Interactive Workshops

Workshop #1 Thursday, October 13th, 5:00-6:15p EDT

Considerations for Publishing Your Traditional, Integrative, Complementary and Alternative Medicine Research: A Primer on Transparent and Ethical Publishing Practices

Workshop Facilitator: Dr. Jeremy Y. Ng, MSc, PhD, Centre for Journalology, Ottawa Hospital Research Institute, Ottawa, Canada

Dr. Jeremy Y. Ng, MSc, PhD, is a postdoctoral fellow at the Centre for Journalology at the Ottawa Hospital Research Institute. Jeremy has worked in the academic publishing industry since 2015 and is the founding publisher of the Journal of Natural Health Product Research. As a researcher, he has published 60+ peer-reviewed articles on a variety of health-related topics, primarily about traditional, integrative, complementary and alternative medicine (TCAIM). More recently, his research interests have expanded to include publication science/journalology, and he leads a series of projects that aim to improve the reporting, dissemination, and publication of research.

Workshop Objectives: To provide those interested in (learning more about) publishing their research in peer-reviewed journals with an overview of transparent and ethical publishing practices. This workshop will be presented with the consideration of the unique challenges pertinent to TCAIM-specific research.

Intended Audience: Researchers, TICAM practitioners, and students with an interest in publishing their research in a peer-reviewed journal. The workshop will be tailored to different audience members’ level of familiarity with the publishing process.

Workshop Description: The publication of research findings in peer-reviewed academic journals is a frequent way to disseminate the findings, which is an important part of the research continuum. There are well-documented problems with poor-quality reporting in the research literature. This issue may be exacerbated by a lack of professional expertise in journalology (also known as publication science). This phenomenon may be especially pronounced among those in the TCAIM community, as many are TCAIM practitioners who may seek to publish the results of their study findings without receiving formal education in research or publishing (e.g., Masters or PhD). To help address this gap in training, this workshop will be offered to provide those with an interest in publishing their research in a peer-reviewed journal with practical guidance about transparent and ethical publishing practices. In this workshop, attendees will learn about a variety of topics relevant to academic publishing which will include the following: study registration, authorship criteria and caveats, identifying a suitable journal to submit their research, publishing models, preparing research for a peer-reviewed journal, permissions and licenses, data sharing, publication ethics, preprinting, and the peer review process. The workshop will also provide attendees with the opportunity to share their challenges faced during the publication process and to learn skills for improving reproducibility, completeness, transparency, and dissemination of research results. This workshop will be presented with the consideration of the unique challenges pertinent to TCAIM-specific research.

Anticipated Outcomes: By the end of the workshop, participants should be able to gain a basic familiarity of the following topics: study registration, authorship criteria and caveats, identifying a suitable journal to submit their research, publishing models, preparing research for a peer-reviewed journal, permissions and licenses, data sharing, publication ethics, preprinting, and the peer review process.

Workshop #2, Monday October 17th, 5:00-6:00p EDT

Evidence-Based Practice Continuing Education for Complimentary and Integrative Professions in Canada: Charting a Collective Future Course

Monique Aucoin¹, Kieran Cooley^{1, 2, 3, 4}, Matthew Leach², Rebecca Lester¹

¹Canadian College of Naturopathic Medicine, ²Southern Cross University, ³University Technology, Sydney, ⁴Pacific College of Health and Science

Workshop Facilitators:

Dr. Monique Aucoin ND MSc is a licensed Naturopathic Doctor and Senior Research Fellow at the Canadian College of Naturopathic Medicine. She is also an instructor at CCNM, teaching Evidence Based Practice to CCNM students and members of the profession. Dr. Aucoin is passionate about studying the relationship between diet and mental health and the use of evidence in the Naturopath profession.

