Standardised versus Individualised treatments

[Guest guest]

Hi All,

 

Do YOU know of good published EVIDENCE for significant

OUTCOME differences between " Standardised " versus

" Individualised " treatments in acupuncture or herbal medicine?

 

If so, please post your response, with the reference(s), to the List.

 

Happy New Year to all,

 

Phil

 

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

 

On another list, Are wrote:

> ... we often underline that we treat individually. How can it be

> possible, then, to use [standardised] protocols.?? Why not treat

> the addicted individually, after their own symptoms, deficiencies

> and peculiarities??

 

Matthew Miller replied:

> This raises a number of interesting problems which are surprisingly

> not often discussed on these AP lists. One is the fact that so many

> studies have shown " standardized " AP protocols to be successful.

> Furthermore, no studies that I am aware of have conclusively shown

> TCM protocols (or any other individualized protocol based on

> another system) to be superior to standardized ones. If other list

> members are aware of any such studies I would be interested to hear

> about them.

>

> Second, there is the question of how much " individualization " is

> necessary for therapeutic success. Many traditional systems go into

> excruciating details, specifying things like number and direction

> of needle rotations based on whether you are treating a male or

> female, etc, etc. There are infinite ways in which treatment can be

> " individualized " and no practitioner could possibly incorporate

> them all. So how does one decide what needs to be " individualized "

> and what can be more " standardized " ? Unfortunately, it seems that

> this often hinges entirely on the personal whims and tastes of the

> practitioner, and not on anything resembling evidence. Matthew

 

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

 

 

Best regards,

 

 

WORK : Teagasc Staff Development Unit, Sandymount Ave., Dublin 4, Ireland

WWW :

Email: <

Tel : 353-; [in the Republic: 0]

 

HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

WWW : http://homepage.eircom.net/~progers/searchap.htm

Email: <

Tel : 353-; [in the Republic: 0]

[Guest guest]

I do not believe there is anything in english that meets this criteria. the

bensoussan study of IBS is summarized at

http://www.herbs.org/current/chinibs.html

 

it was published in JAMA and actually showed better results for standardized

therapy than individualized treatment. According to the study's author, Alan

Bensoussan, standard Chinese herbal preparations were just as effective as

preparations individually tailored to the patient, but the beneficial effects of

the

hand-tailored preparations lasted longer.

 

However, the short term effects of the standard formula were significantly

better than the individualized one. It would be nice to see the formulas and

see if there is some logical reason why this is the case. My hunch would be

that the standard formula focused more on branches and maybe even

specifically contained herbs chosen in consideration of their pharmacological

effects on the bowels. the individual formulas were actually tailored for each

patient. they may have combined root and branch treatment, so while they

were less effective at short term improvement, they had longer lasting benefit.

The details of the formulas would raise some questions about whether it

makes most sense to treat branch patterns strongly in early treatment of

chronic illness or to always treat root and branch in complex multipattern

formulas. this was a jama article. does anyone have the details or know how

to get the formula lists?

 

todd

 

, " " <

@e...> wrote:

> Hi All,

>

> Do YOU know of good published EVIDENCE for significant

> OUTCOME differences between " Standardised " versus

> " Individualised " treatments in acupuncture or herbal medicine?

>

> If so, please post your response, with the reference(s), to the List.

>

> Happy New Year to all,

>

> Phil

>

> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

>

> On another list, Are wrote:

> > ... we often underline that we treat individually. How can it be

> > possible, then, to use [standardised] protocols.?? Why not treat

> > the addicted individually, after their own symptoms, deficiencies

> > and peculiarities??

>

> Matthew Miller replied:

> > This raises a number of interesting problems which are surprisingly

> > not often discussed on these AP lists. One is the fact that so many

> > studies have shown " standardized " AP protocols to be successful.

> > Furthermore, no studies that I am aware of have conclusively shown

> > TCM protocols (or any other individualized protocol based on

> > another system) to be superior to standardized ones. If other list

> > members are aware of any such studies I would be interested to hear

> > about them.

