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1. International ResearchKit App for Women with Menstrual Pain: Development, Access, and Engagement

Author

Wang, Jiani, Rogge, Alizé A, Armour, Mike, Smith, Caroline A, D’Adamo, Christopher R, Pischke, Claudia R, Yen, Hung-Rong, Wu, Mei-Yao, Moré, Ari Ojeda Ocampo, Witt, Claudia M, and Pach, Daniel

Subjects
Information technology, T58.5-58.64, Public aspects of medicine, RA1-1270
Abstract

BackgroundPrimary dysmenorrhea is a common condition in women of reproductive age. A previous app-based study undertaken by our group demonstrated that a smartphone app supporting self-acupressure introduced by a health care professional can reduce menstrual pain. ObjectiveThis study aims to evaluate whether a specific smartphone app is effective in reducing menstrual pain in 18- to 34-year-old women with primary dysmenorrhea in a self-care setting. One group of women has access to the full-featured study app and will be compared with 2 control groups who have access to fewer app features. Here, we report the trial design, app development, user access, and engagement. MethodsOn the basis of the practical implications of the previous app-based study, we revised and reengineered the study app and included the ResearchKit (Apple Inc) framework. Behavior change techniques (BCTs) were implemented in the app and validated by expert ratings. User access was estimated by assessing recruitment progress over time. User evolution and baseline survey respondent rate were assessed to evaluate user engagement. ResultsThe development of the study app for a 3-armed randomized controlled trial required a multidisciplinary team. The app is accessible for the target population free of charge via the Apple App Store. In Germany, within 9 months, the app was downloaded 1458 times and 328 study participants were recruited using it without external advertising. A total of 98.27% (5157/5248) of the app-based baseline questions were answered. The correct classification of BCTs used in the app required psychological expertise. ConclusionsConducting an innovative app study requires multidisciplinary effort. Easy access and engagement with such an app can be achieved by recruitment via the App Store. Future research is needed to investigate the determinants of user engagement, optimal BCT application, and potential clinical and self-care scenarios for app use. Trial RegistrationClinicalTrials.gov NCT03432611; https://clinicaltrials.gov/ct2/show/NCT03432611 (Archived by WebCite at http://www.webcitation.org/75LLAcnCQ).

Published
2020
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6. Content Representation of Tactile Mental Imagery in Primary Somatosensory Cortex

Author

Nierhaus, Till; https://orcid.org/0000-0003-0906-592X, Wesolek, Sara, Pach, Daniel; https://orcid.org/0000-0002-2459-6596, Witt, Claudia M; https://orcid.org/0000-0002-5440-7805, Blankenburg, Felix, Schmidt, Timo T, Nierhaus, Till; https://orcid.org/0000-0003-0906-592X, Wesolek, Sara, Pach, Daniel; https://orcid.org/0000-0002-2459-6596, Witt, Claudia M; https://orcid.org/0000-0002-5440-7805, Blankenburg, Felix, and Schmidt, Timo T

Abstract

The imagination of tactile stimulation has been shown to activate primary somatosensory cortex (S1) with a somatotopic specificity akin to that seen during the perception of tactile stimuli. Using fMRI and multivariate pattern analysis, we investigate whether this recruitment of sensory regions also reflects content-specific activation (i.e., whether the activation in S1 is specific to the mental content participants imagined). To this end, healthy volunteers (n = 21) either perceived or imagined three types of vibrotactile stimuli (mental content) while fMRI data were acquired. Independent of the content, during tactile mental imagery we found activation of frontoparietal regions, supplemented with activation in the contralateral BA2 subregion of S1, replicating previous reports. While the imagery of the three different stimuli did not reveal univariate activation differences, using multivariate pattern classification, we were able to decode the imagined stimulus type from BA2. Moreover, cross-classification revealed that tactile imagery elicits activation patterns similar to those evoked by the perception of the respective stimuli. These findings promote the idea that mental tactile imagery involves the recruitment of content-specific activation patterns in sensory cortices, namely in S1.

Published
2023

7. Effects of blended learning training for oncology physicians to advise their patients about complementary and integrative therapies: results from the multicenter cluster-randomized KOKON-KTO trial

Author

Helmer, Stefanie M; https://orcid.org/0000-0002-4435-4041, Rogge, Alizé A; https://orcid.org/0000-0001-5458-4222, King, Ryan, Canella, Claudia; https://orcid.org/0000-0003-3152-6534, Pach, Daniel; https://orcid.org/0000-0002-2459-6596, Witt, Claudia M; https://orcid.org/0000-0002-5440-7805, Helmer, Stefanie M; https://orcid.org/0000-0002-4435-4041, Rogge, Alizé A; https://orcid.org/0000-0001-5458-4222, King, Ryan, Canella, Claudia; https://orcid.org/0000-0003-3152-6534, Pach, Daniel; https://orcid.org/0000-0002-2459-6596, and Witt, Claudia M; https://orcid.org/0000-0002-5440-7805

Abstract

Background: Many oncology physicians are confronted with the topic of complementary and integrative medicine (CIM) by cancer patients. This study examined whether a blended learning (e-learning and a workshop) to train oncology physicians in providing advice on CIM therapies to their cancer patients, in addition to distributing an information leaflet about reputable CIM websites, had different effects on physician-reported outcomes in regard to consultations compared with only distributing the leaflet. Methods: In a multicenter, cluster-randomized trial, 48 oncology physicians were randomly allocated to an intervention group (CIM consultation and an information leaflet) or a control group (information leaflet only). After the training, the oncology physicians conducted 297 consultations with their cancer patients. Measurements were assessed at oncology physician, physician-patient-interaction (measured by external reviewers), and patient levels. This analysis focused on the physician outcomes of stress reaction and perceived consultation skill competency. In addition, qualitative interviews were conducted with a subsample of oncology physicians who experienced both, the intervention and control condition. Results: The oncology physicians in the intervention group showed a lower stress reaction in all measured dimensions after CIM consultations than those in the control group. There was no significant difference between oncology physicians in the intervention and control groups regarding the perceived consultation skill competency (overburden: intervention 1.4 [95% CI: 0.7;2.1]; control 2.1 [95% CI: 1.4;2.7], tension: 1.3 [95% CI: 0.7;2.0] vs. 1.9 [95% CI: 1.3;2.5], and discomfort with consultation situations: 1.0 [95% CI: 0.4;1.7]; vs. 1.7 [95% CI: 1.2;2.3]). The qualitative data showed that only providing the leaflet seemed impersonal to oncology physicians, while the training made them feel well prepared to conduct a full conversation about CIM and provide the inf

Published
2023

9. Evaluation nichtpharmakologischer Interventionen aus der Integrativen Medizin und Digitalen Gesundheit bei chronischen Schmerzen

Author

Pach, Daniel

Subjects
mHealth, integrative Medicine, pain, randomised controlled trial, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
Abstract

Chronische Schmerzen sind ein wesentliches globales Gesundheitsproblem, welches eine hohe sozioökonomische Belastung auf der Ebene der Individuen, der Gesellschaften und der Institutionen mit sich bringt. Die vorliegende Habilitationsschrift thematisiert die Evaluation nichtpharmakologischer Interventionen aus der Integrativen Medizin und Digitalen Gesundheit bei chronischen Schmerzen. Hierzu wurden randomisierte kontrollierte Studien zu klassischen komplementärmedizinischen Verfahren wie Tuina oder Akupunktur durchgeführt oder zu diesen Verfahren in Kombination mit modernen digitalen Technologien. Eine Wirksamkeit konnte nur zum Teil gezeigt werden. Die per Smartphone-App durchgeführte Selbstakupressur führte bei jungen Frauen zu einer Verringerung der Menstruationsschmerzen im Vergleich zur Normalversorgung. Die Wirkung nahm mit der Zeit zu, und die Therapieadhärenz war gut. Im Gegensatz dazu konnte die Studien-App, die Verfahren aus dem Bereich der Mind-Body-Medizin integrierte, chronische Nackenschmerzen nicht wirksam reduzieren. Die Therapieadhärenz war weniger gut. Unsere aktuelle und noch laufende Studie zu Menstruationsschmerzen zeigte, dass Betroffene auch ohne direkten Kontakt zu Gesundheitsexperten und allein über einen App-Store erreicht werden können und diese die App dann auch nutzen. Im Setting einer Hochschulambulanz zeigte sich eine zusätzliche Behandlung mit sechs Tuina-Sitzungen über drei Wochen bei Patienten mit chronischen Nackenschmerzen als wirksam, sicher und relativ kosteneffektiv im Vergleich zu einer Patientengruppe mit chronischen Nackenschmerzen ohne zusätzliche Intervention. Eine im ambulanten Setting einer Allgemeinarztpraxis durchgeführte individualisierte Akupunktur zeigte sich einer standardisierten Akupunktur bei chronischen Kreuzschmerzen nicht überlegen. Die Studie weist darauf hin, dass eine Vereinfachung der Akupunkturbehandlung und dadurch ein möglicherweise breiterer Einsatz denkbar wären. Als wesentliche Schlussfolgerungen der vorliegenden Arbeit lassen sich ziehen, dass nichtpharmakologische Interventionen der Integrativen Medizin und Digitalen Gesundheit einen wichtigen Beitrag zur Behandlung chronischer Schmerzerkrankungen leisten könnten. Insbesondere die Kombination klassischer komplementärmedizinischer Verfahren und Digitaler Anwendungen scheint lohnend. Weitere Forschung zu Mechanismen, Wirksamkeit, Kosteneffektivität und optimalen Anwendungsszenarios ist notwendig. Die Grundlagen für evidenzbasiertes Arbeiten scheinen jedoch gelegt.

Published
2023
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10. Smartphone-RCCT: an online repository of randomized controlled clinical trials of smartphone applications for chronic conditions

Author

Barth, Jürgen; https://orcid.org/0000-0001-7096-7178, Wang, Jiani; https://orcid.org/0000-0002-0618-8337, Lopez-Alcalde, Jesus; https://orcid.org/0000-0002-1598-8790, Kramm, Christoph, Pach, Daniel; https://orcid.org/0000-0002-2459-6596, Álvarez-Díaz, Noelia; https://orcid.org/0000-0002-5904-3609, Grifol-Clar, Eulàlia; https://orcid.org/0000-0003-3944-0372, Witt, Claudia M; https://orcid.org/0000-0002-5440-7805, Barth, Jürgen; https://orcid.org/0000-0001-7096-7178, Wang, Jiani; https://orcid.org/0000-0002-0618-8337, Lopez-Alcalde, Jesus; https://orcid.org/0000-0002-1598-8790, Kramm, Christoph, Pach, Daniel; https://orcid.org/0000-0002-2459-6596, Álvarez-Díaz, Noelia; https://orcid.org/0000-0002-5904-3609, Grifol-Clar, Eulàlia; https://orcid.org/0000-0003-3944-0372, and Witt, Claudia M; https://orcid.org/0000-0002-5440-7805

Abstract

Background: Chronic health conditions have a big impact on disability, morbidity, and mortality worldwide. Smart‑ phone health applications (apps) can improve the health of patients with chronic conditions and enhance the quality and efficiency of healthcare. The number of randomized controlled trials (RCTs) of smartphone health apps is increas‑ ing, but a collection of the available evidence into a single database is still missing. The purpose of this study is to describe Smartphone-RCCT, which is an in‑progress database of RCTs of smartphone apps for chronic conditions. Methods: For a study to be included in the database, the following criteria had to be met: (a) RCT published in a peer‑reviewed journal; (b) population: adult study participants with one or several chronic conditions that represent the main health problem addressed by the study intervention; (c) intervention: smartphone health app used by the patient; (d) comparator: any control condition; (e) outcomes: any patient‑reported health outcome (studies exclu‑ sively measuring the patients’ knowledge about the chronic conditions or their satisfaction with the smartphone app were excluded); (f) sample size: at least 15 participants per study arm. We searched in electronic databases and other resources to identify relevant studies. Two reviewers selected the studies and extracted data independently. Annual updates are planned. Results: The proposed database is called Smartphone‑RCCT, an open‑access repository collecting bibliographic references and important characteristics of RCTs of smartphone apps for chronic conditions. The database is available for free in Open Science Framework (OSF): https://osf.io/nxerf/. To date, it includes 70 trials. Their references can be exported to standard reference management software and the extracted data is available in a Microsoft Excel file. Conclusions: Smartphone‑RCCT is the first systematic open‑access database collecting peer‑reviewed publications of RCTs of smart

