Josephine P. Briggs, M.D.
The Research Puzzle
Last fall, President Obama visited the National Institutes of Health to discuss the impact of the American Recovery and Reinvestment Act. During his speech, the President made a comment that strongly resonated with me:
“Breakthroughs in medical research take far more than the occasional flash of brilliance, as important as that can be. Progress takes time; it takes hard work; it can be unpredictable; it can require a willingness to take risks and going down some blind alleys occasionally—figuring out what doesn’t work is sometimes as important as figuring out what does—all of this needs the support of government.” [emphasis mine]
I think this concept is often lost in our eagerness to find answers that will bring help to people suffering from disease.
Over the last decade, NCCAM, in collaboration with partners across the NIH, has conducted some high-profile clinical trials of natural products, including St. John’s wort for major depression, Echinacea for the prevention and treatment of colds, glucosamine for osteoarthritis, and Ginkgo biloba for age-related dementia. We have also participated in studies on omega 3 (from fish oils) for cardiovascular and inflammatory diseases and studies of selenium and vitamin E to prevent prostate cancer. We undertook this research because the preliminary data was promising and because people were already using these products, resulting in some urgency to learn if they were safe and whether they worked. Evidence for the beneficial effects of fish oils has grown, but for most of the other examples, the products did not demonstrate clear-cut efficacy.
While these outcomes were understandably disappointing—both to the NIH and to the investigators who led these research projects—these studies all taught us valuable lessons. We learned useful information about these specific products and how we approach research on natural products, product characterization, standardization, and quality. We have also gained better understanding of the natural history of the diseases that were studied and markers of progression. Our future studies will be informed by this knowledge.
I do not lament a study that does not prove efficacy, as finding out what doesn’t work can be as important as finding out what does. Our research has helped inform the public, has had an impact on patterns of use, and helped Americans make informed health decisions. Each study is a piece of the larger research puzzle. In all fields of science and medicine, the scientific process takes time; cures are elusive. Over time, the puzzle will fill in and our understanding of the role of natural products in promoting health will become clearer.