Some of the NCCAM/OAM-funded projects have already added to the scientific literature and influenced clinical care.
In 1997, the OAM joined with the NIH Office of Medical Applications of Research to sponsor a consensus development conference on acupuncture. A 12-member panel concluded that there is clear evidence that needle acupuncture treatment is effective for postoperative and chemotherapy nausea and vomiting, nausea related to pregnancy as well as postoperative dental pain (PT March, 1998).
In 1993, the center began to cofund exploratory pilot projects to identify promising areas of future research. Thirty awards were made that year, and another 12 in 1994. A database of final report research data from OAM grants made in FY 1993 and 1994 is available at the following Web site: <http://altmed.od.nih.gov/nccam/cgi-bin/research/form.cgi>. Objectives, design, outcome measures, results and conclusions are cited for 23 studies. Here are some examples:
Acupuncture: Researchers from the University of Arizona Tucson sought to determine if the effectiveness of acupuncture in alleviating unipolar depression in women is sufficient to warrant a larger clinical trial. Following treatment specifically designed for depression, 64% of women (n=33) experienced full remission. "Based on the results of [a] small sample, acupuncture appears to provide significant symptom relief at a rate comparable to standard treatments such as psychotherapy or pharmacotherapy," the researchers concluded.
Energy therapy: Researchers at the Menninger Clinic looked at whether energy therapy could potentially treat, and produce cost-saving and reduced side effects for, basal cell carcinoma. Two bioenergy healers moved their hands (without touching) approximately one to two inches over the client's head and body. Treatment took place 30 minutes every other day for five days. All patients had tumors photographed and digitized for computer analysis. Four patients showed tumor reduction or elimination confirmed by these photographs during the three-week treatment period. All other patients either showed no effect or the results were equivocal. Static electrical surges of up to 28 volts and 54 volts were measured on the bodies of the two healers while they were engaged in energetic therapy. Based on their fingertips, the researchers concluded that "the findings of significant effects were modest, need replication with better standardization of camera-client distances and the use of color film, and a longer treatment period."
Massage therapy: Researchers from the University of Virginia School of Medicine conducted a controlled trial of the effectiveness of therapeutic massage as an adjunct to standard medical care. Patient volunteers scheduled for abdominal hysterectomy surgery were randomly assigned to receive either standard postsurgical care plus a daily 45-minute therapeutic massage or standard care alone. The researchers found that "cortisol was substantially lower and more often found to be within the normal range by the fifth postoperative day for the massage group relative to the controls…and the massage group used less patient-controlled analgesia." However, they did not find any significant differences between the two groups in use of oral narcotic painkillers or nonsteroidal anti-inflammatory drugs. No additional medical services were used by the massage treatment group during the four-week posthospital period, but five of the 15 standard-care patients required additional physician visits. The investigators concluded "therapeutic massage appears to promote recovery from surgery by reducing subjective tension and enhancing parasympathetic response."
In FY 1998, NCCAM-sponsored research included evaluating the efficacy of acupuncture for back pain, pilot studies of St. John's wort in juvenile depression and self-transcendence in breast cancer support groups.
As the NCCAM continues its work, Jonas has some practical advice for his successor: "Understand that biases abound in these areas. Opinions are often extreme-both pro and con. However, you must go with the research evidence, even if the topic is unpopular or the area is stigmatized."