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The US National Institutes of Health (NIH) has been forced to defend its peer-review system in Congress against charges of bias against ‘mind body medicine’. At the same time last week, it was hosting a conference that declared acupuncture a bona fide treatment for some kinds of nausea and pain, sparking criticism from scientific sceptics.

The charges about ‘mind body medicine’ — the theory that emotions are critical to human health and disease — and the questioning of the NIH's commitment to it, were made at a congressional briefing convened by Representative John Porter (Republican, Illinois), who holds key legislative responsibility for NIH's budget.

Porter argued at the briefing that traditional medicine “has seemed to have left out some very efficacious approaches”. He added later that the NIH had to “give some real guidance to the American people” about what alternative treatments were safe and efficacious. He said: “I don't think [it is] doing that sufficiently.”

The main target of criticism at the briefing was Steven Hyman, director of the National Institute of Mental Health (NIMH), who was assailed by supporters of ‘mind body medicine’ for what they described as an inveterate bias against their approach by NIH and its reviewers.

“The NIH has dug in its heels and hardened its position against mind body medicine,” said Candace Pert of Georgetown University in Washington DC, a pharmacologist who discovered opiate receptors. But, she said, “people want it, it works, and it really does have scientific rationale”.

James Gordon, director of the Center for Mind-Body Medicine at Georgetown, argued that there is a bias built into peer-review committees. He claimed that thousands of carefully controlled studies are published in peer-reviewed journals on many alternative therapies, but NIH peer reviewers are ignorant of them.

Hyman said review panels are groups of human beings and it is impossible to free them from all bias. But he could think of no better way of producing valid, objective results and therapies “than subjecting our proposals to do research to a community of peers in the marketplace of ideas”. He told the briefing: “There have to be appropriate standards of evidence.”

Although Porter, who chairs the House of Representatives spending subcommittee that funds NIH, does not have authority to write laws directing NIH to pay more attention to how the mind influences disease and health, he suggested that other committees with jurisdiction should take up the issue.

In addition to a “major” role in the area for NIMH, Congress should question whether the Office of Alternative Medicine (OAM) and the Office of Behavioral and Social Sciences Research “are really fulfilling the expectations that Congress had” for them in this area, he said.

Porter said he was drawn to the issue in part because this summer he defied the recommendations of three surgeons that he have an operation for a slipped intervertebral disc. A month of rest and relaxation cured him, he says, and provoked his interest in the power of the mind to heal.

Meanwhile, an independent panel convened by the NIH in Bethesda, Maryland, declared at the end of a three-day ‘consensus conference’ that it had found “clear evidence” that acupuncture works for post-operative dental pain and for nausea and vomiting caused by chemotherapy, after surgery and probably during pregnancy.

The findings of the 12-member panel were immediately criticized by sceptics who claimed that the panel was “fixed” against critics of acupuncture. “It was a conference of believers [who] recited their delusions as facts,” said Victor Herbert, a professor of medicine at the Mount Sinai School of Medicine in New York, who dismisses acupuncture as “pseudo-religious cultism”.

But the organizers of the conference, cosponsored by OAM and the Office of Medical Applications of Research, vigorously defended the panel and the process as fair.

Its conclusions were based largely on a three-month review of the available literature, which was judged by the “highest standards”, said David Ramsay, the panel chair and president of the University of Maryland, Baltimore, and a former editor of the American Journal of Physiology. He said: “We did find positive evidence for the efficacy of acupuncture in certain conditions.”

Alan Trachtenberg, a physician at NIH who chaired the conference planning committee, strongly denied any bias in the selection of 25 people to present data to the panel.