Acceptance and use of complementary and alternative medicine among medical specialists: a 15-year systematic review and data synthesis

Background Complementary and Alternative Medicine (CAM) has gained popularity among the general population, but its acceptance and use among medical specialists have been inconclusive. This systematic review aimed to identify relevant studies and synthesize survey data on the acceptance and use of CAM among medical specialists. Methods We conducted a systematic literature search in PubMed and Scopus databases for the acceptance and use of CAM among medical specialists. Each article was assessed by two screeners. Only survey studies relevant to the acceptance and use of CAM among medical specialists were reviewed. The pooled prevalence estimates were calculated using random-effects meta-analyses. This review followed both PRISMA and SWiM guidelines. Results Of 5628 articles published between 2002 and 2017, 25 fulfilled the selection criteria. Ten medical specialties were included: Internal Medicine (11 studies), Pediatrics (6 studies), Obstetrics and Gynecology (6 studies), Anesthesiology (4 studies), Surgery (3 studies), Family Medicine (3 studies), Physical Medicine and Rehabilitation (3 studies), Psychiatry and Neurology (2 studies), Otolaryngology (1 study), and Neurological Surgery (1 study). The overall acceptance of CAM was 52% (95%CI, 42–62%). Family Medicine reported the highest acceptance, followed by Psychiatry and Neurology, Neurological Surgery, Obstetrics and Gynecology, Pediatrics, Anesthesiology, Physical Medicine and Rehabilitation, Internal Medicine, and Surgery. The overall use of CAM was 45% (95% CI, 37–54%). The highest use of CAM was by the Obstetrics and Gynecology, followed by Family Medicine, Psychiatry and Neurology, Pediatrics, Otolaryngology, Anesthesiology, Internal Medicine, Physical Medicine and Rehabilitation, and Surgery. Based on the studies, meta-regression showed no statistically significant difference across geographic regions, economic levels of the country, or sampling methods. Conclusion Acceptance and use of CAM varied across medical specialists. CAM was accepted and used the most by Family Medicine but the least by Surgery. Findings from this systematic review could be useful for strategic harmonization of CAM and conventional medicine practice. Systematic review registration PROSPERO CRD42019125628 Graphical abstract

US FDA best practices for initiating early feasibility studies for neurological devices in the United States

This article describes the efforts of the US Food and Drug Administration (FDA) Office of Neurological and Physical Medicine Devices to facilitate early clinical testing of potentially beneficial neurological devices in the US. Over the past 5 years, the FDA has made significant advances to this aim by developing early feasibility study best practices and encouraging developers and innovators to initiate their clinical studies in the US. The FDA uses several regulatory approaches to help start neurological device clinical studies, such as early engagement with sponsors and developers, in-depth interaction during the FDA review phase of a regulatory submission, and provision of an FDA toolkit that reviewers can apply to the most challenging submissions.

The E-Textile for Biomedical Applications: A Systematic Review of Literature

The use of e-textile technologies spread out in the scientific research with several applications in both medical and nonmedical world. In particular, wearable technologies and miniature electronics devices were implemented and tested for medical research purposes. In this paper, a systematic review regarding the use of e-textile for clinical applications was conducted: the Scopus and Pubmed databases were investigate by considering research studies from 2010 to 2020. Overall, 262 papers were found, and 71 of them were included in the systematic review. Of the included studies, 63.4% focused on information and communication technology studies, while the other 36.6% focused on industrial bioengineering applications. Overall, 56.3% of the research was published as an article, while the remainder were conference papers. Papers included in the review were grouped by main aim into cardiological, muscular, physical medicine and orthopaedic, respiratory, and miscellaneous applications. The systematic review showed that there are several types of applications regarding e-textile in medicine and several devices were implemented as well; nevertheless, there is still a lack of validation studies on larger cohorts of subjects since the majority of the research only focuses on developing and testing the new device without considering a further extended validation.

Transforming Education Using Virtual Reality: Geriatrics Clerkship Before and During Pandemic

Since 2006, the Georgetown University School of Medicine has offered a two-week elective in Geriatrics for third-year medical students. Students rotate through diverse clinical experiences, including general geriatrics, geriatric neurology, physical medicine & rehabilitation, memory disorders, Parkinson’s and dementia, and palliative care. In addition, students learn about arts, humanities & ethics, communication skills, and taking the patient’s perspective. In Fall 2019, pre-pandemic, we added virtual reality (VR) experiences focused on hearing & vision loss, Alzheimer’s disease, and end-of-life conversations created by Embodied Labs. Curricular goals included increasing students’ empathy and sensitivity, decreasing ageism & stereotyping, and increasing clinical knowledge. Findings suggest regardless of pandemic (pre vs. during) or modality (in-person vs. Zoom) that after participating in the VR labs, students are slightly more comfortable taking care of older adult patients with dementia as well as hearing & vision loss, and participating in end-of-life conversations.