Introduction to Health Research for Ayurveda, Siddha and Unani Teachers

8/11/2019 Introduction to Health Research for Ayurveda, Siddha and Unani Teachers

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Introduction to

Health Research Methods

&A discussion on issues in

Ayurveda, Siddha and Unani

research


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What we will look into

Basic research methods in todays

practice

The gap between the fundamentals ofA.S.U. and the available research

methods

Required modifications A couple of examples


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Before we enter

The chorus is A.S.U. need to be moreevidence-based

But A.S.U. systems were born out of attemptsof going beyond the body(after perfecting it)

Unchanged concepts (over millenniums) ....

Somewhere got interrupted


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One Word Can SaveYour Life: No! - New

research shows how

some common testsand procedures arent

just expensive, but

can do more harmthan good.
http://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.htmlhttp://www.thedailybeast.com/newsweek/2011/08/14/some-medical-tests-procedures-do-more-harm-than-good.html


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"From the Vedas we learn a

practical art of surgery,

medicine, music, house

building under which

mechanized art is included.They are encyclopedia of

every aspect of life, culture,

religion, science, ethics, law,

cosmology andmeteorology.

William James (18421910)


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Research defined

Research is an organized and systematic

way to find answers to questions

WhatWhen

Why

Where

Who

How

Research is a creative process


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Research what is it all about?

Central to the scientific enquiry.

Seeing what others see and findingwhat others dont.

Purpose: to add to knowledge

that will better the lives of people


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Research is a scientific process

There is a need to demystify the scientific process. Scientific Inquiry is basically a potentiation of common

sense ,which is one of the most equitably distributedhuman gifts.

As Einstein said The whole of science is nothing morethan a refinement of everyday thinking.

In a sense ,most of us conduct some research in our

daily life.(e.g) ,if we want to buy a car in a proper way, wecollect information about the models anddealers,analyse it then try to reach the scientificconclusion on which one to buy.


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Health Research

Healthmost vital part of human life

Health research & Medical research

Cornerstone of all the advancements

Health for all or Millennium

Development Goalsonly through proper

research


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What health research has

achieved so far

Small pox

Rheumatic fever & Rheumatic heart

disease

Iodine deficiency

Tobacco use & cancer

HIV/AIDS SARS/Avian flu/Swine flu


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Is Health Research a luxury?

Should Countries with scarce resources doresearch ?Yes

Because we are a poor country , wecannot afford not to do research .

(Jawaharlal Nehru) Clinical research needed, but with

honest intentions: Harsh Vardhan

Health researchA vital investment


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Research provides the reliableevidence


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Definition of levels of evidence and

grading of recommendation

Level Type of evidence available from Grade

I a Meta-analysis of RCTsA

I b At least one RCT

I I a At least one well-designed controlled study withoutrandomization

BI I b At least one other type of well-designed quasi-

experimental study

III Well-designed non-experimental descriptivestudies

IV Expert committee reports or opinions and/or clinical

experience of respected authoritiesC


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Health research in India

Since more than 2000 years

1911 to 2011 (IRFA to ICMR)

DHR - 2007 For mariginalized communities - priority

Health research in India is poor: The

Lancet * Research to achieve healthcare for all in India

0.4% in 1988 to 1.8% in 2008*The Hindu, 04.04.2011


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Research


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Research in CCRAS

Basic research

Clinical research

Drug research Literature research

New drug development

Collaborative research


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Tools for health research

Epidemiology

Measures of disease frequency

Causations & Associations

Validity & reliability

Study designs etc.,

Biostatistics

Descriptive statistics

Sample size

Tests of significance etc.,


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Types of health research

Basic and applied

Empirical and theoretical

Qualitative and quantitative


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Types of Research Studies

Research studies can be classifiedas:

Wellness typeCausation type

Disease type

Prognosis type


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Choosing a Research Topic

FINER*Feasible

InterestingNovel

Ethical

Relevant* Hulley et al, 2001


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Study designs

1. Different questions require different

types of Study Designs.

2. It is essential to understand the

structure of different Study Designs

3. Choosing the correct study design is

crucial to the success of the Research


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Epidemiologic Study Designs


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Research cycle


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The life cycle of epidemiological

investigations:

The never ending story

Identifying

data needs

Spelling out the

research question

Formulating the

study objectives

Planning the

analysis

Preparing data

collection instruments

Analysing data

Drawing conclusions

Formulating

recommendations

Involving the

programme

Collecting data

Here we

go again


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Research question spells out the local

public health problem

Problem in district Xamong the populationreached levelduring

Note: The statement specifies: What

How much

Who

Where

When


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Good research & Bad research

There is only one type of research - goodresearch .

Bad research does not deserve the name -Research

Badly done research is utter waste of time ,money and effort; it is unethical as it exposesresearch subjects to the inherent risk ofexperimentation with no reward to them ,to

others or communities


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Poor medical research is a

SCANDAL!*

Due to ignorance or willingly!

Fear of Epidemiology / Biostatistics

Unprofessional, unethical & unacceptable

Very common!?

*BMJ, 1994;308:283-284


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Flawed research

A triple waste

Researchers

Participants and the system!


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To lose ones health renders science null,

art inglorious, strength unavailing, wealth

useless and eloquence powerless

Herophilus, 300 BC

Lets take up the challenge &

RESPONSIBILITY!


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Oilbath is the key to good health

Be sure to take oilbath weekly

Oilbath keeps you healthy

Take regular oilbath

Oilbath prevents &cures many ailments


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Hypothetical Research Question

Your mission:

Reduce the incidence of DPN

Your belief:

Regular oilbath is the key to good health

Your hypothesis

Regular exercise decreases the risk of DPN


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Example of a Cross-Sectional Study

Association between regular oilbath and

DPN in the among DM


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Cross-sectional Study

Sample of Population

Oilbath + Oilbath -

Prevalence of

DPN

Prevalence of

DPN

Time Frame = Present


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Cross-sectional Study

Regular oilbath

+ -

D

P

N

+

- 90

10 90

10


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Case-Control Study

Patients with DPN

Patients w/o DPN

PresentPast

Regular OILBATH +

Regular OILBATH +

Regular OILBATH -

Regular OILBATH -

Cases

Controls


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Example of a Case-Control Study

Are those with DPN less likely to haveOILBATH regularly?


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Prospective Cohort Study

Regular

OILBATH -

Regular

OILBATH +

No DPN

DPN

DPN

No DPN

Present Future


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Example of a Cohort Study

To see the effects of regular

OILBATHon DPN in a DM population


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Experimental Studies

Clinical trials provide the gold

standard of determining the

relationship between OILBATHand

prevention of DPN.


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Clinical Trial

Study

Population

Treatment

Group

Control

Group

Outcomes

Outcomes

R

a

n

d

o

m

iz

e


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Clinical Trial

Study

Population

R

a

nd

o

m

iz

e

OILBATH

No OILBATH

DPN

No DPN

DPN

No DPN

E id i l i l St di


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Epidemiological Studies:

Summary

Cross-Sectional

Case-Control

Cohort RCT

Cost + ++ +++ ++++

Duration + ++ +++ +++

SampleSize

Varies Small Large Varies

Incidence,Prevalence

Prevalence None Incidence Incidence

MultipleOutcomes

Yes No Yes Yes

Bias Prone Yes Yes No No

Causality No No No Yes


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Documents

Introduction to Health Research for Ayurveda, Siddha and Unani Teachers