> >

> > Second, there is the question of how much " individualization " is

> > necessary for therapeutic success. Many traditional systems go into

> > excruciating details, specifying things like number and direction

> > of needle rotations based on whether you are treating a male or

> > female, etc, etc. There are infinite ways in which treatment can be

> > " individualized " and no practitioner could possibly incorporate

> > them all. So how does one decide what needs to be " individualized "

> > and what can be more " standardized " ? Unfortunately, it seems that

> > this often hinges entirely on the personal whims and tastes of the

> > practitioner, and not on anything resembling evidence. Matthew

>

> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

>

>

> Best regards,

>

>

> WORK : Teagasc Staff Development Unit, Sandymount Ave., Dublin 4,

Ireland

> WWW :

> Email: <@e...>

> Tel : 353-; [in the Republic: 0]

>

> HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

> WWW : http://homepage.eircom.net/~progers/searchap.htm

> Email: <@e...>

> Tel : 353-; [in the Republic: 0]

[Guest guest]

Beware of strangers bearing gifts...Allopathic

physicians (especially medical acupuncturists) are

" learning " TCM herbal medicine in weekend courses. It

is easier for them to learn to prescribe symptomatic

herbal formulas for biomedical diseases than to become

fully TCM educated.--- "

< " < wrote:

> I do not believe there is anything in english that

> meets this criteria. the

> bensoussan study of IBS is summarized at

> http://www.herbs.org/current/chinibs.html

>

> it was published in JAMA and actually showed better

> results for standardized

> therapy than individualized treatment. According to

> the study's author, Alan

> Bensoussan, standard Chinese herbal preparations

> were just as effective as

> preparations individually tailored to the patient,

> but the beneficial effects of the

> hand-tailored preparations lasted longer.

>

> However, the short term effects of the standard

> formula were significantly

> better than the individualized one. It would be

> nice to see the formulas and

> see if there is some logical reason why this is the

> case. My hunch would be

> that the standard formula focused more on branches

> and maybe even

> specifically contained herbs chosen in consideration

> of their pharmacological

> effects on the bowels. the individual formulas were

> actually tailored for each

> patient. they may have combined root and branch

> treatment, so while they

> were less effective at short term improvement, they

> had longer lasting benefit.

> The details of the formulas would raise some

> questions about whether it

> makes most sense to treat branch patterns strongly

> in early treatment of

> chronic illness or to always treat root and branch

> in complex multipattern

> formulas. this was a jama article. does anyone

> have the details or know how

> to get the formula lists?

>

> todd

>

> , " Phil

> Rogers " <

> @e...> wrote:

> > Hi All,

> >

> > Do YOU know of good published EVIDENCE for

> significant

> > OUTCOME differences between " Standardised " versus

> > " Individualised " treatments in acupuncture or

> herbal medicine?

> >

> > If so, please post your response, with the

> reference(s), to the List.

> >

> > Happy New Year to all,

> >

> > Phil

> >

> > >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

> >

> > On another list, Are wrote:

> > > ... we often underline that we treat

> individually. How can it be

> > > possible, then, to use [standardised]

> protocols.?? Why not treat

> > > the addicted individually, after their own

> symptoms, deficiencies

> > > and peculiarities??

> >

> > Matthew Miller replied:

> > > This raises a number of interesting problems

> which are surprisingly

> > > not often discussed on these AP lists. One is

> the fact that so many

> > > studies have shown " standardized " AP protocols

> to be successful.

> > > Furthermore, no studies that I am aware of have

> conclusively shown

> > > TCM protocols (or any other individualized

> protocol based on

> > > another system) to be superior to standardized

> ones. If other list

> > > members are aware of any such studies I would be

> interested to hear

> > > about them.

> > >

> > > Second, there is the question of how much

> " individualization " is

> > > necessary for therapeutic success. Many

> traditional systems go into

> > > excruciating details, specifying things like

> number and direction

> > > of needle rotations based on whether you are

> treating a male or

> > > female, etc, etc. There are infinite ways in

> which treatment can be

> > > " individualized " and no practitioner could

> possibly incorporate

> > > them all. So how does one decide what needs to

> be " individualized "

> > > and what can be more " standardized " ?

