US federal investment into clinical trials evaluating complementary and alternative medicine (CAM) is translating badly into medical practice, a new study suggests.

Noting that the US National Institutes of Health (NIH) has invested more than US$2 billion in research looking at the safety and effectiveness of CAM therapies over the last decade, a team led by Dr Jon Tilburt of the NIH and the Mayo Clinic in Rochester, Minnesota surveyed 2,400 practicing acupuncturists, naturopaths, internists and rheumatologists to gauge their awareness of, and attitudes towards, CAM research. The results were published in the 13 April issue of Archives of Internal Medicine.

Of the 1,561 clinicians who completed the survey, 59% were aware of at least one of two major clinical trials recently published on CAM therapies for osteoarthritis of the knee. One of these trials assessed the usefulness of acupuncture in osteoarthritis of the knee and the other looked at the dietary supplement glucosamine. Only 23% of the clinicians were aware of both trials.

The researchers found that acupuncturists (46%) and rheumatologists (49%) were more likely to be aware of the acupuncture study than naturopaths (30%) and general internists (22%). With the glucosamine trial, internists (59%) and rheumatologists (88%) were more aware of the research than acupuncturists (20%) and naturopaths (39%).

A minority of the clinicians in all groups (20% of acupuncturists, 25% of naturopaths, 17% of internists and 33% of rheumatologists) felt “very confident” about their ability to interpret critically the research literature on CAM therapies, the authors pointed out.

More of the clinicians described themselves as “moderately confident” in this respect (59% of acupuncturists, 64% of naturopaths, 67% of internists and 59% of rheumatologists).

These results suggest that the translation of CAM trial results into clinical practice may vary widely based on the training, attitudes and experiences of clinicians, Tilburt et al concluded.

“For clinical research in CAM (and conventional medicine) to achieve its potential social value, concerted efforts must be undertaken that more deliberately train clinicians in critical appraisal, biostatistics and use of evidence-based resources, as well as expanded research opportunities, dedicated training experiences and improved dissemination of research results,” they commented.