Afternoon Inquisition

AI: $250,000 Hot QiGong CAM action

Today Skepchick Approved® Chicago Tribune reporter Trine Tsouderos is discussing a little part of the US’s National Insistute of Health called the National Center for Complimentary and Alternative Medicine (NCCAM).

As skeptics we are generally, well, skeptical of CAM, and with good reason — once a treatment is proven to work, it goes from being “alternative” to being “not alternative”.  Being proven to work is the thing that takes the quotation marks off of the word medicine. And at the pharmacy a label that says “natural alternative” or other CAMtastic buzzword is a label that implicitly says “NOT MEDICINE”.

But there are things out there that can work, maybe possibly… or even maybe probably, that aren’t yet embraced by “Western medicine”. NCCAM is in charge of finding those things. And they have $128 Million to do that. 

The center’s recently adopted strategic plan focuses on studies of supplements and other natural products along with the effect of “mind and body” therapies like yoga, massage andacupuncture on pain and other symptoms. In fiscal years 2008-2011, NCCAM funded more than $140 million in grants involving mind and body therapies, including $33 million for pain research in fiscal 2011.

Now part of me thinks that we shouldn’t be putting millions of dollars of research into figuring out if my qi needs a happy ending to fix my migraines, but another part of me thinks it’s important to study CAM because, you know, what if?

But then $128 Million is a lot of money… and what if we used that money to fund therapies with a chance of working?

How do you feel about funding these therapies? Are we wasting money on studying CAM? Is there a benefit? How would you feel about a loved one being a part of a NCCAM study? What CAM treatments do you think are acceptable for use/study?

The Afternoon Inquisition (or AI) is a question posed to you, the Skepchick community. Look for it to appear Tuesdays, Thursdays, Saturdays, and Sundays at 3pm ET.




Elyse MoFo Anders is the bad ass behind forming the Women Thinking, inc and the superhero who launched the Hug Me! I'm Vaccinated campaign as well as podcaster emeritus, writer, slacktivist extraordinaire, cancer survivor and sometimes runs marathons for charity. You probably think she's awesome so you follow her on twitter.

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  1. Resources are limited and loved ones are dying. Why would one want to waste money on long disproven folklore? Just because idiots pomote something doesn’t make it worthwhile. Put research where there’s the highest chance of gaining useful knowledge. We have already spent enough money proving dumb people are dumb.

  2. The big tipoff that there is no natural viagra is how quickly viagra rose. If the natural viagra could rise to the challange then viagra when it came out would be puffing itself up with claims of working like the previous herbal option. However no one had any idea how to really plunge in to the market until they could fill their product with clandestine pharmaceuticals… Sad day.

  3. If people are going to do it anyways I can see value in spending money to ensure the results are properly validated and controlled.

    If it’s found to be useless some of the fans will change their minds.

  4. I have mixed emotions about this. It would be great if some of the remedies/modalities were to make the transition to medicine. However, findings in the negative will fail to sway woonatics anyway.

  5. When I was a little baby skeptic a few years ago and found myself arguing with my best friend over chelation therapy and ozone therapy and fluoride poisoning and all that crap, one point she would pose time and time again was that the pharmaceutical companies wouldn’t make money if this stuff ended up working, therefore nobody funds studies for it. If the studies were funded, YOU’D SEE that alternative medicine is entirely reliable.

    So when I found out that there was actually a government agency that actually funded studies that are specifically in this questionable area, it might as well have been a gift-wrapped package left on my doorstep filled with alcohol and german chocolate.

    What I’m saying is that as questionable as these studies are, proving these people wrong is preferable to ignoring them and letting them cry conspiracy. Sure, you could say that there’s no such thing as qi or water-memory or something because that’s what all of science has pointed to in the past, but if you can specifically debunk one of these therapies, you’ve got an even better evidential upper hand.

