020年第3期29卷 133-143页

作者： claudia Weidenthaler max-Planck-Institut für Kohlenforschung 45470 Mülheim an der RuhrGermany

Complex aluminum hydrides have been widely studied as potential hydrogen storage materials but also,for some time now, for electrochemical applications. This review summarizes the crystal structures of alkali and alkaline earth aluminum hydrides and correlates structure properties with physical and chemical properties of the hydride compounds. The crystal structures of the alkali metal aluminum hydrides change significantly during the stepwise dehydrogenation. The general pathway follows a transformation of structures built of isolated [AlH4]- tetrahedra to structures built of isolated [Al H6]3- *** crystal structure relations in the group of alkaline earth metal aluminum hydrides are much more complicated than those of the alkali metal aluminum hydrides. The structures of the alkaline earth metal aluminum hydrides consist of isolated tetrahedra but the intermediate structures exhibit chains of cornershared octahedra. The coordination numbers within the alkali metal group increase with cation sizes which goes along with an increase of the decomposition temperatures of the primary hydrides. Alkaline earth metal hydrides have higher coordination numbers but decompose at slightly lower temperatures than their alkali metal counterparts. The decomposition pathways of alkaline metal aluminum hydrides have not been studied in all cases and require future research.

关键词： Complex aluminum hydrides Hydrogen storage Crystal structure