順勢療法討論區 Homeopathy Discuss!

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Speaker ~ Dr KLAUS von AMMON

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admin 發表於 2015-6-5 17:08:36 | 顯示全部樓層 |閱讀模式
DAY 1 – 5 June 2015 ( 930-1030 )
Homeopathy research – the state of play and the way forward
順勢療法的研究 -戲劇的局勢和前進的方向
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Dr Klaus von Ammon ,
Switzerland. Contribution ofclinical observations to the discovery of mode of action of homeopathicmedicines
瑞士。臨床觀察對發現順勢療法藥物作用方式的貢獻

  
Background
  
背景
  
Senior officer in research, teaching & clinical  service, Institute of Complementary Medicine KIKOM, University of Bern
  
  
伯爾尼大學輔助醫學KIKOM學院,科研、教學和臨床服務的高級主管
  
  
Klaus von Ammon completed his medical studies in  Hamburg, Marburg/Lahn, and Munich and is trained in neurosurgery. His main  research topics in homeopathy are in epidemiology (Swiss-PEK and CAMbrella)  and children with ADHD.
  
  
Klaus von Ammon分別在漢堡、馬爾堡/蘭、和慕尼黑完成他的醫學課程,並曾受神經外科的訓練。他的主要研究課題是順勢療法的流行病學(瑞士-PEK和CAMbrella),和患有過度活躍症及專注力不足的兒童
  
Research area
  
研究範圍
Fischer F, Lewith G, Witt CM, Linde K, von Ammon K,  Cardini F, Falkenberg T, Fønnebø V, Johannessen H, Reiter B, Uehleke B,  Weidenhammer W, Brinkhaus B.  [A  research roadmap for complementary and alternative medicine - what we need to  know by 2020]. Forsch Komplementmed. 2014;21(2):e1-16. doi:  10.1159/000360744. Epub 2014 Mar 24.
  
2020年我們需要知道的 --- 輔助和另類醫療的科研藍圖
  
  
BACKGROUND:
  
背景:
  
  
The CAMbrella coordination action was funded within  the Framework Programme 7. Its aim is to provide a research roadmap for  clinical and epidemiological research for complementary and alternative  medicine (CAM) that is appropriate for the health needs of European citizens  and acceptable to their national research institutes and healthcare providers  in both public and private sectors. One major issue in the European research  agenda is the demographic change and its impact on health care. Our vision  for 2020 is that there is an evidence base that enables European citizens to  make informed decisions about CAM, both positive and negative. This roadmap  proposes a strategic research agenda for the field of CAM designed to address  future European health care challenges. This roadmap is based on the results  of CAMbrella’s several work packages, literature reviews and expert  discussions including a consensus meeting.
  
CAMbrella的協調行動由基礎計劃項目7所資助,其目的是為輔助和另類醫療(CAM)的臨床和流行病學研究提供一個研究藍圖,以配合於歐洲公民的健康需求,並能夠於公共及私營部門同時被他們的國家研究機構及醫療服務提供者所接受。歐洲研究議程的一個主要問題是人口結構變化及其對衛生保健的影響。我們的願景是在2020年,擁有一個證據資料庫,使歐洲公民能夠對輔助和另類醫療做出明智的決定,包括正面和負面的決定。這個研究藍圖為輔助和另類醫療提供了一個策略性研究議程,以應對未來歐洲醫療保健領域的挑戰。這個研究藍圖是基於CAMbrella中多個工作組的結果、文學評論、和專家們已達成共識的結論。
  
  
METHODS:
  
方法:
  
  
We first conducted a systematic literature review on  key issues in clinical and epidemiological research in CAM to identify the  general concepts, methods and the strengths and weaknesses of current CAM  research. These findings were discussed in a workshop (Castellaro, Italy,  September 7–9th 2011) with international CAM experts and strategic and  methodological recommendations were defined in order to improve the rigor and  relevance of CAM research. These recommendations provide the basis for the  research roadmap, which was subsequently discussed in a consensus conference  (Järna, Sweden, May 9–11th 2012) with all CAMbrella members and the CAMbrella  advisory board. The roadmap was revised after this discussion in CAMbrella  Work Package (WP) 7 and finally approved by CAMbrella’s scientific steering  committee on September 26th 2012.
  
