Article 4579 of misc.health.alternative:
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From: Monica.King@dartmouth.edu (Monica King, R.N.)
Subject: The Office of Alternative Medicine, a Functional Description
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Many of you have written me asking about clinical trials and studies to
do with some of the herbs, infusions, practices, and essences I have
written about in the past.  I share your hope that more and more
studies such as we are accustomed to in reading professional nursing
and medical journals become available.  Nursing theory, research, and
practice is based on the same academic and research disciplines as
medicine, and we do want ourselves to further enlighten our own and the
understanding of others through such trials.

Now there is a place from which such research is being conducted, and
you are welcome to call them about any questions you have on
alternative healing practices.  It is the newly formed division of the
NIH called the Office of Alternative Medicine.

The Office of Alternative Medicine (OAM) was initiated through
Congressional mandate under the Fiscal Year 1992 National Institutes of
Health Appropriations Bill in October, 1991.   The first year of the
Office was devoted to identifying the Alternative Medicine community
and issues.  In June, 1992, an ad hoc Advisory Panel was convened to
address these two major objectives.  Subsequent to that meeting, a
large meeting was held in Chantilly, VA in September, 1992 to assist
the NIH in establishing a research agenda for the Office.  The
participants were divided into ten working groups representing various
issues.  The working groups were charged with the task of formulating a
series of recommendations related to future research activities of the
NIH.  This work is ongoing and should result in a report to be issued
by the end of the summer of 1993.

Dr. Stephen Groft served as the Acting Director of the Office during
fiscal year 1992 when much of the early work of the Office began.  He
continues to assist the Office staff on an ad hoc basis.  Dr. Joseph
Jacobs was selected as the first permanent Director of the Office and
started on October 26, 1992.  We are proud to say at Dartmouth that Joe
did his residency here, and is widely respected .  Other staff members
include: a Deputy Director, Daniel Eskinazi, DDS,PhD. who has an
interest in acupuncture and homeopathy; a program analyst, John
Spencer, PhD. whose interest is biofeedback as well as mind-body
interaction; Dr. David Larson, a psychiatrist with a strong research
interest in religion and spirituality; and a secretary, Ms. Nora
Richardson.  They have been pulling the Office together to begin to
carry out the objectives identified below.

The goal of the Office is to evaluate alternative or unconventional
medical treatments.  In order to achieve this goal, the following
objectives have been identified:

I. BROKER or COORDINATING ROLE:

One of the primary functions of the Office is to advocate and
facilitate the evaluation of various alternative treatment modalities
by the appropriate Institute within the NIH.  This role is essential
for two reasons:

1> The OAM has a very limited budget and limited staff and cannot
possibly be expected to support large scale definitive studies.
2) The various Institutes at the NIH have the basic science and
clinical expertise in their respective research communities and should
be involved in these evaluations.

An essential requirement to fulfill this role is to develop an
inventory of those existing and future projects at the NIH that may be
classified as being unconventional medical practices.

Another function derived from the brokering role is in the assistance
to potential investigators who might benefit from collaboration with
someone else doing similar work either in th NIH or outside of the NIH.

II. "CLEARING HOUSE" FUNCTION:

There is an increasing demand for information about unconventional
medical practices or treatment modalities especially since increased
media attention has been brought on the office.  There has been a
tremendous number of phone calls to the office posing various
questions.  They have included:

1) Questions concerning opportunities to apply for grant funds for
various projects.
2) Media inquiries about the Office and how it came to be.
3) Individuals looking for jobs.
4) Cancer and AIDS and patients with other diseases looking for
information that can assist them when standard medical therapy offers
no further hope.
5) Requests, on the part of unconventional practitioners to share their
ideas with the Office.
6)Request from providers in the "orthodox" medical community requesting
information on alternative medicine.  This activity has recently been
mandated in legislation from Congress which reauthorizes the NIH.

III. GRANTMAKING FOR INITIAL EVALUATIONS:

A request for Applications (RFA) was released on March 26, 1993,
soliciting applications for grant funds up to 30,000 that can be used
for planning studies of alternative medical practices.  These grants
will provide for the initiation of "pilot projects" to identify
promising areas of research.  Over 450 grant applications have been
submitted in competition for these funds.

Subsequent RFA's will utilize cooperative agreements as the funding
mechanism to enable technical assistance to be given the grantee.

IV. FIELD INVESTIGATIONS:

The purpose of the site visits will be to seek out and evaluate new
opportunities for medical therapy.  This activity will focus on looking
at cancer and AIDS therapies, using the "best case" series methodology
developed by the National Cancer Institute, as well as other promising
treatments.  Patient record will be reviewed and discussion of case
finding will be done with the provider.

The Office of Alternative Medicine will select members of the site team
visit in collaboration with the Institute Centers and Divisions of NIH.

V. TECHNICAL ASSISTANCE TO POTENTIAL GRANTEES:

It is believed that many individuals in the alternative medicine
community have little experience with the grantmaking process of the
NIH and /or may have limited experience in research methodology.  The
Office staff will attempt to enable the potential grantee to submit
applications to the NIH.  the OAM with the Division of Research Grants
will sponsor grant writing workshops during FY 1993 to acquaint the
alternative medical communities with this grant process at the NIH, as
well as the grant writing technique.

VI. CREATION OF A PRGRAM ADVISORY PANEL TO THE OFFICE OF ALTERNATIVE
MEDICINE:

Recent reauthorizing legislation for the NIH from the Congress provides
for the establishment of a National Advisory Council for the Office of
Alternative Medicine.  The Secretary of Health and Human Services will
appoint individuals from the alternative medicine community to serve as
members of a National Advisory  Council to the OAM.  They will provide
programmatic guidance to the NIH.

VII. TECHNOLOGY ASSESSMENT CONFERENCES:

The Office of Science Policiy and Legislation with the Office of
Medical Applications of Research, Office of the Director, National
Institutes of Health, will support activities specified below for the
evaluation of alternative medical practices.

Three technolgy assessments conferences will be conducted under the
terms of the Agreement. Candidate technologies include:
1. Methodologies
2. Homeopathic Medicine
3.Physical Manipulation Therapies

VIII. RESEARCH FELLOWSHIP PROGRAM ON COMPLEMENTARY MEDICINE:

Legislation reauthorizing the NIH was signed by President Clinton this
spring.  This legislation authorizes the Office of Alternative Medicine
to establish a fellowship prgram.  This Prgram will focus not only on
training in research methods, but will support our "field
investigation" program to evaluate unconventional clinical practices.

SOURCE:  JOSEPH JACOBS, MD.  For further information contact the NIH.

Peace, Monica

"The Course in Miracles is the Only Required Course in life."
                           -A Course in Miracles


