Showing papers by "Wolfgang Weidenhammer published in 2007"

The impact of patient expectations on outcomes in four randomized controlled trials of acupuncture in patients with chronic pain

Abstract: In a pooled analysis of four randomized controlled trials of acupuncture in patients with migraine, tension-type headache, chronic low back pain, and osteoarthritis of the knee we investigated the influence of expectations on clinical outcome. The 864 patients included in the analysis received either 12 sessions of acupuncture or minimal (i.e. sham) acupuncture (superficial needling of non-acupuncture points) over an 8 week period. Patients were asked at baseline whether they considered acupuncture to be an effective therapy in general and what they personally expected from the treatment. After three acupuncture sessions patients were asked how confident they were that they would benefit from the treatment strategy they were receiving. Patients were classified as responders if the respective main outcome measure improved by at least fifty percent. Both univariate and multivariate analyses adjusted for potential confounders (such as condition, intervention group, age, sex, duration of complaints, etc.) consistently showed a significant influence of attitudes and expectations on outcome. After completion of treatment, the odds ratio for response between patients considering acupuncture an effective or highly effective therapy and patients who were more sceptical was 1.67 (95% confidence interval 1.20-2.32). For personal expectations and confidence after the third session, odds ratios were 2.03 (1.26-3.26) and 2.35 (1.68-3.30), respectively. Results from the 6-month follow-up were similar. In conclusion, in our trials a significant association was shown between better improvement and higher outcome expectations.

Acupuncture for chronic low back pain in routine care: a multicenter observational study.

Abstract: ObjectiveTo investigate patient characteristics and outcomes after undergoing acupuncture treatment for chronic low back pain (cLBP) in Germany and to analyze chronification, pain grading, and depression as predictors for treatment outcomes.Patients and MethodsPatients with cLBP (ICD-10 diagnoses M5

Qualitätsprofil einer Rehabilitationsfachklinik für Naturheilverfahren – Teil 2: Patienten- und Ergebnisprofil

Abstract: Zielsetzung: Darstellung eines Programms zur Evaluation der stationaren Patientenversorgung (PEP) mit Naturheilverfahren am Beispiel einer Rehabilitationsfachklinik fur Naturheilverfahren mit Schwerpunkt auf Beschreibung der behandelten Patienten und der Ergebnisqualitat. Methoden: Prospektive Kohortenstudie aller stationar aufgenommenen Patienten uber 2 Jahre; Arztfragebogen zur Erhebung medizinischer Basisdaten sowie Patientenfragebogen bei Aufnahme, Entlassung und 3 Nachbefragungen (2, 6 und 12 Monate nach Entlassung) zur Erfassung der Beschwerdeintensitat, der gesundheitsbezogenen Lebensqualitat (SF-36), des Gesundheitsverhaltens, der Inanspruchnahme medizinischer Leistungen, der Arbeitsunfahigkeitstage sowie der Patientenzufriedenheit. Bei Beginn der Intervention: Erhebung soziodemografischer Merkmale und medizinischer Basisdaten, Erfahrungen mit Naturheilverfahren und Behandlungserwartungen. Ergebnisse: 5278 Patienten (83% weiblich, Alter 54,7 ± 11,6 Jahre) mit Diagnosen hauptsachlich aus den Bereichen «Psychovegetatives Erschopfungssyndrom» (36,8%), «Chronische Ruckenerkrankungen» (19,5%) und «Chronische Kopfschmerzen » (11,9%) und medianer Beschwerdedauer von 6 Jahren gingen in die Analysen ein (Rucklauf nach 6 Monaten 80,6%, nach 12 Monaten 73,6%). Die Starke der Hauptbeschwerde reduzierte sich von anfangs 59 ± 25 um durchschnittlich 25 Punkte bei Entlassung (nach 6 Monaten um 19 Punkte), was einer Effektstarke von 0,86 (0,62 nach 6 Monaten) entspricht. 6 Monate nach Entlassung wies knapp die Halfte der Patienten einen klinisch relevanten Anstieg der Lebensqualitat auf (Summenscores des SF-36 um =5 Punkte erhoht). Die Einnahme von Medikamenten ging zuruck, nach dem Klinikaufenthalt waren weniger Arbeitsunfahigkeitstage zu verzeichnen. Die Zufriedenheit der Patienten war durchschnittlich «gut», bezogen auf die Verpflegung in der Klinik war die Zufriedenheit geringer. Eine Subgruppenanalyse bezuglich der Hauptdiagnose der Patienten zeigte unterschiedliche Akzentuierungen im Ergebnisprofil. Schlussfolgerungen: Das Patientenprofil belegt den Bedarf an einer stationaren Rehabilitationsmasnahme und ist der naturheilkundlichen stationaren Versorgung vergleichbar. Das Ergebnisprofil belegt an einer reprasentativen Patientenstichprobe, dass die Mehrzahl der Patienten hinsichtlich unterschiedlicher Outcome-Dimensionen von der Masnahme profitierte und dass dieser Nutzen noch 6-12 Monate nach Entlassung anhielt.

International Congress on Complementary Medicine Research

Abstract: The quantity and quality of research in complementary therapies has increased dramatically over the last decade in parallel with the expertise and intellectual capacity available for evaluating this challenging field. While CAM research is highly heterogeneous, many of the questions and problems within CAM are similar and researchers in general benefit enormously from exchanging ideas. In 2000, the Centre for Complementary Medicine Research at the Technical University in Munich hosted a congress titled ‘Evidence-Based Complementary Medicine – State of the Evidence and Methodological Challenges’. This event was organized in collaboration with the Centre for Alternative Medicine Research and Education, Beth Israel Deaconess Medical Centre, Harvard Medical School. A total of 80 abstracts from 14 different countries were submitted for presentation, of which 65 were accepted [1]. Now in 2007, the Centre for Complementary Medicine Research and the International Society for Complementary Medicine Research (ISCMR) have jointly-organized the International Congress on Complementary Medicine Research which will be held Munich in May. ISCMR was established in 2003 to foster co-operative and multidisciplinary research and development within complementary, traditional and integrative medicine. We hope that ISCMR will build on its success and continue to be a major international forum for researchers in the field. These continuing conferences will be the forum through which leading Complementary and Alternative Medicine (CAM) researchers can present their new research and discuss future strategies. The conference organisers received a total of 264 abstracts from researchers in 26 different countries. In order to ensure scientific quality and to manage the Congress schedule, the Scientific Committee appointed a reviewing panel of 55 international expert volunteers. We are very grateful to them for their time, effort and expertise and would like to formally thank them for their work. Each abstract was evaluated by two external peer reviewers focussing on the criteria ‘relevance’, ‘clarity of methods’, ‘quality of writing style’ and ‘global assessment’. All the abstracts were also read by two of the conference organizers; only if the external peer reviewers disagreed were the actual scores used to decide upon the submission’s acceptance. Typical reasons for low scores were: prior publication of the submitted work, lack of clarity in the abstract, poor English, or a subject which might not be of interest to most Congress participants. We unfortunately had to reject 33% of the abstracts submitted, resulting in a scientific program of real excellence with 68 oral and 110 poster presentations. The variety of research topics submitted has increased dramatically when compared to the 2000 conference (see table). While in 2000 ‘miscellaneous topics’ comprised mainly methodological issues, these conferences’ abstracts now contain a number of new discrete disciplines such as Anthroposophical Medicine and MindBody Medicine, as well as highlighting a number of is-