1. Diversity in Collection Development: Complementary and Alternative Medicine (CAM) Resources or CAM – the New Frontier Susan Murray smurray@torontopubliclibrary.ca Consumer Health Information Service Toronto Reference Library MLA, May 17, 2005

2. CAM - Definitions Alternative medicine - “other,” a type of medicine other than the traditional kind of medicine; independent healing systems outside the realm of western medical theory and practice Also called complementary medicine or complementary health although this is often used to describe therapies that are used along with mainstream medicine, such as massage therapy Also called integrative health MeSH term in 1994, previously therapeutic cults

3. Short History of Medicine I have an earache… 2000 B.C. Here, eat this root. 1000 A.D. That root is heathen, Here, say this prayer. 1850 A.D. That prayer is superstition. Here, drink this potion. 1940 A.D. That potion is snake oil. Here, swallow this pill. 1985 A.D. That pill is ineffective. Here, take this antibiotic. 2000A.D. That antibiotic is artificial. Here, eat this root. Author Unknown Cited: The Complementary and Alternative Medicine Information Source Book. ed. by Alan Rees. Phoenix: Oryx Press, 2001

4. CAM Use - U.S. 36% of American adults used some form of CAM in 2002 – 62% if prayer for health reasons is included $50 billion spent on CAM in 2002 - Most often used to treat back pain or back problems, joint pain or stiffness, and anxiety or depression -Exceptionally high usage by those with life threatening illnesses, such as cancer or HIV/AIDS Barnes, PM, Powell-Griner E, McFann K, Nahin, RL. Complementary and alternative medicine use among adults: United States, 2002. Advance data from vital and health statistics, no 343, Hyattsville, Maryland: National Center for Health Statistics. www.cdc.gov/nchs/nhis.htm

5. What do Users Ask About CAM? Consumers: What is it? How does it work? Is it safe? Does it work? For my condition? Where can I locate practitioners/clinics, etc.? How much does it cost? Health Care Professionals : Is there evidence to support it?

6. Balanced CAM Collection Alternative Systems – Ayurvedic Medicine, TCM, herbalism, naturopathy, homeopathy  Biologically-based therapies – vitamins, herbs, dietary supplements  Body-based therapies – massage, chiropractic  Mind-body therapies – meditation, art therapy, hypnosis, imagery, biofeedback  Energy therapies – Qi Gong, therapeutic touch, reiki, magnetic therapy

7. Challenges in CAM Selection Very diffuse topic area Much questionable material – fads, selling of products, untested treatments More difficult to judge authority of authors, institutions Concern about choosing resources that are potentially harmful Difficult to locate specialized publishers Resources not published, indexed or in English

8. Licensure Abbreviations Alternative Medicine Foundation, Inc. Alternative and Complementary Medicine Resource Guide. http:www.amfoundation.org/geninfo.htm http:www.amfoundation.org/geninfo.htm http:www.amfoundation.org/geninfo.htm  Gancao.net. Titles, initials, translations. http://gancao.net/Referrals/ref.explain.shtml http://gancao.net/Referrals/ref.explain.shtml  Directory of Hypnotherapy Practitioners. Glossary of qualification abbreviations. http://www.therapypages.com/qualifications.htm  Key to professional titles. In Alternative Medicine: The Definitive Guide. 2d ed. (p. 1113-4). Berkeley, CA: Celestial Arts, 2002

9. Selection Criteria Primary: Authority – author, institution, training & experience Accuracy – type of evidence Currency – not as important an issue with CAM Point of view – balance? bias? Audience level and usefulness Scope of coverage - contribution to CAM knowledge base Secondary: Organization Physical format Cost

10. Selection of CAM Resources “ In selecting materials, librarians should not be swayed by whether the treatments have been proven effective, but should collect works on both alternative and orthodox medicine so that consumers are given sufficient information to make choices.” Kupferberg, N. Alternative medicine goes mainstream. Library Journal, July 1994:51-55.

11. Views of Librarians, Medical Students and Physicians About CAM Resources UBC study investigated the personal and professional opinions of librarians, medical students and doctors regarding the availability of CAM for both medical students and the general public Medical students and doctors rejected any restrictions on the library acquiring or circulating these materials Librarians were more hesitant about acquiring radical or revolutionary materials that might cause harm Curry, A, Smith, ST. Information on alternative medicine: a collection management issue. Bull Med Libr Assoc 1998;86(1):95-100.

