Background
Methods
Critical appraisal analysis
Risk of bias assessment
Results
Quality assessment | Methodology | Participant characteristics | CM definition | Score | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Representative sampling method | Sample size >500 | Response rate >75 % | Low recall bias | Age | Gender | Residence location | Socioeconomic status | Health status | |||
Adams et al., 2003 [27] | X | X | X | X | X | X | X | X | X | 9 | |
Adams et al., 2005 [75] | X | X | X | X | X | X | X | X | 8 | ||
Adams et al., 2007 [47] | X | X | X | X | X | X | X | X | X | 9 | |
Adams et al., 2011 [49] | X | X | X | X | X | X | X | X | 8 | ||
Adams et al., 2012 [55] | X | X | X | X | X | X | 6 | ||||
Adams et al., 2013 [73] | X | X | X | X | X | X | X | X | 8 | ||
Alderman & Kiepfer, 2003 [86] | X | X | X | X | 4 | ||||||
Basedow et al., 2014 [46] | X | X | X | X | X | X | X | 7 | |||
Braun & Cohen, 2011 [59] | X | X | X | X | 4 | ||||||
Broom et al., 2012a [68] | X | X | X | X | X | X | 6 | ||||
Broom et al., 2012b [77] | X | X | X | X | X | X | 6 | ||||
Brownie, 2006 [71] | X | X | X | X | X | X | X | X | 8 | ||
Buchbinder et al., 2002 [72] | X | X | X | X | X | X | 6 | ||||
Canaway & Manderson, 2013 [28] | X | X | X | X | X | X | X | X | X | 9 | |
Chatfield et al., 2009 [80] | X | X | X | X | X | X | X | X | 8 | ||
Correa-Velez et al., 2003 [65] | X | X | X | X | X | X | X | 7 | |||
Correa-Velez et al., 2005 [66] | X | X | X | X | X | 5 | |||||
D’Onise et al., 2013 [31] | X | X | X | X | X | X | X | X | 8 | ||
Day, 2002 [82] | X | X | X | X | 4 | ||||||
Day et al., 2004 [39] | X | X | X | X | 4 | ||||||
De Visser et al., 2000 [56] | X | X | X | X | X | 5 | |||||
Dunning, 2003 [38] | X | X | X | X | 4 | ||||||
Edwards et al., 2014 [35] | X | X | X | X | X | 5 | |||||
Feldman & Laura, 2004 [44] | X | X | X | 3 | |||||||
Field et al., 2008 [57] | X | X | X | X | X | X | X | 7 | |||
Fong & Fong, 2002 [43] | X | X | X | 3 | |||||||
Forster et al., 2006 [70] | X | X | X | X | X | X | X | X | 8 | ||
Frawley et al., 2013 [29] | X | X | X | X | X | X | X | X | X | 9 | |
George et al., 2004 [60] | X | X | X | X | 4 | ||||||
Gollschewski et al., 2004 [87] | X | X | X | X | X | X | X | X | 8 | ||
Heath et al., 2012 [69] | X | X | X | X | 5 | ||||||
Hunter et al., 2014 [37] | X | X | X | X | X | X | 6 | ||||
Klafke et al., 2012 [36] | X | X | X | X | X | X | X | 7 | |||
Kremser et al., 2008 [53] | X | X | X | X | X | 5 | |||||
Leong et al., 2009 [84] | X | X | X | X | X | 5 | |||||
Lim et al., 2005 [42] | X | X | X | X | X | X | 6 | ||||
MacLennan et al., 2006 [34] | X | X | X | X | X | X | X | 7 | |||
Magin et al., 2006 [63] | X | X | X | X | 4 | ||||||
Mak & Faux, 2010 [52] | X | X | X | X | X | X | 6 | ||||
Markovic et al., 2006 [51] | X | X | X | X | 4 | ||||||
Murthy et al., 2014a [74] | X | X | X | X | X | X | X | X | X | 9 | |
Murthy et al., 2014b [95] | X | X | X | X | X | X | X | X | X | 9 | |
O’Callaghan& Jordan, 2003 [96] | X | X | X | X | 4 | ||||||
Patching van der Sluijs, et al., 2007 [50] | X | X | X | X | X | 5 | |||||
Rayner et al., 2009 [54] | X | X | X | 3 | |||||||
Sarris et al., 2010 [76] | X | X | X | X | X | 5 | |||||
Shenfield et al., 2002 [58] | X | X | 2 | ||||||||
Shorofi & Arbon, 2010 [45] | X | X | X | X | X | 5 | |||||
Sibbritt et al., 2006 [79] | X | X | X | X | X | X | X | X | X | 9 | |
Sibbritt et al., 2013 [62] | X | X | X | X | X | X | X | X | 8 | ||
Sinha & Efron, 2005 [40] | X | X | X | X | 4 | ||||||
Skouteris et al., 2008 [97] | X | X | X | X | X | 5 | |||||
Smith & Eckert, 2006 [67] | X | X | X | X | X | X | X | 7 | |||
Smith et al., 2013 [85] | X | X | X | X | X | X | 6 | ||||
