I realize I am a little bit late to this party. But recently (here, there, and everywhere) all of ScienceBlogs was abuzz about Sen. Tom Harkin's complaint that various complementary and alternative remedies are not being validated by the NIH office supposedly designed to do so--namely, the National Center for Complementary and Alternative Medicine (NCCAM).
I haven't written about alternative medicine in many years, though I used to follow it fairly closely. But here's what I don't understand. Whatever its suspicious origins, if NCCAM is now doing rigorous studies on the efficicacy of therapies that tons of people out there are already using, isn't this a very good thing?
I certainly don't see how that's an attack on science. Senator Harkin himself may be displeased, and Senator Harkin may nourish sentiments that are pretty unscientific--especially if he's unhappy to see science run its course in this area, and separate wheat from chaff. But it seems like government-sponsored medical research itself is doing just what it's supposed to do in this instance. Am I missing something?
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Chris, the problem is that Harkin has stated that the establishment is discriminating against alternative medicine and that it seems to him that NCCAM has been doing too much to disprove the efficacy of alternative therapies.
In reality, many things have been tested, especially herbal remedies in my field, but the majority of the results have been negative. To the contrary of Harkin's view of NCCAM and the researchers they supported, I would submit that the PIs of these grants were primarily advocates of alternative therapies who were sorely disappointed their ideas didn't flesh out.
Harkin seems to be espousing an advocacy role rather than a scientific role. Moreover, the foursome that he brought to testify to the Senate primarily spoke of preventive medicine approaches that are not considered "alternative" but are rather being co-opted by so-called "integrative medicine" as their own since the more unscientific modalities have not proven effective. Saying that nutrition and cardiovascular preventive approaches are CAM is utterly ridiculous.
Believe me, as a natural products pharmacologist I would love to see some of these remedies have therapeutic efficacy. They may ultimately do so if proper basic science is done first that informs the dosing schedules used for clinical trials. However, NCCAM was under political pressure to show some benefit of anything and therefore supported expensive clinical trials in premature, Hail Mary attempts to get quick and early payoffs. Instead, NCCAM is left with a trash heap of negative data - not because the approaches are being discriminated again but rather because the science did not support their efficacy.
Hence, I argue that NCCAM is a victim of itself, its management, and its own establishment as an advocacy arm, not a scientific arm, of NIH.
I think it's excellent that CAM is putting traditional remedies (emphatically excluding homeopathy) through rigorous studies and trials and we should make every effort to support this.
CAM = Crassulacean Acid Metabolism
I'll echo Abel Pharmboy some. The crux for the scientists is that Harkin's complaint is that the NCCAM is not validating the 'CAM'. Starting with your conclusion is antithetical to good science, and Harkin's complaint sounds exactly like he wanted scientists to do that.
The secondary matter is that even if the NCCAM didn't go down that antiscientific route, it's spent a lot of money testing that things that had little scientific reason to believe they'd be effective were, indeed, not effective. That money could have been spent in other ways. It's not as if there were a shortage of scientific ideas around waiting testing.
Gerardo: +2 internets for that one. As a plant person myself I am especially tickled.
I agree with all, I think. It's good that the NCCAM is invalidating various 'alternatives' that we didn't think were going to amount to much. In fact, it demonstrates that the NCCAM may be doing their research right after all. But I think that the money may have been better spent elsewhere with a more likely medical discovery payoff. Not a cent of The Stimulus to the NCCAM, plz!
Have you read or heard his comments? Have you seen what NCCAM is putting out? I think what you are missing includes 2 important points:
1 - It is outrageous that someone who is so obviously unqualified and biased is given the power to make decisions about policy and funding in matters of science.
2 - The ground that NCCAM gains in disproving some CAM is lost in other areas of their operation. For example, the public "education" they spread is shameful and no closer to reality than what you will find on labels of the "treatments" themselves. Check out their "fact sheets", which dance around studies of effectiveness like the caveats in the small print at the bottom of ads for bogus therapies.
Senator Harkins thinks that CAM should be given respect and a share of the medical market and that taxpayers should be forced to accept it as credible.
I don't see the difference between this and the Intelligent Design movement. Do you?