Field of Science

Help me get NCCAM defunded

Today I received email from the co-chair of Obama's presidential transition team asking me to contribute suggestions on what the new administration should do to improve the country. I know it's a mass email, but I decided to give it a shot, and I'm asking readers of this blog if they can help in a small way.

I've been calling for NIH to shut down NCCAM for a while now. Many others have tried to shut it down as well, including the previous NIH Director, Harold Varmus, who is now on Pres-elect Obama's scientific advisory council. It's a great way to save $225 million (or more), which could be put back into the NIH budget to fund real science instead of pseudoscience.

I submitted this suggestion on the Obama team's website, and you can help me by voting in favor of it. Here's the link. To vote, you'll need to create an account and login, which takes only about 30 seconds.

Within 10 minutes of my posting this suggestion (under Health Care), someone had already voted against it, so I need your support! (10 minutes later someone else voted for it, giving it a net vote of 0 points.) I noted that many of the suggestions under this topic were proposing just the opposite - that Obama should increase funding for alternative medicine, should allow insurance to cover it, etc. We need to at least show the incoming administration that some of us believe that the government should only support evidence-based medicine, not pseudoscience.

UPDATE: Saturday, Jan. 17. As of this morning, voting on my proposal passed 11,000 points! But please go and vote if you haven't already - there are a growing number of people voting "no" on the proposal, leaving comments describing all kinds of quackery that these people insist really work. The vote total is a score - each vote "for" adds 10 points, and votes against deduct 10 points.
Thanks to 2 bloggers at scienceblogs.com, PZ Myers (Pharygula) and Orac (Respectful Insolence) for pulling in such terrific support of my proposal. And thanks also to the bloggers at Science-Based Medicine for their post, which just went up today.

17 comments:

  1. Thank you PZ Myers! PZ posted a link to my proposal to shut down NCCAM. The voting this morning was initially negative; my proposal had a score of -40 within an hour of it going up. But within a few minutes of PZ's posting at Phayrngula, the score is now +180.

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  2. Orac pointed out that my $225 million is not quite accurate. NCCAM's funding is about $121M, while a separate office at the National Cancer Institute, called OCCAM (Office of Cancer Complementary and Alternative Medicine) has another $121M. Here's a link.
    So the true total is about $242 million, split into two NIH centers.

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  3. Is the voting closed? When I click on "VOTE UP" nothing happens. I see no registration link either.

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  4. Apparently the Citizens' Briefing Book closed at 6pm Sunday, so you can't vote any longer.

    Unfortunately, a late surge from proponents of quackery ("alternative medicine") cut into the voting quite a bit. The proposal was at about 11,500 on Saturday, but it ended up at 8,940 after this rash of no votes.

    Thanks to everyone who voted it up! Perhaps it rose high enough to get the attention of the incoming administration. If I hear anything at all, I will post something on this blog.

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  5. I found at least three "CAM" blogs that called on their minions to vote down my proposal - which partly explains the surge in "no" votes at the end. Both blogs are, well, typical promoters of pseudoscience. They are:
    http://www.helfgottblog.com/2009/01/voting-down-the-proposal-to-defund-the-nccam/

    and

    http://integralcaregiver.com/2009/01/19/move-to-defund-nccam-revealing/

    and this one, which is the most zealous in calling for its readers to "Act now!!" to vote down my proposal:
    http://theintegratorblog.com/site/index.php?option=com_content&task=view&id=527&Itemid=189

    Somehow, though, the skeptics won this round, despite the efforts of the pseudoscience proponents.

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  6. My opinion is that some so-called defenders of "science" are so out of touch with reality. Just because disciplines like ayurveda and acupuncture are not understood by you or that the methods they follow are not "modern" does not make them wrong. I know how ayurveda has been used with much better effects than "science" based allopathic drugs. So I think its out of ignorance that you have made this suggestion of defunding NCCAM.

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  7. I kind of agree with Steve. If an "alternative treatment" is effective it will be shown in a controlled study (as has been shown apparently for acupuncture).

    If treatments are obviously nonsensical then they should not be supported. However, then we also should exclude all this religious nonsense (including prayers) from public usage/funding... but then... how shall we deal with Placebo effects that have long been accepted as "effective";-)??

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  8. And many "controlled studies" and other studies nowadays are manipulative - you can use whatever statistical method you want to suit your preferred outcome. This is a common practice among modern pharmaceutical companies and scientists that need a tenure. Denying that modern "science" the pharma field is plagued with flaws (and pointing fingers at other fields) is not going to help.

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  9. This statement from Toms: "Just because disciplines like ayurveda and acupuncture are not understood by you or that the methods they follow are not "modern" does not make them wrong."
    -demonstrates a common logical fallacy often asserted by followers of pseudoscience, usually worded as "we don't know why it works, but it does!"

    Nonsense. If a method works, then we can test it. This is true even if we don't understand the mechanism. Ayurveda doesn't work - it is a combination of mystical "woo" added to ineffective and sometimes poisonous chemicals. Acupuncture has been tested time and time again - and no, Peter, it does not work. See my previous blog posts on both these "methods", or go to the Science-based Medicine blog (see my Blogroll) for even more examples.

