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he PedCAM Network: Past, present, and future�

oleil Surette, Sunita Vohra ∗

niversity of Alberta, Department of Pediatrics, 8213 Aberhart Centre 1, University of Alberta, Edmonton, AB, Canada T6G 2J3vailable online 20 April 2011

KEYWORDSNetworking;Pediatric IntegrativeMedicine;Online Resources

Summary Established in 2004, the Pediatric Complementary and Alternative MedicineResearch & Education (PedCAM) Network (www.pedcam.ca) is a multidisciplinary national andinternational network focused on pediatric research and education with the vision of safe andeffective use of complementary and alternative medicine (CAM) use in children and youth andis designed to be a networking and information resource for both researchers and practitionersin the field of pediatric CAM. PedCAM offers a wide variety of resources and opportunities toresearchers, clinicians, educators and the general public: educational, and funding opportuni-ties; links to core articles and books; a searchable database of pediatric CAM research articles;biweekly electronic updates for members. Currently, it is engaged in several research projectsto strengthen the pediatric CAM knowledge base: (i) a modified Delphi consensus process forestablishing a pediatric CAM research agenda; (ii) the identification of validated pediatric out-

come measures; and (iii) a synthesis of pediatric CAM utilization studies to identify knowledgegaps. The widespread use of CAM in children, and the resulting need for high quality researchand education, suggests that the PedCAM Network will remain relevant and timely in its effortsto connect those working in the field of pediatric CAM in Canada and around the world.

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ediatric complementary and alternative medicine (CAM) is growing field with increased interest from both familiesnd health care providers. A large national survey foundhat one in nine children in the United States have used

AM.1 Rates of CAM use in children are reported in theange of 11—89%,1—7 depending upon the specific definitionf CAM, the population group of interest, and the coun-

� Dr. Vohra receives salary support from AHFMR (now Alberta Inno-ates Health Solutions).∗ Corresponding author: CARE Program for Integrative Health andealing, University of Alberta, Unit 8B Edmonton General Continu-

ng Care Facility, 8B19 11111 Jasper Avenue, Edmonton, AB, Canada5K 0L4. Tel.: +1 780 342 8592; fax: +1 780 342 8464.

E-mail address: svohra@ualberta.ca (S. Vohra).

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965-2299/$ — see front matter © 2011 Elsevier Ltd. All rights reserved.oi:10.1016/j.ctim.2011.03.002

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ry under study. Significant potential obstacles in the fieldf pediatric CAM have been identified,8 including: limitedediatric evidence9; an overwhelming amount of unverifiednline information, much of which is promotional (true ofll CAM)10; widely varying degrees of disclosure regardingAM use to health care providers11,12; and a potential lack ofommunication between pediatricians and CAM providers.8

stablished in 2004, the Pediatric Complementary and Alter-ative Medicine Research & Education (PedCAM) Networkwww.pedcam.ca) is designed to be a networking and infor-ation resource for both researchers and practitioners in

he field of pediatric CAM and has evolved to help addressuch obstacles.

hat is PedCAM?

edCAM is a multidisciplinary national and international net-ork focused on pediatric research and education with the

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The PedCAM Network: Past, present, and future

vision of safe and effective use of complementary and alter-native medicine (CAM) use in children and youth. Its goalsare:

• To operate a sustainable network relevant to the needs ofpediatric CAM researchers and educators.

• To engage in knowledge transfer relevant to researchersand educators, policy makers and practitioners for thebenefit of children and families.

• To provide leadership in the national/international pedi-atric CAM community through networking and partnershipactivities, and in doing so advocate for and enhance thevisibility of the field.

What does PedCAM offer?

PedCAM showcases a wide variety of relevant opportuni-ties for researchers, clinicians, and educators in the fieldthrough the Network’s open access website, augmentedby regular email updates to members only. Complement-ing PedCAM’s mission, the website highlights a wide arrayof educational opportunities, including those for under-graduate, graduate, and post-graduate learners, includingcontinuing education and lectures for the public. Train-ing opportunities and research funding information are alsoavailable on the PedCAM website.

PedCAM has developed a wide variety of resources forresearch, clinical and a general public audience including:links to PubMed searches for two dozen common pedi-atric conditions; a searchable database of pediatric CAMresearch citations, updated monthly; core articles, booksand databases on pediatric CAM; links to tools for practic-ing evidence-based medicine; and links to international CAMorganizations. Members receive a bi-weekly electronic mail-out with updates on funding and educational opportunities,conferences, and newly published research about pediatricCAM. Members can also search a database of the PedCAMmembership by interest, specialty, and location in order toencourage networking.