Published
2022

11. App-Based Relaxation Exercises for Patients With Chronic Neck Pain: Pragmatic Randomized Trial

Author

Pach, Daniel; https://orcid.org/0000-0002-2459-6596, Blödt, Susanne; https://orcid.org/0000-0001-9626-6062, Wang, Jiani; https://orcid.org/0000-0002-0618-8337, Keller, Theresa; https://orcid.org/0000-0002-3603-534X, Bergmann, Beatrice; https://orcid.org/0000-0001-8859-6619, Rogge, Alizé A; https://orcid.org/0000-0001-5458-4222, Barth, Jürgen; https://orcid.org/0000-0001-7096-7178, Icke, Katja; https://orcid.org/0000-0002-4170-8430, Roll, Stephanie; https://orcid.org/0000-0003-1191-3289, Witt, Claudia M; https://orcid.org/0000-0002-5440-7805, Pach, Daniel; https://orcid.org/0000-0002-2459-6596, Blödt, Susanne; https://orcid.org/0000-0001-9626-6062, Wang, Jiani; https://orcid.org/0000-0002-0618-8337, Keller, Theresa; https://orcid.org/0000-0002-3603-534X, Bergmann, Beatrice; https://orcid.org/0000-0001-8859-6619, Rogge, Alizé A; https://orcid.org/0000-0001-5458-4222, Barth, Jürgen; https://orcid.org/0000-0001-7096-7178, Icke, Katja; https://orcid.org/0000-0002-4170-8430, Roll, Stephanie; https://orcid.org/0000-0003-1191-3289, and Witt, Claudia M; https://orcid.org/0000-0002-5440-7805

Abstract

Background: Chronic neck pain is a highly prevalent condition. Learning a relaxation technique is recommended by numerous guidelines for chronic neck pain. Smartphone apps can provide relaxation exercises; however, their effectiveness, especially in a self-care setting, is unclear. Objective: The aim of this pragmatic randomized trial is to evaluate whether app-based relaxation exercises, including audio-based autogenic training, mindfulness meditation, or guided imagery, are more effective in reducing chronic neck pain than usual care alone. Methods: Smartphone owners aged 18 to 65 years with chronic (>12 weeks) neck pain and the previous week’s average neck pain intensity ≥4 on the Numeric Rating Scale (0=no pain to 10=worst possible pain) were randomized into either an intervention group to practice app-based relaxation exercises or a control group (usual care and app for data entry only). For both groups, the follow-up data were collected using app-based diaries and questionnaires. The primary outcome was the mean neck pain intensity during the first 3 months based on daily measurements. Secondary outcomes included neck pain based on weekly measurements, pain acceptance, neck pain–related stress, sick-leave days, pain medication intake, and adherence, which were all measured until the 6-month follow-up. For the primary analysis, analysis of covariance adjusted for baseline neck pain intensity was used. Results: We screened 748 participants and enrolled 220 participants (mean age 38.9, SD 11.3 years; mean baseline neck pain 5.7, SD 1.3 points). The mean neck pain intensity in both groups decreased over 3 months; however, no statistically significant difference between the groups was found (intervention: 4.1 points, 95% CI 3.8-4.4; control: 3.8 points, 95% CI 3.5-4.1; group difference: 0.3 points, 95% CI −0.2 to 0.7; P=.23). In addition, no statistically significant between-group differences regarding neck pain intensity after 6 months, responder rate, pain accept

Published
2022

14. App-Based Relaxation Exercises for Patients With Chronic Neck Pain: Pragmatic Randomized Trial

Author

Pach, Daniel, Blödt, Susanne, Wang, Jiani, Keller, Theresa, Bergmann, Beatrice, Rogge, Alizé A, Barth, Jürgen, Icke, Katja, Roll, Stephanie, Witt, Claudia M, and University of Zurich

Subjects
Adult, Original Paper, mobile phone, Neck Pain, 610 Medicine & health, Health Informatics, Mobile Applications, 10034 Institute of Complementary Medicine, smartphone app, relaxation, mHealth, Humans, Smartphone, Chronic Pain, Exercise, RCT
Abstract

Background Chronic neck pain is a highly prevalent condition. Learning a relaxation technique is recommended by numerous guidelines for chronic neck pain. Smartphone apps can provide relaxation exercises; however, their effectiveness, especially in a self-care setting, is unclear. Objective The aim of this pragmatic randomized trial is to evaluate whether app-based relaxation exercises, including audio-based autogenic training, mindfulness meditation, or guided imagery, are more effective in reducing chronic neck pain than usual care alone. Methods Smartphone owners aged 18 to 65 years with chronic (>12 weeks) neck pain and the previous week’s average neck pain intensity ≥4 on the Numeric Rating Scale (0=no pain to 10=worst possible pain) were randomized into either an intervention group to practice app-based relaxation exercises or a control group (usual care and app for data entry only). For both groups, the follow-up data were collected using app-based diaries and questionnaires. The primary outcome was the mean neck pain intensity during the first 3 months based on daily measurements. Secondary outcomes included neck pain based on weekly measurements, pain acceptance, neck pain–related stress, sick-leave days, pain medication intake, and adherence, which were all measured until the 6-month follow-up. For the primary analysis, analysis of covariance adjusted for baseline neck pain intensity was used. Results We screened 748 participants and enrolled 220 participants (mean age 38.9, SD 11.3 years; mean baseline neck pain 5.7, SD 1.3 points). The mean neck pain intensity in both groups decreased over 3 months; however, no statistically significant difference between the groups was found (intervention: 4.1 points, 95% CI 3.8-4.4; control: 3.8 points, 95% CI 3.5-4.1; group difference: 0.3 points, 95% CI −0.2 to 0.7; P=.23). In addition, no statistically significant between-group differences regarding neck pain intensity after 6 months, responder rate, pain acceptance, pain medication intake, or sick-leave days were observed. There were no serious adverse events that were considered related to the trial intervention. In week 12, only 40% (44/110) of the participants in the intervention group continued to practice the exercises with the app. Conclusions The study app did not effectively reduce chronic neck pain or keep the participants engaged in exercising in a self-care setting. Future studies on app-based relaxation interventions should take into account the most recent scientific findings for behavior change techniques. Trial Registration ClinicalTrials.gov NCT02019134; https://clinicaltrials.gov/ct2/show/NCT02019134 International Registered Report Identifier (IRRID) RR2-10.1186/1745-6215-15-490

Published
2022

18. Five Lessons Learned From Randomized Controlled Trials on Mobile Health Interventions: Consensus Procedure on Practical Recommendations for Sustainable Research

Author

Pach, Daniel, Rogge, Alizé A, Wang, Jiani, Witt, Claudia M, University of Zurich, and Pach, Daniel

Subjects
mobile apps, 10034 Institute of Complementary Medicine, mHealth, 11476 Digital Society Initiative, recommendations, 610 Medicine & health, pain, behavior change techniques (BCTs), 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, 2718 Health Informatics
Abstract

Background: Clinical research on mobile health (mHealth) interventions is too slow in comparison to the rapid speed of technological advances, thereby impeding sustainable research and evidence-based implementation of mHealth interventions. Objective: We aimed to establish practical lessons from the experience of our working group, which might accelerate the development of future mHealth interventions and their evaluation by randomized controlled trials (RCTs). Methods: This paper is based on group and expert discussions, and focuses on the researchers’ perspectives after four RCTson mHealth interventions for chronic pain. Results: The following five lessons are presented, which are based on practical application, increase of speed, and sustainability: (1) explore stakeholder opinions, (2) develop the mHealth app and trial simultaneously, (3) minimize complexity, (4) manage necessary resources, and (5) apply behavior change techniques. Conclusions: The five lessons developed may lead toward an agile research environment. Agility might be the key factor in the development and research process of a potentially sustainable and evidence-based mHealth intervention.

Published
2021
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19. Evaluating the Effects of Acupuncture Using a Dental Pain Model in Healthy Subjects – A Randomized, Cross-Over Trial

Author

de Matos, Nuno M P, Pach, Daniel, Xing, Jing Jing, Barth, Jürgen, Beyer, Lara Elena, Shi, Xuemin, Kern, Alexandra, Lukic, Nenad, Ettlin, Dominik A, Brügger, Mike, Witt, Claudia M, University of Zurich, and Pach, Daniel

Subjects
Nociception, Clinical Neurology, 10223 Clinic for Masticatory Disorders, Acupuncture, Pain, 610 Medicine & health, Toothache, Chinese traditional, 10034 Institute of Complementary Medicine, 2728 Neurology (clinical), Anesthesiology and Pain Medicine, Medicine, Neurology, 2808 Neurology, 2703 Anesthesiology and Pain Medicine, 10069 Clinic of Cranio-Maxillofacial Surgery
Abstract

Acupuncture is a complementary and nonpharmacological intervention that can be effective for the management of chronic pain in addition to or instead of medication. Various animal models for neuropathic pain, inflammatory pain, cancer-related pain, and visceral pain already exist in acupuncture research. We used a newly validated human pain model and examined whether acupuncture can influence experimentally induced dental pain. For this study, we compared the impact of manual acupuncture (real acupuncture), manual stimulation of a needle inserted at nonacupuncture points (sham acupuncture) and no acupuncture on experimentally induced dental pain in 35 healthy men who were randomized to different sequences of all 3 interventions in a within-subject design. BORG CR10 pain ratings and autonomic responses (electrodermal activity and heart rate variability) were investigated. An initial mixed model with repeated measures included preintervention pain ratings and the trial sequence as covariates. The results showed that acupuncture was effective in reducing pain intensity when compared to no acupuncture (β = −.708, P = .002), corresponding to a medium Cohen's d effect size of .56. The comparison to the sham acupuncture revealed no statistically significant difference. No differences in autonomic responses between real and sham acupuncture were found during the intervention procedures., The Journal of Pain, 21 (3-4), ISSN:1526-5900

Published
2020
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22. Effects of training oncology physicians advising patients on complementary and integrative therapies on patient‐reported outcomes: A multicenter, cluster‐randomized trial

Author

Rogge, Alizé A; https://orcid.org/0000-0001-5458-4222, Helmer, Stefanie M, King, Ryan, Canella, Claudia; https://orcid.org/0000-0003-3152-6534, Icke, Katja, Pach, Daniel; https://orcid.org/0000-0002-2459-6596, Witt, Claudia M; https://orcid.org/0000-0002-5440-7805, Rogge, Alizé A; https://orcid.org/0000-0001-5458-4222, Helmer, Stefanie M, King, Ryan, Canella, Claudia; https://orcid.org/0000-0003-3152-6534, Icke, Katja, Pach, Daniel; https://orcid.org/0000-0002-2459-6596, and Witt, Claudia M; https://orcid.org/0000-0002-5440-7805

Abstract

BACKGROUND: Many patients with cancer do not disclose complementary medicine use but want their physician’s advice on this matter. This study evaluated whether using blended learning (e-learning plus a workshop) to train oncology physicians in providing advice on complementary and integrative medicine (CIM) therapies to their patients with cancer, in addition to distributing an information leaflet on reputable CIM websites, had different effects on patient-reported outcomes for the consultation than only distributing the leaflet. METHODS: In this multicenter, cluster-randomized trial, patients from private practices/hospital departments, recruited by 48 oncology physicians randomly allocated to an intervention group (CIM consultation plus information leaflet) or a control group (information leaflet), received CIM information. Patient-reported outcomes included satisfaction (Patient Satisfaction With Information on Cancer Treatment), readiness to make a decision (Preparation for Decision Making), and physician-patient communication (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire and Communication 26 [EORTC QLQ-COMU26]) for the consultation. Qualitative interviews were conducted with a physician subsample. RESULTS: A total of 291 patients (128 in the intervention group and 169 in the control group) advised by 41 physicians participated. Patients in the intervention group rated physician-patient communication higher on all EORTC QLQ- COMU26 scales (mean total score, 84.3 [95% CI, 79.5-89.2] vs 73.6 [95% CI, 69.3- 78.0]; P=.002), were more satisfied with the advice (mean, 4.2 [95% CI, 4.0-4.4] vs 3.7 [95% CI, 3.5-3.8]; P<.001), and were readier to make a decision (mean, 63.5 [95% CI, 57.4-69.6] vs 53.2 [95% CI, 47.8-58.7]; P= .016) than the control group. Physicians who reported patients in both settings seemed satisfied with the advice given. CONCLUSIONS: This study evaluated a novel education intervention for training oncology

Published
2021

23. Current practice of stakeholder engagement: researchers’ experiences in North America, DACH countries and China

Author

Heiss, Anna; https://orcid.org/0000-0001-9707-2729, Wang, Jiani; https://orcid.org/0000-0002-0618-8337, Fei, Yutong; https://orcid.org/0000-0003-3051-0581, Xia, Ruyu; https://orcid.org/0000-0001-9828-5195, Icke, Katja, Pach, Daniel; https://orcid.org/0000-0002-2459-6596, Witt, Claudia M; https://orcid.org/0000-0002-5440-7805, Heiss, Anna; https://orcid.org/0000-0001-9707-2729, Wang, Jiani; https://orcid.org/0000-0002-0618-8337, Fei, Yutong; https://orcid.org/0000-0003-3051-0581, Xia, Ruyu; https://orcid.org/0000-0001-9828-5195, Icke, Katja, Pach, Daniel; https://orcid.org/0000-0002-2459-6596, and Witt, Claudia M; https://orcid.org/0000-0002-5440-7805

Abstract

Aim: To explore the current practice of stakeholder engagement in clinical trials and its evaluation in North America (USA and Canada), DACH countries (Germany, Austria and Switzerland) and China. Participants & methods: We conducted a web-based, anonymous, international, cross-sectional online survey for clinical researchers. Data were analyzed using descriptive and explorative statistical analysis including analysis of variance and analysis of covariance. Results: Stakeholder engagement is more prominent and higher accepted among researchers in North America. Researchers in DACH countries have less knowledge of the stakeholder engagement method and are less likely to apply it. Conclusion: Stakeholder engagement is perceived very differently among participants from DACH countries, North America and China. For a broader acceptance and implementation institutional support and motivational conditions might be needed.