Spinks et al., 2014 [83] | X | X | X | X | X | X | X | X | 8 | ||
Stankiewicz et al., 2007 [48] | X | X | X | X | 4 | ||||||
Steel et al., 2012 [64] | X | X | X | X | X | X | X | X | 8 | ||
Steel et al., 2014a [98] | X | X | X | X | X | X | X | X | X | 9 | |
Steel et al., 2014b [99] | X | X | X | X | X | X | X | X | X | 9 | |
Trutnovsky et al., 2001 [78] | X | X | X | X | 4 | ||||||
Wadhera et al., 2011 [41] | X | X | X | X | X | X | 6 | ||||
Wilkinson & Simpson, 2001 [32] | X | X | X | X | X | X | X | 7 | |||
Wilkinson & Jelinek, 2009 [33] | X | X | X | X | X | X | 5 | ||||
Xue et al., 2007 [30] | X | X | X | X | X | X | X | X | 8 |
Author | Method | Target population | Sample (n) | Appraisal score | Results | Themes | |||
---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | ||||||
Adams et al., 2003 [27] | Longitudinal study | Women | 41,817 | 9 | Higher CM use by non-urban women. CM use in older women used CM in conjunction with medication for chronic disease. >97 % consulted with a CM practitioner. | X | X | ||
Adams et al., 2005 [75] | Longitudinal study | Middle age women | 11,202 | 8 | 15.7 % cancer patients consulted with a naturopath/herbalist. CM users consulted with both CM & conventional practitioners. CM users were more likely rural residents & have school education only (49 %). | X | X | X | |
Adams et al., 2007 [47] | Longitudinal survey | Middle aged women | 11,202 | 9 | 8.7 % women consulted with a naturopath, 1.4 % consulted with an herbalist. CM users more likely in non-urban areas (63 %) compared to 37 % in urban areas. Women who used naturopath also used conventional practitioners more frequently. | X | X | ||
Adams et al., 2011 [49] | Longitudinal study | Middle aged women | 10,638 | 8 | Women who consulted with a CM practitioner experienced more symptoms. Women with diploma or university education use CM more than non-CM users & more likely to reside in urban areas. No difference in consultation numbers between CM users & non-CM users for chiropractic, osteopathy, acupuncture & naturopathy. | X | X | ||
Adams et al., 2012 [55] | Longitudinal study | Self-reported depression | 7,164 | 6 | 62 % of women used both conventional practitioners & CM (chiropractor 18 %, osteopathy 7 %, massage therapy 44 %, acupuncture 9 %, & naturopath 22 %). | X | X | ||
Adams et al., 2013 [73] | Longitudinal study | Middle aged women | 1,800 | 8 | 63.9 % consulted with a massage therapist, 43 % a chiropractor, & 22.9 % naturopath. Women in rural & outer regional areas used chiropractors more than women in cities who used osteopathy or yoga. | X | X | ||
Alderman & Kiepfer, 2003 [86] | Structured interviews | Psychiatry patients | 52 | 4 | 51.9 % used CM in preceding 6 months. High use of nutritional supplements (66.7 %), 18.5 % visited a chiropractor. Drivers for use CM surrounded its usefulness with conventional treatment, natural healing & believed in CM philosophy. | X | X | X | |
Basedow et al., 2014 [46] | Cross sectional survey | Osteoarthritis patients | 435 | 7 | Females were more likely to use CM & > 70 years with a school education. 69 % reported CM use for disease management. 67 % CM users stated CM to be safe & 33 % felt it was effective in pain management. | X | X | X | |
Braun & Cohen, 2011 [59] | Cross sectional survey | Cardiac patients | 161 | 4 | No significant difference in age, gender, income or education between CM users & non-CM users. 51 % reported CM use. 71 % used CM to improve health, 30 % disease management, 20 % disease prevention. | X | X | ||
