At Harvard, Stanford and other prestigious universities, scientists are now testing the use of magnets, mistletoe and meditation, along with other treatments in the confusing menu of alternative health care.
Their work reflects a trend of expanding research into complementary therapies, demonstrating a new level of seriousness about a field still maligned as faith healing and chicanery by prominent voices in conventional medicine.
The number of randomized controlled trials -- considered the "gold standard" for research in science -- will increase from 169 in 1988 to well over 500 this year, according to data recently collected by the Cochrane Collaboration, which analyzes statistics on health care research.
Although the numbers are small, researchers say the trend indicates growing sophistication and the emergence of a scientific foundation for often ancient but misunderstood forms of medical care.
The new research is instigated, in part, by the increasing popularity of alternatives and by the maturation of the National Center for Complementary and Alternative Medicine, a growing part of the National Institutes of Health.
Over the last three years, NCCAM has increased financial support for its nine centers located at universities including Harvard, Stanford, Duke and Maryland. Beginning with a small budget of $2 million in 1992, congressional funding for NCCAM has grown to $68 million for the year 2000.
"We're developing an infrastructure and a capacity for research," said Brian Berman, who coordinates research in complementary medicine for the Cochrane Collaboration. "The centers have more money to do pilot studies in more innovative areas like spirituality and herbal medicine, and we're getting funding for career development of the next generation of researchers. We have a long way to go, but we're no longer open to the criticism that we're not producing good research."
At the University of Maryland, Berman also directs the Complementary Medicine Program, which just received a $7.8 million grant to study acupuncture, Chinese herbal preparations and meditation for treating conditions ranging from osteoarthritis to fibromyalgia.
At other schools, similar grants support studies of the effects of gingko biloba in treating dementia, glucosamine in treating osteoarthritis and St. John's wort for treating depression. At the University of Texas, researchers study the effectiveness of mistletoe for stimulating the immune system to kill cancer cells. At the University of Virginia, scientists have just completed a major study of magnet therapy for reducing pain.
Standards of science unmet
Despite the time-honored traditions of some therapies, such as meditation and acupuncture, the field has compiled relatively little research that meets the standards of Western scientific methods.
Critics bemoaning the popularity of unproven alternatives and their growing markets often point to the lack of "evidence-based research" and lampoon popular proponents of alternatives, such as best-selling authors Dr. Andrew Weil and Dr. Deepak Choprah, as fraudulent gurus.
Last year, Marcia Angell, the editor of The New England Journal of Medicine, published an editorial decrying alternative medicine as "a reversion to irrational medical practice." This spring, her predecessor, Arnold Relman, professor emeritus at Harvard Medical School, said almost all alternatives amounted to little more than a placebo and suggested that doctors avoid endorsing any alternative treatments.
The growing number of studies bolsters arguments of proponents who claim they can subject alternatives to the same critical standards as conventional health care. Medical scientists generally consider randomized controlled trials, which blind a study's investigator and its subjects from knowing who receives actual treatment, the most persuasive kind of experiment.
Progress in acupuncture
At the University of Maryland, Dr. Lixing Lao realized several years ago that he needed a strategy to survive these pioneering years as a scientist with an interest in alternative methods. Trained in China as an acupuncturist, Lao designed acupuncture studies at the university using tried-and-true scientific methods, then tested procedures he already knew as a clinician to be successful. With his results published in respected journals, his studies were cited in 1997 by an NIH panel when it first endorsed the use of acupuncture in conventional medicine.
"We have a good track record and good data," said Lao, now directing large-scale acupuncture studies at the university. "But almost as important, we now have experience writing grants, publishing papers and designing studies."
Still, researchers like Lao face significant complications in conducting studies that their peers in conventional medicine will find acceptable.