我們首先在輔助和另類醫療(CAM)臨床和流行病學研究的關鍵問題上進行系統性的文獻審查,以確定目前CAM研究的基本概念、方法、長處和短處。這些研究會於工作坊(2011年9 月7-9日於意大利卡斯泰拉羅)內,由國際CAM專家作討論,然後制定出策略性和型式上的建議,以提高CAM研究的嚴謹性和相關性。這些建議,隨後會被放到由CAMbrella成員和CAMbrella顧問委員會組成的共識會議(2012年9至11月於瑞典耶納)上作為研究藍圖的討論基礎。該藍圖會於CAMbrella工作組7中被討論然後進行了修改,最後CAMbrella的科學指導委員會於2012年9月26日作審批。
  
  
RESULTS:
  
結果:
  
  
Our main findings show that CAM is very heterogenous  in terms of definitions and legal regulations between the European countries.  In addition, citizens’ needs and attitudes towards CAM as well as the use and  provision of CAM differ significantly between countries. In terms of research  methodology, there was consensus that CAM researchers should make use of all  the commonly accepted scientific research methods and employ those with  utmost diligence combined in a mixed methods framework.
  
我們主要的研究結果表明,在歐洲國家之間的法律法規條款上,輔助和另類醫療(CAM)是非常參差的。此外,公民對於CAM的需求和態度,以及CAM的使用與提供,不同國家之間均有顯著不同。在研究方法上,結果一致認為CAM研究人員應該利用一切普遍被接受的科學研究方法,以混合的方法為基礎,盡一切努力去進行研究。
  
  
CONCLUSIONS:
  
結論:
  
  
We propose 6 core areas of research that should be  investigated to achieve a robust knowledge base and to allow stakeholders to  make informed decisions. These are:
  
為了實現一個強大的知識基礎,並讓利益相關者做出明智的決定,我們提出應該在6個核心研究領域上進行調查,包括:
  
  
1.       Research into the prevalence of CAM in Europe: Reviews show that  we do not know enough about the circumstances in which CAM is used by  Europeans. To enable a common European strategic approach, a clear picture of  current use is of the utmost importance.
  
CAM在歐洲流行程度的研究:評論表明,對於歐洲人運用CAM的情況,我們並未有足夠的了解。要啟用一個歐洲共同的策略方案,清晰了解目前的使用情況是極為重要的。
  
  
2.       Research into differences regarding citizens’ attitudes and needs  towards CAM: Citizens are the driver for CAM utilization. Their needs and  views on CAM are a key priority, and their interests must be investigated and  addressed in future CAM research.
  
有關公民對CAM之不同態度和需求的研究:CAM的使用率靠公民推動。他們對CAM的需求和意見,是一個關鍵的優先事項,他們的意願必須要在以後的CAM研究中被調查及發表。
  
  
3.       Research into safety of CAM: Safety is a key issue for European  citizens. CAM is considered safe, but reliable data is scarce although  urgently needed in order to assess the risk and cost-benefit ratio of CAM.
  
CAM安全性的研究:安全性是歐洲公民的一個關鍵問題。  CAM被認為是安全的,儘管有著迫切需要去評估CAM的風險和成本效益,可靠的數據仍然是稀缺的。
  
  
4.       Research into the comparative effectiveness of CAM: Everybody  needs to know in what situation CAM is a reasonable choice. Therefore, we  recommend a clear emphasis on concurrent evaluation of the overall  effectiveness of CAM as an additional or alternative treatment strategy in  real-world settings.
  
比較CAM效益的研究:每個人都需要知道CAM在什麼情況下是一個合理的選擇。因此,在現實環境中,我們建議應該明確強調當CAM被用作附加的治療、或非主流的治療策略時,要同時進行對CAM整體有效性的評估。
  
  
5.       Research into effects of context and meaning: The impact of  effects of context and meaning on the outcome of CAM treatments must be  investigated; it is likely that they are significant.
  
對醫療全局的作用和意義的研究:必須加以探討CAM醫療的成果對醫療全局的作用和意義上有著什麼影響,它們很可能具有重大意義。
  
  
6.       Research into different models of CAM health care integration:  There are different models of CAM being integrated into conventional medicine  throughout Europe, each with their respective strengths and limitations.  These models should be described and concurrently evaluated; innovative  models of CAM provision in health care systems should be one focus for CAM  research.
  
CAM保健中,將不同類型作一體化的研究:在歐洲各地,傳統醫學以不同型式把CAM加到主流醫學之中,每一種都有各自的優勢和局限性。各種類型都必須要被仔細描述和同時被評價;CAM在醫療保健系​​統中所提供的的創新模式,應該是CAM研究的重點。
  
  
We also  propose a methodological framework for CAM research. We consider that a  framework of mixed methodological approaches is likely to yield the most  useful information. In this model, all available research strategies  including comparative effectiveness research utilising quantitative and  qualitative methods should be considered to enable us to secure the greatest  density of knowledge possible.
  