Broom et al., 2012a [68] | Longitudinal study | Middle aged women | 9,820 | 6 | 33 % consulted with a chiropractor & 40 % massage therapist. 63 % used CM & conventional practitioners. 2 % consulted with a CM practitioner only. | X | |||
Broom et al., 2012b [77] | Longitudinal survey | Middle aged women | 10,492 | 6 | 42.4 % of women consulted with a CM practitioner. Women with back pain were more likely to use conventional therapy & CM (44.2 %). Women who consulted with a CM practitioner had better health compared to non-CM users. | X | |||
Brownie, 2006 [71] | Cross sectional survey | Elderly individuals | 1,263 | 8 | CM supplement use for arthritis, osteoporosis, hypertension & cardiovascular disease management. Females were more likely to report supplement use. | X | X | ||
Buchbinder et al., 2002 [72] | Cross sectional survey | Rheumatoid arthritis patients | 101 | 6 | CM users more likely female & > 60 years. 73.3 % used CM, with 31.7 % consulting with a CM practitioner. 25.7 % used CM & conventional therapy for disease management. | X | X | ||
Canaway & Manderson, 2013 [28] | Mixed methods | Diabetic patients with cardiovascular disease | 2,766 | 9 | CM users more likely to be > 50 years. 54.5 % reported consulting a CM practitioner & 45.1 % used CM regularly. 42.7 % believed in CM, 39.4 % believed CM was safe, 31.3 % used CM to control their health & 27.8 % preferred CM to other therapies. | X | X | X | X |
Chatfield et al., 2009 [80] | Cross sectional survey | Ankylosing spondylitis patients | 75 | 8 | 94.7 % CM users more likely female & have university education. 36 % CM users visited a massage therapist (81.5 %), acupuncture (6.7 %), naturopath (6.7 %) & homeopath (5.3 %). | X | X | X | |
Correa-Velez et al., 2003 [65] | Interviews (design not-specified) | Oncology patients | 111 | 7 | 32 % were CM users with 56 % male & 44 % female, both with higher income. Most consulted practitioners were: reiki practitioner (33 %), a naturopath (27 %), or an integrative practitioner (27 %). 42 % used CM while participating in the study & 64 % CM use over last year. | X | X | X | |
Correa-Velez et al., 2005 [66] | Interviews (semi-structured) | Oncology patients | 39 | 5 | 82 % of participants were regular CM users. Naturopathy (26 %), massage therapy (21 %) & integrative doctors (15 %) were the most common services used. CM used to survive cancer (67 %) & reduce cancer symptoms (33 %). | X | X | X | |
D’Onise et al., 2013 [31] | Cross sectional survey | General population | 1,146 | 8 | CM users were more likely to have a Bachelor degree, high gross household income, & full time employment. 32 % used CM products, 27 % used CM services. Individuals with chronic disease used CM products more than CM services 32.5 % vs 26.3 %. Services used were chiropractor (24.2 %), alternative therapy (5.4 %), & massage therapy (0.3 %). | X | X | X | |
Day, 2002 [82] | Cross sectional survey | Paediatric patients | 92 | 4 | No difference in age for CM users to non-CM users. 35.9 % used CM & 98.6 % were prepared to use CM. | X | X | X | |
Day et al., 2004. [39] | Cross sectional survey | Children with Inflammatory bowel disease | 46 | 4 | Mean age of CM users was 11 years with 72 % being CM users. CM drivers related to dissatisfaction with standard care & advice from others. Homeopathy, chiropractic & massage consultations were used by <4 participants. | X | X | X | X |
De Visser et al., 2000 [56] | Cross sectional survey | HIV/AIDS patients | 894 | 5 | 56 % used CM. 45 % use both CM & conventional therapy. Women were more likely to only use CM. No other gender differences in CM use. Majority of CM users used nutritional & herbal supplements & massage therapy. | X | X | X | X |
