Publication

Abstract : Clinical research on Ayurveda has more than often eval- uated single herbs, formulations or component therapies to comply with reductionistic research designs. On the other hand, complex forms of in- dividualised and multimodal Ayurvedic treatments combining pharmaco- logical and non-pharmacological interventions are administered in real life situations, especially in India, where Ayurveda has a long history and tradition of clinical practice. There is a need to look at the gap between clinical research and clinical practice in the field of Ayurveda to design and develop research methodologies that are rigorous but flexible enough to accommodate the complexity of Ayurveda.Methods: Observational studies and clinical trials conducted at AVC, a 100 bed Ayurvedic hospital in India on more than 1000 patients (AMRA Trial on Rheumatoid Arthritis, RUDRA Observational Studies on Osteo- arthritis, Diabetes, Bronchial Asthma, Cervical Spondylosis and Lumbar Spondylosis), have generated data on outcomes of complex Ayurvedic clinical interventions. These diseases have also been studied with con- ventional research designs and data is accessible from published research providing the opportunity to characterise the complexity of Ayurvedic treatments administered in clinical practice vis a vis those administered in clinical research by comparing research designs, outcome measures and treatment outcomes. Results: The complexity of Ayurvedic clinical interventions in actual clinical practice could be delineated highlighting the approaches to in- dividualisation of treatments as well as the iterative and recursive nature of its therapies. Ayurvedic nosology differs from modern classification of diseases implicating the need for specific strategies in setting inclusion/ exclusion criteria and defining treatment outcome measures. A compar- ative study of Ayurvedic interventions in rheumatoid arthritis revealed variations in treatment outcomes based on differences in research design, diagnostic protocols and outcome measures. The implications were found to be same for other diseases.Conclusion: Conventional research demands modification of Ayurvedic treatment protocols to fit into the study designs. As a result, Ayurveda is evaluated in research settings using treatment protocols that differs from actual practices, pointing out the relevance of modifying research designs to accommodate the whole medical system (WMS) features of Ayurveda with examples that identify the gaps between research and practice in Ayurveda. Defining Ayurveda as a whole medical system: Examples of clinical encounters in real life situations (PDF Download Available). Available from: https://www.researchgate.net/publication/257581457_Defining_Ayurveda_as_a_whole_medical_system_Examples_of_clinical_encounters_in_real_life_situations [accessed Mar 24, 2016].