Published
2021

24. Five Lessons Learned From Randomized Controlled Trials on Mobile Health Interventions: Consensus Procedure on Practical Recommendations for Sustainable Research

Author

Pach, Daniel; https://orcid.org/0000-0002-2459-6596, Rogge, Alizé A; https://orcid.org/0000-0001-5458-4222, Wang, Jiani; https://orcid.org/0000-0002-0618-8337, Witt, Claudia M; https://orcid.org/0000-0002-5440-7805, Pach, Daniel; https://orcid.org/0000-0002-2459-6596, Rogge, Alizé A; https://orcid.org/0000-0001-5458-4222, Wang, Jiani; https://orcid.org/0000-0002-0618-8337, and Witt, Claudia M; https://orcid.org/0000-0002-5440-7805

Abstract

Background: Clinical research on mobile health (mHealth) interventions is too slow in comparison to the rapid speed of technological advances, thereby impeding sustainable research and evidence-based implementation of mHealth interventions. Objective: We aimed to establish practical lessons from the experience of our working group, which might accelerate the development of future mHealth interventions and their evaluation by randomized controlled trials (RCTs). Methods: This paper is based on group and expert discussions, and focuses on the researchers' perspectives after four RCTs on mHealth interventions for chronic pain. Results: The following five lessons are presented, which are based on practical application, increase of speed, and sustainability: (1) explore stakeholder opinions, (2) develop the mHealth app and trial simultaneously, (3) minimize complexity, (4) manage necessary resources, and (5) apply behavior change techniques. Conclusions: The five lessons developed may lead toward an agile research environment. Agility might be the key factor in the development and research process of a potentially sustainable and evidence-based mHealth intervention. Keywords: behavior change techniques (BCTs); mHealth; mobile apps; pain; recommendations.

Published
2021

26. Somatosensory Stimulation With XNKQ Acupuncture Modulates Functional Connectivity of Motor Areas

Author

Nierhaus, Till, Chang, Yinghui, Liu, Bin, Shi, Xuemin, Yi, Ming, Witt, Claudia M., Pach, Daniel, University of Zurich, Nierhaus, Till, and Pach, Daniel

Subjects
General Neuroscience, functional connectivity, 2800 General Neuroscience, 610 Medicine & health, centrality, stroke, 10034 Institute of Complementary Medicine, precuneus, red nucleus, resting-state fMRI, acupuncture, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, Neuroscience, Original Research
Abstract

Xingnao Kaiqiao (XNKQ) acupuncture is an acupuncture technique used for stroke patients. In 24 healthy volunteers, we applied this complex acupuncture intervention, which consists of a manual needle-stimulation on five acupuncture points (DU26 unilaterally, PC6, and SP6 bilaterally). XNKQ was compared to three control conditions: (1) insertion of needles on the XNKQ acupuncture points without stimulation, (2) manual needle-stimulation on five nearby non-acupuncture points, and (3) insertion of needles on the non-acupuncture points without stimulation. In a within-subject design, we investigated functional connectivity changes in resting-state functional magnetic resonance imaging (fMRI) by means of the data-driven eigenvector centrality (EC) approach. With a 2 × 2 factorial within-subjects design with two-factor stimulation (stimulation vs. non-stimulation) and location (acupuncture points vs. non-acupuncture points), we found decreased EC in the precuneus after needle-stimulation (stimulation

Published
2019
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29. International ResearchKit App for women with menstrual pain: Development, Access, and Engagement

Author

Wang, Jiani; https://orcid.org/0000-0002-0618-8337, Rogge, Alizé A; https://orcid.org/0000-0001-5458-4222, Armour, Mike; https://orcid.org/0000-0001-7539-9851, Smith, Caroline A; https://orcid.org/0000-0002-7828-0597, D’Adamo, Christopher R; https://orcid.org/0000-0002-2415-8158, Pischke, Claudia R; https://orcid.org/0000-0002-2256-8903, Yen, Hung-Rong; https://orcid.org/0000-0002-0131-1658, Wu, Mei-Yao; https://orcid.org/0000-0002-1004-0757, Moré, Ari Ojeda Ocampo; https://orcid.org/0000-0003-4073-4087, Witt, Claudia M; https://orcid.org/0000-0002-5440-7805, Pach, Daniel; https://orcid.org/0000-0002-2459-6596, Wang, Jiani; https://orcid.org/0000-0002-0618-8337, Rogge, Alizé A; https://orcid.org/0000-0001-5458-4222, Armour, Mike; https://orcid.org/0000-0001-7539-9851, Smith, Caroline A; https://orcid.org/0000-0002-7828-0597, D’Adamo, Christopher R; https://orcid.org/0000-0002-2415-8158, Pischke, Claudia R; https://orcid.org/0000-0002-2256-8903, Yen, Hung-Rong; https://orcid.org/0000-0002-0131-1658, Wu, Mei-Yao; https://orcid.org/0000-0002-1004-0757, Moré, Ari Ojeda Ocampo; https://orcid.org/0000-0003-4073-4087, Witt, Claudia M; https://orcid.org/0000-0002-5440-7805, and Pach, Daniel; https://orcid.org/0000-0002-2459-6596

Abstract

Background: Primary dysmenorrhea is a common condition in women of reproductive age. A previous app-based study undertaken by our group demonstrated that a smartphone app supporting self-acupressure introduced by a health care professional can reduce menstrual pain. Objective: This study aims to evaluate whether a specific smartphone app is effective in reducing menstrual pain in 18- to 34-year-old women with primary dysmenorrhea in a self-care setting. One group of women has access to the full-featured study app and will be compared with 2 control groups who have access to fewer app features. Here, we report the trial design, app development, user access, and engagement. Methods: On the basis of the practical implications of the previous app-based study, we revised and reengineered the study app and included the ResearchKit (Apple Inc) framework. Behavior change techniques (BCTs) were implemented in the app and validated by expert ratings. User access was estimated by assessing recruitment progress over time. User evolution and baseline survey respondent rate were assessed to evaluate user engagement. Results: The development of the study app for a 3-armed randomized controlled trial required a multidisciplinary team. The app is accessible for the target population free of charge via the Apple App Store. In Germany, within 9 months, the app was downloaded 1458 times and 328 study participants were recruited using it without external advertising. A total of 98.27% (5157/5248) of the app-based baseline questions were answered. The correct classification of BCTs used in the app required psychological expertise. Conclusions: Conducting an innovative app study requires multidisciplinary effort. Easy access and engagement with such an app can be achieved by recruitment via the App Store. Future research is needed to investigate the determinants of user engagement, optimal BCT application, and potential clinical and self-care scenarios for app use. Trial registration: Cli

Published
2020

30. Additional file 2: of Comparing physicians’ and patients’ reporting on adverse reactions in randomized trials on acupuncture—a secondary data analysis

Author

Schwaneberg, Thea, Witt, Claudia, Roll, Stephanie, and Pach, Daniel

Subjects
body regions, fungi, education, skin and connective tissue diseases
Abstract

Definitions of the terms adverse event (AE), adverse reaction (AR) and suspected adverse reaction (SAR) by international institutions. (DOCX 20 kb)

Published
2019
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32. Additional file 1: of Evaluation of a blended-learning training concept to train oncology physicians to advise their patients about complementary and integrative medicine (KOKON-KTO): study protocol for a prospective, multi-center, cluster-randomized trial

Author

Helmer, Stefanie, AlizĂŠ Rogge, Fischer, Felix, Pach, Daniel, Horneber, Markus, Roll, Stephanie, and Witt, Claudia

Abstract

Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 Checklist. (DOC 124 kb)

Published
2019
Full Text
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33. Default mode network as a neural substrate of acupuncture: evidence, challenges and strategy

Author

Zhang, Yuqi, Zhang, Haolin, Nierhaus, Till, Pach, Daniel, Witt, Claudia M, Yi, Ming, Zhang, Yuqi, Zhang, Haolin, Nierhaus, Till, Pach, Daniel, Witt, Claudia M, and Yi, Ming

Abstract

Acupuncture is widely applied all over the world. Although the neurobiological underpinnings of acupuncture still remain unclear, accumulating evidence indicates significant alteration of brain activities in response to acupuncture. In particular, activities of brain regions in the default mode network (DMN) are modulated by acupuncture. DMN is crucial for maintaining physiological homeostasis and its functional architecture becomes disrupted in various disorders. But how acupuncture modulates brain functions and whether such modulation constitutes core mechanisms of acupuncture treatment are far from clear. This Perspective integrates recent literature on interactions between acupuncture and functional networks including the DMN, and proposes a back-translational research strategy to elucidate brain mechanisms of acupuncture treatment.

Published
2019

34. Evaluation of a blended-learning training concept to train oncology physicians to advise their patients about complementary and integrative medicine (KOKON-KTO): study protocol for a prospective, multi-center, cluster-randomized trial

Author

Helmer, Stefanie M, Rogge, Alizé A, Fischer, Felix, Pach, Daniel, Horneber, Markus, Roll, Stephanie, Witt, Claudia M, Helmer, Stefanie M, Rogge, Alizé A, Fischer, Felix, Pach, Daniel, Horneber, Markus, Roll, Stephanie, and Witt, Claudia M

Abstract

Background Many cancer patients are interested in complementary and integrative medicine during and after regular cancer treatment. Given the high number of users it is important that physicians and patients engage in a dialog about useful complementary and integrative medicine therapies during cancer treatment. In a prospective, multi-center, cluster-randomized evaluation study we will develop, implement and evaluate a training program for oncology physicians advising their patients on complementary and integrative medicine. The main objective of the study is to evaluate whether training physicians in a blended-learning approach (e-learning + skills-training workshop) in providing advice to their cancer patients on complementary and integrative medicine, in addition to handing out an information leaflet about reputable websites, has different effects on the outcomes of patients, physicians, and their interaction level, compared to only giving out the information leaflet. Methods/design Forty-eight oncology physicians will be included into a cluster-randomized trial to either participate or not in the blended-learning training. Physicians will then advise 10 cancer patients each, resulting in 480 patients participating in the trial. The blended learning consists of nine units of up to 45 min of e-learning and 18 units of up to 45 min of on-site skills-training workshop focusing. Outcomes will be measured on the physician, patient, and physician-patient-interaction level. Discussion A blended-learning program for oncology physicians to advise their cancer patients in a systematic way and a reasonable time frame on complementary and integrative medicine will be evaluated in depth in a large cluster-randomized trial.

