TESTING ALTERNATIVE THERAPIES - La Trobe University’s decision to accept funding from Swisse for a new centre to research alternative medicines has sparked controversy.
There’s been a fair bit of debate recently over the role of industry funding in research into complementary and alternative medicines, including on this site. Much of it has argued that research funded by industry is inherently compromised, but it doesn’t have to be.
There are limited government funding options in Australia for complementary medicine research so it’s important that industry supports such research. It’s equally important that there are mechanisms in place to ensure the research is conducted at a high level, with checks on quality, such as trial registration and peer review of papers.
Show me the money
In Australia, there are two major government bodies that fund research – the National Health and Medical Research Council (NHMRC) and the Australian Research Council (ARC).
Since 2012, the ARC no longer funds health or medical research at all, while the NHMRC largely restricts its funding of clinical trials to those investigating medical and health conditions.
If we wish to find out whether or not a dietary supplement improves some aspect of health among people without a defined medical condition, the choice is effectively between industry-supported research or no research.
Indeed, in my experience, it’s not unheard of to receive feedback for grant applications saying although the science is sound, the research should be supported by industry! This suggests that there is a reasonably common belief that such support, when available, is more appropriate for these kinds of studies.
Even if this position changed, competition for research support is so high that, last year, for instance, the NHMRC funded around 16% of applications for its highly-regarded project grants. So it’s likely industry will play an increasingly valuable role in supporting Australian research.
But researchers don’t just undertake industry-funded research because of the lack of other funding. The motivation for scientific investigation is the same for any academic – to increase our understanding and knowledge.
Ensuring research integrity
Industry-funded research is subject to the same peer-review processes as any other. Peer reviewers are made aware of funding sources and judge research on its merit. If it’s of a high enough quality, the research is published in well-regarded international journals.
The gold standard for testing the efficacy of any health intervention is the clinical trial – a controlled study involving human volunteers. Like studies of pharmaceutical drugs, research into the health effects of nutritional supplements relies on clinical trials.
The requirements for research to support health claims from nutritional interventions and supplements have varying levels of stringency in the United States, Europe and Australia, but all trials should be conducted to the standards of good clinical practice.
This involves registering the study on a public clinical trials registry, such as the Australian New Zealand Clinical Trials Registry, to ensure the research is transparent.
Industry-sponsored trials also routinely use statisticians not associated with the researchers, who follow a pre-determined statistical plan.
Typically, studies are monitored by independent auditors to ensure all data are recorded and entered into the database accurately. This database is “locked” prior to analysis, which is performed using codes so the statistician cannot tell the active treatment data set from the placebo data set.
These processes are time consuming, resource-heavy and not always pleasant but most scientists welcome the rigour they add to their work. Interestingly, most studies funded by national grant funding schemes are not subject to the same level of scrutiny.
It is difficult to know whether researchers unconsciously put a positive spin on industry-sponsored studies by exaggerating certain outcomes to ensure continued funding.
But is there any reason to think the reporting of research funded by other sources cannot also be (unconsciously) spun to avoid being among of 84% applicants who don’t get funding the next time around?
In order to maintain rigour, researchers working with alternative medicines have an obligation to report negative or null (when the intervention does harm or does nothing) findings. In my experience, this is always written into the research contract.
Of course, statements made for the purposes of marketing can be appallingly misleading. But this is completely independent of the science undertaken to evaluate the efficacy of products, and could be avoided by consultation with the researchers involved.
The funding landscape in Australia is becoming increasingly sophisticated and, as with other areas, industry support for alternative medicines has its place.
This is the final article in our series about complementary and alternative therapies. Click on the links below to read the others:
Can we scientifically test herbal medicines?