Operational Definition of Complementary, Alternative, and Integrative Medicine


Researchers, clinicians, and the general public have varying ideas of what constitutes 'complementary', 'alternative', or 'integrative' medicine, and there is no official definition of these therapies. We have recently collaborated on a project to construct a comprehensive list of the therapies that are considered complementary, alternative, or integrative (CAIM). The construction of this list has been informed by a systematic search of peer-reviewed and quality-assessed resources and consists of thousands of terms and synonyms of terms which, taken together, may serve as an operational definition of CAIM. The development of this operational definition is described in a 2022 paper in BMC Complementary Medicine and Therapies, which serves to supplement our 2011 paper in Alternative Therapies in Health and Medicine. Note that this 2022 listing of CAIM terms is inclusive and represents many therapies that will not be considered CAIM in all settings. On the other hand, this list may omit therapies that are still emerging. The authors have made plans to revisit this definition regularly (see the publication for details).

We have also collaborated on the development of a bibliographic database keyword search strategy for CAIM based on this 2022 operational definition, to standardize CAIM research involving systematic searches such as systematic reviews and bibliometric analyses. This has been published in a 2022 paper also in BMC Complementary Medicine and Therapies.

It is important to note that, for pragmatic reasons, this inclusive listing of CAIM therapies is not identical to the scope of the Cochrane Complementary Medicine Field with regard to Cochrane reviews. We continue to exclude four main categories of CAIM interventions:

  1. Because vitamins, minerals, and other nutrients are often used in conventional medicine, we developed general rules for considering vitamins and other supplements as within or outside our scope. When selecting Cochrane reviews for our scope, we have decided to exclude the following types of vitamin, mineral, and other nutrient interventions:
    1. vitamins and other supplements that are administered parenterally in hospital settings;
    2. dietary supplementation for treatment or prevention of medically diagnosed deficiency states or disorders; and
    3. vitamin or mineral supplements for preventing or treating disease in countries where vitamin or mineral deficiency is widespread.
  2. We also exclude exercise therapies, with the exception of mind-body exercise (e.g., tai chi, yoga) or exercise that is designed to prevent or treat mental or emotional problems (e.g., exercise for depression);
  3. We exclude psychotherapy, with the exception of unconventional psychotherapies (e.g., Morita therapy); and
  4. We exclude supplements, nutritional interventions, and light therapy for preterm infants, which are likely to be carried out only in hospital settings as part of conventional care.

The full list of therapies comprising the updated 2022 operational definition of CAIM is available here.