Published
2019

35. Multiple sclerosis-related fatigue: Altered resting-state functional connectivity of the ventral striatum and dorsolateral prefrontal cortex

Author

Jaeger, Sven, Paul, Friedemann, Scheel, Michael, Brandt, Alexander, Heine, Josephine, Pach, Daniel, Witt, Claudia M, Bellmann-Strobl, Judith, Finke, Carsten, Jaeger, Sven, Paul, Friedemann, Scheel, Michael, Brandt, Alexander, Heine, Josephine, Pach, Daniel, Witt, Claudia M, Bellmann-Strobl, Judith, and Finke, Carsten

Abstract

OBJECTIVE Since recent studies suggested a role of the striatum and prefrontal cortex for multiple sclerosis (MS)-related fatigue, we investigated resting-state functional connectivity alterations of striatal subdivisions and the dorsolateral prefrontal cortex (dlPFC). METHODS Resting-state functional magnetic resonance imaging was acquired in 77 relapsing-remitting MS patients (38 fatigued (F-MS), 39 non-fatigued (NF-MS)) and 41 matched healthy controls (HC). Fatigue severity was assessed using the fatigue severity scale. Seed-based connectivity analyses were performed using subregions of the striatum and the dlPFC as regions of interest applying non-parametric permutation testing. RESULTS Compared to HC and NF-MS patients, F-MS patients showed reduced caudate nucleus and ventral striatum functional connectivity with the sensorimotor cortex (SMC) and frontal, parietal, and temporal cortex regions. Fatigue severity correlated negatively with functional connectivity of the caudate nucleus and ventral striatum with the SMC and positively with functional connectivity of the dlPFC with the rostral inferior parietal gyrus and SMC. CONCLUSION MS-related fatigue is associated with reduced functional connectivity between the striatum and sensorimotor as well as attention and reward networks, in which the ventral striatum might be a key integration hub. Together with increased connectivity between the dlPFC and sensory cortical areas, these connectivity alterations shed light on the mechanisms of MS-related fatigue.

Published
2019

38. Effectiveness of app-based self-acupressure for women with menstrual pain compared to usual care: A randomized pragmatic trial

Author

Blödt, Susanne, Pach, Daniel, von Eisenhart-Rothe, Sanna, Lotz, Fabian, Roll, Stephanie, Icke, Katja, Witt, Claudia M, Blödt, Susanne, Pach, Daniel, von Eisenhart-Rothe, Sanna, Lotz, Fabian, Roll, Stephanie, Icke, Katja, and Witt, Claudia M

Abstract

BACKGROUND: Primary dysmenorrhea is common among women of reproductive age. Non-steroidal anti-inflammatory drugs and oral contraceptives are effective treatments, although the failure rate is around 20-25%. Therefore additional evidence-based treatments are needed. In recent years, the use of smartphone applications (apps) has increased rapidly and may support individuals in self-management strategies. OBJECTIVE: We aimed to investigate the effectiveness of app-based self-acupressure in women with menstrual pain. MATERIALS AND METHODS: A two-armed randomized pragmatic trial was conducted from December 2012 to April 2015 with recruitment until August 2014 in Berlin, Germany, among women aged 18-34 years with self reported cramping pain ≥6 on a numeric rating scale (NRS) for the worst pain intensity during the previous menstruation. After randomization women performed either app-based self-acupressure (n=111) or followed usual care only (n=110) for six consecutive menstruation cycles. The primary outcome was the mean pain intensity (NRS 0-10) on the days with pain during the third menstruation. Secondary outcomes included worst pain intensity during menstruation, duration of pain, 50% responder rates (reduction of mean pain by at least 50%), medication intake, sick leave days and body efficacy expectation assessed at the 1(st), 2(nd), 3(rd), and 6(th) menstruation cycle. RESULTS: We included 221 women (mean age 24.0 (sd 3.6) years). The mean pain intensity difference during the third menstruation was statistically significant in favor for acupressure (acupressure: 4.4 95% CI [4.0; 4.7]; usual care 5.0 [4.6; 5.3]; mean difference -0.6 [-1.2; -0.1], p=0.026). At the sixth cycle, the mean difference between the groups -1.4 [-2.0; -0.8] (p<0.001) reached clinical relevance. At the third and sixth menstruation cycle, responder rate was 37% and 58% respectively in the acupressure group in contrast to 23% and 24% in the usual care group. Moreover, the worst pain intensity (

