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Journal of Alternative and Complementary Medicine 2014 May ; 20 (5) :75-76
Comparative effectiveness research on different treatment options for rheumatoid arthritis in Ayurveda

Abstract
Purpose: This study aims to compare the outcomes of systematic reviews, clinical trials and reports from actual pointof care in real life situations with a view to identify the contradictions in the findings from these varying sources withreference to Rheumatoid arthritis (RA). Additionally it aims to identify implications of the results for research andclinical practice of Ayurveda. Methods: Four systematic reviews including one Cochrane review on efficacy of Ayurvedic interventions inmanagement of Rheumatoid arthritis was (RA) reviewed to compare the findings. Rigorous clinical trials evaluatingAyurvedic interventions in RA published in high impact journals that were not included in the systematic reviews wereanalyzed independently. Outcomes of Ayurvedic treatments in real life clinical practice (20 doctors) were also carefullydocumented for comparison. Results: There is a discrepancy between the conclusions of systematic reviews, independent clinical trials and reportsfrom actual point of care. Systematic reviews unanimously agree that there is no evidence indicating efficacy ofAyurvedic treatments in RA. On the other hand, the independent high quality clinical trials, one of which won an awardfor excellence in methodology contradict one another with respect to the reported clinical outcomes. The findings fromreal life clinical practice indicate not only strikingly different outcomes, but also treatment methods that have not beenadequately studied before. Conclusion: There is a gap between research and clinical practice in Ayurveda, which is clearly demonstrated by thisstudy on Rheumatoid arthritis. An over reliance on reductionistic methods of research leads to piece meal evaluationof Ayurveda ignoring its complex whole system approach in actual clinical practice. Variations in traditional diagnosis,the choice of treatments and the methodology of research are responsible for the contradictions in the researchfindings. Best clinical practices at the point of actual care should be identified and studied using appropriate research methodologies.

DHARA ID: D063859


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