> Unfortunately, it seems that

> > > this often hinges entirely on the personal whims

> and tastes of the

> > > practitioner, and not on anything resembling

> evidence. Matthew

> >

> > >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

> >

> >

> > Best regards,

> >

> >

> > WORK : Teagasc Staff Development Unit, Sandymount

> Ave., Dublin 4,

> Ireland

> > WWW :

> > Email: <@e...>

> > Tel : 353-; [in the Republic:

> 0]

> >

> > HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

> > WWW :

> http://homepage.eircom.net/~progers/searchap.htm

> > Email: <@e...>

> > Tel : 353-; [in the Republic:

> 0]

>

>

 

 

 

 

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[Guest guest]

Hi All & Hi Shar,

 

Phil wrote:

> Do YOU know of good published EVIDENCE for significant OUTCOME

> differences between " Standardised " versus " Individualised "

> treatments in acupuncture or herbal medicine? If so, please post

> your response, with the reference(s), to the List.

 

Shar replied:

> Can you qualify what you are after? for instance I do know of

> studies which treat wm dx heart conditions according to TCM

> Differential diagnosis, using common pts and then specific to DD

> pattern. I think the specific pts were still the same or selected

> from a group. Is this what you mean? When I think of my meridian

> styles of AP there is always a root treatment based on the

> patient, but that will usually be standard ie if in Toyohari the

> primary 'Sho' is Kidney then the Rx points will be Kid 7 and Lu 5,

> and the pulse will be checked for a change; then the controlling

> cycle is assessed, ie Sp and then the pathogenic qi in the yang

> channels is cleared and finally supportive or symptomatic

> treatment is made. One can vary the points in any part of the

> treatment, but usually they are yuan, cleft, mother points unless

> others are known to be clinically more effective or if the person

> say had a wind cold condition at the same time, one might use a

> different Lung pt. So such treatment is both standard and

> individual. Recently in Clinical Acupuncture and Oriental Medicine

> Journal Vol 3 Number 2; the topic has been about the use of

> complex theory and non linear analysis and chaos theory as the

> vehicle to research Oriental medicine through. My copy is out on

> loan, but from memory, I think there is a research institute in

> the States devoted to Complex theory research that is going to

> tackle OM under its funding and auspice. Sorry I can't be more

> specific. Shar

 

Most of us who use AP or Chinese Herbal Med have been taught

NOT to treat the presenting SYMPTOMS (unless they are serious),

but instead to address the complete PATTERN (Root AND Branch)

of the person/animal.

 

We are also taught to vary (individualise) our treatment at each

session, depending on the findings/Dx at that session.

 

My question is this: Is there any good PUBLISHED evidence that

the " individualised " treatments are significantly more effective than a

" standardised " ( " cookbook " ) approach that addresses the main

presenting symptoms.

 

I have seen very little in published sources to substantiate the claim

that " standardised " (cookbook) methods are less effective than

" individualised " methods.

 

IMO, this is probably because there is little good research done to

test the comparison.

 

However, if there is NOT good evidence that individualised

treatments (highly complex and probably poorly repeatable

BETWEEN individual traditional practitioners) are no better than

simplified " standardised " approaches, can we justify the former?

 

If not, must we view our personal view of AP/TCM like that of our

personal view of God/religion - a belief/way of working without

scientific proof?

 

 

 

Best regards,

 

 

WORK : Teagasc Staff Development Unit, Sandymount Ave., Dublin 4, Ireland

WWW :

Email: <

Tel : 353-; [in the Republic: 0]

 

HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

WWW : http://homepage.eircom.net/~progers/searchap.htm

Email: <

Tel : 353-; [in the Republic: 0]

[Guest guest]

Beware of strangers bearing gifts...Allopathicphysicians (especially medical acupuncturists) are"learning" TCM herbal medicine in weekend courses. Itis easier for them to learn to prescribe symptomaticherbal formulas for biomedical diseases than to becomefully TCM educated.--- ">>>Todd

I think its like everything else. Some will put the time and some will not

alon