Published
2018

39. World Congress Integrative Medicine & Health 2017: Part one

Author

Brinkhaus, Benno, Falkenberg, Torkel, Haramati, Aviad, Willich, Stefan N, Briggs, Josephine P, Willcox, Merlin, Linde, Klaus, Theorell, Töres, Wong, Lisa M, Dusek, Jeffrey, Wu, Darong, Eisenberg, David, Berger, Bettina, Kemper, Kathi, Schröer, Beate, Klein, Hedda, Ferreri, Rosaria, Kaplan, Gary, Matthes, Harald, Rotter, Gabriele, Schiff, Elad, Arnon, Zahi, Hahn, Eckhard, Luberto, Christina M, Martin, David, Schwarz, Silke, Tauschel, Diethard, Flower, Andrew, Gramminger, Harsha, Gupta, Hedwig H, Gupta, S. N, Kerckhoff, Annette, Kessler, Christian S, Michalsen, Andreas, Kim, Eun S, Jang, Eun H, Kim, Rana, Jan, Sae B, Mittwede, Martin, Mohme, Wiebke, Arye, Eran, Bonucci, Massimo, Saad, Bashar, Breitkreuz, Thomas, Rossi, Elio, Kebudi, Rejin, Daher, Michel, Razaq, Samaher, Gafer, Nahla, Nimri, Omar, Hablas, Mohamed, Kienle, Gunver S, Samuels, Noah, Silbermann, Michael, Bandelin, Lena, Lang, Anna-Lena, Wartner, Eva, Holtermann, Christoph, Binstock, Maxwell, Riebau, Robert, Mujkanovic, Edin, Cramer, Holger, Lauche, Romy, Michalsen, Andres, Ward, Lesley, Irnich, Dominik, Stör, Wolfram, Burnstock, Geoffrey, Schaible, Hans-Georg, Ots, Thomas, Langhorst, Jost, Sundberg, Tobias, Amarell, Catherina, Anheyer, Melanie, Eckert, Marion, Ogal, Mercedes, Schönauer, Annette, Reisenberger, Birgit, Brand, Bernhard, Anheyer, Dennis, Dobos, Gustav, Kroez, Matthias, Ammendola, Aldo, Mao, Jun J, Witt, Claudia, Yang, Yufei, Oritz, Miriam, Horneber, Markus, Voiß, Petra, Rosenstiel, Alexandra, Amarell, Catharina, Schad, Friedemann, Schläppi, Marc, Kröz, Matthias, Büssing, Arndt, Sela, Gil, Avshalomov, David, Attias, Samuel, Cotton, Sian, Jong, Miek, Jong, Mats, Scheffer, Christian, Edelhäuser, Friedrich, AlBedah, Abdullah, Lee, Myeong S, Khalil, Mohamed, Ogawa, Keiko, Motoo, Yoshiharu, Arimitsu, Junsuke, Ogawa, Masao, Shimizu, Genki, Stange, Rainer, Kraft, Karin, Kuchta, Kenny, Watanabe, Kenji, Bonin, D, Gruber, Harald, Koch, Sabine, Pohlmann, Urs, Caldwell, Christine, Krantz, Barbara, Kortum, Ria, Martin, Lily, Wieland, Lisa S, Kligler, Ben, Fogerite, Susan, Zhang, Yuqing, Riva, John J, Lumpkin, Michael, Ratner, Emily, Ping, Liu, Jian, Pei, Hamme, Gesa-Meyer, Mao, Xiaosong, Chouping, Han, Schröder, Sven, Hummelsberger, Josef, Wullinger, Michael, Brodzky, Marc, Zalpour, Christoff, Langley, Julia, Weber, Wendy, Mudd, Lanay M, Wayne, Peter, Witt, Clauda, Weidenhammer, Wolfgang, Fønnebø, Vinjar, Boon, Heather, Steel, Amie, Bugarcic, Andrea, Rangitakatu, Melisa, Adams, Jon, Sibbritt, David, Wardle, Jon, Leach, Matthew, Schloss, Janet, Dieze, Helene, Ijaz, Nadine, Heinrich, Michael, Lewith, George, Graz, Bertrand, Adam, Daniela, Grabenhenrich, Linus, Ortiz, Miriam, Binting, Sylvia, Reinhold, Thomas, Andermo, Susanne, Nordberg, Johanna H, Arman, Maria, Bhasin, Manoj, Fan, Xueyi, Libermann, Towia, Fricchione, Gregory, Denninger, John, Benson, Herbert, Martin, David D, Boers, Inge, Vlieger, Arine, Teut, Michael, Ullmann, Alexander, Lotz, Fabian, Roll, Stephanie, Canella, Claudia, Mikolasek, Michael, Rostock, Matthias, Beyer, Jörg, Guckenberger, Matthias, Jenewein, Josef, Linka, Esther, Six, Claudia, Stoll, Sarah, Stupp, Roger, Witt, Claudia M, Chuang, Elisabeth, McKee, Melissa D, Klose, Petra, Lange, Silke, Chung, Vincent C H, Wong, Hoi L C, Wu, Xin Y, Wen, Grace Y G, Ho, Robin S T, Ching, Jessica Y L, Wu, Justin C Y, Coakley, Amanda, Flanagan, Jane, Annese, Christine, Empoliti, Joanne, Gao, Zishan, Liu, Xugang, Yu, Shuguang, Yan, Xianzhong, Liang, Fanrong, Hohmann, Christoph D, Steckhan, Nico, Ostermann, Thomas, Paetow, Arion, Hoff, Evelyn, Hu, Xiao-Yang, Wu, Ruo-Han, Logue, Martin, Blonde, Clara, Lai, Lily Y, Stuart, Beth, Fei, Yu-Tong, Moore, Michael, Liu, Jian-Ping, Jeitler, Michael, Zillgen, Hannah, Högl, Manuel, Stöckigt, Barbara, Seifert, Georg, Kessler, Christian, Khadivzadeh, Talat, Bashtian, Maryam H, Aval, Shapour B, Esmaily, Habibollah, Kim, Jihye, Kim, Keun H, Klocke, Carina, Joos, Stefanie, Koshak, Abdulrahman, Wie, Li, Koshak, Emad, Wali, Siraj, Alamoudi, Omer, Demerdash, Abdulrahman, Qutub, Majdy, Pushparaj, Peter, Kruse, Sigrid, Fischer, Isabell, Tremel, Nadine, Rosenecker, Joseph, Leung, Brenda, Takeda, Wendy, Liang, Ning, Feng, Xue, Liu, Jian-ping, Cao, Hui-juan, Shinday, Nina, Philpotts, Lisa, Park, Elyse, Fricchione, Gregory L, Yeh, Gloria, Munk, Niki, Zakeresfahani, Arash, Foote, Trevor R, Ralston, Rick, Boulanger, Karen, Özbe, Dominik, Gräßel, Elmar, Luttenberger, Katharina, Pendergrass, Anna, Pach, Daniel, Strobl, Judit, Chang, Yinhui, Pasura, Laura, Liu, Bin, Jäger, Sven F, Loerch, Ronny, Jin, Li, Icke, Katja, Shi, Xuemin, Paul, Friedemann, Rütz, Michaela, Lynen, Andreas, Schömitz, Meike, Vahle, Maik, Salomon, Nir, Lang, Alon, Lahat, Adi, Kopylov, Uri, Horin, Shomron, Noi, Ofir, Avidan, Benjamin, Elyakim, Rami, Gamus, Dorit, NG, Siew, Chang, Jessica, Wu, Justin, Kaimiklotis, John, Schumann, Dania, Buttó, Ludovica, Haller, Dirk, Smith, Caroline, Lacey, Sheryl, Chapman, Michael, Ratcliffe, Julie, Johnson, Neil, Lyttleton, Jane, Boothroyd, Clare, Fahey, Paul, Tjaden, Bram, Vliet, Marja, Wietmarschen, Herman, Tröger, Wilfried, Vuolanto, Pia, Aarva, Paulina, Sorsa, Minna, Helin, Kaija, Wenzel, Claudia, Zoderer, Iris, Pammer, Patricia, Simon, Patrick, Tucek, Gerhard, Wode, Kathrin, Henriksson, Roger, Sharp, Lena, Stoltenberg, Anna, ying, Yang, Wang, Li-qiong, Li, Jin-gen, Wang, Ying, Balneaves, Lynda, Capler, Rielle, Bocci, Chiara, Guffi, Marta, Paolini, Marina, Meaglia, Ilaria, Porcu, Patrizia, Ivaldi, Giovanni B, Dragan, Simona, Bucuras, Petru, Pah, Ana M, Petrescu, Marius, Buleu, Florina, Stoichescu, Gheorghe, Christodorescu, Ruxandra, Kao, Lan, Cho, Yumin, Klafke, Nadja, Mahler, Cornelia, von Hagens, Cornelia, Uhlmann, Lorenz, Bentner, Martina, Schneeweiß, Andreas, Mueller, Andreas, Szecsenyi, Joachim, Neri, Isabella, Schnabel, Katharina, Cree, Margit, Suhr, Ralf, Baccetti, Sonia, Firenzuoli, Fabio, Monechi, Maria V, Stefano, Mariella, Amunni, Gianni, Wong, Wendy, Chen, Bingzhong, Amri, Hakima, Kotlyanskaya, Lucy, Anderson, Belinda, Evans, Roni, Marantz, Paul, Bradley, Ryan, LaForce, Cathryn, Zwickey, Heather, Kligler, Benjamin, Brooks, Audrey, Kreitzer, Mary J, Lebensohn, Patricia, Goldblatt, Elisabeth, Esmel, Neus, Herrera, Maria, Jocham, Alexandra, Berberat, Pascal O, Schneider, Antonius, Masetti, Morgana, Murakozy, Henriette, Agdal, Rita, Atarzadeh, Fatemeh, Jaladat, Amir M, Hoseini, Leila, Amini, Fatemeh, Bai, Chen, Liu, Tiegang, Zheng, Zian, Wan, Yuxiang, Xu, Jingnan, Wang, Xuan, Yu, He, Gu, Xiaohong, Daneshfard, Babak, Nimrouzi, Majid, Tafazoli, Vahid, Alorizi, Seyed M E, Saghebi, Seyed A, Fattahi, Mohammad R, Salehi, Alireza, Rezaeizadeh, Hossein, Zarshenas, Mohammad M, Fox, Kealoha, Hughes, John, Kostanjsek, Nenad, Espinosa, Stéphane, Fisher, Peter, Latif, Abdul, Lefeber, Donald, Paske, William, Öztürk, Ali Ö, Öztürk, Gizemnur, Tissing, Wim, Naafs, Marianne, Busch, Martine, Sanaye, Mohammad R, Dräger, Kilian, Leininger, Brent, Shafto, Kate, Breen, Jenny, Wüst, Ana P, Puigmartí, Carolina, Dongen, Martien, Dagnelie, Pieter, Thijs, Carel, White, Shelley, Wiesener, Solveig, Salamonsen, Anita, Stub, Trine, Abanades, Sergio, Blanco, Mar, Masllorens, Laia, Sala, Roser, Ahnoumy, Shafekah, Han, Dongwoon, He, Luzhu, Kim, Ha Y, Choi, Da, Alræk, Terje, Kristoffersen, Agnete, Sceidt, Christel, Bruset, Stig, Musial, Frauke, Saha, Felix J, Haller, Heidemarie, Azizi, Hoda, Khadem, Nayereh, Hassanzadeh, Malihe, Estiri, Nazanin, Azizi, Hamideh, Tavassoli, Fatemeh, Lotfalizadeh, Marzieh, Zabihi, Reza, Shabestari, Mahmoud M, Paeizi, Reza, Azari, Masoumeh A, Taghanaki, Hamidreza, Baars, Erik, Bruin, Anja, Ponstein, Anne, Segantini, Sergio, Voller, Fabio, Barth, Jürgen, Kern, Alexandra, Lüthi, Sebastian, Zieger, Anja, Otto, Fabius, Beccia, Ariel, Dunlap, Corina, Courneene, Brendan, Bedregal, Paula, Passi, Alvaro, Rodríguez, Alfredo, Chang, Mayling, Gutiérrez, Soledad, Beissner, Florian, Preibisch, Christine, Arau, Annemarie, Popovici, Roxana, Meissner, Karin, Beljanski, Sylvie, Belland, Laura, Reyes, Laura, Hwang, Ula, Sethe, Dominik, Hilgard, Dörte, Heusser, Peter, Bishop, Felicity, Abbadey, Miznah, Bradbury, Katherine, Carnes, Dawn, Dimitrov, Borislav, Fawkes, Carol, Foster, Jo, MacPherson, Hugh, Roberts, Lisa, Yardley, Lucy, Holmes, Michelle, Little, Paul, Cooper, Cyrus, Bogani, Patrizia, Maggini, Valentina, Gallo, Eugenia, Miceli, Elisangela, Biffi, Sauro, Mengoni, Alessio, Fani, Renato, Guendling, Nadine, Guendling, Peter W, Bronfort, Gert, Haas, Mitch, Schulz, Craig, Bu, Xiangwei, Wang, J., Fang, T., Shen, Z., He, Y., Zhang, X., Zhang, Zhengju, Wang, Dali, Meng, Fengxian, Baumann, Klaus, Frick, Eckhard, Jacobs, Christoph, Grünther, Ralph-Achim, Lötzke, Désirée, Jung, Sonny, Recchia, Daniela R, Robens, Sibylle, Stankewitz, Josephin, Jeitler, Mika, Cheon, Chunhoo, Jang, Bo H, Ko, Seong G, Huang, Ching W, Sasaki, Yui, Ko, Youme, Cheshire, Anna, Ridge, Damien, Peters, David, Panagioti, Maria, Simon, Chantal, Cho, Hyun J, Choi, Soo J, Jung, Young S, Im, Hyea B, Cooley, Kieran, Simmons, Laura, Wasson, Rachel, Kraemer, Kristen, Sears, Richard, Hueber, Carly, Derk, Gwendolyn, Lill, JR, An, Ruopeng, Steinberg, Lois, Rodriguez, Lourdes D, Fuente, Francisca G, Vega, Miguel, Román, Keyla, Ruiz, Jonatan, Villanueva, Irene, Fuente, Francisca, Guerrero, Fanny, Castillo, Noelia, Saez, Gualberto, Jimenez, José I, Gomez, Olga, Muñoz, Luis, Diez, Camino, Dicen, Demijon, Diezel, Helene, Frawley, Jane, Broom, Alex, Dong, Fei, Ma, Xueyan, Yan, Liyi, Wu, Liqun, Ma, Jiaju, Zhen, Jianhua, Dubois, Julie, Rodondi, Pierre-Yves, Schwartze, Sophia, Trapp, Barbara, Cysarz, Dirk, Brinkhaus, Benno, Falkenberg, Torkel, Haramati, Aviad, Willich, Stefan