Issue link: https://www.massageandbodyworkdigital.com/i/68173
SOMATIC RESEARCH (CER). CER is "a rigorous evaluation of the impact of different options that are available for treating a given medical condition for a particular set of patients. Such a study may compare similar treatments, such as competing drugs, or it may analyze very different approaches, such as surgery and drug therapy."4 we seek? It does not require that we invent a placebo for massage. This is positive. It does, however, advocate an either/or rather than an add-on method of research. This is fine in the reductionist model, but again, it does not represent real world massage applications. Are there other applications of outcomes research? According to the U.S. Department of Health and Human Services: "Outcomes research seeks to understand the end results of particular health-care practices and interventions. End results include effects that people experience and care about, such as change in the ability to function. In particular, for individuals with chronic conditions—where cure is not always possible—end results include quality of life as well as mortality. No longer just the domain of a small cadre of researchers, outcomes research has altered the culture of clinical practice and health-care research by changing how we assess the end results of health-care services. In doing so, it has provided the foundation for measuring the quality of care."5 It appears there is room for interpretation. Perhaps we should be encouraging NIH and NCCAM to prioritize funding CER that focuses on real world outcomes. Sounds very similar to what Congress had in mind when they created NCCAM. NCCAM 2011–2015 STRATEGIC PLAN NCCAM is developing a strategic plan that will impact the next five years Anywhere from $400 million to $1 billion is to be set aside for CER. Will CER give us the information of research funding. In response to NCCAM's call for comment on the new strategic plan, John Weeks on www. theintegratorblog.com pointed out some serious disconnects between this proposed direction, a direction that will determine how $600 million will be spent over the next five years, and the original mandate from Congress. The 1998 Congress mandate that established NCCAM identified practical, real world outcomes as the focus for NCCAM, yet less than 1 percent of NCCAM's budget has funded effectiveness and cost-effectiveness research.6 The emphasis has been to continue funding RCTs and basic science, similar to what has been done for Western medical research rather than to shift to a new paradigm and delve into what is possible with CAM therapies. Dozens of representatives from CAM organizations have written to NCCAM Director Dr. Josephine Briggs to share their concerns about the direction NCCAM is heading and the need to limit research on basic science and find new methods beyond RCTs to study outcomes. While the debate has slowed down and we await the final version of NCCAM's strategic plan, we can ponder the possibility that all levels of evidence are necessary building blocks to identifying studies that can answer our questions, and that funding real world outcomes research takes priority over RCTs and basic science research. Let's ensure our government funds focus on discovering how to integrate massage and Research methods for massage and holistic therapies. Philadelphia: Mosby. Resource Hymel, G., ed. 2006. bodywork into health-care systems and preventative wellness models. And let's discover ways of designing collaborative research to define how CAM therapies work together to ensure the health of our clients, rather than focusing on identifying the one best intervention. created a varied and interesting career out of massage: from specializing in pre- and postsurgical lymph drainage to teaching, writing, consulting, and volunteering. Her consulting includes assisting insurance carriers on integrating massage into insurance plans, and educating researchers on massage therapy theory and practice to ensure research projects and protocols are designed to match how we practice. Contact her at soapsage@ comcast.net. An LMP since 1984, Diana Thompson has NOTES 1. Search of "complementary and alternative medicine" on PubMed, December 7, 2009. 2. National Center for Complementary and Alternative Medicine, "Statistics on Complementary and Alternative Medicine in the United States." Available at http:// nccam.nih.gov/news/camstats (accessed January 2010). 3. The Henry J. Kaiser Family Foundation, "Kaiser Daily Health Policy Report." Available at www. kaisernetwork.org/Daily_Reports/rep_index. cfm?DR_ID=57761 (accessed January 2010). 4. U.S. Department of Health & Human Services, Office of Extramural Research, "NIH Challenge Grants in Health and Science Research (RC1)." Available at http://grants.nih.gov/grants/funding/ challenge%5Faward (accessed January 2010). 5. U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality, "Outcomes Research: Fact Sheet." Available at www.ahrq.gov/ clinic/outfact.htm (accessed January 2010). 6. John Weeks, "How NCCAM's 'Real World' Congressional Mandate is Optimal for NCCAM's 2010–2015 Strategic Plan," The Integrator Blog. Available at http://theintegratorblog.com/site/ index.php?option=com_content&task=view&id =606&Itemid=189 (accessed January 2010). connect with your colleagues on massageprofessionals.com 121