Study

[Guest guest]

I just read the entire article " the variability of TCM pattern diagnosis and

herbal prescription on RA patients.

It is a very well designed study. All the practitioners are PRC graduates of at

least a 5 year program with herbal training. All are at least 5 years in

practice in the US. All practice in the same area in US.

This study, as was in my study, show very poor agreement between practitioners.

The so-called less stringent analysis in which they found better agreement is

not very valid because the limited terms used would have overlaps if

artificially looked for. This was the same in my study which while we wrote as

fair agreement in reality also means very little because of repeated terms used

in TCM (we had high agreement of K Yin-deficiency in our study, but that is

almost like saying menopausal hot flashes, kind of obvious). As far as having a

better agreement on herbs, this was basically having many of the practitioners

base their formula on Yi Yi Ren Tang. This again is a bit misleading because

this formula is often PRC recommended for RA and often used allopathically.

As i said many times i do not believe it is possible to have good agreement in

TCM evaluations.

They do make the point, which is true and important to remember when evaluating

TCM, that in practice the Dr sees the patient often and that diagnosis and

treatment would change based on feedback, i.e., there is much flexibility with

both diagnosis and treatment.

Alon

 

 

[Guest guest]

On Feb 3, 2004, at 2:20 PM, Alon Marcus wrote:

 

> They do make the point, which is true and important to remember when

> evaluating TCM, that in practice the Dr sees the patient often and

> that diagnosis and treatment would change based on feedback, i.e.,

> there is much flexibility with both diagnosis and treatment.

 

As we've been wrestling with issues of research, paradigm, efficacy,

practitioner intent, etc. we're going to have to ultimately factor in

the term " art " here eventually.

 

I don't personally like this word to describe what we do as it can be a

rationalization for some really wacky choices. But ultimately, we may

have to look at the needles, the points, the herbs, even the diagnosis

as tools for the artist who puts it all together in order to achieve a

healing response.

 

If we want to assess art therapy, we don't really look at the painting

that a patient creates, but the health that returns to the patient.

Perhaps this is what we'll need to do with researching the efficacy of

what we do, observe the patient's changes rather than trying to compare

the paintings.

 

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Pain is inevitable, suffering is optional.

-Adlai Stevenson