Science based evidence based practise in ayurveda

Science Based Evidence-Based Practice –Ayurveda

Dr.Remya Krishnan MD ( Ayu) PhD,Faculty, Applied Pharmacology –

Ayurveda

Evaluate yourself• Do you often evaluate the patient outcome in your clinical

practice ?• Do you attempt to revise your medical decision based on “Science

based evidence” ?• Have you ever thought that the results which you make in the

patient are many times serendipity results ? • Do you feel depressed if your patients report worsening of status

for some reasons unknown to you ? • Do you often wish for a standardised right approach to make

your practice” scientific “ ?

But why do this happen ?!

• This happens because of the wide gaps between “what we know “ and “what we practice “.

• This could happen also because we do not know exactly what we know and what we do not know .

• We also do not know what we must know .

Why we are like that ?

• Too much of misled training in our Science .• Too much of wrong information to handle

our Science. • Too much of preference to “cookbook

approach” in practice • Too much of business interests vested in our

science.

You provide poor quality of healthcare

If you belong to this category : a. Feel aversion towards samhithas ? b. Feel restless or irritable if you happen to be in the midst of a case disussion in Ayurvedic perspective ?

c. Work more like an officer and less like a doctor ?

Would you like to fix the gap ?

• The gap between “what we know” and “what we practice “.

• Interactive training workshops on SBEBP ( Science Based Evidence Based Practice ) will help for that.

• Interactive workshops are stronger than “one way lectures “

SBEBP

The practice of doing the RIGHT TREATMENT in the RIGHT TIME in the RIGHT SITUATION in RIGHT PATIENT.

SBEBP

• Science Based Evidence Based Practice – Best Science Based Evidence is translated into clinical practice.

• Treatment- Standardised guidelines to monitor and evaluate the quality and appropriateness of your treatment protocols.

• Research- Standardised methodology to develop, uncover or add new science based evidences into practice

Possible suspicions on SBEBP

• Is it a new term for Ayurveda ?• We know that Ayurveda is scientific , then why coin

the term Science Based Evidence Based Ayurveda?• As we think that Patient care is based on diverse

logic of doctors , how to standardise ?• What is “scientific “ without RCT or meta analysis

etc ?

Benefits of the training programme

At the end of training sessions, You will be able to :A. Define and describe what is accurate scientific practice of Ayurveda – SBEBA.B. Identify the reasons for promoting the practice of SBEBA.

C.Know and appraise the best “Science based evidence” to integrate in your clinical practice

What is“Best evidence

NOT ?”

Best evidence in Ayurveda is NOT

The results published in academic journals or systemic reviews published in data bases .Not RCT reviews.Not case control studies.Not the study reports of expert committees.

Best evidence in Ayurveda is NOT

Not professional experiences .Not gathered from patients.Not every stuff which displays statistical data .Not cook book practice Not cost mounting practice (When best evidence is applied, treatment cost falls , not rise.)

Best evidence • That which pertinently guides you from the Basic Science to

manage the particular clinical situation in your particular patient.

• Basic Science led evidence is the best evidence.• Clinical decisions should be ideally led by inbuilt science led

evidence.

You have to know “what you intend to do “and “how you do it” and NOT “what to do”…

Best Evidence

Is to be applied in : a. Confirmation of Diagnosis

b. Estimation of prognosis. c.Formulation of scientifically pertinent

treatment protocol .

Why do I need “Best evidence “?

• For scientific Rogi pareeksha (examination of patient) • For scientific Roga pareeksha ( examination of disease ) • For scientific estimation of prognosis of clinical situation with

respect to the patient.• To select the pertinent scientific Treatment Principle for the

situation.• To individualise the Treatment Principle. • To produce the “intended effects “ in the patient.• To evaluate the scientific response of treatment .

• To scientifically ensure that we are doing “right” and not that which is “probably right”.

What is Science based Evidence-Based Ayurveda ?

Science Based Evidence Based Medicine is the

conscientious, explicit, and judicious integration of Ayurvedic science based

evidence in making decisions about the care of individual patients in their own unique

circumstances.

What is “SBEBA” NOT?

• SBEBA is not EBM • “Cookbook medicine”• Risk-benefit analysis• Randomized Control

trials

SBEBA- CHIEF RESOURCES

• Charaka Samhitha • Ashtangahridaya• Ashtangasangraha• Susrutha samhitha

WRONG WAYS OF DECISION MAKING

How do I make decisions?• Dogma: Superstitious “belief “in a medicinal

formulation• Tradition: “We’ve always done it that way”• Convention: “Everyone does it this way”• Replication : Professor does this way .

How do I decide what to do?

• Depend on SBEBA resources .

• Develop appraisal skill .• Decide the pertinent

solution .

STAGES OF EVIDENCE TRANSMISSION

Evidence based observation Evidence based assumption

Evidence based analysisEvidence based reasoning

Evidence based confirmation

Science based evidence based Observation

Science based evidence based Assumption

Science based evidence based Analysis

Science based evidence based Reasoning

Science based evidence based Confirmation OAARC ► BEST evidence

Integrating Science based evidence & practice

What are the intended effects ?

• Cure of the disease depending on the prognostic standards – all subjective as well as objective parameters .

• Attainment of health – Clear manifestation of Arogya lakshanas .

• When we treat for the “intended effects”,

there is 0 risk for the patient .

• http://www.amazon.it/Evidence-Based-Ayurveda-Rational-Prescribing-ebook/dp/B00AR0DU00

A novel technique for standardised health care in Ayurveda named “Evidence Triad Approach” is developed by Dr. Remya Krishnan in her reformed health care practice system in Ayurveda called Science Based Evidence Based Practice.

Evidence Triad Approach

Barriers of SBEBP

• Lack of support from Government and policy makers of Ayurveda.

• Lack of knowledge and unfamiliarity with the guidelines in Basic science and methodologies of appraisal by the policy making superior authorities of Ayurveda.

• Peer pressure to continue the practices that are steeped ina tradition – “We have always done this way and do not want to change “.

• Medical Faculties unenthusiastic in modifying the way they practice and teach .

Excellent optimised Practice of Medicine requires practice of science

If you are interested to know, learn and practice the utmost scientific SBEBA (Science Based Evidence Based Ayurveda)

Contact [email protected]

Let us initiate

Let us initiate the best scientific trend in Ayurvedic practice – Science Based Evidence Based Practice(SBEBP)

WELCOME AYURVEDIC COMMUNITY !