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Comment & Response
January 24, 2019

Methodology Flaws and Implications of a Complementary Medicine Study—In Reply

Author Affiliations
  • 1Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut
  • 2Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, Connecticut
JAMA Oncol. 2019;5(3):433. doi:10.1001/jamaoncol.2018.6650

In Reply We appreciate the correspondence regarding our article1 and are happy for the opportunity to respond. The main critiques were that (1) we did not properly identify complementary medicine (CM), (2) we underascertained the number of patients who underwent CM, and (3) the definition of CM was not accurate.

In response to the first critique, we identified the CM group as those patients who received “Other-Unproven: Cancer treatments administered by nonmedical personnel.” This likely includes treatments for cancer with a proposed, albeit unproven, biological mechanism, safety, and effectiveness. This is distinct from those therapies used for improvement of quality of life, including mind-body therapies such as yoga, meditation, prayer, or acupuncture, which were most likely therapies not included within the CM group. The use of CM as defined by this variable was recorded by physicians and interpreted by trained cancer registrars.

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