Project Concept Review

Project Title: Centers of Excellence for Research on CAM

Council Date: September 11, 2009

Program Officer:
Barbara C. Sorkin, Ph.D.
Email: sorkinb@mail.nih.gov

Background

NCCAM's signature P01 initiative, the Centers of Excellence for Research on CAM (CERC), was first published in December, 2002, with the first two CERC awarded in September, 2003. The CERC initiative, as recommended by the 2002 Expert Panel review of NCCAM's Centers programs, focused on elucidating mechanisms of action of CAM interventions. The Expert Panel had reviewed Center programs sponsored by NCCAM and its predecessor, the Office of Alternative Medicine.

Seventy-four CERC applications (including re-submissions and competitive renewals) were reviewed between 2003 and July 2008, and 17 CERC were awarded, including two competitive renewals, one in 2008 and one in 2009. Nine CERC were funded between September, 2007 and early 2009.

The most recent CERC FOA, originally issued in October, 2005, expired in February, 2008.

The awarded CERC in accord with the initiative announcements to date, are generally mechanistic in focus, but otherwise span the range of CAM interventions from mind-body medicine through botanicals and acupuncture, and a range of health or disease applications from Alzheimer's disease and pancreatic cancer through pain and obesity. The program has supported the development of strong interdisciplinary teams, and recruitment of investigators into areas of research important for NCCAM, and grantees have demonstrated scientific productivity.

Data from the 2002 and 2007 National Health Interview Surveys indicate that alleviation of pain is by far the most common health problem for which Americans turn to CAM. Indeed, chronic back pain and other musculoskeletal conditions constitute six of the top ten cited indications. In addition, a large body of basic, translational, and clinical research evidence points toward the potential promise of several CAM interventions in treating pain. Potential of this research for affecting practice is supported by recommendations to consider massage, chiropractic, and acupuncture that are now included in guidelines of the American College of Physicians and the American Pain Society.

Nonetheless, there remain numerous and important basic, translational, and clinical research questions which must be addressed in pursuing the promising leads which have emerged in the past decade and building an evidence base regarding the safety and utility of CAM approaches in treating pain. NCCAM has therefore identified use of CAM for alleviation of pain as a high priority for future research supported by the Center. Such research requires the kind of multi-disciplinary, multi-level, interactive approach facilitated by the program project grant mechanism. It is therefore proposed that NCCAM re-issue the CERC FOA with an initial emphasis on this broad and important field of investigation.

Purpose of Proposed Initiative

The proposed goals for re-issuing NCCAM's Centers of Excellence for Research on CAM (CERC) initiative are:

Objectives

To continue the most successful aspects of the existing program while honing it to enhance productivity and ensure that it is targeted to research areas where there is a strong likelihood of making contributions that will significantly improve health and well-being, and advance the field of CAM research.

Proposed Funding Mechanism

The proposed announcement would use the P01 (Program Project) mechanism to support multi-project Centers with Administrative Cores and optional research cores, at an increased maximum budget of $1.25 million direct costs per year for up to five years. Opportunities for competing renewal at the end of the project period will be determined based on the state of the relevant science at that time.