Dunning, 2003 [38] | Focus groups | Diabetic patients & practitioners | 10 | 4 | 80 % were CM users. CM used for non-diabetic reasons. All participants used CM & conventional care for diabetes. Naturopathy & massage services were more likely used. | X | X | ||
Edwards et al., 2014 [35] | Cross sectional survey | Oncology patients | 639 | 5 | Females had higher CM use (88.6 %). 82.9 % used CM during their cancer treatment with 56.3 % using manual therapies. CM users reported CM improved quality of life (42.6 %), supported health (33.6 %), managed cancer symptoms (26.2 %) & believe CM gave them hope. | X | X | X | X |
Feldman & Laura, 2004 [44] | Cross sectional survey | University students | 518 | 3 | 81.1 % used CM in the past 2 years. 82.5 % CM users female. Common treatments were relaxation techniques (41.7 %), massage therapy 38.2 %, herbal medicine (37.3 %), & art therapy (32.2 %). Drivers for CM were better results (34.5 %), lifestyle factors (33.1 %) & felt CM had fewer side effects (32.1 %). | X | X | X | |
Field et al., 2008 [57] | Cross sectional survey | Women with high breast cancer risk | 892 | 7 | 55 % reported CM use. 13.7 % used acupuncture, 28.2 % massage therapy, 12.3 % naturopathy & 7 % osteopathy. CM use was noted more in tertiary education & >50 year old individuals who resided in a major city. | X | X | ||
Fong & Fong, 2002 [43] | Cross sectional survey | Paediatric inpatients | 120 | 3 | 33 % used CM. Massage therapies used by 17 %, 46 % naturopath, 29 % chiropractor & 10 % herbalist. | X | X | ||
Forster et al., 2006 [70] | Cross sectional survey | Pregnant women | 588 | 8 | 36 % used herbal medicine during pregnancy. No identification of CM services used. | X | |||
Frawley et al., 2013 [29] | Longitudinal survey | Pregnant women | 1,835 | 9 | CM users were more likely to have a university degree, full time employment & higher income compared to non-CM users. 48.1% of women consulted with CM practitioners & 52 % used a CM product during pregnancy. Massage therapy was the most used 34.1 %, followed by chiropractic 16.3 %, acupuncture 0.6 %, naturopathy 7.2 %, osteopathy 6.1 % & doula services 1.4 %. | X | X | X | |
George et al., 2004 [60] | Cross sectional survey | Chronic obstructive pulmonary disease patients | 173 | 4 | 41 % were CM users, mean age of 70 years. 55 % of CM users were male. CM used to promote health, reduce side effects & reduce disease progression. | X | X | X | |
Gollschewski et al., 2004 [87] | Cross sectional survey | Menopausal women | 886 | 8 | 82.5 % CM users. CM users were middle aged (<55 years) & married. 66.8 % of women used nutritional supplements for menopausal management. | X | |||
Heath et al., 2012 [81] | Cross sectional survey | Palliative care in children with cancer | 96 | 5 | No significant difference in CM usage in terms of age, family income or education. 30 % used CM at end of life stage. 44 % reported using more than 1 CM therapy. | X | X | ||
Hunter et al., 2014 [37] | Cross sectional survey | Radiotherapy patients | 152 | 6 | 45.4 % CM users. Higher CM use in females & Caucasians. Young individuals more likely to use CM. CM users more likely to have secondary education & lower income. 2.9 % used acupuncture, 17.39 % chiropractor, 26.09 % massage therapy, 2.9 % osteopathy, 5.8 % naturopathy, 2.9 % Chinese Medicine & 1.45 % homeopathy. CM use was more likely in individuals diagnosed with breast, rectum, kidney, endometrium & skin cancers. | X | X | X | |
Klafke et al., 2012 [36] | Cross sectional survey | Male cancer patients | 403 | 7 | No difference in sociodemographic factors between CM users & non-CM users. 61.5 % used CM while undergoing cancer treatment. | X | X | ||
