Intended for healthcare professionals

Clinical Review ABC of complementary medicine

What is complementary medicine?

BMJ 1999; 319 doi: (Published 11 September 1999) Cite this as: BMJ 1999;319:693

Research issues in traditional Chinese medicine

The publication of a series of clinical reports on complementary
medicine, including traditional Chinese medicine (TCM), in many issues in
the BMJ last year indicated that there is an emerging/re-
emerging interest in the value of TCM in health. Further advancement of
this interest must be backed up by findings of research with
methodological rigour.

To this end, there are three issues for immediate action: the broadening
of research perspectives and foci for examining the value of TCM and the
building of a research infrastructure for TCM.
There are at least five perspectives. Only two, however, have been
commonly used: the clinical efficacy perspective which aims to scrutinize
the effectiveness of TCM in treating diseases and the pharmacological or
basic science perspective which aims to identify the active ingredients of
medicinal herbs and their uses and effects on treating diseases.

While it is important to continue to use these two perspectives, other
perspectives must also be more extensively adopted. These are the
epidemiological, behavioural and policy perspectives.
For example, the epidemiological perspective can identify user
characteristics, patterns, extent and predictors of use as well as the
long-term effects of TCM on users and non-users. The behavioural
perspective can look at why and how people use TCM through an examination
of the individuals' health care seeking behaviour and the responses of the
mainstream health care system within the cultural, psycho-social and socio
-structural frameworks. The policy perspective can search for the reasons
and options of how the health care system of a country is organised
through an examination of the power relations of the different
professional and vested-interest groups in the system, the cost-utilities
and effectiveness, and the need for health resource redistribution in
different modalities.

Moreover, the focus of these perspectives, particularly the clinical
efficacy and pharmacological or basic science perspectives, needs to be
broadened to include assessing the value of TCM in restoring health,
preventing illness and promoting health.

To enable research activities to be undertaken, an infrastructure
conducive to undertaking these activities must first be built. Knowledge
of and skills in research and other related disciplines such as
psychology, sociology, health economics and policy analysis are obviously
key components of this infrastructure. There are other key components and
these include relevant literature and data base, funding availability,
interest from mainstream researchers and review mechanisms such as ethics
committees and peer-review mechanisms.

Dr K C Tang

Senior Lecturer, Department of Public Health and Community Medicine
The University of Sydney

1. Vickers, A. and Zollman C. ABC of Complementary Medicine: What
is complementary medicine. BMJ 1999; 7211:693-696 (11 Sept).

2. Vickers, A. and Zollman C. ABC of Complementary Medicine:
Acupuncture. BMJ 1999; 7215:973-976 (9 Oct).

3. Vickers, A. and Zollman C. ABC of Complementary Medicine: Herbal
medicine. BMJ 1999; 7216:1050-1053 (16 Oct).

4. Vickers, A. and Zollman C. ABC of Complementary Medicine:
Unconventional approaches to nutritional medicine. BMJ 1999; 7222: 1419-
1422 (27 Nov).

5. Zollman C. and Vickers, A. ABC of Complementary Medicine:
Complementary medicine and the patients. BMJ 1999; 7223: 1486-1489 (4

Competing interests: No competing interests

17 January 2000
K C Tang