Applying Principles from Complex Systems to Studying the Efficacy of CAM Therapies

Abstract

In

A Complex, Nonlinear Dynamic Systems Perspective on Ayurveda and Ayurvedic Research

“…NDS and complexity theory focus on (1) ascertaining patterns reflected in whole systems as opposed to isolating components; (2) relationships and dynamic interaction rather than static endpoints; (3) transitions, change and cumulative effects, consistent with delivery of therapeutic packages in the reality of the clinical setting; and (4) simultaneously exploring both local and global levels of healing phenomena. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] NDS and complexity theory focus on therapeutic features such as nonlinear transitions between states of health/illness; the qualitative nature of shifts in health status-gradual or sudden, precarious or stable, resulting from large or small stimuli; and looking at emergent properties and behaviors stemming from interactions between organismic and environmental systems. [5][6][7][8][9][10][11][19][20][21] NDS and complexity theory provide perspectives for investigating how features of internal (psychophysiologic) and external (social-environmental) health are interrelated.…”

“…Some of the key concepts that constrain and guide clinician behavior are the following capacities of the individual patient: (1) Resilience/Robustness: how well the system can absorb disturbance, reorganize while undergoing change, and maintain effective function 3,7,9,19,20 ; (2) Adaptability: potential for ease of change in elements of the system to influence resilience 3,7-10,12,20 ; (3) Modulation/Calibration: shifts in system structure and input that reorient function and output in an effort to adapt to contextual factors 3,6,7,21 ; and (4) Transformability: potential for creating a fundamentally new system when environmental influences make the existing system untenable. 3,7,19 These concepts are related to, and influence, the occurrence and frequency of critical fluctuations. Critical fluctuations denote ''sudden disturbance and increased variability in system behavior before reorganization.''…”

“…These transformations can take on positive or negative characteristics and the end result will depend on the interaction between individual and environment as influenced by time, space, and contextual factors. [7][8][9]12,21 By accessing intersecting global and local levels of analyses, in both the diagnosis and treatment process, the Ayurvedic clinician simultaneously encompasses a broad span of knowledge about interactive transitions within the system as a whole. In treatment, the emphasis remains on sustaining a spectrum of actions on multiple interdependent subsystems of the individual, at numerous points in time, and in relation to context.…”

“…[1][2][3][6][7][8][9][10][11][19][20][21] This is relevant for the application of therapeutic similars/dissimilars as they intersect with baseline constitution and states of disequilibrium; (2) Emergent properties, in which complexity develops from the interaction of multiple simple parts. [1][2][3][4][6][7][8][9][10][11][12]15,19,20 The simple manifestation of the qualities at one level or context is exponentially complicated by an expression of similars/dissimilars within another level or context; and (3) Fractals, in which repeating, self-similar patterns occur over multiple spatial and temporal scales. 1,2,4,[6][7][8]18,19 In Ayurvedic diagnosis and treatment, the expression of qualities occurs over and over-across time and in various sites, within the organism and its environment-to create the past, present, and potential future map of individual health status.…”

Whole Complementary and Alternative Medical Systems and Complexity: Creating Collaborative Relationships

“…were identified as suggested research guidelines to be subsequently vetted and then used within the CAM research community.Whilethisworkshopbeganthediscussionabout theapplicabilityofcomplexsystemsandmultivariatemethodological approaches in studying complex intervention packages used in delivering WS-CAM treatment, it focused primarily on research designs that could capture and test multimodaltreatmentswithinCAM(e.g.,TCMwithmultiple components) rather than studying the holistic process and patternsofhealingwithinthepatientasanindivisiblesystem or network [30]. Its efficacy orientation emphasized testing therapies rather than evaluating the process of change and evolutionofreal-worldpatientoutcomes,whichwerethefoci ofour5thworkshop.…”