Dr. Kieran Cooley ND is Director of Research at the Canadian College of Naturopathic Medicine. He has taught Evidence Informed Practice in the Doctor of Oriental and Asian Medicine program at Pacific College of Health & Science and is part of the International Naturopathy Research Leadership and Building Capacity program at the Australian Research Centre for Complementary and Integrative Medicine at University of Technology, Sydney.

Associate Professor Matthew Leach is Deputy Director: Education at the National Centre for Naturopathic Medicine, Southern Cross University. A/Prof Leach is a recognised international expert in complementary and integrative medicine, evidence-based practice and health services research, as well as naturopathic medicine education. He has published more than 162 refereed journal articles, 13 book chapters and a seminal textbook on clinical decision-making; his work has been cited more than 4,431 times, and has had clinical, education, research and policy impact.

Rebecca Lester is a 4th year naturopathic intern at the Canadian College of Naturopathic Medicine. She has been involved with research throughout her education and currently holds the position of Student Assistant for the research department at CCNM promoting naturopathic research to the student body.

Workshop Objectives:

1. Review and discuss the definitions, strengths, and limitations of Evidence-Based Practice (EBP) within the context of complementary and integrative medicine (CIM).

2. Discuss existing programs, opportunities and evidence to support EBP use and education in Canadian CIM professions.

3. Share learnings from a recent EBP Continuing Education (CE) research project for Naturopathic doctors.

4. Enable participants to identify barriers to the delivery of EBP CE programs within their own CIM profession and generate potential strategies to navigate these barriers.

5. Create a plan for coordinated action and collaboration to support EBP CE in CIM.

Intended Audience: Researchers, educators and thought leaders from Canadian CIM professions. These individuals will be personally invited to attend the session and interested individuals will be encouraged to assist with facilitation of the small group sessions. Interested clinicians (i.e. users) are also welcome to attend.

Workshop Description: There is increased interest in the use of evidence-based practice (EBP) within most health care professions, including complementary and integrative medicine (CIM) professions in Canada. EBP involves the combination of best scientific evidence with clinician expertise and patient preferences. Although EBP has a range of established benefits, there is evidence that EBP is used sub-optimally within CIM professions. Additionally, formal tailored opportunities for CIM professionals to improve their EBP skills have been highly limited to date. The workshop takes a critical look at EBP, including its strengths and limitations, and the currently available opportunities for EBP education within each of the CIM professions represented in the workshop. There is also an opportunity to highlight the seminal work that has been done to date in the Canadian naturopathic and chiropractic professions. This includes a review of the process used in a recent project to co-design, deliver and evaluate an EBP CE course tailored to the needs and preferences Canadian Naturopathic Doctors, including the results of the project evaluation. The latter half of the workshop enables each of the represented professions to reflect on opportunities to execute similar projects, designed to meet the EBP education needs of their professional members. Attendees will be encouraged to identify barriers and explore opportunities to overcome these barriers. With the support of the workshop facilitators, members of each profession will also have an opportunity to plan a course of action and a follow-up plan to improve EBP education within their profession.

Anticipated Outcomes: The results of the workshop will be presented in a publication. The action and follow-up plans generated by each of the represented professions will be used to guide follow-up and support over the months after the workshop. The workshop aims to strengthen collaborative partnerships and support future coordinated actions to foster EBP education in CIM.

Workshop #3, Monday October 17th, 6:00-7:00p EDT

Grading Traditional, Complementary and Integrative Medicine Evidence using GRADE Approaches

Workshop Facilitators:

Jianping Liu¹, Yutong Fei¹, Jennifer Hunter², Ruyu Xia¹

¹Beijing University of Chinese Medicine, ²Western Sydney University

Yutong Fei is a professor of clinical epidemiology and the Vice director of the Centre for Evidence-Based Chinese Medicine at the Beijing University of Chinese Medicine. She is the Chair of the ISCMR China Chapter and Co-Chair of Beijing GRADE Center. Her research interests include clinical research methodology, randomized control trials, systematic reviews, qualitative research and the translation of evidence into clinical practice guidelines.

