Does the current model of Western medical research (RCT) properly represent the efficacy of TCM? (please comment)

AcuGuru

I believe that western research needs to be done to find the effectiveness of TCM practice's in specific diseases!

In order for us to do this we need to devide each disease group into there different TCM patterns for each disease ! this means there could be 2-6+ different groups for each disease!

Accuracy would only be found for those who actually completed full treatment and followed dietary and lifestyle suggestions by their practitioners !

Now we only need someone to fund this research ! any suggestions ?

Hey Devils Advovate, how did you set up the poll. Did you do it yourself on the CMT site or did they have to set it up for you? I have been on the site here and there and I am learning each time what else you can do on here. Has anyone figured out how to have your voice heard on radio program? Where on the site do you go to record or it done by the admin people.

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Your question uses the word 'efficacy' which in itself is problematic. The term 'efficacy' technically refers to the response of a specific medical condition to a very repeatable treatment protocol when ALL so-called non-specific factors have been isolated and eliminated from having any influence on the outcome - a rather bizarre scenario from our perspective to say the least (and I am NOT just talking about placebo effect here at all). I would argue you cannot measure the efficacy of chinese medicine without dismantling it to such a degree it is no longer chinese medicine. Because our clinical encounters are so rich and complex, we can only possibly subject our medicine to measures of 'effectiveness' - which is different from 'efficacy'. I wrote a few articles on this a few years ago - one in the Journal of Chinese Medicine (JCM), one in the North American Journal of Oriental Medicine (NAJOM) and one in the Journal of Alternative and Complementary Medicine (JACM).

Its tempting to entertain AcuGuru's recommendation above - that we 'subdivide' all patients in a modern disease category into groups exhibiting each major TCM 8 Principle Pattern (8PP) pattern within the overall disease category - the problem is that those 8PP patterns as presented in textbooks are ideal conceptual endpoints presented for the purpose of learning the basics (didactic) - when in clinical reality, you more often than not find people are a little bit of this and a little bit of that - and whether you are an herbalist or an acupuncturist - you modify your approach to match the whole situation - I don't think in reality, real people could be placed in such tidy boxes as would be required of research. Furthermore, it does not take very long - certainly not for me anyway, for someone to come to me for one thing (lets say migraines for example) - and within 2 visits, we are discussing their pms, menstrual pain, sinusitis, constipation and hip pain as well - sometimes to the point that they forget about their migraines! Modern research would just throw all that stuff out as 'noise' or 'confounding variables' or some such nonsense.

I think the ONLY fully valid research model for our medicine that truly and primarily honours what we do - is one that would view the entire encounter between you and your patient from start to finish (everything that occurs between the two of you for as many treatments as it takes) as one big black box - looks at the patient going in and the patient coming out of the other end - and measures what outcomes are detectable and observable and reportable when the patient comes out the other end of the box. I think research designed in that way would produce some very astounding results and bring the full strength of our medicine to light.

Daniel Schulman
Charlottetown