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.

NPI are protocols to be implemented with a target population, but they are merely specifications. They must be contextualized and personalized. The NPI Registry offers best practices and tips for optimal implementation. Furthermore, the NPIS recommends interdisciplinary training in health ethics for their application. The scientific society works with its partners to develop and recognize this foundational training, which could be conducted particularly in higher education institutions in collaboration with the Ministry of Health. This ethical training includes all the prerequisites of knowledge, skills, and attitudes necessary for interprofessional practice in health. Health professionals with practical experience, such as doctors, will have equivalencies.

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.

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).

The term non-pharmacological intervention (NPI) was not chosen by the scientific society NPIS but has become necessary. It has been used by scientists since 1975. Various authorities and agencies have adopted it, including the World Health Organization since 2003, the French National Authority for Health since 2011, the National Solidarity Fund for Autonomy since 2014, the Ministry of Health since 2018, the High Council for Public Health since 2019, the European Centre for Disease Prevention and Control since 2020, the General Inspectorate of Social Affairs since 2022, the Economic, Social and Environmental Council since 2023, and Health Insurance since 2024. Many national and supranational scientific societies use the term NPI in their recommendations. These health solutions are often "squeezed" between health products and public health measures, despite efforts by professionals to raise awareness and recognition of them. They represent an underestimated area of intangible services situated between goods (e.g., medications, medical devices) and general public health recommendations (e.g., dietary rules, hygiene measures, environmental actions).

They can be lost in compilations of health solutions that mix health promotion actions with targeted programs or confuse methods for identifying a health problem with methods for resolving it. The challenge is to improve the traceability of practices for continuous enhancement of their quality, safety, implementation, and training. These practices can be easily shared from one country to another. The term NPI does not imply "anti-medication" or "alternative medicine" (parallel medicine). Instead, it draws from the rigor of the globally standardized drug validation process to establish good scientific and clinical practices. Over time, we believe that the abbreviation NPI will come to be more widely recognized than its full title, similar to WHO, IBM, SEAT, and many others.

Registers of non-pharmacological practices with imprecise criteria and boundaries.
Catalogs compile various health practices among which NPI may be submerged. Some target the general population, while others are more specific. The selection criteria are heterogeneous, and objectives and practical modalities vary widely. Three examples include two from the United States (EBCCP and Mindtools) and one from France (Capitalisation Santé).

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.