  6. To me, it would be a lot of money, but in terms of the US Federal medical research budget, it is about 1/3 of 1%; or about 41 cents/person. Given the billions that people voluntarily spend on quackery, it is possible that the revenues accruing to the gov’t from the quackery industry are more than $128 million.

  7. I expect most skeptics would be simply against any CAM funding. I would have agreed up until a few years ago when I found myself, quite by accident, being involved in a CAM program. (Strange but true.) I learned quite a bit about what CAM really is. And, I have not changed my mind much about that it is worth. But, having said that, I’m pretty sure that most people who consider themselves “evidence based” are actually rejecting CAM without understanding what they are really rejecting. I.e., without evidence.

    I’ve been thinking for quite some time about writing a “skeptical skepticism” post about that. Maybe this is the time.

    BTW, the amount of money we are talking about here is about a half of a percent of the NIH budget. Not that being a small amount is OK if it is wasted, but it is relatively not a lot of money. If a good portion of that money is testing new claims, then I’m happy. If it is retesting the same old previously tested and disproven claims, then I’m not as happy.

  8. While there may be a benefit to *some* treatments, I believe the money should be spent on research directly to placebo effect, which is the underlying “reason” why many CAM treatments do work for some.

    There is one aspect of CAM therapies that could be copied- much of what makes people keep coming back to CAM is the feeling they get that they are being listened to by their “doctor”, and that they are taking an active role in their own treatment. Call it the now-seems-to-be-missing “bedside manner”.

    Maybe that 128 million could fund some training on this area of doctor-patient interaction?

  9. Dunno if this is what they had in mind, but there is a HUGE amount of research needed into “supplements and natural products”.

    We haven’t even identified many of the species on this planet, let alone investigated their unique biochemistry – and who knows how many new medicines are waiting to be found, in jungles and in the deep sea for example?

    Regarding supplements, as example, I was involved in folate measurement for our state for some years, and say 15 years ago, severe folate deficiency was not all that uncommon. Then the link to neural tube defect was found, supplementation became common, and today folate deficiency seems to be rare as rocking horse droppings.

    Today the same sort of thing is happening with vitamin D and of course, a great deal of research remains to be done there vis a vis eg osteoporosis, MS etc.

    A few years ago selenium in cancer looked promising but did not pay out in big studies – yet still may be of use in selected sub populations. For instance, there are areas with selenium deficient soils.

    As the facts change almost daily, it is really hard to keep up with this sort of stuff, even if you are involved to some degree in the game.

    1. Great post Greg.

      Regarding milk thistle, I presented a paper at work a few years ago based on this article
      in which milk thistle was used to treat a case of toadstool poisoning in France.

      A quick Google indicates that the active ingredient is in Phase 2/3 clinical trials in the US:

      So yes, I strongly agree with your first post where you stress the need to examine the evidence carefully before rejecting any and all CAM findings.

  10. This is kind of ridiculous.

    Are you serious that we shouldn’t be doing research on these methodologies because some of the people who claim that they work claim a mechanism that makes no sense?

    Look, I hate to break it to you, but there was a time when willow bark was a magic treatment. It was only later that people doing research were able to prove an actual biological mechanism.

    But we say about treatments that in many situations haven’t been studied that they work via placebo effect or don’t work at all.

    Come on, skeptics: Is it not obvious that there was a time in the development of every treatment proven by research to have a beneficial, non-placebo function that it was entirely unproven.

    You do research on treatments that aren’t proven – because doing research on treatments that are proven would be idiotic!!!11!11!!!1!!one!11

    The only difference between CAM and complete BS is that some people already think it works through life experience and anecdote transfer over long periods of time. Of course personal experience isn’t evidence, and it can be hard to explain that to devotees, but we grind up berries and test them for medical activity all the time –because you never know when a positive result will come.

    But you think it’s bound to be negative just because someone else thinks it’s bound to be positive? What kind of skepticism is that?

    Do the research on treatments not yet proven, whether they have a preexisting constituency or not. Be skeptical, not a naysayer.