Kremser et al., 2008 [53] | Cross sectional survey | Breast cancer patients | 367 | 5 | 87.5 % used CM with 65.7 % CM users resided in NSW. CM use related to improving physical health (86.3 %), improving emotional health (86.3 %), supporting immune system (68.8 %), reducing side effects (49.2 %) and reducing the return of breast cancer (39.9 %). 41.4 % used massage therapy, 13.7 % acupuncture and 4.4 % naturopathy. | X | X | X | |
Leong et al., 2009 [84] | Cross sectional survey | Multiple sclerosis (MS) patients | 428 | 5 | 66.3 % female & 60.3 % male participants used CM. Higher use in rural areas (70.4 %). 72.1 % used CM & conventional therapy for disease management. | X | X | ||
Lim et al., 2005 [42] | Cross sectional survey | Children | 503 | 6 | 51 % of children reported CM use with no difference in gender. Most common CM practitioners included 7 % chiropractic, 7 % aromatherapy, 5 % naturopathy, 5 % dietary & 5 % massage. | X | X | ||
MacLennan et al., 2006 [34] | Longitudinal study | General population | 3,015 | 7 | CM users were more likely 35–44 years. 29.3 % of women used CM services compared to males (23.6 %). 52.2 % used CM over the last year. Common practices included chiropractic 16.7 % & naturopathy 5.7 %. CM consultation higher in rural areas (29.4 %). | X | X | ||
Magin et al., 2006 [63] | Interviews (semi-structured) | Individuals with skin complaints | 26 | 4 | Most CM users were female. CM users felt CM was more efficacious than conventional medicine. Consultations were commonly with naturopaths & herbalists. | X | X | X | |
Mak & Faux, t2010 [52] | Cross sectional survey | Osteoporotic patients | 202 | 6 | CM users were more likely female & 67 years old with post-secondary education. 51.5 % used CM for disease management. 19 % consulted with an acupuncturist, 12 % chiropractor/osteopathy, 6 % naturopathy & 2 % massage therapy. Drivers for CM used were holistic (53 %), reducing pain (29 %) & control over health (8.1 %). | X | X | X | X |
Markovic et al., 2006 [51] | Cross sectional survey | Women with gynaecological cancers | 53 | 4 | 17 % of women used CM. Most CM users were low income. Acupuncture was the only service used. | X | X | X | X |
Murthy et al., 2014a [74] | Longitudinal study | Older aged women | 1,310 | 9 | Women in rural areas were more likely to use massage therapist. 76.4 % had a CM consultation with 41.4 % consulting with a massage therapist, 37.3 % chiropractor, 13.3 % acupuncture & 8.8 % osteopathy. | X | X | ||
Murthy et al., 2014b [95] | Longitudinal study | Older aged women | 1,310 | 9 | Sociodemographics were not associated with CM use. 75.2 % used self-prescribed CM products. Women were more likely to use CM treatments & a conventional practitioner. | X | X | ||
O’Callaghan & Jordan, 2003 [96] | Cross sectional survey | University students | 171 | 4 | CM used more likely female (77 %) & mean age of 29 years. 36.3 % CM users. 72 % consulted with a naturopath, 33 % aromatherapy & 31 % acupuncture. | X | X | X | |
Patching van der Sluijs et al., 2007 [50] | Cross sectional survey | Menopausal women | 1,296 | 5 | 53.8 % used CM services or products. 20.3 % consulted with a CM practitioner (7.2 % naturopath & 4.8 % acupuncture, were the most common). | X | X | ||
Rayner et al., 2009 [54] | Focus groups | Fertility clinic patients & practitioners | 15 | 3 | CM used for infertility due to a negative experience from assisted reproductive technologies or participants having a positive experience with CM. | X | X | ||
