Guest guest Posted January 7, 2005 Report Share Posted January 7, 2005 I just gave my presentation at scripps about therapeutic drug herb interaction. While the talk was well received in general, as I predicted, the chinese research was unanimously dismissed as so flawed as to be worthless. I presented some of the better studies from the BP website on diabetes. They had controlled matching groups and outcome criteria. However there were major flaws in each of the studies from a general perpsective. No long term followup. Using diverse treatment groups and then only doing an analysis of median values with no details. But this biggest objection of all is one we can never get around. It is not accepted that massive polypharmacy studies are valid. So the mere fact of having a 15 herb formula being studied invalidates the study from the get go. Especially if the study allows, as most of the ones I cited do, the prescriber to add herbs to a base formula for a wide range of varying presentations and then fail to account for these variables in the final analysis. It was a cogent and cutting crititque. While I anticipated it, there was no defense I could offer short of some science fiction about advanced computer modeling. This experience is crystallizing a trend in my thoughts over the past year. There is absolutely no interest amongst mainstream researchers in what we actually do. We have failed to prove the validity of our model and now it may be too late. Research in supplements is pressing full steam ahead, but it does not include much TCM and I suspect much less in the future. The emphasis is clear. It will be on single substances and not formulas. Each herb in a formula will need to be proven safe and effective ALONE before they are ever combined for valid research. That is their attitude and I don't expect it to change. This is why I have been saying for years that unless we FIRST prove that pattern differentiation is real and we have inter-rater reliability, nothing else we do will matter. Any positive study can be easily dismissed if the assessment criteria have not first been validated. Bob Felt has also made that point here and elsewhere in print for over a decade. Sadly,the advice fell on deaf ears. We are on our own, as we always have been and likely always will be. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 8, 2005 Report Share Posted January 8, 2005 At 1:04 AM +0000 1/8/05, wrote: >We have failed to prove the >validity of our model and now it may be too late. Research in >supplements is pressing full steam ahead, but it does not include >much TCM and I suspect much less in the future. The emphasis is >clear. It will be on single substances and not formulas. Each herb >in a formula will need to be proven safe and effective ALONE before >they are ever combined for valid research. That is their attitude >and I don't expect it to change. This is why I have been saying for >years that unless we FIRST prove that pattern differentiation is >real and we have inter-rater reliability, nothing else we do will >matter. Any positive study can be easily dismissed if the >assessment criteria have not first been validated. -- Thanks for your description of your experience at this conference. You seem to be somewhat disappointed by it, but I have to say I am not (but then I didn't have to suffer as you did). These researchers are not interested in what we do, and are heavily biased in their approach to what is medicine. What these researchers seem to be saying is that medicine should be defined by their research methods, and if something doesn't fit their methodology then it isn't medicine. Clearly such a position is nonsense, and reflects only their bias as researchers per se, and researchers in pursuit of pharmaceuticals in particular. There is nothing we can prove to these people. What we need to do is formulate our own ways to validate what we do, and speak up for that. As you say, we may have done a poor job so far. Nonetheless, how difficult would it be to replicate one of the diabetes studies you refer to, with added follow up? (btw, it would be interesting if you were to post more detailed critiques of these diabetes studies you presented; I agree with you that we all need to learn as much as we can about doing good research in our field) In my view we do not need to prove pattern differentiation is " real " . I don't even know what that means. If we can show to our satisfaction that treatment based on pattern differentiation is effective, why is that not sufficient to our needs, and the needs of our patients. Even if we were able to prove to their satisfaction that pattern diagnosis was valid, these researchers would still not be interested in what we do. They would still want to reduce the research to single substances. They are probably incapable of thinking outside that frame of reference. That's their limitation, not ours. Rory -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 8, 2005 Report Share Posted January 8, 2005 Todd Dont be dishearten. Change takes time and seeds once planted may sprout in time. It is important to keep having a presence. I been there and can sympathize alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 8, 2005 Report Share Posted January 8, 2005 thanks for going as well as presenting your findings to us here. The validation of TCM can not be allowed to rest with WM period. course the Qi, Ed Kasper LAc Santa Cruz, CA. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2005 Report Share Posted January 9, 2005 This reminds me of my own experiences lecturing at various institutions over the years. One that comes to mind was only a block away from the Scripps seminar site, at Novartis Institute. It is a huge operation, backed by hundreds of millions of dollars investment in the building and equipment alone. I was contacted by a woman who was a major researcher there, who had just returned from researching potential drugs from Chinese medicinals in Yunnan province. I made my case to the cream of young research scientists for the place of polypharmacy, but their questions came down to the same narrow interest. What herb could have its active constituents isolated in vitro in order to develop new drugs for cancer and other diseases? Novartis at that point (five years ago) had equipment that could analyze 10,000 substances at the same time, looking for new drugs. Interestingly, since then Novartis has moved to the forefront of what is called 'combinatorial chemistry' under the direction of Peter Schulz, who believes that the future of medicine