S23: Research Design and Methodology for Ayurveda as a Whole System of Medicine
Christian S. Kessler1, Anand Dhruva2, Jennifer Rioux3, P. Ram Manohar4
1Charité Medical University Berlin (Chair for Complementary and Integrative Medicine Prof. Andreas Michalsen) & Immanuel Hospital Berlin, Germany; 2University of California, San Francisco, USA; 3Department of Family and Community Medicine, University of Arizona, USA; 4The Ayurvedic Trust, Coimbatore, India
Ayurveda is the most prominent traditional medical system in South Asia with an enduring tradition that extends back several thousand years. There are currently over 400,000 Ayurvedic physicians and more than 300 university affiliated colleges and Ayurveda universities in India alone. In addition to its key role in Asian health care systems, it is playing a growing role in international Complementary and Integrative Medicine (CIM) contexts, especially in Europe and North America. Ayurvedic medicine is characterized by a complex and multidimensional approach focusing on the delivery of individualized treatments. The current challenge is to conduct research to investigate Ayurveda as an evidence-based, safe, effective method of health care in the modern context. Clinical trials of Ayurvedic therapeutic interventions should incorporate innovative and appropriate research methodologies that reflect the holistic approach and individually tailored treatment strategies associated with Ayurveda. Results of such clinical research evidence (e.g. adapted & pragmatic RCTs, observational studies, patient-centered research outcome studies, systematic reviews, meta-analyses, and case-reports) will be used to inform and influence policy makers, health care professionals, and patients about whether particular Ayurvedic approaches should be reimbursed by public funding or health insurance companies. It will help to inform discussions on official licensing of Ayurvedic medicine and other CIM treatment methods, particularly in the developed countries. Expanded studies will also be useful for investigating the safety and efficacy of Ayurvedic botanical medicines. High quality research initiatives are vital for investigating the efficacy and effectiveness of Ayurveda as a preventive approach and for managing and resolving both chronic and acute conditions. Traditional Indian Systems of Medicine (TIM) in South Asia have been experiencing a resurgence in popularity in their native countries and in the West, as they become simultaneously more accessible and more in demand. The current scientific evidence on Ayurvedic therapies, and Ayurveda as a whole system of medicine, often does not reflect the emic/indigenous theories of Ayurveda and utilizes primarily western-conventional oriented outcome measures of benefit. Ongoing challenges associated with Ayurvedic research include: methodological issues, limited funding, a lack of multidisciplinary and international research initiatives, and a heavy bias in favour of preclinical research and single drug interventions, and a lack of focus on real life clinical situations.