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Overview of the Publications From the Anthroposophic Medicine Outcomes Study (AMOS): A Whole System Evaluation Study.

Hamre HJ, Kiene H, Ziegler R, Tröger W, Meinecke C, Schnürer C, Vögler H, Glockmann A, Kienle GS - Glob Adv Health Med (2014)

Bottom Line: Anthroposophic medicine is a physician-provided complementary therapy system that was founded by Rudolf Steiner and Ita Wegman.AMOS INCORPORATED TWO FEATURES PROPOSED FOR THE EVALUATION OF INTEGRATIVE THERAPY SYSTEMS: (1) a sequential approach, starting with the whole therapy system (use, safety, outcomes, perceived benefit), addressing comparative effectiveness and proceeding to the major system components (physician counseling, anthroposophic medicinal products, art therapy, eurythmy therapy, rhythmical massage therapy) and (2) a mix of different research methods to build an information synthesis, including pre-post analyses, prospective comparative analyses, economic analyses, and safety analyses of individual patient data.This article provides an overview of the main research questions, methods, and findings from these publications: anthroposophic treatment was safe and was associated with clinically relevant improvements in symptoms and quality of life without cost increase; improvements were found in all age, diagnosis, and therapy modality groups and were retained at 48-month follow-up; nonrespondent bias, natural recovery, regression to the mean, and adjunctive therapies together could explain a maximum of 37% of the improvement.

View Article: PubMed Central - PubMed

Affiliation: Institute for Applied Epistemology and Medical Methodology at the University of Witten-Herdecke, Freiburg, Germany (Dr Hamre).

ABSTRACT
Anthroposophic medicine is a physician-provided complementary therapy system that was founded by Rudolf Steiner and Ita Wegman. Anthroposophic therapy includes special medicinal products, artistic therapies, eurythmy movement exercises, and special physical therapies. The Anthroposophic Medicine Outcomes Study (AMOS) was a prospective observational multicenter study of 1631 outpatients starting anthroposophic therapy for anxiety disorders, asthma, attention deficit hyperactivity disorder, depression, low back pain, migraine, and other chronic indications under routine conditions in Germany. AMOS INCORPORATED TWO FEATURES PROPOSED FOR THE EVALUATION OF INTEGRATIVE THERAPY SYSTEMS: (1) a sequential approach, starting with the whole therapy system (use, safety, outcomes, perceived benefit), addressing comparative effectiveness and proceeding to the major system components (physician counseling, anthroposophic medicinal products, art therapy, eurythmy therapy, rhythmical massage therapy) and (2) a mix of different research methods to build an information synthesis, including pre-post analyses, prospective comparative analyses, economic analyses, and safety analyses of individual patient data. AMOS fostered two methodological innovations for the analysis of single-arm therapy studies (combined bias suppression, systematic outcome comparison with corresponding cohorts in other studies) and the first depression cost analysis worldwide comparing primary care patients treated for depression vs depressed patients treated for another disorder vs nondepressed patients. A total of 21 peer-reviewed publications from AMOS have resulted. This article provides an overview of the main research questions, methods, and findings from these publications: anthroposophic treatment was safe and was associated with clinically relevant improvements in symptoms and quality of life without cost increase; improvements were found in all age, diagnosis, and therapy modality groups and were retained at 48-month follow-up; nonrespondent bias, natural recovery, regression to the mean, and adjunctive therapies together could explain a maximum of 37% of the improvement.

No MeSH data available.


Related in: MedlinePlus

Symptom Score stratified by therapy modality group.Range: 0 (not present) to 10 (worst possible). Patients aged 1-75 years, enrolled 1999-2001, n = 810. Data summarized from references 34–37.
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Figure 1: Symptom Score stratified by therapy modality group.Range: 0 (not present) to 10 (worst possible). Patients aged 1-75 years, enrolled 1999-2001, n = 810. Data summarized from references 34–37.

Mentions: All primary outcome measures improved significantly from baseline to the primary follow-up assessment after 6 months,25-28,30,41 12 months,29,31,34-38 or 48 months;26 in the whole sample,25 in adults and children, in all analyzed diagnosis groups,28-33 and in all therapy modality groups34-37,41 (Figure 1) (P <.001 for all 24 pre-post comparisons). Standardized response mean effect sizes were large for 21 comparisons and medium for three comparisons (Table 6). Improvements were similar in patients not using conventional therapy for their main disorder.41


Overview of the Publications From the Anthroposophic Medicine Outcomes Study (AMOS): A Whole System Evaluation Study.