我們還提出了CAM研究的基礎方法。我們認為,以混合方式方法作為基礎,或可能產生出最有用的信息。在這個模式中,所有可用的研究策略,包括利用定量和定性方法比較效益研究,都應該被考慮,以保障我們能夠獲得最多相關知識的可能性。
  
  
Stakeholders,  such as citizens, patients and providers, should be involved in every stage  of developing the specific and relevant research questions, study design and  the assurance of real-world relevance for the research. Furthermore,  structural and sufficient financial support for research into CAM is needed  to strengthen CAM research capacity if we wish to understand why it remains  so popular within the EU.
  
利益相關者,例如公民、病人和提供者,應參與制定具體相關研究課題、研究設計的每一個階段,以保證研究與現實世界的關聯性。此外,如果我們希望了解,為什麼CAM在歐盟範圍內如此受歡迎,它的研究必須有結構及有充足的資金作支持,以加強研究的能力。
  
  
In order to consider employing CAM as part of the  solution to the health care, health creation and self-care challenges we face  by 2020, it is vital to obtain a robust picture of CAM use and reliable  information about its cost, safety and effectiveness in real-world settings.  We need to consider the availability, accessibility and affordability of CAM.  We need to engage in research excellence and utilise comparative  effectiveness approaches and mixed methods to obtain this data. Our recommendations  are both strategic and methodological. They are presented for the  consideration of researchers and funders while being designed to answer the  important and implicit questions posed by EU citizens currently using CAM in  apparently increasing numbers.
  
為了考慮採用CAM作為現今醫療問題的其中一個解決方法,協助我們面對2020年於醫療保健、創造健康和自我保健的挑戰,最重要的是要獲得使用CAM的整體圖像,以及它在真實環境中的成本、安全性和有效性的各方面可靠資料。我們需要考慮CAM的可用性、可及性和可負擔性。我們需要確保研究擁有卓越的質素,以及能夠利用比較效益方法和混合方法來獲取這些數據。我們的建議同時具有策略性和方法性。它們考慮到研究人員和資助者,正在使用CAM的歐盟公民人數顯然正在增加,它們的設計是為了回應歐盟公民有關CAM的重要及潛在問題。
  
  
We propose that the EU actively supports an EU-wide  strategic approach that facilitates the development of CAM research. This  could be achieved in the first instance through funding a European CAM  coordinating research office dedicated to foster systematic communication  between EU governments, public, charitable and industry funders as well as  researchers, citizens and other stakeholders.
  
我們建議,歐盟積極支持整個歐盟範圍內的策略方針,協助CAM的科研發展。第一步,是通過資助歐洲CAM協調研究辦公室,致力於推動歐盟各國政府、公眾、慈善和產業資助者以及研究人員、公民和其他利益相關者之間的系統通信。
  
  
The aim of this office would be to coordinate  research strategy developments and research funding opportunities, as well as  to document and disseminate international research activities in this field.  With the aim to develop sustainability as second step, a European Centre for  CAM should be established that takes over the monitoring and further  development of a coordinated research strategy for CAM, as well as it should  have funds that can be awarded to foster high quality and robust independent  research with a focus on citizens health needs and pan-European  collaboration.歐洲CAM協調研究辦公室的目的是協調研究策略發展、和籌募科研經費的機會,記錄和發佈在該領域的國際研究活動。而第二步,是開發可持續性,其目的在於應建立歐洲CAM醫療中心,接管CAM協調性研究策略的監測和進一步發展,它應該以公民的健康需求和泛歐洲合作為重點,被授予研發基金,以培育高品質和強大的自主研發。
  
  
We wish to establish a solid funding for CAM  research to adequately inform health care and health creation decision-making  throughout the EU. This centre would ensure that our vision of a common,  strategic and scientifically rigorous approach to CAM research becomes our  legacy and Europe’s reality. We are confident that our recommendations will  serve these essential goals for EU citizens.
  
我們希望為CAM研究建立一個雄厚的資金,為整個歐盟的醫療保健和創建醫療的決策提供充分報告。該中心將確保我們的願景,是一個共同的、策略性的、及擁有科學嚴謹的態度的CAM研究,讓此在歐洲實現,並成為我們的傳統。我們相信,我們的建議將為歐盟公民達成這些基本目標。
  


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