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  10. Steven, I agree in principle with your comments. The preponderance of pseudoscience is disturbing and it's terrible to see time and again people using sham science to take advantage of people. I do however think you've taken quite a hard line against acupuncture. Generally I agree with you, if it really worked we should have a mountain of evidence - there's been hundreds of studies on the topic. But a lack of strong evidence doesn't necessarily mean that there is no positive benefit. I have had acupuncture treatment from a physiotherapist who described potential mechanisms of action (creating local inflammation... that seemed plausible) and who explained that their scope of practice was very limited and excluded eastern philosophy. To be honest with you, it seemed to work on my knee. If all the positive effects of acupuncture can be attributed to the placebo effect, well at the very least acupuncture is a very potent tool for inducing it!

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  11. Anon: I take a hard line against acupuncture because it deserves it: I've read multiple studies now, and none of them show any effect beyond placebo. The purported mechanisms of acupuncture all seem to be post-hoc attempts to create a plausible-sounding hypothesis. But when tested, these hypotheses fail. In fact, a new study just appeared this week in the British Medical Journal, by Madsen et al. Here's a quote from one of the investigators: "“senior researcher Asbjorn Hrobjartsson said: “Our findings question both the traditional foundation of acupuncture…and the prevailing theory that acupuncture has an important effect on pain in general." Or see this link: http://dcscience.net/?p=945.

    Yet another study that fails to show any effect of acupuncture. As if we hadn't studied it enough already.

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  12. Steven, there are enough "papers" (Search PubMed, please!) to prove basically that what we 'know' in biology often ends up wrong. In addition, there are lots of papers inserted with support from pharma companies to push their drugs. You can choose to deny this fact - that's your cup of tea. And if you are a scientist that looks only at links that support your mindset, there is no point in your blog. Your knowledge of ayurveda is pathetic. I am not commenting any longer as I do not see you worthy of science and life!!! All the best in your endeavors!

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  13. Toms: another logical fallacy: "there are scientitic papers that have later been proven wrong, therefore [insert favorite woo theory] is right." Sorry, no.

    In fact, one of the great things about science is that it gets revised all the time. Yes indeed, papers are later shown to be wrong - and we give up those theories and move on. In contrast, proponents of ayurveda, acupuncture, homeopathy, etc., refuse to move on. Instead they move the goal posts, constantly trying to explain why "more study is needed."

    And you threw in another logical fallacy there, Toms - the ad hominem argument, where you attack me personally. A time-honored strategy, but logically invalid.

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  14. Interesting. You know, you're probably right, mechanistically it's quite improbable, and the evidence for it working is absent. The one thing that still intrigues me is the placebo effect. I checked out the link. The notion that "the size of the placebo effect is too small to be useful to patients" is in strong contradiction to the reality that people strongly believe that it works, and not just the practitioners. This must be a flaw in their study design, or more probably a warning against over-interpretation of data. You know what? A theatrical placebo is OK with me if it makes me feel better. Thanks for the discussion.

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  15. The Change.gov website is no longer making proposals (including mine) available. So for those who want to know what my original proposal said, here it is:

    Defund the National Center for Complementary and Alternative Medicine (NCCAM)

    Biomedical research funding is falling because of the nation's budget problems, but biomedical research itself has never been more promising, with rapid progress being made on a host of diseases. Here's a way to increase the available funding to NIH without increasing the NIH budget: halt funding to NCCAM, the National Center for Complementary and Alternative Medicine. This Center was created not by scientists, who never thought it was a good idea, but by Congress, and specifically by just two Congressmen in the 1990's who believed in particular "alternative" (but scientifically dubious) treatments. Defunding NCCAM would save at least $225 million, possibly more.

    Defunding NCCAM would also provide a direct societal benefit. Practitioners of so-called "alternative" medicines constantly refer to NIH's support as a way of validating their practices and beliefs, most of which are not supported by evidence. The fact is that after >10 years, NCCAM has not yet found a single piece of positive evidence for any of these methods, which include acupuncture, "qi", homoepathy, magnet therapy, and other treatments.

    Any legitimate, promising medical treatment can be funded by one of the existing NIH Institutes. There's no need for a separate center for "alternative" therapies - but what has happened is that NCCAM has become a last refuge for poorly designed, unscientific studies that couldn't get funded through the normal peer-reviewed process.

    A useful discussion of this issue and the history of NCCAM can be found at http://www.quackwatch.org/01QuackeryRelatedTopics/nccam.html.

    We can quickly save $225 million and move the funding into more promising research programs by eliminating NCCAM.

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  16. I cannot believe people actually waste time on Tom.

    Acpuncture is based on the theory of "Meridians" carrying Qi flows. No such a system called "Meridians" has ever been found in human anatomy, we cut bodies open and meridians are not there, simple as that.

    Acpuncture also claims that Qi directs all living beings and how lives were formed and evolved, which contradicts to the theory of EVOLUTION.

    Why should I discard the theory of EVOLUTION just for acpuncture? Bullshit.

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