12. Evolving Area Growing number of publications from mainstream authors and publishers, particularly academic publishers Articles in professional medical journals Evidence-based material Librarian- produced CAM collection guides and websites

13. CAM Selection Aids - I The Complementary and Alternative Medicine Information Source Book. ed. by Alan Rees. Phoenix: Oryx Press, 2001. -includes core list, reviews of 355 popular books, associations/organizations, magazines/newsletters, reviews of 35 professional texts, and 60 Internet sites reviewed by Tom Flemming Rees’ CHI reviews continued by Majors Scientific Books Report: Alan Rees on Consumer Health https://www.majors.com/marketing/marketsite/indexlib.html

14. CAM Selection Aids - II CAPHIS – collection development http://caphis.mlanet.org/resources/index.html http://caphis.mlanet.org/resources/index.html e.g. CHIS healthnavigators Reviews: Consumer Connections, Library Journal, Choice, Booklist listservs: CAMLIB-L, CAPHIS, MEDLIB CAMLIB-L majordomo@library.ucsf.edu

15. CAM Selection Aids- III Scanning magazines and journals - BMJ, Lancet, NEJM, JAMA Journal of Consumer Health on the Internet http://www.haworthpress.com/web/JCHI http://www.haworthpress.com/web/JCHI - alternative and complementary therapies column that focuses on an Internet site, a specific diagnosis, or a therapeutic modality: (vol.9(1) 2005 featured Tai Chi Vendor catalogues: Login, Majors Dalhousie University.School of Pharmacy. http://pharmacy.dal.ca/druginfo/alterna.htm -provides links to publishers’ sites for ordering material on general CAM, homeopathy, herbal medicine

16. CAM Selection Aids – Core Lists Brandon-Hill Lists discontinued in 2004 - continued by Doody Enterprises http://www.doody.com/dct/ http://www.doody.com/dct/ Check CHI core lists, such as CAPHIS for CAM books: http://caphis.mlanet.org/resources/index.html

17. CAM Electronic Resources – Guides and Lists  Rosenthal Center for Complementary and Alternative Medicine - directory of CAM databases http://www.rosenthal.hs.columbia.edu/Databases.html Bastyr University – online resources bibliography http://www.bastyr.edu/Library/resources/online/default.asp Complementary Therapies on the Internet. By William Mac Beckner and Brian M. Berman. New York: Churchill Livingstone, 2003. Guide to Complementary and Alternative Medicine on the Internet. By Lillian R. Brazin. New York: Haworth Information Press, 2003. The Herbal Internet Companion: Herbs and Herbal Medicine Online. By David Owen. New York: Haworth Information Press, 2002.

18. CAM Electronic Resources – Selected Website Directories Alternative medicine : health care information resources www-hsl.mcmaster.ca/tomflem/altmed.html www-hsl.mcmaster.ca/tomflem/altmed.html The Alternative Medicine Homepage www.pitt.edu/~cbw/altm.html www.pitt.edu/!cbw/altm.html www.pitt.edu/~cbw/altm.html

19. CAM Electronic Resources – Selected Websites CAM on PubMed www.nlm.nih.gov/nccam/camonpubmed.html www.nlm.nih.gov/nccam/camonpubmed.html Canadian Health Network - Complementary and Alternative Health www.canadian-health-network.ca/ www.canadian-health-network.ca/ MEDLINEplus: Alternative Medicine www.nlm.nih.gov/medlineplus/alternativemedicine.html www.nlm.nih.gov/medlineplus/alternativemedicine.html www.nlm.nih.gov/medlineplus/alternativemedicine.html National Center for Complementary and Alternative Medicine (NCCAM) www.nccam.nih.gov/ www.nccam.nih.gov/ www.nccam.nih.gov/

20. CAM Courses Evidence-Based Approach to Complementary and Alternative Medicine - MLA 2005 CE course taught by Stephanie Weldon How to Find Good Complementary & Alternative Medicine (CAM) Information on the Web - MLA accredited online course taught by Diane Kovacs http://www.kovacs.com/mlacealt.html

21. CAM Readings Curry, Ann. Information on Alternative Medicine: A Collection Management Issue. Bulletin of the Medical Library Association January 1998 86(1):95-100. http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=226331&blobtype=pdf Owen, David and Fang, Min-Lin. Information-Seeking Behavior in Complementary and Alternative Medicine (CAM): An Online Survey of Faculty at a Health Sciences Campus. Journal of the Medical Library Association July 2003 91(3):311-321. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=164394 Walji, Muhammed et al. Efficacy of Quality Criteria to Identify Potentially Harmful Information: A Cross-Sectional Survey of Complementary and Alternative Medicine Web Sites. Journal of Medical Internet Research 6(2)article e21. http://www.jmir.org/2004/2/e21/