Publication bias for CAM trials in the highest impact factor medicine journals is partly due to geographical bias.

OBJECTIVE: To assess the presence of publication bias and its relation to geographical bias in clinical trials involving complementary and alternative medicine (CAM) published in the highest impact factor general medicine journals. STUDY DESIGN AND SETTING: All CAM clinical trials published in the four highest impact factor general medicine journals, Lancet and British Medical Journal (European), and New England Journal of Medicine and Journal of American Medical Association (U.S.), between 1965 and 2004 were abstracted using Medline. Three reviewers abstracted data from the individual studies. In a multivariate analysis, factors predictive of a positive study were assessed. RESULTS: A total of 259 studies met the inclusion criteria. CAM trials published in the European journals were significantly more likely to be positive compared to those published in the U.S. journals (76% vs. 50%, odds ratio [OR]=3.15, P<0.0001). Studies originating outside of the United States were significantly more likely to be positive compared to the U.S. studies (75% vs. 49%, P<0.0001). Adjusting for location and other variables in a multivariate model, the OR for European vs. U.S. journals to publish a positive CAM trial was 1.95 (P=0.11). CONCLUSION: Publication bias related to CAM trials among the highest impact factor general medicine journals is partly due to geographical bias.

Use of complementary and alternative medicine treatments by patients with obstructive sleep apnea hypopnea syndrome.

STUDY OBJECTIVES: To assess the proportion of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) reporting previous or current use and interest in future use of complementary and alternative medicine (CAM) therapies. DESIGN: Cross-sectional, point-of-care, anonymous survey. SETTING: Sleep disorders center at a Midwest tertiary care center. PARTICIPANTS: Six hundred forty-six consecutive patients undergoing polysomnography. MEASUREMENTS: The survey instrument comprised 45 items specifically related to CAM therapies, in addition to obtaining baseline data. RESULTS: Response rate was 81% (522/646). A total of 406/522 (78%) patients were diagnosed with OSAHS. Mean age +/- SD was 57 +/- 14 years, and 267 participants (66%) were men. Overall, 237 (58%) participants reported ever using CAM. Ever and current CAM use specifically for improving sleep was reported by 20% and 7% of the participants, respectively. Twenty-six percent of participants reported ever using biologic products, and 52% reported ever using nonbiologic CAM treatments. A high proportion (58%) of the participants showed interest in future CAM use for improving sleep. CONCLUSION: A high proportion of patients with OSAHS report previous or current use, and interest in future use, of CAM treatments. This underscores the need to conduct further research in this field.