Complementary and alternative medical (CAM) therapies are used by a significant portiOn of the U.S. population; however, their safety, efficacy, cost-effectiveness, and mechanisms of action remain poorly understood. We propose a center to facilitate collaborative, scientifically rigorous investigation of CAM therapies to increase the research capacity of the alternative medicine community. This center's principal objective is to investigate CAM therapies as they are applied to common chronic medical conditions. In concept, this is an Office of Alternative Medicine-supported general medicine research center. in an effort to narrow its clinical focus, the center will initially review and assess CAM research opportunities in the areas of: (l) low back pain; and, (2) ischemic heart disease. Procedures will be developed whereby inquiries and proposals from the CAM community are incorporated in the center's assessment of these two areas. This assessment will also include an investigation of specialized methodological issues relating to placebo; specifically, the extent to which belief, expectation, conditioning, patient preferences and patient provider interaction predict or influence an individual patient's response to any therapy, conventional or alternative. In addition, this center will investigate legal issues which may affect research involving the integration of CAM and conventional medical therapies. In prioritizing research opportunities, special attention will be paid to protocols which can be successfully implemented in managed care settings. This center represents a first step in developing future comprehensive centers devoted to complementary and alternative medical therapies.
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