Sarris et al., 2010 [76] | Cross sectional survey | Middle & older aged women | 511 | 5 | 48 % consulted with a CM practitioner. Higher use of CM in 40–64 year olds (56.2 %). Older women consulted with a massage therapist or naturopath. Women who consulted with a practitioner had more health conditions. | X | X | ||
Shenfield et al., 2002 [58] | Structured interviews | Asthmatic children | 174 | 2 | 51.7 % used CM in past year. 62.1 % currently use CM. 71.2 % used CM for preventative reasons & 17.5 % to improve asthma symptoms. 32 % visited a homeopath & 32 % a naturopath. | X | X | X | |
Shorofi & Arbon, 2010 [45] | Cross sectional survey | Hospitalised patients | 353 | 5 | 90.4 % used CM, with women more likely to use CM. Services used were massage therapy (45 %), chiropractic (39.7 %), herbal medicine (38.2 %), & acupuncture (19.8 %). Rural CM users were more likely to use manual therapies compared to urban users who used biologically based therapies. | X | X | X | |
Sibbritt et al., 2006 [79] | Longitudinal study | Middle aged women | 11,143 | 9 | 16 % CM users consulted with a chiropractor &/or osteopathy were mid-aged. CM users were more likely rural residents & with school education only. Users were more likely to use CM with conventional medicine. | X | X | ||
Sibbritt et al., 2013 [62] | Longitudinal survey | Middle aged women | 10,287 | 8 | 8.6 % of women used Chinese medicine. Users were more likely to have school education, born in Australia & live in rural or remote areas. Users were also more likely to frequently visit a doctor & Chinese medicine practitioner. Users also used other CM professionals including massage therapy (54 %), naturopathy (50 %), chiropractor (19 %), osteopathy (8 %) & acupuncture (47 %). | X | X | ||
Sinha & Efron, 2005 [40] | Cross sectional survey | Children with attention deficit hyperactivity disorder | 75 | 4 | 67.6 % used CM for Attention deficit hyperactivity disorder. 58 % found CM helpful. CM use was associated with reducing side effects (67.4 %), hoping for a cure (66.7 %), reducing symptoms (88.9 %) & additional treatment to conventional therapy (69.7 %). 20 % visited a chiropractor. | X | X | X | |
Skouteris et al., 2008 [97] | Cross sectional survey | Pregnant women | 321 | 5 | Sociodemographics were not different between CM users & non-CM users although CM users reported poorer health. 73.2 % reported CM use of which 29 % used CM for pregnancy related symptoms. 49.5 % consulted with a massage therapist & 5.9 % a naturopath | X | X | X | |
Smith & Eckert, 2006 [67] | Cross sectional survey | General population | 2,985 | 7 | 18.4 % of children used CM. Most common consultations were chiropractic 34 %, massage therapy 21 %, & homeopathy 10.7 %. CM was used for preventing illness (39 %). | X | X | ||
Smith et al., 2013 [85] | Cross sectional survey | Female family planning patients | 221 | 6 | Younger women had less CM use compared to older women. 83 % of women report CM use, 33 % had consultations with a CM practitioner including chiropractic 12.4 %, acupuncture 11 % & 9.5 % naturopathy. CM users (49 %) viewed CM as having more natural benefit, (44 %) better alternative to conventional treatment, (38 %) as effective treatment & (36 %) gives individual control. | X | X | X | X |
Spinks et al., 2014 [83] | Cross sectional survey | Diabetic patients with cardiovascular disease | 2,915 | 8 | Females were more likely to use CM & have a higher education & higher income. Chronic disease was associated with increased CM use. Women consulted with acupuncturists, naturopaths, nutritionists, chiropractors, & massage therapists. | X | X | X | |
