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Session 2: Clinical studies and clinical application of traditional & indigenous medicine

IMEvidence: Application of Systematic Review for Evidence-Based

Practices of Traditional & Complementary Medicine

Ami Fazlin Syed Mohamed

Herbal Medicine Research Center, Institute for Medical Research, Jalan Pahang, 50588
Kuala Lumpur, Malaysia

Background and Rationale: IMEvidence is the acronym for evidence based integrated
medicine. This project advocates the application of the best available evidence gained from
the scientific method to clinical decision making. In the effort of integrating traditional &
complementary medicine (T&CM) with conventional medicine, it is important to evaluate the
evidence of the treatmentsû safety and efficacy. The issue is that the scattered and small sized
studies might erroneously render certain treatment inadequate due to the superficial evi-
dences. One solution is to evaluate such issues by assembling all published literatures/journals
on the relevant topics and to review the evidence in a systematic method.
Objectives: To appraise the outcome of systematic reviews that has been conducted for
IMEvidence.
Methods: The evaluation was based on whether the authors followed the systematic
review methods which includes the process of identifying, reviewing and extracting the cita-
tion indexed articles from several databases with specific methodologies based on the pre-
determined SICOM (study samples, type of intervention, comparison, outcomes and study
model) criteria. These would be followed by abstract and full text screening. For the titles with
clinical trials publications, a statistical assessment was applied to combine the results and
resolve any scoring differences to minimize bias.
Results: Eight different topics that ranged from specific herb or T&CM therapies used
as treatment for specific diseases were chosen. Based on the highest level of the available
evidence pertaining to a topic, the types review in IMEvidence were narrative or systematic
reviews. There are many levels of scientific evidence including the preclinical and clinical
stages and based on the eight titles, there were two systematic reviews with one meta-
analysis conducted. The six narrative reviews are based on mixtures of articles that ranged
from in vitro and in vivo studies to observational study designs.
Conclusion: A proper systematic review highlight that there is scientific evidence for
herbal & T&CM treatments in specific diseases where some studies have progressed into
clinical trials that enabled meta-analysis to be conducted. The narrative reviews indicate that
the treatment can be evaluated further. All these will assist the progress of integrated medi-
cine.
Key words: Evidence-based medicine, IMEvidence, traditional & complementary, inte-
grated