N, Briggs, Josephine P, Willcox, Merlin, Linde, Klaus, Theorell, Töres, Wong, Lisa M, Dusek, Jeffrey, Wu, Darong, Eisenberg, David, Berger, Bettina, Kemper, Kathi, Schröer, Beate, Klein, Hedda, Ferreri, Rosaria, Kaplan, Gary, Matthes, Harald, Rotter, Gabriele, Schiff, Elad, Arnon, Zahi, Hahn, Eckhard, Luberto, Christina M, Martin, David, Schwarz, Silke, Tauschel, Diethard, Flower, Andrew, Gramminger, Harsha, Gupta, Hedwig H, Gupta, S. N, Kerckhoff, Annette, Kessler, Christian S, Michalsen, Andreas, Kim, Eun S, Jang, Eun H, Kim, Rana, Jan, Sae B, Mittwede, Martin, Mohme, Wiebke, Arye, Eran, Bonucci, Massimo, Saad, Bashar, Breitkreuz, Thomas, Rossi, Elio, Kebudi, Rejin, Daher, Michel, Razaq, Samaher, Gafer, Nahla, Nimri, Omar, Hablas, Mohamed, Kienle, Gunver S, Samuels, Noah, Silbermann, Michael, Bandelin, Lena, Lang, Anna-Lena, Wartner, Eva, Holtermann, Christoph, Binstock, Maxwell, Riebau, Robert, Mujkanovic, Edin, Cramer, Holger, Lauche, Romy, Michalsen, Andres, Ward, Lesley, Irnich, Dominik, Stör, Wolfram, Burnstock, Geoffrey, Schaible, Hans-Georg, Ots, Thomas, Langhorst, Jost, Sundberg, Tobias, Amarell, Catherina, Anheyer, Melanie, Eckert, Marion, Ogal, Mercedes, Schönauer, Annette, Reisenberger, Birgit, Brand, Bernhard, Anheyer, Dennis, Dobos, Gustav, Kroez, Matthias, Ammendola, Aldo, Mao, Jun J, Witt, Claudia, Yang, Yufei, Oritz, Miriam, Horneber, Markus, Voiß, Petra, Rosenstiel, Alexandra, Amarell, Catharina, Schad, Friedemann, Schläppi, Marc, Kröz, Matthias, Büssing, Arndt, Sela, Gil, Avshalomov, David, Attias, Samuel, Cotton, Sian, Jong, Miek, Jong, Mats, Scheffer, Christian, Edelhäuser, Friedrich, AlBedah, Abdullah, Lee, Myeong S, Khalil, Mohamed, Ogawa, Keiko, Motoo, Yoshiharu, Arimitsu, Junsuke, Ogawa, Masao, Shimizu, Genki, Stange, Rainer, Kraft, Karin, Kuchta, Kenny, Watanabe, Kenji, Bonin, D, Gruber, Harald, Koch, Sabine, Pohlmann, Urs, Caldwell, Christine, Krantz, Barbara, Kortum, Ria, Martin, Lily, Wieland, Lisa S, Kligler, Ben, Fogerite, Susan, Zhang, Yuqing, Riva, John J, Lumpkin, Michael, Ratner, Emily, Ping, Liu, Jian, Pei, Hamme, Gesa-Meyer, Mao, Xiaosong, Chouping, Han, Schröder, Sven, Hummelsberger, Josef, Wullinger, Michael, Brodzky, Marc, Zalpour, Christoff, Langley, Julia, Weber, Wendy, Mudd, Lanay M, Wayne, Peter, Witt, Clauda, Weidenhammer, Wolfgang, Fønnebø, Vinjar, Boon, Heather, Steel, Amie, Bugarcic, Andrea, Rangitakatu, Melisa, Adams, Jon, Sibbritt, David, Wardle, Jon, Leach, Matthew, Schloss, Janet, Dieze, Helene, Ijaz, Nadine, Heinrich, Michael, Lewith, George, Graz, Bertrand, Adam, Daniela, Grabenhenrich, Linus, Ortiz, Miriam, Binting, Sylvia, Reinhold, Thomas, Andermo, Susanne, Nordberg, Johanna H, Arman, Maria, Bhasin, Manoj, Fan, Xueyi, Libermann, Towia, Fricchione, Gregory, Denninger, John, Benson, Herbert, Martin, David D, Boers, Inge, Vlieger, Arine, Teut, Michael, Ullmann, Alexander, Lotz, Fabian, Roll, Stephanie, Canella, Claudia, Mikolasek, Michael, Rostock, Matthias, Beyer, Jörg, Guckenberger, Matthias, Jenewein, Josef, Linka, Esther, Six, Claudia, Stoll, Sarah, Stupp, Roger, Witt, Claudia M, Chuang, Elisabeth, McKee, Melissa D, Klose, Petra, Lange, Silke, Chung, Vincent C H, Wong, Hoi L C, Wu, Xin Y, Wen, Grace Y G, Ho, Robin S T, Ching, Jessica Y L, Wu, Justin C Y, Coakley, Amanda, Flanagan, Jane, Annese, Christine, Empoliti, Joanne, Gao, Zishan, Liu, Xugang, Yu, Shuguang, Yan, Xianzhong, Liang, Fanrong, Hohmann, Christoph D, Steckhan, Nico, Ostermann, Thomas, Paetow, Arion, Hoff, Evelyn, Hu, Xiao-Yang, Wu, Ruo-Han, Logue, Martin, Blonde, Clara, Lai, Lily Y, Stuart, Beth, Fei, Yu-Tong, Moore, Michael, Liu, Jian-Ping, Jeitler, Michael, Zillgen, Hannah, Högl, Manuel, Stöckigt, Barbara, Seifert, Georg, Kessler, Christian, Khadivzadeh, Talat, Bashtian, Maryam H, Aval, Shapour B, Esmaily, Habibollah, Kim, Jihye, Kim, Keun H, Klocke, Carina, Joos, Stefanie, Koshak, Abdulrahman, Wie, Li, Koshak, Emad, Wali, Siraj, Alamoudi, Omer, Demerdash, Abdulrahman, Qutub, Majdy, Pushparaj, Peter, Kruse, Sigrid, Fischer, Isabell, Tremel, Nadine, Rosenecker, Joseph, Leung, Brenda, Takeda, Wendy, Liang, Ning, Feng, Xue, Liu, Jian-ping, Cao, Hui-juan, Shinday, Nina, Philpotts, Lisa, Park, Elyse, Fricchione, Gregory L, Yeh, Gloria, Munk, Niki, Zakeresfahani, Arash, Foote, Trevor R, Ralston, Rick, Boulanger, Karen, Özbe, Dominik, Gräßel, Elmar, Luttenberger, Katharina, Pendergrass, Anna, Pach, Daniel, Strobl, Judit, Chang, Yinhui, Pasura, Laura, Liu, Bin, Jäger, Sven F, Loerch, Ronny, Jin, Li, Icke, Katja, Shi, Xuemin, Paul, Friedemann, Rütz, Michaela, Lynen, Andreas, Schömitz, Meike, Vahle, Maik, Salomon, Nir, Lang, Alon, Lahat, Adi, Kopylov, Uri, Horin, Shomron, Noi, Ofir, Avidan, Benjamin, Elyakim, Rami, Gamus, Dorit, NG, Siew, Chang, Jessica, Wu, Justin, Kaimiklotis, John, Schumann, Dania, Buttó, Ludovica, Haller, Dirk, Smith, Caroline, Lacey, Sheryl, Chapman, Michael, Ratcliffe, Julie, Johnson, Neil, Lyttleton, Jane, Boothroyd, Clare, Fahey, Paul, Tjaden, Bram, Vliet, Marja, Wietmarschen, Herman, Tröger, Wilfried, Vuolanto, Pia, Aarva, Paulina, Sorsa, Minna, Helin, Kaija, Wenzel, Claudia, Zoderer, Iris, Pammer, Patricia, Simon, Patrick, Tucek, Gerhard, Wode, Kathrin, Henriksson, Roger, Sharp, Lena, Stoltenberg, Anna, ying, Yang, Wang, Li-qiong, Li, Jin-gen, Wang, Ying, Balneaves, Lynda, Capler, Rielle, Bocci, Chiara, Guffi, Marta, Paolini, Marina, Meaglia, Ilaria, Porcu, Patrizia, Ivaldi, Giovanni B, Dragan, Simona, Bucuras, Petru, Pah, Ana M, Petrescu, Marius, Buleu, Florina, Stoichescu, Gheorghe, Christodorescu, Ruxandra, Kao, Lan, Cho, Yumin, Klafke, Nadja, Mahler, Cornelia, von Hagens, Cornelia, Uhlmann, Lorenz, Bentner, Martina, Schneeweiß, Andreas, Mueller, Andreas, Szecsenyi, Joachim, Neri, Isabella, Schnabel, Katharina, Cree, Margit, Suhr, Ralf, Baccetti, Sonia, Firenzuoli, Fabio, Monechi, Maria V, Stefano, Mariella, Amunni, Gianni, Wong, Wendy, Chen, Bingzhong, Amri, Hakima, Kotlyanskaya, Lucy, Anderson, Belinda, Evans, Roni, Marantz, Paul, Bradley, Ryan, LaForce, Cathryn, Zwickey, Heather, Kligler, Benjamin, Brooks, Audrey, Kreitzer, Mary J, Lebensohn, Patricia, Goldblatt, Elisabeth, Esmel, Neus, Herrera, Maria, Jocham, Alexandra, Berberat, Pascal O, Schneider, Antonius, Masetti, Morgana, Murakozy, Henriette, Agdal, Rita, Atarzadeh, Fatemeh, Jaladat, Amir M, Hoseini, Leila, Amini, Fatemeh, Bai, Chen, Liu, Tiegang, Zheng, Zian, Wan, Yuxiang, Xu, Jingnan, Wang, Xuan, Yu, He, Gu, Xiaohong, Daneshfard, Babak, Nimrouzi, Majid, Tafazoli, Vahid, Alorizi, Seyed M E, Saghebi, Seyed A, Fattahi, Mohammad R, Salehi, Alireza, Rezaeizadeh, Hossein, Zarshenas, Mohammad M, Fox, Kealoha, Hughes, John, Kostanjsek, Nenad, Espinosa, Stéphane, Fisher, Peter, Latif, Abdul, Lefeber, Donald, Paske, William, Öztürk, Ali Ö, Öztürk, Gizemnur, Tissing, Wim, Naafs, Marianne, Busch, Martine, Sanaye, Mohammad R, Dräger, Kilian, Leininger, Brent, Shafto, Kate, Breen, Jenny, Wüst, Ana P, Puigmartí, Carolina, Dongen, Martien, Dagnelie, Pieter, Thijs, Carel, White, Shelley, Wiesener, Solveig, Salamonsen, Anita, Stub, Trine, Abanades, Sergio, Blanco, Mar, Masllorens, Laia, Sala, Roser, Ahnoumy, Shafekah, Han, Dongwoon, He, Luzhu, Kim, Ha Y, Choi, Da, Alræk, Terje, Kristoffersen, Agnete, Sceidt, Christel, Bruset, Stig, Musial, Frauke, Saha, Felix J, Haller, Heidemarie, Azizi, Hoda, Khadem, Nayereh, Hassanzadeh, Malihe, Estiri, Nazanin, Azizi, Hamideh, Tavassoli, Fatemeh, Lotfalizadeh, Marzieh, Zabihi, Reza, Shabestari, Mahmoud M, Paeizi, Reza, Azari, Masoumeh A, Taghanaki, Hamidreza, Baars, Erik, Bruin, Anja, Ponstein, Anne, Segantini, Sergio, Voller, Fabio, Barth, Jürgen, Kern, Alexandra, Lüthi, Sebastian, Zieger, Anja, Otto, Fabius, Beccia, Ariel, Dunlap, Corina, Courneene, Brendan, Bedregal, Paula, Passi, Alvaro, Rodríguez, Alfredo, Chang, Mayling, Gutiérrez, Soledad, Beissner, Florian, Preibisch, Christine, Arau, Annemarie, Popovici, Roxana, Meissner, Karin, Beljanski, Sylvie, Belland, Laura, Reyes, Laura, Hwang, Ula, Sethe, Dominik, Hilgard, Dörte, Heusser, Peter, Bishop, Felicity, Abbadey, Miznah, Bradbury, Katherine, Carnes, Dawn, Dimitrov, Borislav, Fawkes, Carol, Foster, Jo, MacPherson, Hugh, Roberts, Lisa, Yardley, Lucy, Holmes, Michelle, Little, Paul, Cooper, Cyrus, Bogani, Patrizia, Maggini, Valentina, Gallo, Eugenia, Miceli, Elisangela, Biffi, Sauro, Mengoni, Alessio, Fani, Renato, Guendling, Nadine, Guendling, Peter W, Bronfort, Gert, Haas, Mitch, Schulz, Craig, Bu, Xiangwei, Wang, J., Fang, T., Shen, Z., He, Y., Zhang, X., Zhang, Zhengju, Wang, Dali, Meng, Fengxian, Baumann, Klaus, Frick, Eckhard, Jacobs, Christoph, Grünther, Ralph-Achim, Lötzke, Désirée, Jung, Sonny, Recchia, Daniela R, Robens, Sibylle, Stankewitz, Josephin, Jeitler, Mika, Cheon, Chunhoo, Jang, Bo H, Ko, Seong G, Huang, Ching W, Sasaki, Yui, Ko, Youme, Cheshire, Anna, Ridge, Damien, Peters, David, Panagioti, Maria, Simon, Chantal, Cho, Hyun J, Choi, Soo J, Jung, Young S, Im, Hyea B, Cooley, Kieran, Simmons, Laura, Wasson, Rachel, Kraemer, Kristen, Sears, Richard, Hueber, Carly, Derk, Gwendolyn, Lill, JR, An, Ruopeng, Steinberg, Lois, Rodriguez, Lourdes D, Fuente, Francisca G, Vega, Miguel, Román, Keyla, Ruiz, Jonatan, Villanueva, Irene, Fuente, Francisca, Guerrero, Fanny, Castillo, Noelia, Saez, Gualberto, Jimenez, José I, Gomez, Olga, Muñoz, Luis, Diez, Camino, Dicen, Demijon, Diezel, Helene, Frawley, Jane, Broom, Alex, Dong, Fei, Ma, Xueyan, Yan, Liyi, Wu, Liqun, Ma, Jiaju, Zhen, Jianhua, Dubois, Julie, Rodondi, Pierre-Yves, Schwartze, Sophia, Trapp, Barbara, and Cysarz, Dirk

