Advancing Music Health Research Through Quality Reporting: Introduction to Reporting Guidelines for Music-Based Interventions

In the last 25 years, there has been a substantial increase in the use of integrative and complementary health approaches.^1-3 Globally, the World Health Organization (WHO) reported that more countries are integrating these practices into their national health systems, with an expected compound annual growth rate (CAGR) of 25% from 2024 to 2033. ⁴ In the same year, the WHO also released the first ever report synthesizing global evidence on the role of the arts, including music, to health and wellbeing. ² The report reviewed more than 3000 studies and identified significant benefits of arts engagement in preventing illness, promoting health, and managing/treating a variety of health conditions across the lifespan.

Music is the most widely studied art form in relation to health outcomes, with a substantive body of descriptive, qualitative, and experimental research. Increasing evidence suggests benefits of music-based interventions (MBIs) for anxiety, depressive symptoms, and pain associated with health conditions and their treatment. ⁵ In addition, researchers, caregivers, and caregiving organizations in cognitive health and dementia care are increasingly adopting MBIs due to their ease of delivery, paucity of side effects, and potential appeal for individuals living with dementia. ⁶ Despite this growth, systematic reviews and meta-analyses have identified persistent problems including limitations due to small sample sizes and study designs lacking rigor and replicability.^6-8

To address this need, the National Institutes of Health (NIH), in collaboration with the Renée Fleming Foundation and the Foundation for the NIH, convened three workshops. These sessions were designed to gather unbiased perspectives from a diverse group of experts and stakeholders, including those in neuroscience, music therapy, music medicine, behavioral intervention development, clinical trial methodology, and patient and arts advocacy. The workshops directly led to the creation of the NIH MBI Toolkit, which provides guidelines and recommendations for key components in MBI studies to enhance data collection, ensure rigor and replicability, facilitate cross-study comparisons, and advance biomedical research.^9,10

Music-based interventions (MBIs) are broadly defined as the use of music or music-based experiences to address any dimension of health or human development. ¹¹ Like other integrative therapies, MBIs often aim to resolve complex health challenges that engage multiple systems, necessitating a systematic and rigorous approach to their trial design and execution. This approach encompasses theoretically grounded and well-designed efficacy trials to establish their benefits, along with mechanistic studies to unravel how MBIs activate the biological, psychological, social, and/or behavioral “mechanisms of action” that ultimately lead to health improvements. The NIH MBI toolkit provides a “How to” guide for understanding these complex relationships and for designing rigorous, reproducible intervention studies; however, challenges with detailed intervention reporting persist. ⁹

Fully describing music interventions is difficult because of the complexity of music both as a stimulus and more holistic experience. This complexity stems from fundamental elements like rhythm, pitch, and tempo, and the fact that music can carry deep personal or cultural meaning. This challenge is amplified by the varied ways individuals experience music, from actively creating it to receptively listening, and other unique factors unique to these interventions. Lack of specificity about the music condition under investigation hinders cross-study comparisons, generalization, and integration of findings into clinical practice. ¹² Indeed, a 2018 review of music intervention reporting revealed that less than 50% of the studies provided essential information, such as details about the music used, the theoretical or scientific rationale for the chosen music experience, interventionist qualifications, treatment fidelity strategies, or a description of the intervention setting. ¹³ Findings from this and other reviews indicate sustained problems with reporting quality,^14-18 despite availability of the 2011 Reporting Guidelines for Music-Based Interventions. ¹⁹ The limited adoption and use of the original guidelines may stem from factors such as low awareness, perceived irrelevance, lack of item clarity, or the absence of a published guidance statement to support their implementation.

To address these concerns, we convened an interdisciplinary group of experts to improve the utility and validity of the 2011 guidelines using a rigorous consensus process that incorporated a series of Delphi surveys and expert panel meetings. Global Advances for Integrative Medicine and Health has reprinted the original validation paper and the companion Explanation and Elaboration (E&E) guide in this special issue.^11,20 The E&E guide elucidates the scope and intended use of the 2025 Reporting Guidelines for Music-Based Interventions (RG-MBI) checklist and includes a rationale for each checklist item, concrete instructions for optimal reporting, and annotated reporting examples from published research. ¹¹

The updated RG-MBI checklist and E&E statement aim to guide researchers toward more consistent and transparent reporting of music intervention studies.^11,20 Wider adoption of these guidelines by authors, editors, and peer reviewers will lead to better-reported studies, which in turn will facilitate greater replication, improved cross-study comparisons, robust systematic reviews, and ultimately, the implementation of findings in clinical practice. Efforts like those by the editorial team at Global Advances for Integrative and Health - who offer article reprints, editorials, and include the guidelines in instructions to authors - are crucial for improving uptake and use. We anticipate that collective adoption will enhance reporting quality and accelerate scientific understanding of how music can be used to improve our health, development, and well-being. Our ultimate goal is to highlight the potential of effective music-based interventions that can be replicated with confidence, easily incorporated into health practice guidelines, and endorsed as valuable integrative care models.