Dr. Xia currently works at the Center for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine. Her research interests include optimal management of antibiotic in acute minor illness with a focus on using Chinese herbal medicine for symptom management, acupuncture for depression, clinical research methodology, qualitative research, systematic reviews and network meta-analysis.

Dr. Jennifer Hunter is an academic general practitioner and director of Health Research Group in Sydney, Australia. Jennifer has broad methodological expertise in mixed methods, health services research, qualitative research, randomised controlled trials, systematic reviews and clinical practice guidelines. She serves on several national and international committees and boards, including ISCMR, the International Society for Traditional, Complementary and Integrative Medicine.

Jianping Liu is a Professor in Clinical Epidemiology at the Beijing University of Chinese Medicine, where he is Director of the Evidence-Based Chinese Medicine Center for Clinical Research and Evaluation, Affiliate of the Cochrane China Network. Professor Liu is a pioneer in the dissemination of evidence-based medicine and clinical research methodology in China; is widely involved in researches in infectious diseases, epidemiology, and traditional Chinese medicine; and has expertise in Chinese Medicine, Evidence-Based Medicine, and clinical research methodology.

Workshop Objectives:

When integrating various therapies, decisions makers, clinicians and patients want to know about the potential benefits and harms of the different therapeutic options. The GRADE approach provides a framework for determining our confidence in the available evidence. The workshop will provide researcher and clinicians with additional skills for assessing the quality and certainty of a body of evidence, such as that presented in a systematic review.

Intended Audience: The workshop is intended for those who have a basic understanding of clinical research and are seeking to synthesize this knowledge when rating the quality and certainty of a body of evidence, such as that presented in systematic reviews of traditional, complementary and integrative medicine.

Workshop Description:

The certainty of the evidence (also referred to as quality of evidence or confidence in effect estimates) for clinical effects is an important factor in the decision-making process when making clinical recommendations for traditional, complementary and integrative medicine. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) offers a transparent and structured process for developing and presenting summaries of evidence for systematic reviews and recommendations in health care. The purpose of this workshop is to provide hands-on experience with GRADE’s approach to rating the evidence certainty and the endpoint of this process, the GRADE evidence profile (EP) and the summary of findings. The workshop will also provide an overview of the core concepts of the GRADE approach for developing recommendations that is required to incorporate the best available traditional, complementary and integrative medicine evidence into clinical practice guidelines.

The workshop will cover the following: 1. Introduction to GRADE Evidence Profiles and Summary of Findings Tables; 2. Rating the quality of evidence—study limitations (Risk of Bias), inconsistency, indirectness, imprecision, publication bias, and factors that can raise confidence; 3. Hands on: Practice and discussion (traditional, complementary and integrative medicine systematic review example).

Anticipated Outcomes:

1. Participants will have an overall understanding of the GRADE process of developing recommendations, and GRADE evidence summary.

2. Participants could apply GRADE’s approach to rating the quality of evidence.

3. Participants will acquire core concepts required to incorporate best traditional, complementary and integrative medicine evidence into practice.

Pre-workshop materials:

Cochrane review for workshop exercises. You will need a copy of the FULL report:

Smith CA, Armour M, Lee MS, Wang LQ, Hay PJ. Acupuncture for depression. Cochrane Database of Systematic Reviews 2018, Issue 3. Art. No.: CD004046. DOI: 10.1002/14651858.CD004046.pub4. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004046.pub4/epdf/full/en

Recommended introductory reading: Liu JP. GRADE Methods in traditional medicine. Integr Med Res. 2022 Jun;11(2):100836. Epub 2022 Jan 26. https://doi.org/10.1016/j.imr.2022.100836

Workshop #4: Tuesday October 18th, 1:00p EDT

Implementation Strategies for Increasing Access to Acupuncture Therapy as Part of Comprehensive Pain Care

Workshop Facilitators:

Linda Rapson MD Toronto, Ontario, Canada: Dr. Rapson has 48 years’ experience integrating acupuncture into western medicine, in particular treating neuropathic pain. Consultant in acupuncture at Toronto Rehabilitation Institute, Lyndhurst Centre, a University of Toronto-affiliated hospital specializing in spinal cord injury rehab, since 1992, an Affiliate Scientist at KITE TRI/UHN on the Neural Engineering and Therapeutics Team and Assistant Professor in the Department of Family and Community Medicine at UofT, Dr. Rapson was co-winner of the Dr. Rogers Prize in 2021. She sees acupuncture as both a tool to decrease prescribing of opioids and a treatment for addiction withdrawal that can reduce fatal outcomes.

Heather Boon BScPhm, PhD Toronto, Ontario, Canada: Dr. Heather Boon is Professor and Vice-Provost, Faculty & Academic Life at the University of Toronto, Canada. She served as Dean of the Leslie Dan Faculty of Pharmacy, University of Toronto from 2014-18. Professor Boon studies the safety, efficay and regulation of traditional, complementary and integrative health practices and products.

Heather Tick, MA MD San Diego, California, USA: Heather is a Clinical Professor at the University of Washington, Departments of Family Medicine, Anesthesia & Pain Medicine. She is the first holder of the Gunn-Loke Professorship in Integrative Pain Medicine. Her work has focused on clinical care and teaching, as well as research into comprehensive pain care prioritizing effective, safe and evidence-based nonpharmacologic options. Her goal for over 30 years has been to change how pain medicine is practiced. She chaired and now co-chairs the Academic Consortium for Integrative Medicine & Health Pain Task Force and is the Chair of the SIG in Musculoskeletal Pain for International Association for the Study of Pain.

Arya Nielsen, PhD Madison, Wisconsin, USA: As Assistant Clinical Professor at Icahn School of Medicine at Mount Sinai, Department of Family Medicine & Community Health, Arya studies nonpharmacologic pain care, specifically acupuncture therapies for acute and chronic pain. She is a senior acupuncture consultant on two NIH-funded multi-site trials: Acupuncture for low back pain in adults 65 and older (HEAL grant) and Acupuncture for acute pain in the Emergency Department. She co-Chairs the Academic Consortium for Integrative Medicine & Health Pain Task Force and served on a 2014 Joint Commission Stakeholder Panel on pain that supported their 2018 mandate to provide nonpharmacologic options in hospital settings.

Workshop Objectives:

1. To discuss why opioids have been a disappointing monotherapy pain care strategy.

2. To summarize the evidence-base for acupuncture as effective opioid-sparing pain care.

3. To brainstorm implementation strategies for increasing access to acupuncture to improve pain care, as well as decrease costs, opioid use, addiction liabilities and deaths.

Intended Audience:
Clinicians, researchers, students, policy makers and health system administrators interested in facilitating integration of evidence-based acupuncture therapy into real world settings for treating pain, reducing addiction and saving lives.

Workshop Description
The workshop will begin with two brief presentations:

Dr. Heather Tick will discuss the “Imperative to Understand our Options”: To understand the necessity for comprehensive pain care this talk will review abundant clinical, translational and basic science research that chronicles the failed promises of opioids for chronic pain. Opioids cause dependence, tolerance and brain adaptations that interfere with bonding and attachment, disrupt normal physiology and are therefore not effective for chronic pain.

Dissemination of evidence-based research is a fundamental to implementation strategies. Based on a recent review of systematic reviews and meta-analyses, Arya Nielsen, PhD will discuss the evidence for acupuncture therapy and opioid sparing in post-operative pain care and for acute pain in the Emergency Department.

The presentations will be followed by a brainstorming session facilitated by L Rapson and H Boon to draw on the information from the presentations and the experiences of the participants to identify practical implementation strategies to address the issues raised in this workshop.

Anticipated Outcomes
A list of implementation strategies that participants can draw on to develop proposals for funding, system changes, demonstration projects and research projects.