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2017
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40. World Congress Integrative Medicine & Health 2017: Part one

Author

Brinkhaus, Benno, primary, Falkenberg, Torkel, additional, Haramati, Aviad, additional, Willich, Stefan N., additional, Briggs, Josephine P., additional, Willcox, Merlin, additional, Linde, Klaus, additional, Theorell, Töres, additional, Wong, Lisa M., additional, Dusek, Jeffrey, additional, Wu, Darong, additional, Eisenberg, David, additional, Berger, Bettina, additional, Kemper, Kathi, additional, Stock-Schröer, Beate, additional, Sützl-Klein, Hedda, additional, Ferreri, Rosaria, additional, Kaplan, Gary, additional, Matthes, Harald, additional, Rotter, Gabriele, additional, Schiff, Elad, additional, Arnon, Zahi, additional, Hahn, Eckhard, additional, Luberto, Christina M., additional, Martin, David, additional, Schwarz, Silke, additional, Tauschel, Diethard, additional, Flower, Andrew, additional, Gramminger, Harsha, additional, Gupta, Hedwig H., additional, Gupta, S. N., additional, Kerckhoff, Annette, additional, Kessler, Christian S., additional, Michalsen, Andreas, additional, Kim, Eun S., additional, Jang, Eun H., additional, Kim, Rana, additional, Jan, Sae B., additional, Mittwede, Martin, additional, Mohme, Wiebke, additional, Ben-Arye, Eran, additional, Bonucci, Massimo, additional, Saad, Bashar, additional, Breitkreuz, Thomas, additional, Rossi, Elio, additional, Kebudi, Rejin, additional, Daher, Michel, additional, Razaq, Samaher, additional, Gafer, Nahla, additional, Nimri, Omar, additional, Hablas, Mohamed, additional, Kienle, Gunver Sophia, additional, Samuels, Noah, additional, Silbermann, Michael, additional, Bandelin, Lena, additional, Lang, Anna-Lena, additional, Wartner, Eva, additional, Holtermann, Christoph, additional, Binstock, Maxwell, additional, Riebau, Robert, additional, Mujkanovic, Edin, additional, Cramer, Holger, additional, Lauche, Romy, additional, Michalsen, Andres, additional, Ward, Lesley, additional, Irnich, Dominik, additional, Stör, Wolfram, additional, Burnstock, Geoffrey, additional, Schaible, Hans-Georg, additional, Ots, Thomas, additional, Langhorst, Jost, additional, Sundberg, Tobias, additional, Amarell, Catherina, additional, Anheyer, Melanie, additional, Eckert, Marion, additional, Ogal, Mercedes, additional, Schönauer, Annette, additional, Reisenberger, Birgit, additional, Brand, Bernhard, additional, Anheyer, Dennis, additional, Dobos, Gustav, additional, Kroez, Matthias, additional, Ammendola, Aldo, additional, Mao, Jun J., additional, Witt, Claudia, additional, Yang, Yufei, additional, Oritz, Miriam, additional, Horneber, Markus, additional, Voiß, Petra, additional, von Rosenstiel, Alexandra, additional, Amarell, Catharina, additional, Schad, Friedemann, additional, Schläppi, Marc, additional, Kröz, Matthias, additional, Büssing, Arndt, additional, Bar-Sela, Gil, additional, Avshalomov, David, additional, Attias, Samuel, additional, Brinkhaus, Benno, additional, Cotton, Sian, additional, Jong, Miek, additional, Jong, Mats, additional, Scheffer, Christian, additional, Edelhäuser, Friedrich, additional, AlBedah, Abdullah, additional, Lee, Myeong Soo, additional, Khalil, Mohamed, additional, Ogawa, Keiko, additional, Motoo, Yoshiharu, additional, Arimitsu, Junsuke, additional, Ogawa, Masao, additional, Shimizu, Genki, additional, Stange, Rainer, additional, Kraft, Karin, additional, Kuchta, Kenny, additional, Watanabe, Kenji, additional, Bonin, D, additional, Gruber, Harald, additional, Koch, Sabine, additional, Pohlmann, Urs, additional, Caldwell, Christine, additional, Krantz, Barbara, additional, Kortum, Ria, additional, Martin, Lily, additional, Wieland, Lisa S., additional, Kligler, Ben, additional, Gould-Fogerite, Susan, additional, Zhang, Yuqing, additional, Riva, John J., additional, Lumpkin, Michael, additional, Ratner, Emily, additional, Ping, Liu, additional, Jian, Pei, additional, Hamme, Gesa-Meyer, additional, Mao, Xiaosong, additional, Chouping, Han, additional, Schröder, Sven, additional, Hummelsberger, Josef, additional, Wullinger, Michael, additional, Brodzky, Marc, additional, Zalpour, Christoff, additional, Langley, Julia, additional, Weber, Wendy, additional, Mudd, Lanay M., additional, Wayne, Peter, additional, Witt, Clauda, additional, Weidenhammer, Wolfgang, additional, Fønnebø, Vinjar, additional, Boon, Heather, additional, Steel, Amie, additional, Bugarcic, Andrea, additional, Rangitakatu, Melisa, additional, Adams, Jon, additional, Sibbritt, David, additional, Wardle, Jon, additional, Leach, Matthew, additional, Schloss, Janet, additional, Dieze, Helene, additional, Ijaz, Nadine, additional, Heinrich, Michael, additional, Lewith, George, additional, Graz, Bertrand, additional, Adam, Daniela, additional, Grabenhenrich, Linus, additional, Ortiz, Miriam, additional, Binting, Sylvia, additional, Reinhold, Thomas, additional, Andermo, Susanne, additional, Nordberg, Johanna Hök, additional, Arman, Maria, additional, Bhasin, Manoj, additional, Fan, Xueyi, additional, Libermann, Towia, additional, Fricchione, Gregory, additional, Denninger, John, additional, Benson, Herbert, additional, Martin, David D., additional, Boers, Inge, additional, Vlieger, Arine, additional, Teut, Michael, additional, Ullmann, Alexander, additional, Lotz, Fabian, additional, Roll, Stephanie, additional, Canella, Claudia, additional, Mikolasek, Michael, additional, Rostock, Matthias, additional, Beyer, Jörg, additional, Guckenberger, Matthias, additional, Jenewein, Josef, additional, Linka, Esther, additional, Six, Claudia, additional, Stoll, Sarah, additional, Stupp, Roger, additional, Witt, Claudia M., additional, Chuang, Elisabeth, additional, McKee, Melissa D., additional, Klose, Petra, additional, Lange, Silke, additional, Chung, Vincent C. H., additional, Wong, Hoi L. C., additional, Wu, Xin Y., additional, Wen, Grace Y. G., additional, Ho, Robin S. T., additional, Ching, Jessica Y. L., additional, Wu, Justin C. Y., additional, Coakley, Amanda, additional, Flanagan, Jane, additional, Annese, Christine, additional, Empoliti, Joanne, additional, Gao, Zishan, additional, Liu, Xugang, additional, Yu, Shuguang, additional, Yan, Xianzhong, additional, Liang, Fanrong, additional, Hohmann, Christoph D., additional, Steckhan, Nico, additional, Ostermann, Thomas, additional, Paetow, Arion, additional, Hoff, Evelyn, additional, Hu, Xiao-Yang, additional, Wu, Ruo-Han, additional, Logue, Martin, additional, Blonde, Clara, additional, Lai, Lily Y., additional, Stuart, Beth, additional, Fei, Yu-Tong, additional, Moore, Michael, additional, Liu, Jian-Ping, additional, Jeitler, Michael, additional, Zillgen, Hannah, additional, Högl, Manuel, additional, Stöckigt, Barbara, additional, Seifert, Georg, additional, Kessler, Christian, additional, Khadivzadeh, Talat, additional, Bashtian, Maryam Hassanzadeh, additional, Aval, Shapour Badiee, additional, Esmaily, Habibollah, additional, Kim, Jihye, additional, Kim, Keun H., additional, Klocke, Carina, additional, Joos, Stefanie, additional, Koshak, Abdulrahman, additional, Wie, Li, additional, Koshak, Emad, additional, Wali, Siraj, additional, Alamoudi, Omer, additional, Demerdash, Abdulrahman, additional, Qutub, Majdy, additional, Pushparaj, Peter, additional, Kruse, Sigrid, additional, Fischer, Isabell, additional, Tremel, Nadine, additional, Rosenecker, Joseph, additional, Leung, Brenda, additional, Takeda, Wendy, additional, Liang, Ning, additional, Feng, Xue, additional, Liu, Jian-ping, additional, Cao, Hui-juan, additional, Shinday, Nina, additional, Philpotts, Lisa, additional, Park, Elyse, additional, Fricchione, Gregory L., additional, Yeh, Gloria, additional, Munk, Niki, additional, Zakeresfahani, Arash, additional, Foote, Trevor R., additional, Ralston, Rick, additional, Boulanger, Karen, additional, Özbe, Dominik, additional, Gräßel, Elmar, additional, Luttenberger, Katharina, additional, Pendergrass, Anna, additional, Pach, Daniel, additional, Bellmann-Strobl, Judit, additional, Chang, Yinhui, additional, Pasura, Laura, additional, Liu, Bin, additional, Jäger, Sven F., additional, Loerch, Ronny, additional, Jin, Li, additional, Icke, Katja, additional, Shi, Xuemin, additional, Paul, Friedemann, additional, Rütz, Michaela, additional, Lynen, Andreas, additional, Schömitz, Meike, additional, Vahle, Maik, additional, Salomon, Nir, additional, Lang, Alon, additional, Lahat, Adi, additional, Kopylov, Uri, additional, Ben-Horin, Shomron, additional, Har-Noi, Ofir, additional, Avidan, Benjamin, additional, Elyakim, Rami, additional, Gamus, Dorit, additional, NG, Siew, additional, Chang, Jessica, additional, Wu, Justin, additional, Kaimiklotis, John, additional, Schumann, Dania, additional, Buttó, Ludovica, additional, Haller, Dirk, additional, Smith, Caroline, additional, de Lacey, Sheryl, additional, Chapman, Michael, additional, Ratcliffe, Julie, additional, Johnson, Neil, additional, Lyttleton, Jane, additional, Boothroyd, Clare, additional, Fahey, Paul, additional, Tjaden, Bram, additional, van Vliet, Marja, additional, van Wietmarschen, Herman, additional, Tröger, Wilfried, additional, Vuolanto, Pia, additional, Aarva, Paulina, additional, Sorsa, Minna, additional, Helin, Kaija, additional, Wenzel, Claudia, additional, Zoderer, Iris, additional, Pammer, Patricia, additional, Simon, Patrick, additional, Tucek, Gerhard, additional, Wode, Kathrin, additional, Henriksson, Roger, additional, Sharp, Lena, additional, Stoltenberg, Anna, additional, Xiao-ying, Yang, additional, Wang, Li-qiong, additional, Li, Jin-gen, additional, Wang, Ying, additional, Balneaves, Lynda, additional, Capler, Rielle, additional, Bocci, Chiara, additional, Guffi, Marta, additional, Paolini, Marina, additional, Meaglia, Ilaria, additional, Porcu, Patrizia, additional, Ivaldi, Giovanni B., additional, Dragan, Simona, additional, Bucuras, Petru, additional, Pah, Ana M., additional, Badalica-Petrescu, Marius, additional, Buleu, Florina, additional, Hogea-Stoichescu, Gheorghe, additional, Christodorescu, Ruxandra, additional, Kao, Lan, additional, Cho, Yumin, additional, Klafke, Nadja, additional, Mahler, Cornelia, additional, von Hagens, Cornelia, additional, Uhlmann, Lorenz, additional, Bentner, Martina, additional, Schneeweiss, Andreas, additional, Mueller, Andreas, additional, Szecsenyi, Joachim, additional, Neri, Isabella, additional, Schnabel, Katharina, additional, Cree, Margit, additional, Suhr, Ralf, additional, Baccetti, Sonia, additional, Firenzuoli, Fabio, additional, Monechi, Maria V., additional, Di Stefano, Mariella, additional, Amunni, Gianni, additional, Wong, Wendy, additional, Chen, Bingzhong, additional, Amri, Hakima, additional, Kotlyanskaya, Lucy, additional, Anderson, Belinda, additional, Evans, Roni, additional, Marantz, Paul, additional, Bradley, Ryan, additional, Booth-LaForce, Cathryn, additional, Zwickey, Heather, additional, Kligler, Benjamin, additional, Brooks, Audrey, additional, Kreitzer, Mary J., additional, Lebensohn, Patricia, additional, Goldblatt, Elisabeth, additional, Esmel-Esmel, Neus, additional, Jiménez-Herrera, Maria, additional, Jocham, Alexandra, additional, Berberat, Pascal O., additional, Schneider, Antonius, additional, Masetti, Morgana, additional, Murakozy, Henriette, additional, Van Vliet, Marja, additional, Agdal, Rita, additional, Atarzadeh, Fatemeh, additional, Jaladat, Amir M., additional, Hoseini, Leila, additional, Amini, Fatemeh, additional, Bai, Chen, additional, Liu, Tiegang, additional, Zheng, Zian, additional, Wan, Yuxiang, additional, Xu, Jingnan, additional, Wang, Xuan, additional, Yu, He, additional, Gu, Xiaohong, additional, Daneshfard, Babak, additional, Nimrouzi, Majid, additional, Tafazoli, Vahid, additional, Alorizi, Seyed M. Emami, additional, Saghebi, Seyed A., additional, Fattahi, Mohammad R., additional, Salehi, Alireza, additional, Rezaeizadeh, Hossein, additional, Zarshenas, Mohammad M., additional, Fox, Kealoha, additional, Hughes, John, additional, Kostanjsek, Nenad, additional, Espinosa, Stéphane, additional, Fisher, Peter, additional, Latif, Abdul, additional, Lefeber, Donald, additional, Paske, William, additional, Öztürk, Ali Ö., additional, Öztürk, Gizemnur, additional, Tissing, Wim, additional, Naafs, Marianne, additional, Busch, Martine, additional, Sanaye, Mohammad R., additional, Dräger, Kilian, additional, Leininger, Brent, additional, Shafto, Kate, additional, Breen, Jenny, additional, Simões-Wüst, Ana P., additional, Moltó-Puigmartí, Carolina, additional, van Dongen, Martien, additional, Dagnelie, Pieter, additional, Thijs, Carel, additional, White, Shelley, additional, Wiesener, Solveig, additional, Salamonsen, Anita, additional, Stub, Trine, additional, Abanades, Sergio, additional, Blanco, Mar, additional, Masllorens, Laia, additional, Sala, Roser, additional, Al-Ahnoumy, Shafekah, additional, Han, Dongwoon, additional, He, Luzhu, additional, Kim, Ha Yun, additional, In Choi, Da, additional, Alræk, Terje, additional, Kristoffersen, Agnete, additional, von Sceidt, Christel, additional, Bruset, Stig, additional, Musial, Frauke, additional, Saha, Felix J., additional, Haller, Heidemarie, additional, Azizi, Hoda, additional, Khadem, Nayereh, additional, Hassanzadeh, Malihe, additional, Estiri, Nazanin, additional, Azizi, Hamideh, additional, Tavassoli, Fatemeh, additional, Lotfalizadeh, Marzieh, additional, Zabihi, Reza, additional, Shabestari, Mahmoud Mohammadzadeh, additional, Paeizi, Reza, additional, Azari, Masoumeh Alvandi, additional, Bahrami-Taghanaki, Hamidreza, additional, Baars, Erik, additional, De Bruin, Anja, additional, Ponstein, Anne, additional, Segantini, Sergio, additional, Monechi, Maria Valeria, additional, Voller, Fabio, additional, Barth, Jürgen, additional, Kern, Alexandra, additional, Lüthi, Sebastian, additional, Zieger, Anja, additional, Otto, Fabius, additional, Beccia, Ariel, additional, Dunlap, Corina, additional, Courneene, Brendan, additional, Bedregal, Paula, additional, Passi, Alvaro, additional, Rodríguez, Alfredo, additional, Chang, Mayling, additional, Gutiérrez, Soledad, additional, Beissner, Florian, additional, Preibisch, Christine, additional, Schweizer-Arau, Annemarie, additional, Popovici, Roxana, additional, Meissner, Karin, additional, Beljanski, Sylvie, additional, Belland, Laura, additional, Rivera-Reyes, Laura, additional, Hwang, Ula, additional, Sethe, Dominik, additional, Hilgard, Dörte, additional, Heusser, Peter, additional, Bishop, Felicity, additional, Al-Abbadey, Miznah, additional, Bradbury, Katherine, additional, Carnes, Dawn, additional, Dimitrov, Borislav, additional, Fawkes, Carol, additional, Foster, Jo, additional, MacPherson, Hugh, additional, Roberts, Lisa, additional, Yardley, Lucy, additional, Holmes, Michelle, additional, Little, Paul, additional, Cooper, Cyrus, additional, Bogani, Patrizia, additional, Maggini, Valentina, additional, Gallo, Eugenia, additional, Miceli, Elisangela, additional, Biffi, Sauro, additional, Mengoni, Alessio, additional, Fani, Renato, additional, Brands-Guendling, Nadine, additional, Guendling, Peter W., additional, Bronfort, Gert, additional, Haas, Mitch, additional, Schulz, Craig, additional, Bu, Xiangwei, additional, Wang, J., additional, Fang, T., additional, Shen, Z., additional, He, Y., additional, Zhang, X., additional, Zhang, Zhengju, additional, Wang, Dali, additional, Meng, Fengxian, additional, Baumann, Klaus, additional, Frick, Eckhard, additional, Jacobs, Christoph, additional, Grünther, Ralph-Achim, additional, Lötzke, Désirée, additional, Jung, Sonny, additional, Recchia, Daniela R., additional, Robens, Sibylle, additional, Stankewitz, Josephin, additional, Jeitler, Mika, additional, Cheon, Chunhoo, additional, Jang, Bo H., additional, Ko, Seong G., additional, Huang, Ching W., additional, Sasaki, Yui, additional, Ko, Youme, additional, Cheshire, Anna, additional, Ridge, Damien, additional, Peters, David, additional, Panagioti, Maria, additional, Simon, Chantal, additional, Cho, Hyun J., additional, Choi, Soo J., additional, Jung, Young S., additional, Im, Hyea B, additional, Cooley, Kieran, additional, Tummon-Simmons, Laura, additional, Wasson, Rachel, additional, Kraemer, Kristen, additional, Sears, Richard, additional, Hueber, Carly, additional, Derk, Gwendolyn, additional, Lill, JR, additional, An, Ruopeng, additional, Steinberg, Lois, additional, Rodriguez, Lourdes Diaz, additional, la Fuente, Francisca García-de, additional, De la Vega, Miguel, additional, Vargas-Román, Keyla, additional, Fernández-Ruiz, Jonatan, additional, Cantarero-Villanueva, Irene, additional, García-De la Fuente, Francisca, additional, Jiménez-Guerrero, Fanny, additional, Galiano-Castillo, Noelia, additional, Diaz-Saez, Gualberto, additional, Torres-Jimenez, José I., additional, Garcia-Gomez, Olga, additional, Hortal-Muñoz, Luis, additional, Diaz-Diez, Camino, additional, Dicen, Demijon, additional, Diezel, Helene, additional, Frawley, Jane, additional, Broom, Alex, additional, Dong, Fei, additional, Ma, Xueyan, additional, Yan, Liyi, additional, Wu, Liqun, additional, Ma, Jiaju, additional, Zhen, Jianhua, additional, Dubois, Julie, additional, Rodondi, Pierre-Yves, additional, Schwartze, Sophia, additional, Trapp, Barbara, additional, and Cysarz, Dirk, additional

