Will a name change make NIH research center less controversial?
A controversial National Institutes of Health center has a new name. The National Center for Complementary and Alternative Medicine (NCCAM) is now the National Center for Complementary and Integrative Health (NCCIH). Could a name change help give the center more credibility?
NCCAM/NCCIH has been controversial since its inception in 1991 under yet another name—the Office of Alternative Medicine. The OAM became an official NIH center (NCCAM) in 1999, and in 2014 it had a budget of $123.8 million. Over its lifetime, the center has faced repeated criticism for funding studies of what many consider to be dubious treatments with very little supporting scientific evidence—such as distant prayer to treat AIDS, energy healing to treat prostate cancer, and shark cartilage extract to treat lung cancer. In a 2006 policy forum in Science, physician-scientists Donald Marcus and Arthur Grollman concluded:
"We believe that NCCAM funds proposals of dubious merit; its research agenda is shaped more by politics than by science; and it is structured by its charter in a manner that precludes an independent review of its performance. The central issue is not whether research into alternative therapies should be supported by NIH. In view of the popularity of alternative therapies, it is appropriate to evaluate the efficacy and safety of selected treatments. The issue is that the administration of research by NCCAM falls below the standards of other NIH institutes and that the evaluation of alternative therapies could be performed by mechanisms that are already in place at NIH."
A 2012 article in the Skeptical Inquirer reviewed the studies funded by NCCAM from 2000-2011. The authors concluded that there were "no discoveries that would lead to new areas of scientific medical research or treatment" in this time period. In an era of exceptionally tight research dollars, it is unsurprising that there have been calls by scientists to defund the center altogether.
In recent years, center director Josephine Briggs has tried to turn its reputation around and has emphasized that NCCAM/NCCIH is dedicated to funding scientifically rigorous studies. Briggs announced the proposed name change last spring and asked for public comment. In this invitation for comments, Briggs stated that "large population-based surveys have reinforced the fact that the use of true alternative medicine—that is, the use of unproven practices in place of treatments we know to be safe and effective—that that is rare.\" She added that there has been growing use of "integrative healthcare within communities across the U.S., including hospitals, hospices, and military health facilities.\" She explained the core reason for seeking a name change: "We also recognize that our current name is not explicit about our research mission, and that it may be misconstrued as advocacy or promotion of unproven practices."
Now the question is whether the term "integrative health" makes the center's research mission clear. The FAQ page about the name change says: "The goal of an integrative approach is to enhance overall health, prevent disease, and to alleviate debilitating symptoms such as pain and stress and anxiety management that often affects [sic] patients coping with complex and chronic disease, among others. However, the scientific foundation for many complementary approaches is still being built."
And there's the rub. It's doubtful that a name change will mollify all the center's critics. For many critics—some of whom have argued that the scientifically sound research supported by the NCCIH could easily be enveloped by the other institutes—there is no alternative or integrative medicine. There are simply evidence-based treatments and interventions that work and those that do not. If the center shows that it is dedicated to "[improving] the capacity of the field to carry out rigorous research" (Objective 5 of the center's 2011-2015 Strategic Plan), that will do more to quash the center's critics than any name change could.
Opinions expressed in this blog are those of the author and are not necessarily the opinions of AAAS, its officers, general members, and/or AAAS MemberCentral department or staff.