Right. At this point, we are not initiating any new major studies of this sort. That was a big study that was funded together with the National Institute of Aging. It was one of the biggest longitudinal studies on the development of Alzheimer’s ever done. We’re pretty proud of the study, not only because of information about ginkgo per se, but also because of the important information it gave us about Alzheimer’s disease and its development.

Right now, we are not thinking about developing new studies of this sort in herbals but we are talking about how to look at things like pain management, particularly back pain management.

I want to ask again about whole systems research. Are you open to, and are you seeking out, research projects that involve integrative multi-factorial interventions, such as approaches that combine changes in nutrition, exercise and stress reduction rather than limiting the intervention to one specific therapy?

We are talking about how to do that kind of research in a way that will ensure that it can actually be rigorously defined. There are two questions implicit in your discussion. One is, “What is the intervention?” The other is, “What is the outcome you’re after?” It is important, in thinking about this kind of research, to figure out both how to define with the kind of precision that will result in rigor, what kind of interventions are useful to couple together, and then what kind of measures you want to use to see if it works.

We’re very impressed with the idea that some of the CAM practitioner approaches may have particular promise for promoting healthy behaviors, like promoting healthy eating and promoting more physical activity. We’re interested in seeing people develop grant proposals on the impact of integrative health approaches and complementary practitioner approaches to the promotion of health behaviors. That’s something we’re going to be talking with the advisory council about. We think it’s an important area for us to strengthen the research in.

Do you feel that NCCAM research is a success when a study shows a benefit from a CAM approach and a failure when a study shows no benefit? And do you find yourself personally happier with one that shows a positive effect rather than no effect?

Oh, absolutely! We’re always happy when we can demonstrate benefit. We try to go into this work really neutral and to maintain neutrality, but like all health care providers, we’re interested in helping people. So we are very pleased when, as we’ve seen in pain management, data comes together showing that some of the CAM approaches are really helping in pain management. That’s very satisfactory. The ginkgo results were very disappointing to the investigators and to us. The study was very rigorously done, very careful, and it’s still of enormous value, but certainly this result isn’t what people hoped for.

I want to ask you about the role of placebos and controls in clinical research because this is a real challenge for non-pharmaceutical, or non-substance based, therapies …

I totally agree with you. The notion that you can have double-blinded studies with a placebo control works in a drug study, but is really un-doable when you have an intervention where the context and the interaction with the practitioner is part of the benefit. We struggle with this problem a lot.