Review of

[Guest guest]

Peer review as we know it is a way to quickly evaluate new ideas/information, but it is a less reliable standard than the test of time. Many ideas that stand the test of peer review fail to withstand the test of time, or are superseded.>>>>perhaps you are right. I am not as trusting of the so called test of time. At least in the west we have so much evidence of repeated ideas that lasted a long time and then shown to be incorrect. Shit, WM is replete with drugs and procedures that have been used for a long time, even in these modern times, which only after critical evidence based review are now showing to be useless. And even after that many of these are still used---because Drs and patients are still convinced they work.

Alon

 

 

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Rory Kerr

Monday, January 21, 2002 6:07 AM

Review of

At 9:29 AM -0800 1/16/02, ALON MARCUS wrote:>do you think for example that Li Dang's writing went through some >kind of peer review as they were created--I've no idea. His work was certainly read, critiqued, and used in some way, but that may not look like the way peer review is done today. But does it matter to us?Peer review serves a purpose in evaluating new ideas for the people living at the time the ideas are published. That something wasn't peer reviewed in the thirteenth century is of no particular medical significance to us today. Li's ideas have been constantly tested and evaluated in the eight centuries since he published them, and continue to be so.Peer review as we know it is a way to quickly evaluate new ideas/information, but it is a less reliable standard than the test of time. Many ideas that stand the test of peer review fail to withstand the test of time, or are superseded.Rory-- Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

At 11:11 AM -0800 1/21/02, ALON MARCUS

wrote:

Peer review as

we know it is a way to quickly evaluate new

ideas/information, but it is a less reliable standard than the

test

of time. Many ideas that stand the test of peer review fail to

withstand the test of time, or are superseded.

>>>>perhaps you are right. I am not as trusting

of the so called test of time. At least in the west we have so much

evidence of repeated ideas that lasted a long time and then shown to

be incorrect. Shit, WM is replete with drugs and procedures that have

been used for a long time, even in these modern times, which only

after critical evidence based review are now showing to be useless.

And even after that many of these are still used---because Drs and

patients are still convinced they work.

--

Fair enough, but I was answering your criticism that early works

were not peer reviewed in their own time. You implied that absence of

peer review was a deficiency in the evaluation of those works. My

answer to that is that the review process continues on these works,

and that the presence or absence of peer review back in the thirteenth

century would be of little significance to us today.

 

To take the example you provided, Li Dong-yuan, there are a

multitude of ideas in his book, many of which have been maintained as

useful, and some of which have fallen out of favor. His formula bu

zhong yi qi tang remains widely used, and is the subject of modern

research. It is unlikely that BZYQT is going to be proven useless by

research; more likely is that we will gain some insights into how best

it can be used and when not to use it.

 

I agree it's a good idea to research BZYQT and not simply rely on

the test of time. But that does not mean we should adopt an attitude

of perpetual mistrust until the project is complete. Many herbal

treatments that have proven useful over time have also been confirmed

as useful by careful modern studies. As clinicians we should do the

best we can, with what is available to us.

 

Rory

--

[Guest guest]

I agree it's a good idea to research BZYQT and not simply rely on the test of time. But that does not mean we should adopt an attitude of perpetual mistrust until the project is complete. Many herbal treatments that have proven useful over time have also been confirmed as useful by careful modern studies. As clinicians we should do the best we can, with what is available to us.

 

Rory,

>>>>I agree but always with great caution. I think the most important aspect is attitude. If we do not take a mistrusting one it is too easy to just not see.

Only a broad view (multiple center studies) will allow us to truly see.

I terms of studies. I agree with Bob when he says that we should not embrace the one variable gold standard. But that is not what the scientific model is only about. There are many variations within a blinded randomized study designs that are expectable and still illuminating. And in the end unfortunately these are the only type of studies that can truly illuminate many issues of efficacy. Clinical audits are not reliable unless there is objective studies such as blood tests, mri etc.

It is this type of peer review I am talking about. One that comes from clinical studies and known FACTS of clinical studies not from an agreed upon set of ideas.

Alon

 

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Rory Kerr

Monday, January 21, 2002 1:09 PM

Re: Review of

 

At 11:11 AM -0800 1/21/02, ALON MARCUS wrote:

Peer review as we know it is a way to quickly evaluate newideas/information, but it is a less reliable standard than the testof time. Many ideas that stand the test of peer review fail towithstand the test of time, or are superseded.

>>>>perhaps you are right. I am not as trusting of the so called test of time. At least in the west we have so much evidence of repeated ideas that lasted a long time and then shown to be incorrect. Shit, WM is replete with drugs and procedures that have been used for a long time, even in these modern times, which only after critical evidence based review are now showing to be useless. And even after that many of these are still used---because Drs and patients are still convinced they work.

--

Fair enough, but I was answering your criticism that early works were not peer reviewed in their own time. You implied that absence of peer review was a deficiency in the evaluation of those works. My answer to that is that the review process continues on these works, and that the presence or absence of peer review back in the thirteenth century would be of little significance to us today.