    The part of this that is ripe for skepticism is not the basic question, should we do or prohibit research on treatments that some people already use but have not been established as effective (or safe, for that matter) by any reliable scientific effort. What is ripe for skepticism is whether or not some of these methods haven’t already received research attention in Europe or other places. Being proved ineffective is not the same as being unproven or unstudied.

    So, folks: mebbe we can stop making our decisions without evidence and study questions about which we don’t yet have evidence based answers? Is that too controversial a position to hold here?

  11. Although it would be great to have a double blind, peer reviewed trial to show to CAM proponents, I agree with @Jimmy, I don’t think it would convince anyone. They will claim big pharma conspiracies, scientific limitations, or alternative bogus studies or anecdotes. Besides, next week you will just get another claim, it never ends.

    Lets find new medicines, but before public money is spent on testing anything it should pass a basic plausibility test. If the treatment violates know laws of physics, test something else. CAM organisations can fund their own studies if they want.

    How much of this is retesting? Most popular CAM treatments have been tested. Sometimes all you need to do is a literature review.

  12. I think it is not a waste to study CAM, you need good quality, RCT’s to show whether or not CAM should become true medicine. I would rather it be studied openly where the studies could be critiqued. A benefit would be quality evidence for or against CAM that would follow the scientific method. More evidence against something is just as good as evidence for.

    However I do not think that these studies may necessarily be the best quality considering the possible bias from the association itself. I would be extremely skeptical of any studies that came from this money because of the possible confirmation bias.

    If a family member was involved in a trial, I would be okay with it if they were doing it for science, however if they had a life threatening illness and they believed that the CAM would cure it, I would most likely be very angry and hopefully get them to drop out of the study.

    Which CAM are acceptable for study is such a difficult concept. Ultimately I do not think that there is strong evidence for any CAM working so to subject people to acupuncture to cure their pancreatic cancer is very difficult to accept. Ultimately I would not be able to decide this!!

    However this is an interesting question, and ultimately I would follow research and scientific principle with what should be studied.

  13. In pricipal I agree possible remidies should be tested. However, I’ve just finished Skepital Inquire’s article about NCCAM. The author outlines the huge sums of money that have been spent on researching distance healing, therapeutic touch, homeothopy, reiki, etc.

    So I can’t support the program unless some oversight is put in place to stop wasting money researching things that we already know can’t work.

  14. After the liberalisation of Norwegian health provider laws in 2004 we got “The National Research Center in Complementary and Alternative Medicine”. They started out looking at and doing research on CAM. When they only found overall negative results, they moved on to the following three-pronged approach:

    a) Doing research on the _use of_ CAM and patient experience.

    b) Providing information on CAM. “- H-pathy is… – H-pathy is said to… and in tiny print – H-pathy is unsupported by the available research results.”

    c) Collecting “The Registry of Exceptional Courses of Disease”.

    At this point I think the Norwegian government should defund what’s basically a center for CAM apologetic research.

  15. As a scientist I am never opposed to research funding :-)

    I think the important thing is just that the studies be well-designed. There is no point in repeating the same experiments endlessly. Someone says “having butterflies land on you cures diabetes,” sure, test it out. If you test it and it doesn’t and that doesn’t convince your butterfly nut, well, some people just aren’t convinced by evidence. Funding more tests at that point is just a waste of money, unless the butterfly nut can come find a real flaw in the test you already did.

    I pretty much trust the NIH to be smarter than that, though. Hopefully they aren’t spending all their money endlessly trying to convince the unconvincable. If there’s anything that *is* related to “mind body connections” it’s pain, so it sounds to me like they’re looking in the right places.

  16. What I’d like to see is a bit of an accompanying shift in policy, wherein once something gets researched in a NCCAM study, and is found horribly wanting, that it be officially dubbed ‘fraud’ to continue making specious claims for that class of therapy. This would, ideally, be enforced with jail time for the snake oil salesmen.

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