Hamre HJ, Kiene H, Ziegler R, Tröger W, Meinecke C, Schnürer C, Vögler H, Glockmann A, Kienle GS - Glob Adv Health Med (2014)

Symptom Score stratified by therapy modality group.Range: 0 (not present) to 10 (worst possible). Patients aged 1-75 years, enrolled 1999-2001, n = 810. Data summarized from references 34–37.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3921612&req=5

Figure 1: Symptom Score stratified by therapy modality group.Range: 0 (not present) to 10 (worst possible). Patients aged 1-75 years, enrolled 1999-2001, n = 810. Data summarized from references 34–37.
Mentions: All primary outcome measures improved significantly from baseline to the primary follow-up assessment after 6 months,25-28,30,41 12 months,29,31,34-38 or 48 months;26 in the whole sample,25 in adults and children, in all analyzed diagnosis groups,28-33 and in all therapy modality groups34-37,41 (Figure 1) (P <.001 for all 24 pre-post comparisons). Standardized response mean effect sizes were large for 21 comparisons and medium for three comparisons (Table 6). Improvements were similar in patients not using conventional therapy for their main disorder.41

Bottom Line: Anthroposophic medicine is a physician-provided complementary therapy system that was founded by Rudolf Steiner and Ita Wegman.AMOS INCORPORATED TWO FEATURES PROPOSED FOR THE EVALUATION OF INTEGRATIVE THERAPY SYSTEMS: (1) a sequential approach, starting with the whole therapy system (use, safety, outcomes, perceived benefit), addressing comparative effectiveness and proceeding to the major system components (physician counseling, anthroposophic medicinal products, art therapy, eurythmy therapy, rhythmical massage therapy) and (2) a mix of different research methods to build an information synthesis, including pre-post analyses, prospective comparative analyses, economic analyses, and safety analyses of individual patient data.This article provides an overview of the main research questions, methods, and findings from these publications: anthroposophic treatment was safe and was associated with clinically relevant improvements in symptoms and quality of life without cost increase; improvements were found in all age, diagnosis, and therapy modality groups and were retained at 48-month follow-up; nonrespondent bias, natural recovery, regression to the mean, and adjunctive therapies together could explain a maximum of 37% of the improvement.

View Article: PubMed Central - PubMed

Affiliation: Institute for Applied Epistemology and Medical Methodology at the University of Witten-Herdecke, Freiburg, Germany (Dr Hamre).

ABSTRACT
Anthroposophic medicine is a physician-provided complementary therapy system that was founded by Rudolf Steiner and Ita Wegman. Anthroposophic therapy includes special medicinal products, artistic therapies, eurythmy movement exercises, and special physical therapies. The Anthroposophic Medicine Outcomes Study (AMOS) was a prospective observational multicenter study of 1631 outpatients starting anthroposophic therapy for anxiety disorders, asthma, attention deficit hyperactivity disorder, depression, low back pain, migraine, and other chronic indications under routine conditions in Germany. AMOS INCORPORATED TWO FEATURES PROPOSED FOR THE EVALUATION OF INTEGRATIVE THERAPY SYSTEMS: (1) a sequential approach, starting with the whole therapy system (use, safety, outcomes, perceived benefit), addressing comparative effectiveness and proceeding to the major system components (physician counseling, anthroposophic medicinal products, art therapy, eurythmy therapy, rhythmical massage therapy) and (2) a mix of different research methods to build an information synthesis, including pre-post analyses, prospective comparative analyses, economic analyses, and safety analyses of individual patient data. AMOS fostered two methodological innovations for the analysis of single-arm therapy studies (combined bias suppression, systematic outcome comparison with corresponding cohorts in other studies) and the first depression cost analysis worldwide comparing primary care patients treated for depression vs depressed patients treated for another disorder vs nondepressed patients. A total of 21 peer-reviewed publications from AMOS have resulted. This article provides an overview of the main research questions, methods, and findings from these publications: anthroposophic treatment was safe and was associated with clinically relevant improvements in symptoms and quality of life without cost increase; improvements were found in all age, diagnosis, and therapy modality groups and were retained at 48-month follow-up; nonrespondent bias, natural recovery, regression to the mean, and adjunctive therapies together could explain a maximum of 37% of the improvement.

No MeSH data available.


Related in: MedlinePlus