Error correction in CM

[Luke Rickards]

It is often stated that modern scientific inquiry has been so 'successful' at answering questions about the nature of the stuff around us and in us because it has inbuilt systems of error correction.

There is no doubt that ancient Chinese medical philosophers and clinicians were seeking to describe and document truths about the world. Do you think that we have received this legacy with an inherent system of checks and balances so that continued knowledge may be developed while ensuring internal validity? If not, do you think it is appropriate to import another system of error correction to do this job (of course, this assumes that internal validity is desirable)?

[Michael Broer]

Is this about scientific research of CM efficacy?

[Luke Rickards]

Not exclusively.

[Michael Broer]

Do you think that we have received this legacy with an inherent system of checks and balances so that continued knowledge may be developed while ensuring internal validity?

Its a hard one to answer because acupuncture is an art as well as a science. Successful treatment often involves a certain amount of creativity and lateral thinking with regard to qualities more so than quantities. Error correction? Um...if you're not just referring to research...; If I make a clinical error, ie the patient doesn't respond to treatment or gets worse, then you go back and reassess the diagnosis and/or try a different approach. Have I already imported another system of error correction? I don't know.

If not, do you think it is appropriate to import another system of error correction to do this job (of course, this assumes that internal validity is desirable)?

If you want to "scientificise" acupuncture by researching the biomedical mechanisms, for example, then its unavoidable isn't it? But then, is it still acupuncture?

A terrible response, I know. I just feel that there's a point you want to make here and if I respond, however badly I've missed your point, you might expand on that...

Cheers

[Luke Rickards]

Hi Mike,

It's not so much about making a point - I'm just interested in how others think about the problems that plague me in my practice.

Any input on a public forum is an act of courage (especially so for those who choose not be anonymous) and I didn't see anything terrible about your response.

If you want to "scientificise" acupuncture by researching the biomedical mechanisms, for example, then its unavoidable isn't it? But then, is it still acupuncture?

I'm not actually referring to the biomedicalisation of CM here. I'm referring to internal validity of CM and how that might be ensured in a system that has been and continues to be dominated by subjective data collection and dissemination.

If I make a clinical error, ie the patient doesn't respond to treatment

For example, how do you know that you have made an error in the application of CM when your patients don't respond. Perhaps it is an error that has been past down through history but has been hidden by all kinds of other effects- natural progression/resolution, placebo, additional things that have done to people who did respond, luck etc, and hasn't poked its head up consistently with the right people to be eliminated?

then you go back and reassess the diagnosis and/or try a different approach.

This is certainly one way to respond to an error if it was yours, but it won't actually tell you the origin of the error. To keep "trying a different approach" doesn't demonstrate a strength in the application of CM principles and implies a hope that one might simply get lucky.

Sean Walsh's work on the inter-examiner reliability of pulse diagnosis is a good example of what I mean here. Mark Aird's work is another. Neither are attempting to biomedicalise CM, but both have used scientific methods to forward the internal knowledge of the system.

Do you think this is in the spirit of CM? Will injection of this kind of thinking into CM adversely affect the "art"? If so, is there another way? Or is it not even necessary?

I am aware Peter has some well-formed views on this subject and I eagerly await his input. No doubt AcuMed will also enlighten us - I can't wait!

[Michael Broer]

Any input on a public forum is an act of courage (especially so for those who choose not be anonymous) and I didn't see anything terrible about your response.

Thanks mate. I appreciate the encouragement. It is a bit scary sometimes, especially when responding to such excellent minds. Its a great topic for the forum and after your recent reply to my post, I have a better understanding of what you're on about.

Sean Walsh's work on the inter-examiner reliability of pulse diagnosis is a good example of what I mean here. Mark Aird's work is another. Neither are attempting to biomedicalise CM, but both have used scientific methods to forward the internal knowledge of the system.

Could you provide some links or a reference perhaps so that I could take a look at the work of these guys? I would be very interested to look at these examples properly before attempting to further add to this discussion.

I am aware Peter has some well-formed views on this subject and I eagerly await his input. No doubt AcuMed will also enlighten us - I can't wait!

Me too! Don't hold back guys!