A few months ago the National Center for Complementary and Alternative Medicine launched a website bringing consumer health information together with easy access to their related research. The NCCAM is a branch of the federal National Institute of Health that was created in 1998 to further scientific research of medical modalities and substances currently outside conventional mainstream medicine, such as acupuncture, nutritional supplements, and therapeutic touch. Their goal is to use that research to help clearly define where these modalities may integrate, or not, into more mainstream medical practice.
I applaud the website for being easy to use and for bringing so much consumer and practitioner information together. Finding current and past research is a snap and I appreciate their focus on informing consumers. The inclusion of a link to the Cochrane Review website is extremely helpful for finding quick, down and dirty, clear information on specific conditions and modalities based on reviews of published findings.
However, I was dismayed by what I found while searching through the acupuncture research. The first main problem was that hundreds of research projects that were funded by the NCCAM lacked published results, many of those studies being completed well over 5 years ago. Without being able to see the results of so many studies how can the public know basic, vital information related to NCCAM research? Why were the studies completed but never published? The second glaring problem is that many of the published studies were terribly designed, suffering from minimal to no blinding or controls, a serious lack of clear and reproducible materials and methods, and weak statistical analysis. The results from such studies are at best unusable and at worst harm the status and viability of acupuncture as an integrative medical modality. Poor science is worse than no science, and after over a decade of NCCAM funded research we are left with mountains of poor science. While looking over the Cochrane reviews, the large majority lamented that the evidence from available studies was inconclusive due to poor study quality and that more research needs to be done. Only a few conditions could reasonably be stated as responsive or unresponsive to acupuncture. A quick search on PubMed reveals that only recently have researchers been really pushing for better quality acupuncture studies. It seems incredible to me that the NCCAM would fund the poor quality studies they have for so long, and leads me to question how bad the ones that never got published were by comparison. I am left shaking my head in wonder at the apparent lack of concern for the the quality of research funded over the past 12 years, what a sad waste of resources and time. The serious implications of this problem include the growing movement to de-fund the NCCAM all together and to push complementary medicine out of use and back into the fringes of quackery where they think it belongs. With more than a decade of terrible research to back them up, who can blame them at this point?
My next step is to investigate the funding approval process in the hope of finding out where the system has broken down and how it can be improved. With so many people invested in good science and the promise of complementary modalities such as acupuncture, there must be a way to reverse the trend and start producing some high quality scientific studies. Whatever the outcome, whether acupuncture is found to be useful or not, we need solid scientific evidence to help guide us.