Alternates to clinical trial design for Ayurveda :

In Chronic non-communicable diseases, in non-

emergency settings

Dr Vina Vaswani, Director, Centre

for Ethics, Yenepoya University
Deralakatte, Mangalore India
 Ayurveda: The original Indian
system of medicine
Ayurveda, science of all times
Sanskrit: Ayu-age; veda-science
Clinical examination in 2 areas
I. Examination of patient (Trividha pariksha)
Inspection (Darsana )
Touch (Sparsana )
Interrogation (Prasna)
II. Consideration of the disease and the context
 Identifying doshas
Body-mind governed by biological energies
which are displaced in illness - dosha
Clinical examination to detect imbalance
(doshas) and restore balance
Doshas provide blue print for an individual for
health and fulfilment
Three common doshas: Vata, Pitta and Kapha
Body constitutions that favor doshas
 8 steps of
detailed
examination
 Treatment modalities
Non-specific modalities (oil massages, dietary
alterations) play a significant role
Several herbal combinations (more in the nature
of general tonics)
Few specific herbal remedies
 The Ayurveda approach
Every patient is unique and responds differently
to same doses of medicines
In contrast modern medicine averages every
body into a same mould
If a practice is based on individuality not
commonality, the measurable end points cannot
be the same
 Efficacy paradox
Efficacy in modern research is measured against
a placebo
But this is an assumption that might be
fallacious
Ayurveda treatment - non-specific modalities
aimed at assisting body to relocate its balance
Randomized Clinical Trials in Ayurveda - akin to
searching for mangoes on an apple tree
 The new RCT…
Randomized Clinical Comparison Trials?
A new schema where outcomes from different
studies could be merged to assess the larger
picture
In the existing hierarchical structure of research
in modern medicine, an error in the early levels
will multiply its effect in the RCT
Circular structure for research eliminates this
 Circularity of the trial design

Mix
Mixand
and
match
matchfrom
from
various
various
quadrants
quadrants
can
canbebe
easily
easily
performed
performed Wallach et al
2006
 Endnote
Alternate systems of medicine are well
entrenched and accepted by public but not
healthcare professionals
The need of the hour is to relocate these
systems within the realm of science
The research model needs out-of-box thinking