1. What do we lack
?????????????????
Dr Remya Krishnan MD (Ay) PhD,
Associate Professor , Ayurveda

2. • Ayurveda differs from Modern Medicine in the
process of medical decision making .
• EBM in Modern Medicine refers to the
concept that clinical decisions are formally
supported by data based evidence derived
from RCT.
• EBM in Ayurveda refers to the process of
medical decision making formally supported
by basic research evidence in science

3. Ayurveda is a settled science the theorems
( definite) and laws of which are proven
and established by cause- mechanism-
effect relationship .
Modern Medicine is an unsettled science
the theories ( indefinite) and observations
are temporarily proven and approved by
probability based statistics.

4. Though the basic science of Ayurveda
insists to practice “Science Based
Evidence” (SBE), Ayurveda doctors until
today have not recognised and
incorporated its necessity and relevance
in their practice.

5. Substandard health care practices
Excessive cost from irrational use of
medicinal drug resources .
Unsettled complexities and confusions in
clinical practice
Absence of global acceptance of the
science as Medical system

6. Scientific method in Ayurveda is not
hypothesis formation and data collection,
classification and analysis for accepting or
rejecting a particular diagnosis or
treatment .
Scientific method in Ayurveda is the
judicious appraisal of science and science
based techniques for conclusive decision
making

7. The science of Ayurveda incorportes
quantitative tools and highly accurate
basement knowledge even when multiple
factors act individually or together to affect
the disease risk, progression or in
response to treatment .
The knowledge and tools constitute the
scientific substratum of Ayurveda .

8.  Modern Medicine is still in infancy of
understanding and utilising the complexities
and subtleness in diagnosis , management
and prevention of any disease despite of
technological advancement.
 The scientific basement and tools of
Ayurveda on pertinent application would
enable a scientist physician to solve the
complexities in every named and unnamed
diseases

9. No teaching and learning of Evidence
based practice of Ayurveda .
Physicians can never practice EBM if they
are unfamiliar with science because in
Ayurveda the intended and crucial
primary evidences are embedded in
science

10.  The physicians who possess specialised
skills in certain procedures and techniques
continue the same in each and every case
they get without appraisal of situation by
evidence based guidelines in science.
 For eg kshara sutra experts and
Panchakarma skilled physicians would
recommend these to all patients of them
irrespective of whether it is intended or not .

11. Acceptance of RCT double blind study
reports of drug and procedures as
approved evidence for medical decision
making in place of Science Based
Evidence (SBE ) of primary validity is
leading to serendipity results

12. Physicians adopting variable practice
styles based on tradition, convention,
personal experiences , recollection etc and
thus hardly know how to employ science in
practice.

13. Opinions of greatness imposed
personalities in the background of tradition,
business etc .
They create a wide misled impact in
national and international platforms.

14. Patient welfare is many times the last
concern that drives most of the clinical
decisions.
Economic incentives and financial issues (
dispensing and prescribing by common
unit) exert stimulatory influences .
Ignorance of “what is intended” forces the
physician to practice business and not
science

15. A physician of Ayurveda hardly knows the
accurate mode of examination and case
eliciting with relevant background
questions when patients describe their
signs and symptoms .
At present , there is no standardised
science based working diagnostic plan to
work out accurate diagnosis for Ayurvedic
physicians

16.  Dr. Rajkumar and Dr.Remya Krishnan had
developed a working diagnostic and
treatment plan derived from science by
employing science based parameters called
Evidence Triad Approach (ETA)
 The physicians can reach the most
scientifically optimised decisions by pertinent
application of Science Based Evidence in
three levels of increasing order of superiority
namely the silver, golden and the diamond
evidence by applying ETA.

17. ETA incorporates all the required scientific
decision making components in a well
structured format for confirmation of
diagnosis and management decisions in all
the cases that are encountered with

18. A patient presenting with dry cough –
The clinician decided even before starting
to elicit the history that the patient is
having vatik kasa by hearing “dry cough” .
According to the physician the status is
kasa owing to pranavaha srotodushti and
is Vata predominant

19.  The clinican failed to elicit the intrinsic and
extrinsic factors which initiate the disease
which would have clearly informed the
adhisthana and samutthana vishesha of kasa
in the patient .
 The patient was having all subjective and
objective features of allergic cough (more dry
cough early morning and middle of night
exacerbated by certain specific agents )which
is probably vishaja kasa .

20. Vishaja kasa requires immediate attention
to the triggering cause gara visha in rakta
vaha srotas leading to dry cough and not
vitiated Vata in Pranavaha srotas .
Treatment for Vata/ Vata kaphaja kasa
targeted to Pranavaha srotas will NEVER
produce cure of the disease .

21. The physician went wrong not because the
patient (clinical status) got diverged from
the textbook but rather the physician had
got diverged from science .
Most of the physicians fail to recognise the
underlying initiators of pathogenesis and
thus make their initial diagnosis wrong

22. When the initial diagnosis itself is wrong,
then every subsequent calculatiuons are
wrong .
Though the patients provide accurate
information, the physicians are unable to
make use of them in correct mode in
medical decision making

23. Experience can never make the situation
changed. The more experienced the
physician is, the more experienced his
errors will be and he becomes stubborn to
accept errors and continuously practice
the error .
 Pertinent experience based on science is
only valid experience.

24. Clinical practice guidelines based on Basic
research evidences already exist in
Ayurveda.Intense training is required for
the physicians to employ them accurately
in practice and research.
Guidelines are to be conveyed by applying
the scientifically standardised tools of EBA

25. These science based evidence based
guidelines will serve to define and describe
explicitly why and how the particular
diagnostic and treatment decisions in
particular situation are only scientifically
accurate for the situation in specific.
Guidelines are based on inbuilt basic
research evidences and hence are
primarily evidence based .

26.  SBEBA provides a finished set of tools and
techniques to practice Evidence Based
Ayurveda.
 SBEBA is thus an enormously significant
contibution that is changing the current
irrational way of practice of Ayurveda.
 SBEBA advocates to replace reliance upon
the “gray haired tradition based healers” with
systemic learning, appraisal and application
of indepth science of Ayurveda in accordance
to variable state and stage .

27. THANKYOU