Suppose you needed to have a CT scan for a sudden, severe headache and partial loss of vision and your doctor asked a nutritionist to read it, rather than a radiologist. Would you trust the diagnosis? Evaluation by a different — and what most would consider a lesser — standard is essentially how a significant amount of research funding is approved by one component of the National Institutes of Health.

Let me step back for a minute before plunging ahead. Federally funded scientific research runs the gamut from studies of basic physical and biological processes to the development of applications to meet immediate needs, such as the development of a universal flu vaccine or clinical trials for Alzheimer’s disease. Government funding is especially essential for providing the scientific knowledge that underlies new medical treatments. The NIH, the nation’s major funder of nonmilitary research, has generally been a reliable supporter of high-quality research, conducted at its Bethesda, Md., campus and at universities and research institutes across the U.S.

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  • I guess the person who wrote Miller’s comments for him (and let’s be honest with his history of getting companies to write his pieces for him we can’t assume he actually wrote this) doesn’t seem to realize is that NCCIH’s standards for peer review are subject to the same rigor as every other institute at NIH. So, in effect, Henry (or his writer) have a problem with NIH’s review process. That’s a pretty big hill to climb.

    The country spends $35 billion per year on complementary and integrative health. NCCIH’s $100 million budget is a good investment to determine safety and efficacy. And, if Miller looked beyond the very old, cherry picked studies he cited, he’d realize that too.

    Shame on STAT for even publishing someone who has been barred from other outlets because of questions about his integrity.

  • “I am surprised by this essay, which confounds topic and methods and fails to both accurately understand and appreciate the key importance of rigorous alternative medicine and ethics research. Given that 40% of Americans use some form of alternative medicine and given the history of ethical abuses in research, it is clear we need more, not less of these activities.
    The fact that topical experts sit on review groups does not reduce but enhances the review process. Would Dr. Miller recommend that a surgical research application never be reviewed by someone with experience in surgery? No application is judged by a single reviewer and as someone who has both organized and been on NIH review panels, I know firsthand the rigor and care they take in constructing these panels. That includes the National Center for Complementary and Integrative Health (NCCIH), which follows standard NIH procedures.
    The fact that a study result turns out negative is even more evidence that the study was done rigorously and not by advocates, therefore, Dr. Miller’s conclusion does not follow logically from his example. For every negative study NCCIH has funded there are many that have turned out positive and now form a body of evidence being recommended in national guidelines for non-pharmacological treatments for pain as alternatives to opioids like that being recommended by the American College of Physicians. Again, we need more, not less of this research.

  • Bravo and kudos. Well said.
    Of course the alt med people will swarm to bring out the knives now.
    There is no such thing as alternative, complementary or integrative medicine. There is only medicine. The standards need to be singular.
    “Many of the interventions have proven to be worthless.” “Many”? Name 3 that have been proven to have real-world worth.

    • You are so misinformed as is Henry miller, an FDA hack. Medical docs rarely bother to look at the voluminous studies affirming the utility of alternative medicine. This may be why so many patients have migrated away from conventional medicine and pharmaceuticals, with excellent results.

  • This article is founded on a fundamental misunderstanding:
    ‘…complementary and integrative health — which is sometimes referred to as alternative medicine…’
    Herein lies the problem.
    They are fundamentally different concepts, and research is vital in order to separate clinically valuable interventions from quackery. One cannot compare shamanism to massage delivered within a multidisciplinary care team.

  • My, my, the very same author that was dropped by Forbes for ghostwriting for Monsanto. This seems to be a catch-22 situation. Constant clamoring for evidence based claims, but when 0,37% of the NIH budget is used for that very reason, more clamoring.

  • I must say it would appear, from your comments, that you have quite a bias against alternative or complimentary practices in healthcare. As a very experienced primary care physician, and now a senior executive with a moderate sized healthcare provider in Population Health, I think it is our responsibility to review and study alternatives to our extremely expensive, poor quality healthcare system. When I was working, several years back, with a large insurance company, I discovered that 60% or our members with back pain first sought out chiropractors for their care, unknown to me or our company. They did that because we were not offering what they wanted, or needed. Is that good? Shouldn’t we review the outcomes for our members? We did and guess what. They were right. Chiropractors provided way less expensive( as measured by claims using Episode Treatment Groupers), better outcome, much better experience care that conventional treatment. Just because we do it, and get paid for it, does not mean it is the best care available. You write well, it would be nice if you realized there is value to non-conventional approaches to healthcare. What we are doing now is unsustainable.
    Jim

    • (Author response) Thank you for the thoughtful comment. I am not against low-tech, non-pharmaceutical approaches to medical care — see, for example, http://www.newsweek.com/low-tech-revolution-transforming-medicine-786275. But the point of the article is that NCCIH’s set-aside means that the complementary medicine community — much of whose work is pedestrian, trivial, or worse — are competing only against one another while much genuinely important research that could lead to medicine’s Next Big Thing is going unfunded.

    • Well said. The body is more like a musical instrument than a digital device. The complexity ( 1B proteins per cell) is mind boggling. So tech med is very, very far removed from understanding, and likely never will.

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