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Studying Alternatives

Unconventional medical therapies are now under scientific scrutiny.

Can Gingko biloba prevent dementia? Is shark cartilage helpful against lung cancer? Does prayer fight breast cancer? Stephen Straus ‘68 is leading efforts at the National Institutes of Health to study the efficacy of a wide range of therapies that fall outside the realm of conventional Western medicine.

Straus directs the National Center for Complementary and Alternative Medicine, which in the past has drawn criticism from professionals who are skeptical that alternative treatments can withstand the rigorous scientific scrutiny of the medical community. But Straus, a well-respected virologist with more than 20 years’ experience in clinical research at the National Institutes of Health, insists his work is good, solid biomedical research-no different from any other investigation into causes and cures of disease.

“Alternative” medicine includes any practice not considered part of mainstream medicine-everything from chiropractic therapy and acupuncture to botanical extracts and prayer. “Complementary” medicine uses alternative therapies in conjunction with traditional remedies. Over the past two decades, the popularity of alternative medicine has grown dramatically. A 1999 study revealed that more than one-quarter of all U.S. adults had used at least one alternative therapy over the course of a year. According to Straus, that’s reason enough to study the field.

“In an era in which we have so many things we know do prevent and treat and cure diseases, to leave people doing things without an evidence base seems like a lost opportunity,” he says.

Straus says that the U.S. public is hungry for answers, backed by hard data, about the efficacy of alternative therapies. As proof, he points to traffic on the center’s Web site, which averages about 100,000 visitors a month. And he has hosted three national town meetings, standing-room only. “People are hungry to understand what to do. I go to the chiropractor, and it makes my neck feel better. Am I deluding myself, or is this real?’”

The center was created by an act of Congress in 1998, and today its budget, which tops $100 million, funds about 150 research projects. Those studies include investigations into the use of Echinacea to treat the common cold, yoga to relieve insomnia, and acupuncture to fix a variety of conditions, including cardiovascular disease. As for results, Straus points to a 2001 study, which concluded that for major depression, Saint-John’s-wort is no more effective than a placebo.

Despite the National Institutes of Health’s imprimatur, critics from the larger medical community say the center is pork barrel that has produced no significant findings. Wallace Sampson, professor emeritus at Stanford University’s School of Medicine, is a longtime critic of alternative medicine. He founded the Scientific Review of Alternative Medicine, a journal that scrutinizes the claims of alternative medicine. Sampson says that the center’s research is wasting money on the unethical study of the implausible.

“The methods that [the center] funds are worthless,” he charges. “Some are absurd, such as healing by distant prayer or contemplation; some are absurd and already disproved, such as therapeutic touch, chelation therapy, and homeopathy. Many of the trials are so ill conceived the results will be uninterpretable.

“[The center] is an employment agency for pseudoscience and should be defunded quickly, with the funding diverted to valid basic scientific research,” says Sampson.

Straus says he “respectfully” disagrees with such critics and says people who are passionately for or against alternative medicine are extremist minorities. “[The center] is not a rogue enterprise,” he says. “This is the National Institutes of Health.”

To his credit, Straus has earned the respect of his fellow directors at the institutes, many of whom are cosponsoring studies with the center. “I think he’s brought scientific discipline to an area that has needed it,” says Stephen Katz, director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Katz is cosponsoring a study of acupuncture as a treatment for arthritis pain.

In fact, Straus says, conquering the controversy has been one of the most gratifying aspects of his job. “I think we’ve succeeded in changing the dialogue to a great extent,” he says, adding that people have gone from asking why the center should exist to asking what results it has produced. “Most people are fascinated by this. They are applauding what we’re doing, and they’re impatient for evidence.”

Armed with a love of research and an open mind, Straus is unfailingly upbeat about the challenges he faces. And he has no worries about tarnishing his reputation as a legitimate scientist.

“My entire career has been about discovery, and I think we as a society can benefit by good and considerable investment in research in any area,” he says. “I like what I do-I love coming to work every day. What’s to worry about?”

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