is in combinations of drugs, not in single drugs, i.e. polypharmacy. While this approach is different then the combination of crude medicinals in prescriptions as in Chinese medicine, it is based on a similar idea of matching the body's complexity with a complex of medical substances. Add to this the work being done at the Institute for Systems Biology, and perhaps the future isn't so bleak. For years, I thought it might be possible to be an herbal consultant to the pharmaceutical industry, as we have lots of research into natural products being done in San Diego, in such places as Novartis and Scripps Institute of Oceanography. The Chinese have accumulated a huge database of natural medicines, with accompanying pharmaceutical data, and it is a shame that this 'treasure chest' is largely being ignored. I met with one drug company group based in Ithaca, N.Y. a few years back who were trying to 'patent' a group of polypharmacy Chinese extracts for cancer treatment as well. None of my inquiries were ever followed up upon (perhaps it was my beard?). I needed to learn that scientists, researchers and entrepreneurs have their own clubs, which are almost impossible to join without the correct credentials. No one cares about an herbal medicine professor and private practitioner in these clubs, no matter how much experience one may have. On Jan 7, 2005, at 5:04 PM, wrote: > > I just gave my presentation at scripps about therapeutic drug herb > interaction. While the > talk was well received in general, as I predicted, the chinese > research was unanimously > dismissed as so flawed as to be worthless. I presented some of the > better studies from > the BP website on diabetes. They had controlled matching groups and > outcome criteria. > However there were major flaws in each of the studies from a general > perpsective. No > long term followup. Using diverse treatment groups and then only > doing an analysis of > median values with no details. But this biggest objection of all is > one we can never get > around. It is not accepted that massive polypharmacy studies are > valid. So the mere fact > of having a 15 herb formula being studied invalidates the study from > the get go. > Especially if the study allows, as most of the ones I cited do, the > prescriber to add herbs to > a base formula for a wide range of varying presentations and then > fail to account for these > variables in the final analysis. > > It was a cogent and cutting crititque. While I anticipated it, there > was no defense I could > offer short of some science fiction about advanced computer > modeling. This experience is > crystallizing a trend in my thoughts over the past year. There is > absolutely no interest > amongst mainstream researchers in what we actually do. We have > failed to prove the > validity of our model and now it may be too late. Research in > supplements is pressing full > steam ahead, but it does not include much TCM and I suspect much less > in the future. > The emphasis is clear. It will be on single substances and not > formulas. Each herb in a > formula will need to be proven safe and effective ALONE before they > are ever combined for > valid research. That is their attitude and I don't expect it to > change. This is why I have > been saying for years that unless we FIRST prove that pattern > differentiation is real and we > have inter-rater reliability, nothing else we do will matter. Any > positive study can be easily > dismissed if the assessment criteria have not first been validated. > Bob Felt has also made > that point here and elsewhere in print for over a decade. Sadly,the > advice fell on deaf > ears. We are on our own, as we always have been and likely always > will be. > > Todd Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2005 Report Share Posted January 9, 2005 I am actually surprised at your description of this year's response, because last year I had some positive interactions with people at the Scripps conference. A couple of the presenters (last year) who were M.D.'s were very sympathetic to Chinese medicine, and one of the presenters had taken two workshops on Chinese herbal medicine with me in San Francisco. Another M.D. was in a partnership with a Chinese medicine practitioner in Albuquerque, N.M. On Jan 8, 2005, at 2:48 PM, alon marcus wrote: > Dont be dishearten. Change takes time and seeds once planted may > sprout in time. It is important to keep having a presence. I been > there and can sympathize > alon > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 10, 2005 Report Share Posted January 10, 2005 " I made my case to the cream of young research scientists for the place of polypharmacy, but their questions came down to the same narrow interest. What herb could have its active constituents isolated in vitro in order to develop new drugs for cancer and other diseases? Novartis at that point (five years ago) had equipment that could analyze 10,000 substances at the same time, looking for new drugs. " Z'ev's posting gives credence to the point of view of " critical medical anthropology (CMA), " one of the main schools of contemporary medical anthropology. This school is heavily influenced by Marxism in terms of its class reading of social and system dynamics. It is the CMA folks who gave us the term " biomedical hegemony. " According to CMAists, biomedicine is an outgrowth of and inextricably entwined with capitalism, including its research methodology which is designed to discover/create medicines to increase personal and corporate wealth. From this point of view, we, as proponents of CM, are engaged in a " class struggle " over resources in the marketplace, and we are heavily outgunned, i.e., undercapitalized. The goods news, according to CMA theory, is that all complex societies by their nature allow for medical pluralism one way or another. So perhaps the issue is simply carving out a viable niche and recognizing that that's the best we can do. From that point of view, perhaps we should only be concerned with getting our own house in order -- whatever that may mean. As an unabashed capitalist myself, it's basic business 101 to identify a currently unmet or undermet need, come up with a product that fills that need, then let consumers with that need know you have a solution to their want. Price that solution at the correct point and provide that solution in an acceptable way to the niche you are marketing to. Just thinking out loud here. Bob Quote Link to comment Share on other sites More sharing options...
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