 

To take the example you provided, Li Dong-yuan, there are a multitude of ideas in his book, many of which have been maintained as useful, and some of which have fallen out of favor. His formula bu zhong yi qi tang remains widely used, and is the subject of modern research. It is unlikely that BZYQT is going to be proven useless by research; more likely is that we will gain some insights into how best it can be used and when not to use it.

 

I agree it's a good idea to research BZYQT and not simply rely on the test of time. But that does not mean we should adopt an attitude of perpetual mistrust until the project is complete. Many herbal treatments that have proven useful over time have also been confirmed as useful by careful modern studies. As clinicians we should do the best we can, with what is available to us.

 

Rory-- Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

As clinicians we should do the

> best we can, with what is available to us.

 

And as recipients of the traditions of

medical arts of ancient Chinese origin, we

should do the best we can to maintain the

integrity of those traditions and see to

their continued transmission to future

generations.

 

Ken

[Guest guest]

Alon,

 

known FACTS of clinical studies not from an agreed upon set of ideas.

> Alon

 

Can you clarify the distinction you're

making between " facts " and " agreed

upon set of ideas. "

 

Ken

[Guest guest]

Can you clarify the distinction you'remaking between "facts" and "agreedupon set of ideas."

>>>>There is a difference between agreeing that methodology (ideas) is correct for example and another that critically looks at research to see if it is in complete opposite to other research for example.

One can peer review a book or study and say well everything looks like good TCM (ideas). The authors speaks good Chinese, is well known and educated and therefore what he says looks OK. Lets print the book.

Another type is to I see if what this author says is close to other clinical research. These are too different kinds of reviews. A study that says that about 90-99 % of patients got significant relief for anything other than acute infection, or some surgical procedure would probably not make it in any good peer reviewed j in WM. Especially if it is a chronic type of disease.

Now since almost 100% of all studies published in China (and which at least are abstracted into english) say that 80-99% of patients had significant results. This is hard to do but we need to start somewhere.

Alon

 

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dragon90405

Monday, January 21, 2002 4:31 PM

Re: Review of

Alon,known FACTS of clinical studies not from an agreed upon set of ideas.> Alon Can you clarify the distinction you'remaking between "facts" and "agreedupon set of ideas."KenChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

weshould do the best we can to maintain theintegrity of those traditions and see totheir continued transmission to future>>>>Only the parts that withstand critical review. Just because it a tradition to me means nothing

Alon

 

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dragon90405

Monday, January 21, 2002 4:28 PM

Re: Review of

As clinicians we should do the > best we can, with what is available to us.And as recipients of the traditions of medical arts of ancient Chinese origin, weshould do the best we can to maintain theintegrity of those traditions and see totheir continued transmission to futuregenerations.KenChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

Alon,

> we

> should do the best we can to maintain the

> integrity of those traditions and see to

> their continued transmission to future

> >>>>Only the parts that withstand critical review. Just because it

a tradition to me means nothing

 

In this you reflect an important theme

of Chinese intellectual life. This is

one of the critical dynamics of the

transmission of traditional Chinese

medicine. There is a well developed

and rather sophisticated epistemology

which underlies the theory and logic

of Chinese medicine. You are not

unique in your insistance upon

empirical results and efficacy of

methods. Chinese doctors have been

taking precisely the stand that you

articulate here for centuries.

 

It's a tradition.

 

Ken

[Guest guest]

In this you reflect an important themeof Chinese intellectual life. This isone of the critical dynamics of thetransmission of traditional Chinesemedicine. There is a well developedand rather sophisticated epistemologywhich underlies the theory and logicof Chinese medicine. You are notunique in your insistance uponempirical results and efficacy ofmethods. Chinese doctors have beentaking precisely the stand that youarticulate here for centuries.>>>>

Ken,

No argument. But we must benefit from what we now know via modern correctly and honestly done research. Empirical results are the truth of each patient encounter, however in a broad sense of successful utilization of a medical method (e.g. TCM in a particular condition) only a broader view that comes from good studies is truly accurate. It is to this perspective that I am talking from. I have no problem understanding and benefiting from so called tradition and experience. It would be foolish to do so.

Alon

 

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dragon90405

Tuesday, January 22, 2002 11:22 AM

Re: Review of

Alon,> we> should do the best we can to maintain the> integrity of those traditions and see to> their continued transmission to future> >>>>Only the parts that withstand critical review. Just because it a tradition to me means nothingIn this you reflect an important themeof Chinese intellectual life. This isone of the critical dynamics of thetransmission of traditional Chinesemedicine. There is a well developedand rather sophisticated epistemologywhich underlies the theory and logicof Chinese medicine. You are notunique in your insistance uponempirical results and efficacy ofmethods. Chinese doctors have beentaking precisely the stand that youarticulate here for centuries.It's a tradition.KenChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.