Evidence for CAM Healthcare Options: The ECHO pilot project

Spinal pain is one of the most common and costly afflictions in the U.S. population. Chiropractic, acupuncture and naturopathy are among the most commonly used complementary and alternative medicine (CAM) therapies by U.S. adults for spinal pain. These therapies are used in individual CAM practices and as part of integrative health care approaches. Although there is a growing collection of clinical trials examining the use of CAM for spinal pain, very little is known regarding the actual clinical practice of CAM or integrative medicine and there are few sustained opportunities for research among CAM practitioners who routinely see patients with musculoskeletal conditions. Our long-term goal is to establish a large and sustainable electronic network of CAM providers who systematically collect health outcomes assessments from their patients, track patient outcomes, and engage in clinical research to evaluate the comparative effectiveness and cost-effectiveness of CAM approaches for patients with musculoskeletal complaints. During the first six months, we developed a secure web-based data collection system with modules for patients and providers including a core set of outcome measures. In March 2010, we will launch the Evidence for CAM Healthcare Options (ECHO) project, a prospective pilot observational study in a small number of CAM and integrative care sites for patients with spinal pain. Our ECHO pilot study will allow us to identify and address unanticipated challenges with data collection protocols and outcome measures; obtain preliminary data characterizing network CAM practices; and, estimate the recruitment period required to conduct future prospective comparative effectiveness research.