I agree with Davis and Darden's1 premise that previous studies of complementary and alternative medicine (CAM) use among children are difficult to compare, given different definitions of CAM and inclusion of different populations. Yet, in their attempt to "generate a generalizable population-based estimate of CAM use among US children," the authors make a key error of omission. The Medical Expenditure Panel Survey used for this study asks only if the person consulted "someone who provides these types of treatments." Most patients using CAM do not initially consult providers of these treatments; this much we already know. In the landmark study by Eisenberg et al,2 almost half (47%) of respondents who used "unconventional" therapies did so without consulting either conventional or unconventional providers. This self-guided approach is deliberate, as one of the key appeals of CAM is its self-healing aspect. Parents are often seeking to reestablish control they have lost over their child's illness, especially among those families coping with chronic illness. If a survey of CAM use among children is to be considered generalizable, it must include self-prescribed therapies.
Rosen LD. Complementary and Alternative Medicine Use in Children Is Underestimated. Arch Pediatr Adolesc Med. 2004;158(3):291. doi:10.1001/archpedi.158.3.291-c