PedCAM aims to accomplish its goals in part by develop-ing national and international partnerships. Over the pastfew years PedCAM has developed partnerships with the fol-lowing organizations: IN-CAM, the Canadian InterdisciplinaryNetwork for Complementary and Alternative Medicine(Canada); IPIM, the International Pediatric IntegrativeMedicine Network (USA); CCTN, the Children’s Complemen-tary Therapy Network (UK); and ISCMR, the InternationalSociety for Complementary Medicine Research. PedCAM isalso an Associate Member of ICCR, the International Collab-oration on Complementary Therapy Resources. As a partner,PedCAM promotes pediatric content at many of these orga-nizations’ national and international CAM meetings.

What is PedCAM doing now?

In addition to its international partnerships, PedCAM is

engaged in several research undertakings to strengthenthe pediatric CAM knowledge base: (i) a modified Delphiconsensus process for establishing a pediatric CAM researchagenda; (ii) the identification of validated pediatric

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utcome measures; and (iii) a synthesis of pediatric CAMtilization studies to identify knowledge gaps.

consensus-based Delphi process to develop aediatric CAM research agenda

s part of an international initiative, members of theedCAM Network have developed a modified four stage Del-hi consensus process to develop a research agenda forediatric CAM. The first stage was an open-ended surveyroadly disseminated to practitioners, researchers, educa-ors and consumers asking them to identify the primaryssues in the field of pediatrics. The second stage identi-ed approximately 70 experts in pediatric CAM through theirublications and asked them to identify research prioritiesbased on the results from stage one) and assess their feasi-ility. The third stage was a face-to-face meeting amongstxperts in pediatric CAM. Attendees were selected basedn their research expertise, their area of CAM interest, andheir geographic location to ensure a diverse representation.he purpose of this stage was to identify the priorities toocus on to advance the knowledge base in pediatric CAM.n the fourth and final stage, the summary document pro-uced from the third stage has been disseminated to all thetakeholders from stages 1 to 3 for feedback. The resultsf the consensus process will be disseminated to key stake-older groups including researchers and funding agencies.t is anticipated that regional variation in CAM use, access,nd preferences, will potentially require adaptation of theesearch agenda to meet local needs.

atabase development of validated pediatricutcome measures

AM research has been plagued with issues regard-ng appropriate outcome measurement. In response tohis, accessible databases of relevant outcome measuresave been created, for example, the IN-CAM Outcomesatabase (http://www.outcomesdatabase.org/). Recogniz-

ng the importance and utility of such an approach, PedCAMas initiated a project to identify validated pediatric out-omes measures and create an online pediatric databaseo facilitate access by pediatric CAM researchers. PedCAM’soal for this initiative is to promote high quality pediatricAM research by facilitating ready access to relevant vali-ated measures. To do this, over 2000 randomized controlledrials have been identified from top journals. While dataxtraction is ongoing, this initiative has already confirmedhe relevance of the approach; the results will be used to:i) populate the online inventory of validated measures;ii) identify which clinical areas need validated outcomeseveloped; and (iii) complement other work being done toromote rigorous outcome assessment, such as that led byhe ORBIT team.13,14

ynthesizing knowledge on the epidemiology of

ediatric CAM use

n 1999, Edzard Ernst conducted a systematic review ofediatric CAM utilization studies and concluded that it was

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ifficult to draw firm conclusions from the data due tohe heterogeneity of the studies.15 He identified a lack ofeporting on safety, efficacy and costs; and variability inhe definition of CAM, prevalence reporting and researchethodologies. More than 10 years later, it remains unknown

f any of the concerns have been addressed. In response,edCAM has undertaken a scoping review of pediatric CAMse studies to try to answer these questions. Recognizinghat the epidemiology of use is an important starting placeor many researchers and educators, PedCAM will host annline searchable inventory of the citations identified by thecoping review, which will continue to be regularly updated.ne anticipated result will be the initiation of a discussionn developing consensus for reporting pediatric CAM uti-ization research. The online information hosted by PedCAMill serve as an enabler for policymakers and researchers

nterested in gathering information on the epidemiology ofediatric CAM use.

hat are PedCAM’s future plans?

hile the field of pediatric CAM has had hundreds of ran-omized controlled trials, relatively little effort has beenade to date to synthesize this knowledge. The PedCAMetwork is working towards reducing some of the barri-rs to information access and isolation in pediatric CAMo help encourage researchers, educators, and clinicians.oing into the future, PedCAM activities will continue to

ocus on Network goals to increasing partnership, collab-ration, and communication about pediatric CAM acrossommunities. In Canada, PedCAM will take the results of theelphi process to identify which research priorities fit withinur national context. Internationally, we will continue tooster discussions with other networks and agencies so theyay self-identify which research priorities are most relevant

o them. PedCAM is delighted to strengthen the internationalediatric CAM community through networking and facilita-ion of knowledge creation/access. The widespread use ofAM in children, and the resulting need for high qualityesearch and education, suggests that the PedCAM Networkill remain relevant and timely in its efforts to connect

hose working in the field of pediatric CAM in Canada andround the world.

onflict of interest statement

one.

S. Surette, S. Vohra

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