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©Kunz & Kunz, Reflexions, Summer/Fall, 1996

Selection of Exploratory Centers

Goals for research centers established

The Exploratory Centers were chosen following a process begun in 1994.
"The purpose this RFA (#OD-94-004, mandating establishment of centers) is to provide a mechanism to examine the potential effectiveness and validity of alternative medical (AM) therapies and to provide clinical /scientific/technical assistance to AM investigators as they develop their research projects."

"The mission of the OAM is to encourage and support the investigation of AM practices, with the ultimate goal of integrating validated alternative medical practices into health and medical care. 'AM practices' are therapies represented by preliminary clinical data on which systematic and scientific retrospective and / or prospective research projects could be based.

"The AM community possesses a potentially useful accumulation of patient data that could be evaluated for treatment outcome. The NIH and OAM recognize the need for: (1) scientifically-based research for AM therapies across the range of diseases; (2) identification of the role of AM in clinical outcomes, prevention, and health improvement; (3) development of both an independent and collaborative research capacity in the AM community; (4) multi-disciplinary research approaches in AM research; (5) a network of research organizations that includes both the AM and conventional medical communities; and dissemination of research findings.

"The Public Health Service is committed to achieving the health promotion and disease prevention objectives of 'Healthy People 2000,' an initiative for setting national health policy and priorities. Although 'Healthy People 2000' does not currently specify an Alternative Medicine objective, this RFA involves priority areas within the 'Healthy People 2000' objectives that involve alternative medical health care. To obtain a copy of 'Healthy People 2000' (Full Report: Stock No. 017-001-00474-0) or Summary Report: Stock No. 017-001-00473-1) through the Superintendent of Documents, Government Printing Office, Washington DC 20402-9325 (telephone 202-783-3238)."

Research objective: background

"The demographics, prevalence and patterns of use of unconventional medicine in the United Sates have recently been described (New England J. Med. 328:246-252, 1993). The most relevant findings are the following: (a) most people use unconventional therapies for chronic rather than life-threatening medical conditions; (b) The elderly are significant users of alternative therapies; (c) users of alternative therapies do not inform their primary care physicians; (d) extrapolation to the United States population suggests that Americans made approximately 425 million visits to providers of unconventional therapy during 1990; and (e) expenditures associated with alternative therapies appear similar to non-reimbursed expenses incurred for all hospitalizations in the United States. These findings indicate that alternative medicine modalities pickup a larger role in the self-health care of U. S. citizens than previously understood.

"Despite that broad use of alternative medicine treatments, there is a paucity of data available to demonstrate convincingly whether these AM practices are efficacious, safe, and/or beneficial, lead to positive clinical outcomes, improve quality of life, reduce or eliminate adverse symptoms, prevent disease, or promote or enhance health. A similar conclusion was reached in a 1990 report on unconventional can treatments by the U. S. Office of Technology Assessment, OTA-H-405, 1990, p. 225.

Exploratory Center Concept

"The exploratory center is viewed as a first step in developing future specialized or comprehensive centers in Alternative Medicine. It will support planning for new interdisciplinary programs involving experienced investigators from conventional medicine and clinicians and investigators from Alternative Medicine. It will provide clinical/scientific/technical assistance to investigators, as well as funds for pilot studies on Alternative Medicine topics from investigators outside the center". (NIH Guide, Vol. 23, No. 15, April 15, 1994)
Example of center goals

The Center to Evaluate Alternative Therapies for Addictions and Related Disorders at the Minnesota Medical Research states that funds will be used to focus on utilization, applicability, and effectiveness of certain alternative medical treatments for addictive, health, and physiological complications of substance abuse. Major activities will be:
1. to establish linkages among alternative medical practitioners and between alternative and conventional medical practitioners;
2. to conduct field assessments of alternative therapies;
3. to develop and promote the transfer of knowledge of alternative therapies through education and technical assistance; and
4. to work with an advisory group, conduct peer reviews and evaluations, and maintain liaison with other alternative medical centers and interests. (Alternative Medicine (NIH OAM), Nov. 1994)


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