Each NPI file in the NPI Registry has been submitted by a practitioner or researcher through the dedicated platform hosted by the NPIS. Each file undergoes review by an independent and integrated scientific committee. This committee invites relevant scientific societies and health authorities to validate the NPI files and/or to oversee the decisions made. Each validated file is then reviewed by a committee of users and professionals. Once labeled NPIS©, the file is translated into at least English and French and integrated into the NPI Registry.

The file contains standardized content supported by scientific studies that align with the NPIS definition of NPI, the expected specifications (Table 2), and the consensual evaluation framework for NPI, known as the NPIS Model. It includes a manual for professionals, an information notice for users, a section on funding options, and an area for anonymous user feedback. This ensures the file remains dynamic and part of a virtuous cycle of continuous improvement for the NPI.

A minimum of one prototypical study, one mechanistic study, two interventional studies, and one implementation study published in a peer-reviewed journal is required for an NPI proposal to be accepted by the expert committee tasked with validating the NPI file and awarding the NPIS© label. Specifically, experts must have evidence to anonymously vote on each criterion of the NPI file proposed to the NPIS by a submitter:

• Described (≥ 1 prototypical study)
• Explainable (≥ 1 mechanistic study)
• Effective (≥ 2 interventional studies)
• Safe (≥ 2 interventional studies)
• Implementable (≥ 1 implementation study in the country)

A professional must understand all the specifics of the NPI, the criteria justifying its use, how to implement its protocol, whom to contact, useful tips, required materials, and any prerequisite training needed.

Accessible Protocols in Consultation

• Enhanced Quality and Safety: Strengthens the quality and safety of existing practices through formalization, harmonization, and securitization.
• Integration with Professional Software: Codified NPI can be integrated into healthcare management software.
• Digital Documentation: Access to documentation from computers, tablets, or smartphones for ease of use.
• Broad Validation: Extends validation to all relevant professionals in the region.
• Quick and Easy Access: Facilitates rapid access to information at critical decision-making moments for prevention and care.
• Simplicity in Tracking: Eases the follow-up and evolutionary process of best implementation practices (e.g., identifying barriers, professional leadership, availability of training and support).

Quality Control and Adherence to Protocols

• Traceability: Utilizes unique coded protocols for tracking.
• Strengthened Care Link: Enhances the relationship between care provision and patient support.
• Monitoring Relevant Indicators: Provides tools for tracking key performance indicators.
• Continuous Education Tool: Serves as a resource for ongoing professional development.
• Regular Updates: Incorporates regular updates based on user feedback.

Means of Valuation

• Response to Identified Multidisciplinary Issues: Addresses problems identified by healthcare teams in a specific territory.
• Extended Roles for Various Professionals: Expands the roles of many professionals, particularly non-physicians.
• Elimination of Ineffective Protocols: Phases out protocols that are ineffective, hazardous, or costly.
• Reduction in Meeting Time: Decreases the need for multiple meetings focused on intervention planning.
• Support for Innovation: Encourages professionals to experiment with new practices, boosting their confidence.
• Financial Valuation: Ensures appropriate financial and resource allocation for effective implementation.

NPI are a field in which many amalgamations occur between scientific knowledge and opinion, due to their objective—human health—and their operational mode, which involves immaterial protocols. However, it is essential to learn to distinguish science from research amidst the multiplication of tools and information channels (Klein, 2020), particularly on the subject of NPI. The same communication channels transmit both scientific knowledge and beliefs, opinions, comments... Information of different statuses becomes intertwined. Knowledge can turn into the belief of a particular community, and vice versa.

Research, on the other hand, pertains to questions for which we do not yet have answers. These well-defined questions still have no answer. A researcher works on the subject using various methods and strategies. Research fosters doubt. Scientific societies work to advance research within a specific territory and theme.

Given that NPI are universal health protocols centered on individuals and administered by humans, an international multidisciplinary scientific society needed to be created. This has been achieved since 2021. This society is called the Non-Pharmacological Intervention Society (NPIS).

Indeed, the NPI Registry contributes to the development of precision medicine. For example, how can we advance this field in the non-pharmacological treatment of pain without confusing patients when a prestigious medical school like Stanford publishes such a vague, incomplete, and unranked list on its website?

• Physical activity
• Acupressure
• Acupuncture
• Application of heat or cold
• Aquatherapy
• Art therapy
• Biofeedback
• Family coaching
• Individual coaching
• Psychological conditioning
• Desensitization
• Therapeutic education
• Occupational therapy
• Horticultural therapy
• Hypnosis
• Physiotherapy
• Massage lotions
• Meditation
• Music therapy
• Posturology
• Companion presence
• Psychosocial support
• Transcutaneous electrical nerve stimulation (TENS)
• Comfort therapy
• Theatre therapy
• Psychosocial therapy
• Tonification and strengthening
• Yoga

How many hopes dashed? How much time wasted? How many futile efforts? How much money squandered? How many unnecessary carbon emissions from transport? This subtly highlights pharmacological treatments and pain surgeries, which have precise contents and proven effects. The NPIS and its partners propose a solution to break this deadlock in favor of those affected by health issues. The goal is to provide reliable information on the most relevant NPI. It is also about no longer opposing pharmacological and non-pharmacological therapies, but rather associating them wisely and at the right time.

The connection between mechanistic, interventional, and implementation studies forms the backbone of the epistemological positioning of the NPIS Model regarding the evaluation of NPI. This does not mean that an interventional study, for example, cannot explore biological mechanisms or psychosocial processes. Instead, this backbone provides coherence to the studies and structures the validation process of NPI for integration into a standardized practice framework.

An evidence-based data point is a theoretical or practical knowledge acquired through rigorous and integrated scientific methods and reasoning. The NPIS Model follows this logic in the health field (see Figure 3). It provides specific methodological and ethical recommendations for NPI for studies focusing on their mechanisms and explanatory processes (mechanistic study), their content (prototypical study), their evolution over time (observational study), their benefits and risks (interventional study), and their application and personalization modalities (implementation study).