The NCCAM was set up under the NIH in 1992 through the effort of Senator Tom Harkin (D-Iowa), with an initial outlay of $2 million of federal funding. Since then it has grown to a budget of $122 million.
Its mission is to investigate alternative medical practices such as acupuncture, homeopathy, and natureopathy. Another part of the NIH also studies these types of treatments, for a total annual outlay of $300 million. Thanks to the efforts of the Science Based Medicine blog, Steven Salzberg’s blog on pseudoscience, and an article and blog posting in the Washington Post, this expenditure is now receiving some scrutiny.
Unfortunately, the scientific record for the alternative approaches that NCCAM has investigated have not been encouraging. A great book on the subject, “Snake Oil Science: The Truth about Complementary and Alternative Medicine” by R. Barker Bausell goes through the current evidence in some detail, and it is largely the case that none of these treatments have been found to be more effective than placebo.
In the case of homeopathy, which has thousands of practitioners, the evidence is especially clear, by a quirk of this particular practice. Since homeopathy argues that the more diluted the dosage, the more potent the drug, it is quite easy to do studies where the placebo and the test groups are given pills that are nearly identical. This avoids a frequent problem with placebo control studies, which is that the placebo groups can usually tell (through lack of any drug related side effects) that they are in the placebo group.
Despite the dearth of evidence in support of many of the alternative treatments investigated by the NCCAM, Senator Harkin continues his support for the center. As recently as a few weeks ago he stated:
"One of the purposes when we drafted that legislation in 1992 . . . was to investigate and validate alternative approaches. Quite frankly, I must say it's fallen short. I think quite frankly that in this center, and previously in the office before it, most of its focus has been on disproving things, rather than seeking out and proving things."
(Quoted by Kimball Atwood: http://www.sciencebasedmedicine.org/?p=399)
This illuminating passage stands as a testimonial to, at best, a poor understanding of the scientific method, and at worst a disingenuous gloss of a record of failure. To state that the purpose is to validate alternative approaches, if that’s what Senator Harkin truly believes, seems to get the cart before the horse. NCCAM's purpose was to subject these approaches to rigorous scientific evaluation. That has happened, and the results have been negative in many cases.
There is a need for a branch of the NIH that will investigate treatments which are unlikely to be picked up by researchers or private companies. However, it should also come clean and make recommendations as to what approaches have withstood scientific scrutiny, and those that have not, and stop funding investigations of the latter. Thus, we should reform the NCCAM, or close it down and re-establish an office to concern itself with the needed studies.