Published
2017
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41. Sustained effects of acupuncture stimulation investigated with centrality mapping analysis

Author

Long, Xiangyu, Huang, Wenjing, Napadow, Vitaly, Liang, Fanrong, Pleger, Burkhard, Villringer, Arno, Witt, Claudia M, Nierhaus, Till, Pach, Daniel, Long, Xiangyu, Huang, Wenjing, Napadow, Vitaly, Liang, Fanrong, Pleger, Burkhard, Villringer, Arno, Witt, Claudia M, Nierhaus, Till, and Pach, Daniel

Abstract

Acupuncture can have instant and sustained effects, however, its mechanisms of action are still unclear. Here, we investigated the sustained effect of acupuncture by evaluating centrality changes in resting-state functional magnetic resonance imaging after manually stimulating the acupuncture point ST36 at the lower leg or two control point locations (CP1 same dermatome, CP2 different dermatome). Data from a previously published experiment evaluating instant BOLD effects and S2-seed-based resting state connectivity was re-analyzed using eigenvector centrality mapping and degree centrality mapping. These data-driven methods might add new insights into sustained acupuncture effects on both global and local inter-region connectivity (centrality) by evaluating the summary of connections of every voxel. We found higher centrality in parahippocampal gyrus and middle temporal gyrus after ST36 stimulation in comparison to the two control points. These regions are positively correlated to major hubs of the default mode network, which might be the primary network affected by chronic pain. The stronger integration of both regions within the whole-brain connectome after stimulation of ST36 might be a potential contributor to pain modulation by acupuncture. These findings highlight centrality mapping as a valuable analysis for future imaging studies investigating clinically relevant outcomes associated with physiological response to acupuncture stimulation.

Published
2016

42. Difficulties choosing control points in acupuncture research. response: commentary: differential cerebral response, measured with both an EEG and fMRI, to somatosensory stimulation of a single acupuncture point vs. two non-acupuncture points

Author

Nierhaus, Till, Pach, Daniel, Huang, Wenjing, Long, Xiangyu, Napadow, Vitaly, Roll, Stephanie, Liang, Fanrong, Pleger, Burkhard, Villringer, Arno, Witt, Claudia M, Nierhaus, Till, Pach, Daniel, Huang, Wenjing, Long, Xiangyu, Napadow, Vitaly, Roll, Stephanie, Liang, Fanrong, Pleger, Burkhard, Villringer, Arno, and Witt, Claudia M

Published
2016

44. Difficulties Choosing Control Points in Acupuncture Research. Response: Commentary: Differential Cerebral Response, Measured with Both an EEG and fMRI, to Somatosensory Stimulation of a Single Acupuncture Point vs. Two Non-Acupuncture Points

Author

Nierhaus, Till, primary, Pach, Daniel, additional, Huang, Wenjing, additional, Long, Xiangyu, additional, Napadow, Vitaly, additional, Roll, Stephanie, additional, Liang, Fanrong, additional, Pleger, Burkhard, additional, Villringer, Arno, additional, and Witt, Claudia M., additional

Published
2016
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45. Differential cerebral response to somatosensory stimulation of an acupuncture point vs. two non-acupuncture points measured with EEG and fMRI

Author

Nierhaus, Till, Pach, Daniel, Huang, Wenjing, Long, Xiangyu, Napadow, Vitaly, Roll, Stephanie, Liang, Fanrong, Pleger, Burkhard, Villringer, Arno, Witt, Claudia M, Nierhaus, Till, Pach, Daniel, Huang, Wenjing, Long, Xiangyu, Napadow, Vitaly, Roll, Stephanie, Liang, Fanrong, Pleger, Burkhard, Villringer, Arno, and Witt, Claudia M

Abstract

Acupuncture can be regarded as a complex somatosensory stimulation. Here, we evaluate whether the point locations chosen for a somatosensory stimulation with acupuncture needles differently change the brain activity in healthy volunteers. We used EEG, event-related fMRI, and resting-state functional connectivity fMRI to assess neural responses to standardized needle stimulation of the acupuncture point ST36 (lower leg) and two control point locations (CP1 same dermatome, CP2 different dermatome). Cerebral responses were expected to differ for stimulation in two different dermatomes (CP2 different from ST36 and CP1), or stimulation at the acupuncture point vs. the control points. For EEG, mu rhythm power increased for ST36 compared to CP1 or CP2, but not when comparing the two control points. The fMRI analysis found more pronounced insula and S2 (secondary somatosensory cortex) activation, as well as precuneus deactivation during ST36 stimulation. The S2 seed-based functional connectivity analysis revealed increased connectivity to right precuneus for both comparisons, ST36 vs. CP1 and ST36 vs. CP2, however in different regions. Our results suggest that stimulation at acupuncture points may modulate somatosensory and saliency processing regions more readily than stimulation at non-acupuncture point locations. Also, our findings suggest potential modulation of pain perception due to acupuncture stimulation.

Published
2015

46. Akupunktur- und Moxibustionstherapie

Author

Pach, Daniel

Subjects
placebo, moxibustion, acupuncture
Abstract

Hintergrund und Zielstellung: Die Akupunktur- und Moxibustionstherapie gehört zu den Therapieverfahren der Chinesischen Medizin und wird trotz zum Teil unklarer Evidenzlage in Deutschland häufig in Anspruch genommen. Unter Einsatz verschiedener wissenschaftlicher Methoden sollte ein Beitrag zur Erhöhung der Evidenzbasis der Akupunktur- und Moxibustionstherapie geleistet werden. Methoden: Studientypen verschiedener Evidenzstufen kamen zur Anwendung. Eine experimentelle Studie zur Untersuchung der Infraroteigenschaften von Moxazigarren wurde durchgeführt. In einer methodisch-theoretischen Arbeit wurden Kriterien für eine optimale Kontrolltherapie (Placebo) in Doppeltblindstudien herausgearbeitet und deren Anwendbarkeit überprüft. Und in einer großen Beobachtungsstudie wurden systematisch Daten zur Sicherheit der Akupunktur erhoben. Ergebnisse: In der experimentellen Studie zeigte sich, dass Moxazigarren vor allem Infrarot(IR)-Strahlung im langwelligen Infrarotbereich (IR-C, 83,5 - 87,5%) mit kleinen Anteilen im mittleren (IR-B, 9,0 - 12,1%) sowie kurzwelligen Infrarotbereich (IR-A, 2,2 - 5,5%) emittieren. Damit ist nur ein kleiner Teil der Infrarot-Strahlung, die von Moxazigarren abgegeben wird, in der Lage tiefere Hautschichten oder sogar die Unterhaut, wo viele Akupunkturpunkte postuliert werden, zu erreichen. In der methodisch- theoretischen Arbeit wurden 8 Items zur Beurteilung von Placebos in klinischen Studien entwickelt. Diese umfassen eine Hypothese zur Wirkweise des Verums, die klare Beschreibung des Placebos und die Möglichkeit und den Erfolg der Verblindung von Patient und Therapeut sowie die Berücksichtigung der Verblindung bei der Auswertung. Die Checkliste ist für klinische Studien anwendbar. In der Beobachtungsstudie berichteten 8,6 % der beobachteten Patienten Nebenwirkungen. Zumeist waren diese Ereignisse, wie Hämatome, Blutungen, Schmerzen oder vegetative Symptome, jedoch nicht schwerwiegend. Schwerwiegende Nebenwirkungen sind sehr selten beobachtet worden. Hierzu zählen Pneumothorax und Nervenläsionen. Keine Nebenwirkung führte zu permanenten Schäden Schlussfolgerung: Für neue klinische Studien zur Akupunktur- und Moxibustions-therapie gibt es zur Zeit keine Placebos als Kontrolltherapie. Die Akupunktur ist ein sicheres Verfahren. Leichte Nebenwirkungen sind jedoch häufig. Zur kurzfristigen Verbesserung der klinischen Evidenzlage sollten sowohl für Wirksamkeits- als auch für Sicherheitsstudien die Standardtherapie oder eine unbehandelte Gruppe (Warteliste) als Kontrolle herangezogen werden., Background and Objectives: Acupuncture and moxibustion are widely used in Germany although their evidence is not clear. The aim of our study was to improve the evidence of acupuncture and moxibustion using different scientific methods. Methods: Study types of different evidence grades were used. An experiment to measure the infrared characteristics of moxa sticks was performed. Criteria for optimal control therapies in double blind trials were developed and tested in a methodological study. And in an observational trial data on acupuncture safety was systematically evaluated. Results: The experimental trial did show that all sticks investigated showed a similar spectral distribution of the emitted IR radiation with maxima of about 83.5 to 87.5% in the range long-wavelength IR radiation (IR-C) and with small contributions of both short wavelength IR radiation (IR-A) between 2.2% and 5.5% and of middle wavelength IR radiation (IR-B) between 9.0% and 12.1% of the total IR emission. Thus, only a small proportion of the IR radiation emitted by moxa sticks is capable of affecting subepidermal tissue, a possible location of acupuncture points. Within the methodological study eight items for the assessment of placebos in clinical trials were developed: a hypothesis about the mode of action of the verum, a clear description of the placebo, and items describing blinding, the success of blinding and the impact of blinding on the analysis. The checklist is applicable for clinical trials. In the observational trial 8.6% of the patients reported experiencing at least one adverse effect. Common adverse effects were bleedings or haematoma, pain or vegetative symptoms, but they were not severe. Severe adverse effects such as pneumothorax and nerve lesions were observed very rarely. There were no permanent injuries associated with the acupuncture treatments. Conclusion: Until now no placebos are available which suit as control therapies for new clinical trials on acupuncture and moxibustion. Acupuncture is a safe therapy, although minor events are common. To improve the evidence base in the near future a standard therapy or a no-treatment group (waiting list) should be used as a control in efficacy and in safety trials.

Published
2011

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