Rubbing it in: Woo not "sweating to the NIH payline"

Last week, I wrote a quick and (semi-) facetious piece about how my colleague and I are sweating to the NIH payline, as we wait to find out whether our R01 application will be funded or not. With its being rumored that National Cancer Institute (NCI) paylines will be in the range of the 12th percentile, it's going to be really, really tight whether we make it below that line or not, although my colleague's being a new PI will certainly help.

Wouldn't you know it that Writedit, the blogger whose excellent and highly useful blog, Medical Writing, Editing & Grantsmanship I discovered and plugged last week would have to return the favor by showing up in my blog to rub some salt into our wounds.

Yes, he's informed me that I should really be applying to research woo, because the paylines for the National Center for Complementary and Alternative Medicine will be considerably more liberal in FY 2007. Quoth Writedit:

The home of complementary and alternative medicine is upping its projected success rate from 14% in FY06 to 17% in FY07. The usual blah-blah-blah about preferring 4-year grants to 5-year grants and cutting budgets as needed. They still have a remarkably liberal payline policy though.

For R21s, priority scores of 160 and better are most likely to be funded. I bet a lot of you would love to get news like this from your IC!

So, in other words, while the NCI's paylines remain mired in the 10-12 percentile range (the best scenario this time around is a payline of the 12th percentile) while threatening to fall even further and with the situation even worse at other Institutes, if you do a grant on alternative medicine and submit it to NCCAM, the payline will be at the 17th percentile, a level not seen at the NCI for three years or more now. (The Payline was the 16th percentile when my R01 was originally funded.) Heck, if you're an new investigator, the payline could well be as high as the 20th percentile. (They cut new investigators a break in order to encourage them.)

I tell you, it's time for me to get into woo here. As Writedit puts it:

With liberal paylines like these, time to start thinking outside the box, folks.

Of course, there's "outside the box" and there's "outside of this planet," and all too often the woo supported by NCCAM falls into the latter category. As tempting as it is, I don't know if I can do it. I do have standards, you know.

On the other hand, if the NCI payline falls into the single digits next time, it may be time for Orac to find a way to make woo research pay. Any ideas are, of course, appreciated and might be shamelessly stolen...

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it may be time for Orac to find a way to make woo research pay

Can you rewrite your R01, add a few wooish words, and submit it to NCCAM? Or start adding extract of anything to your cells until you find an extract of something that causes apoptosis in cell culture, write that up as preliminary data, send that grant in to NCCAM and use the money obtained thereby to support your real research? The lab I'm in (I'm not the PI so I don't want to say "my lab") just got an R01 bounced. It's quite discouraging. 10% is ridiculous. But good luck.

I agree with Ahistoricality. If you have to appeal to the Woo payline, you may as well break out the hardcore scientific method on the woo. I'm picturing some sort of science ninja stealthily cutting through the woo BS. Stealthily because you have to get the funding, then start hacking at the woo.

The only challenge is to be deemed "woo-worthy" enough to get your grant assigned to NCCAM. For example, a DCA project might be viewed as best going to NCI since it is a molecule that has already been studied for conventional treatment of rare mitochondrial disorders. It also helps to be submitting from an institution that has a track record of getting NCCAM grants. This page lists all of NCCAM's FY06 awards; green tea/EGCG is already very highly represented. Lots of other interesting reading, though.

Perhaps you can get some help from Alan Sokal in writing up your proposals.

Ah wealth and power to be found in becomming a woomeister, and all it costs is a wafer thin slice of your soul :)

Seriously though someone needs to do some serious reprioritising of budgets.

Simple approach..

(a) Submit a detailed research proposal for (for example) homeopathy. Get the funding.
(b) Entirely fabricate the results, showing that it dosen't work. No one is EVER going to be able to tell..
(c) USe the cash for proper research instead...

By Andrew Dodds (not verified) on 06 Mar 2007 #permalink

Be sneaky and say you want to compare whatever woo they have to the research you actually want to do. Just use the woo group as your control!

Rather than risking defrauding the federal government, which is one of those things that you really don't want to hear right after your full name as spoken by a federal judge...

Since homeopathy is essentially the definition of a placebo, why not have your study as normal, but split the placebo group into "standard" placebo and homeopathy. Thus you test treatment vs. placebo vs. homeopathy.

Of course, I'm guessing that it's not so simple, since most cancer studies on humans cannot ethically use placebo medication. Or, of course, if you're not even studying humans or using a placebo of any kind, then this is completely useless for you.

That being said, I really do want you to submit a grant to NCCAM, because I'm sure at least a few people there are aware of you, and the reaction from them would probably be priceless.

most cancer studies on humans cannot ethically use placebo medication

You could use it as a supplement, though: standard therapies plus placebo/homeopathy/something that might do some good.

Could you make your real research sound like woo? Say, for example, you wanted to study the effects of cis-platinum on some exotic cancer type. You could describe it as "derived from a naturally occuring element, this medication is traditionally* used in a number of cultures against a wide variety of cancer types. Its use in certain settings has been questioned by allopaths**, but its success in traditional medicine* makes it an intriguing substance for further study." Or if you're working on VEGF, "this natural product, believed by many traditional healers*** to be vital for life, may play a key role in tumorgenesis and explorations of it could lead to more natural methods of treating cancer and other diseases." Or something. I'm not sure I have the woo language down right yet.

*Been around since the 1970s, at least. Surely 30+ years is a tradition.
**For example, no one would think of treating metastatic renal cell with it first line.
***Allopathic medicine has quite a long tradition. As does biological research.

The world changes but you refuse to change with it. You'll be old, stodgy and washed up in no time. I'm not surprised you'd rather become obsolete than adapt to a changing world...

By What goes arou… (not verified) on 07 Mar 2007 #permalink

The world has changed quite a bit since Hahnemann invented homeopathy... yet there are still people who try to push without any regard to why Avogadro's Number invalidates it.

That is one of the great way the world has changed. Some folk remedies have turned into real meds (aspirin does not mess up the tummy like willow bark tea, though). Then there are some old remedies that have since been shown to cause more harm than good... yet folks still sell them. This includes the mercury used in some tradional meds ( http://www.cmaj.ca/cgi/content/full/168/2/201 ), and laetrile still being pushed as a cancer cure... even through with real studies it was shown to not work in vivo, PLUS it caused cyanide poisoning! See http://www.theannals.com/cgi/content/full/39/9/1566 .

It is certainly better to learn which treatments cause more harm, and to keep up with real medical research.

The world changes but you refuse to change with it. You'll be old, stodgy and washed up in no time. I'm not surprised you'd rather become obsolete than adapt to a changing world...

If the world is "changing" away from science and therapies with some scientific evidence of efficacy, then it's up to us in academic medicine to try to change that, rather than just accept it, as you apparently would have us do.

And, besides, I never said I wouldn't submit an application to study woo. In fact, I've been highly tempted to do just that; it's just that trying to make it sound scientific enough would be so very, very difficult.

So as you don't get busted for fraud (even though NCCAM lives on it) just use some typical pseudo-medical speak which sounds impressive and then say it is a 'comparison' trial.

Eg: "Comparison of the effectiveness of Anaerobic exertion with supporting Poaceae monocotyledon materials and endoskeletal calcium from G. Gallus (translation: dancing around in a grass skirt waving chicken bones) and conventional monoclonal antibody therapy"

Given said skirt and bones would cost a few dollars, the remainder of the funding would go to useful research for the 'comparison'.

And maybe you would even get some dancing lessons out of it ;)