Stankiewicz et al., 2007 [48] | Cross sectional survey | Infertility clinic patients | 97 | 4 | 66 % CM users, 26 % used CM with conventional medicine. 48 % used CM services, most commonly acupuncture (9 %), naturopathy (17 %) & chiropractic (14 %). | X | X | X | |
Steel et al., 2012 [64] | Longitudinal study | Pregnant women | 1,835 | 8 | 49.4 % consulted with a CM practitioner (massage therapy 34.1 %, 16.3 % chiropractor were more common). 22.2 % consulted with both a CM & conventional practitioners. | X | X | ||
Steel et al., 2014a [98] | Longitudinal survey | Pregnant women | 1,835 | 9 | Women in non-urbans areas were more likely to consult a chiropractor. Women felt CM promoted holistic health & reduced conventional side effects. 53 % of women who used non-pharmacological pain management used a CM practitioner or products (49 %). | X | X | X | X |
Steel et al., 2014b [99] | Longitudinal survey | Pregnant women | 2,445 | 9 | Chiropractor users were more likely located in non-urban areas & have permanent employment. 49.4 % consulted with a CM practitioner. 74.4 % used non-pharmacological pain management. 60.7 % used CM products or services. 80.7 % consulted with a practitioner. CM users believed CM had fewer side effects & was more natural & offered more control compared to conventional treatment. | X | X | X | X |
Trutnovsky et al., 2001 [78] | Cross sectional survey | Sexual health clinic patients | 63 | 4 | 59 % – 96 % CM use, depending on condition. CM users more likely to be female. | X | X | ||
Wadhera et al., 2011 [41] | Cross sectional survey | Children | 98 | 6 | No difference between CM users & non-CM users regarding age, gender & illness. 67 % used CM previously or currently. 70 % used CM for disease management. Drivers for use surrounded dissatisfaction with conventional treatment, belief in CM, reduce side effects & lack of suitable conventional treatment. | X | X | X | |
Wilkinson & Simpson, 2001 [32] | Cross sectional survey | Rural residents | 300 | 7 | Females were more likely to consult & use CM products. 62.7 % consulted with a CM practitioner. 70.3 % use some form of CM. 68.7 % used CM products. Chiropractors consulted 55.3 %. 56.2 % felt CM improved quality of life. | X | X | X | |
Wilkinson & Jelinek, 2009 [33] | Cross sectional survey | Rural residents | 102 | 5 | There was no difference in gender & CM services used. 78 % used CM therapies, 66 % consulted with a CM practitioner (15 % naturopathy, 17 % massage, 17 % chiropractic). Drivers with CM use were positive attitudes towards CM, holism, anti-science, individual responsibility & rejection to authority. | X | X | X | |
Xue et al., 2007 [30] | Cross sectional survey | General population | 1,067 | 8 | 71.2 % were CM users & identified as females, higher income earners & having a higher education. 16.4 % visited a clinical nutritionist, 73.7 % massage therapy, 29.1 % Western herbal medicine & 90.6 % chiropractor. | X | X |
Risk of bias assessment | External validity | Internal validity | Score | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Representativeness to national population | True representation of the target population | Random sampling methods | Likelihood of nonresponse bias minimal | Data directly collected from participants | Acceptable case definition | Validated study tool used | Consistent data collections methods | Appropriate prevalence period | Appropriate parameters of numerator & denominator | Summary of overall risk of study bias | ||
Adams et al., 2003 [27] | X | X | X | X | X | X | X | X | X | X | 10 | |
Adams et al., 2005 [75] | X | X | X | X | X | X | X | X | X | 9 | ||
Adams et al., 2007 [47] | X | X | X | X | X | X | X | X | X | 9 | ||
