Josephine P. Briggs, M.D.
Considering All Perspectives
Recently, a series of articles appeared in the media that were critical of complementary and alternative medicine (CAM) and how NCCAM directs taxpayer resources to study these modalities. While the articles contained several misconceptions regarding NCCAM’s research, they also raised some important concerns that I share. No one likes criticism, but it is important to listen to the critics and look for any threads of truth that can help us fulfill our mission better. While the value of research on CAM interventions will probably continue to be the subject of some controversy, there are many areas of promise in CAM that need to be pursued. NCCAM is committed to this path.
NCCAM’s mission (to explore CAM practices in the context of rigorous science, to increase CAM research capacity, and to disseminate information to the public and professionals) is important.
Approximately 4 in 10 adult Americans use CAM. Our research aims, above all else, to ensure that the public and their health care providers can make the most informed health care decisions about the value and safety of CAM practices based upon state-of-the-art scientific evidence.
Our research priorities are based primarily on two factors: public use of CAM and scientific promise.
I see considerable promise in the ability of certain CAM modalities to address symptoms and quality of life issues. From the recent NHIS data, we know that chronic pain is the most common health condition prompting people to turn to CAM. There is very substantial and mounting evidence that some CAM interventions hold promise of offering help, are safe, and appear to be based on well understood physiological processes.
Safety is a critical concern.
I believe that our field must pay careful attention to concerns and criticisms in this regard. It is as important to ensure the safety of CAM practices as it is to ensure the safety of drugs and other medical practices. For example, we know from research that some seniors take multiple prescription medications and multiple herbal products and/or dietary supplements. Understanding their interactions and safety are important research pursuits. From other NCCAM-supported research and FDA reports we know that there are reasons to be concerned about the quality and safety of some herbal and botanical products. These points also bring home the need for patients and providers to have an open dialogue about CAM use.
Our research investment is building an evidence base for CAM that is affecting health care practice.
Over the last 10 years, we have funded over 2200 research projects, resulting in more than 3300 journal articles published in peer-reviewed journals. Both positive and negative study outcomes inform and advance the evidence base for CAM in important ways and will also shape future research. Recent practice guidelines by the American College of Physicians and the American Pain Society cite CAM approaches as useful options to be included in treatment of chronic back pain. The translation of our research into practice has a real, direct effect on patient care.
I welcome a dialogue with all of our stakeholders on our research priorities. Our strategic planning process over the next year will be a critical opportunity to define future directions. I invite your comments and continued participation.