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Complementary and alternative medicine Medicine Politics Quackery

Government-funded woo

It’s that time of year again! Time for the one Center of the NIH dedicated to studying “remedies,” regardless of how scientifically implausible or lacking in evidence to support them, the National Center for Complimentary and Alternative Medicine (NCCAM) to put forth its budget request for FY 2008. What’s the bill for government-funded studies of woo?

$121,699,000.

Depressing. Let’s see what the possible justification is for sending $121 million on studying things such as homeopathy:

Large numbers of American health care consumers are using CAM modalities in an effort to preempt disease and disability or promote health and a sense of well-being. Despite the relative paucity of information about the effectiveness and safety of these uses, Americans are de facto personalizing medicine through approaches that often require their active ongoing participation in a diverse variety of health practices and behavior change approaches.

Driven largely by consumer demand for CAM, integrative medicine — which can be defined as a health care approach that makes use of all appropriate evidence-based disciplines, therapies, and health care professionals to achieve optimal health and healing — is rapidly becoming a major force shaping health care systems in the United States and around the world. At the same time, studies continue to show that open communication between conventional medical practitioners and their patients about CAM use is uncommon. Such communication is vital to ensure well-coordinated, comprehensive, and safe care.

In other words, scientific evidence and plausibility doesn’t matter; because a lot of people believe this woo, we have to spend your taxpayer dollars to try to come up with “scientific” evidence that it works. More annoyingly, NCCAM claims:

Whether a study’s result is positive or negative, we expand our knowledge not only about the tested therapy, but also learn more about the condition it is supposed to treat.

Here’s the problem. Negative studies don’t matter. If a study shows that a particular CAM “remedy” does no better than placebo, CAM practitioners don’t believe it. Can anyone point me in the direction of a single “alternative” remedy that, after multiple negative studies, has been abandoned? For example, multiple studies show that chelation therapy for cardiovascular disease is no better than placebo. Yet, people still use it, and NCCAM is still studying it to determine whether it is efficacious. Indeed, there appears to be no woo so implausible, so without basis in science, that NCCAM won’t take it seriously. Homeopathy? Check. Qi gong? Check. Craniosacral manipulations? Check. In children, yet! Shamanic healing? Check! Distant healing? Check!

Your tax dollars hard at work.

I used to think that NCCAM had value, but over the last couple of years I’ve come to realize that it’s the only branch of the NIH dedicated to promoting pseudoscience. It’s the political construct of woo-loving Senators and Representative to put the imprimatur of the federal government on quackery. It does fund some decent studies on herbal remedies, but if you wander beyond plausible treament modalities with pharmacological activity, you find that almost no woo is too beyond the pale to be supported by NCCAM.

Given the current tight budget of the NIH, this $120 million could be better spent distributed among the various Institutes, rather than locked up to study so much dubious “science.” There is nothing that NCCAM does that couldn’t be done better with its functions dispersed throughout the rest of the NIH. Good studies of herbal remedies and other “alternative” treatments would be funded, regardless of whether its NCCAM or another Institute, while other Institutes wouldn’t waste money funding studies of quackery like distant healing.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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