Adams et al., 2011 [49] | X | X | X | X | X | X | X | X | 8 | |||
Adams et al., 2012 [55] | X | X | X | X | X | X | X | X | X | X | 10 | |
Adams et al., 2013 [73] | X | X | X | X | X | X | X | X | X | 9 | ||
Alderman & Kiepfer, 2003 [86] | X | X | X | 3 | ||||||||
Basedow et al., 2014 [46] | X | X | X | X | X | 5 | ||||||
Braun & Cohen, 2011 [59] | X | X | X | X | X | 5 | ||||||
Broom et al., 2012a [68] | X | X | X | X | X | X | X | X | X | X | 10 | |
Broom et al., 2012b [77] | X | X | X | X | X | X | X | X | X | X | 10 | |
Brownie, 2006 [71] | X | X | X | X | X | 5 | ||||||
Buchbinder et al., 2002 [72] | X | X | X | X | X | X | X | 7 | ||||
Canaway & Manderson, 2013 [28] | X | X | X | X | X | X | X | 7 | ||||
Chatfield et al., 2009 [80] | X | X | X | X | X | 5 | ||||||
Correa-Velez et al., 2003 [65] | X | X | X | X | X | X | X | 7 | ||||
Correa-Velez et al., 2005 [66] | X | X | 2 | |||||||||
D’Onise et al., 2013 [31] | X | X | X | X | X | X | X | X | X | X | X | 11 |
Day, 2002 [82] | X | X | X | 3 | ||||||||
Day et al., 2004 [39] | X | 1 | ||||||||||
De Visser et al., 2000 [56] | X | X | X | 3 | ||||||||
Dunning, 2003 [38] | X | X | 2 | |||||||||
Edwards et al., 2014 [35] | X | X | X | X | X | X | 6 | |||||
Feldman & Laura, 2004 [44] | X | X | 2 | |||||||||
Field et al., 2008 [57] | X | X | X | X | 4 | |||||||
Fong & Fong, 2002 [43] | X | X | 2 | |||||||||
Forster et al., 2006 [70] | X | X | X | X | X | 5 | ||||||
Frawley et al., 2013 [29] | X | X | X | X | X | X | X | X | X | X | 10 | |
George et al., 2004 [60] | X | X | X | 3 | ||||||||
Gollschewski et al., 2004 [87] | X | X | X | X | X | 5 | ||||||
Heath et al., 2012 [69] | X | X | X | 3 | ||||||||
Hunter et al., 2014 [37] | X | X | X | X | X | 5 | ||||||
Klafke et al., 2012 [36] | X | X | X | X | X | 5 | ||||||
Kremser et al., 2008 [53] | X | X | X | 3 | ||||||||
Leong et al., 2009 [84] | X | X | X | X | 4 | |||||||
Lim et al., 2005 [42] | X | X | X | X | 4 | |||||||
MacLennan et al., 2006 [34] | X | X | X | X | X | X | X | X | X | 9 | ||
Magin et al., 2006 [63] | X | X | 2 | |||||||||
Mak & Faux, 2010 [52] | X | X | X | X | X | 5 | ||||||
Markovic et al., 2006 [51] | X | X | X | 3 | ||||||||
Murthy et al.,2014a [74] | X | X | X | X | X | X | X | X | X | 9 | ||
Murthy et al., 2014b [95] | X | X | X | X | X | X | X | X | X | 9 | ||
O’Callaghan & Jordan, 2003 [96] | X | X | 2 | |||||||||
Patching van der Sluijs, et al., 2007 [50] | X | X | X | X | X | 5 | ||||||
Rayner et al., 2009 [54] | X | X | 2 | |||||||||
Sarris et al., 2010 [76] | X | X | X | X | 4 | |||||||
Shenfield et al., 2002 [58] | X | X | 2 | |||||||||
Shorofi & Arbon, 2010 [45] | X | X | X | X | 4 | |||||||
Sibbritt et al., 2006 [79] | X | X | X | X | X | X | X | X | X | 9 | ||
Sibbritt et al., 2013 [62] | X | X | X | X | X | X | X | X | X | 9 | ||
Sinha & Efron, 2005 [40] | X | X | X | 3 | ||||||||
Skouteris et al., 2008 [97] | X | X | X | X | X | 5 | ||||||
Smith & Eckert, 2006 [67] | X | X | X | X | X | X | 6 | |||||
Smith et al., 2013 [85] | X | X | X | X | X | X | 6 | |||||
Spinks et al., 2014 [83] | X | X | X | X | X | X | X | X | X | 9 | ||
Stankiewicz et al., 2007 [48] | X | X | X | X | X | 5 | ||||||
Steel et al., 2012 [64] | X | X | X | X | X | X | X | X | X | 9 | ||
Steel et al., 2014a [98] | X | X | X | X | X | X | X | X | X | 9 | ||
Steel et al., 2014b [99] | X | X | X | X | X | X | X | X | X | 9 | ||
Trutnovsky et al., 2001 [78] | X | X | 2 | |||||||||
Wadhera et al., 2011 [41] | X | X | X | X | X | 5 | ||||||
Wilkinson & Simpson, 2001 [32] | X | X | X | X | 4 | |||||||
Wilkinson & Jelinek, 2009 [33] | X | X | X | X | 4 | |||||||
Xue et al., 2007 [30] | X | X | X | X | X | X | X | 7 |