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An operational definition is dynamic, and changes based on both historical time period and geographical location whereby many jurisdictions may integrate or consider their traditional system s of medicine as conventional care. This definition is not only over a decade old but also did not use systematic methods to compile the therapies. Screening of eligible resources, and data extraction of CAIM therapies across them, were each conducted independently and in duplicate.
CAIM therapies across eligible sources were deduplicated. Six hundred four unique CAIM terms were included in this operational definition. This updated operational definition is the first to be informed by systematic methods, and could support the harmonization of CAIM-related research through the provision of a standard of classification, as well as support improved collaboration between different research groups.
Keywords: Complementary and alternative medicine, Integrative medicine, Operational definition, Standard of classification. Defining complementary, alternative and integrative medicine CAIM has been both complex and dynamic. In all three instances, these terms imply a relationship to conventional medicine, which may limit the categorization of therapies that have an undefined or non-existent relationship to conventional care [ 2 ].
Despite the difficulties in defining CAIM, it is well-documented that therapies described as complementary, alternative, traditional, or integrative are used with a high prevalence across the world. Many patients use CAIM in combination with, and a minority in lieu of, conventional care. Eighty-eight percent of World Health Organization member states countries have acknowledged the use of CAIM, having formally developed policies, laws, regulations, programs and offices for CAIM, as examples [ 3 , 4 ].
