2. Correspondence
Edward Roddy
Academic Rheumatology
Clinical Sciences Building
Nottingham City Hospital
Hucknall Road
NG5 1PB
UK
E-mail:
[email protected]
Keywords:
clinical guidelines,
evidence-based medicine, strength of
recommendation
Accepted for publication:
27 April 2005
Evidence-based clinical guidelines: a new system to better
determine
true strength of recommendation
Edward Roddy MRCP (Specialist Registrar in Rheumatology),
3. 1
Weiya Zhang PhD (Senior Lecturer in
Musculoskeletal Epidemiology),
1
Michael Doherty MA MD FRCP (Professor of Rheumatology),
1
Nigel K. Arden MD MSc MRCP (Senior Lecturer in
Rheumatology),
2
Julie Barlow PhD (Professor of Health
Psychology),
3
Fraser Birrell MA PhD MRCP (Senior Lecturer in
Rheumatology),
4. 4
Alison Carr PhD (Special Lecturer
in Musculoskeletal Epidemiology),
1
Kuntal Chakravarty FRCP (Consultant Rheumatologist),
5
John Dickson FRCP MRCGP (Community Specialist in
Rheumatology),
6
Elaine Hay MD FRCP (Professor of
Community Rheumatology),
7
Gillian Hosie FRCP (General Practitioner),
8
5. Michael Hurley PhD (Reader in
Physiotherapy & ARC Research Fellow),
9
Kelsey M. Jordan MRCP (Rheumatology Research Fellow),
2
Christopher McCarthy PhD (Research Physiotherapist),
10
Marion McMurdo MD FRCP (Professor of Ageing and
Health),
11
Simon Mockett MPhil (Senior Lecturer),
12
Sheila O’Reilly MD MRCP (Consultant Rheumatologist),
6. 13
George Peat PhD MCSP (Research Fellow),
7
Adrian Pendleton MD MRCP (Specialist Registrar in
Rheumatology),
14
Selwyn Richards MA MSc FRCP (Consultant Rheumatologist)
15
1
Academic Rheumatology, Clinical Sciences Building,
Nottingham City Hospital, Hucknall Road, Nottingham, UK
2
7. MRC Epidemiology Resource Centre, Southampton General
Hospital, Tremona Road, Southampton, Hampshire, UK
3
Interdisciplinary Research Centre in Health, School of Health
and Social Sciences, Coventry University, Priory St,
Coventry, UK
4
Musculoskeletal Research Group, University of Newcastle upon
Tyne, UK
5
Haroldwood Hospital, Gubbins Lane, Romford, Essex, UK
6
Langbaurgh PCT, Langbaurgh House, Bow Street, Guisborough,
Cleveland, UK
7
Primary Care Sciences Research Centre, Keele University,
8. Staffordshire, UK
8
Primary Care Rheumatology Society, Northallerton, North
Yorkshire, UK
9
King’s College London, Rehabilitation Research Unit, Dulwich
Hospital, East Dulwich Grove, London, UK
10
The Centre for Rehabilitation Science, University of
Manchester, Oxford Road, Manchester, UK
11
Department of Medicine, University of Dundee, Ninewells
Hospital, Dundee, UK
12
Division of Physiotherapy Education, School of Community
Health Sciences, University of Nottingham, Nottingham City
9. Hospital, Hucknall Road, Nottingham, UK
13
Derbyshire Royal Infirmary, London Road, Derby, UK
14
Craigavon Area Hospital, 68 Lurgan Road, Portadown, Co
Armagh, UK
15
Poole Hospital, Longfleet Road, Poole, UK
Abstract
Rationale, aims and objectives
Clinical practice guidelines often grade the
‘strength’ of their recommendations according to the robustness
of the sup-
porting research evidence. The existing methodology does not
allow the
strength of recommendation (SOR) to be upgraded for
recommendations
for which randomized controlled trials are impractical or
10. unethical. The pur-
pose of this study was to develop a new method of determining
SOR, incor-
porating both research evidence and expert opinion.
Methods
A Delphi
technique was employed to produce 10 recommendations for the
role of
exercise therapy in the management of osteoarthritis of the hip
or knee. The
SOR for each recommendation was determined by the
traditional method,
closely linked to the category of research evidence found on a
systematic
literature search, and on a visual analogue scale (VAS).
Recommendations
were grouped A-D according to the traditional SOR allocated
and the
mean VAS calculated. Difference across the groups was
assessed by one-
E. Roddy
et al.
348
12. ANOVA
. However, certain recom-
mendations which, for practical reasons, could not assessed in
randomized
controlled trials and therefore could not be recommended
strongly by the
traditional methodology, were allocated a strong
recommendation by VAS.
Conclusions
This new system of grading strength of SOR is less con-
strained than the traditional methodology and offers the
advantage of
allowing SOR for procedures which cannot be assessed in RCTs
for prac-
tical or ethical reasons to be upgraded according to expert
opinion.
Introduction
Clinical guidelines have been defined as ‘systemati-
cally developed statements to assist practitioner
and patient decisions about appropriate health care
for specific clinical conditions’ (Field & Lohr 1990).
Guidelines that employ an evidence-based format
currently grade each recommendation in two ways:
first, by classifying the ‘category of evidence’ and,
second, by giving a ‘strength of recommendation’.
13. Although several methods of producing such grades
are described, in most of these, including the method
most commonly used by clinical guidelines in rheu-
matology (Pendleton
et al
. 2000; Jordan
et al
. 2003;
Dougados
et al
. 2004; Zhang
et al
. 2004; Roddy
et al
.
2005), the latter is strongly dependent on the former
14. (Shekelle
et al
. 1999) (Table 1). That is, the strength
of recommendation (SOR) primarily reflects the
robustness of the research evidence, with evidence
from randomized controlled trials (RCTs) and
systematic reviews automatically conferring the
strongest recommendation. However, although this
traditional method allows a downgrading of the SOR
for reasons including side effects or inconsistent
studies, it does not allow an upgrading of recommen-
dations in situations where RCTs are impractical or
unethical, e.g. total joint replacement, but effective-
ness is not in doubt. Furthermore, the practice of
evidence-based medicine requires the integration of
clinical expertise with the best available evidence
from systematic research (Sackett
et al
. 1996). Dur-
ing the development of recent recommendations for
the role of exercise in the management of osteo-
arthritis (OA) of the hip or knee (Roddy
et al
15. . 2005),
we found that the SOR allocated by this method was
often discordant with the consensus opinion of the
Table 1 Traditional hierarchy for category of evidence and
strength of recommendation (Shekelle
et al
. 1999)
Categories of evidence
1A. meta-analysis of RCT
1B. at least one RCT
2A. at least one CT without randomization
2B. at least one type of quasi-experimental study
3. descriptive studies (comparative, correlation, case-control)
4. expert committee reports/opinions and/or clinical opinion of
respected authorities
Strength of recommendation
A. Directly based on category 1 evidence
B. Directly based on category 2 evidence or extrapolated
recommendation from category 1 evidence
C. Directly based on category 3 evidence or extrapolated
recommendation from category 1 or 2 evidence
D. Directly based on category 4 evidence or extrapolated
recommendation from category 1, 2 or 3 evidence
17. each recommendation.
Methods
A multi-disciplinary panel employed a Delphi tech-
nique to produce 10 recommendations relating to
the role of exercise in the management of OA of
the hip or knee (Roddy
et al
. 2005). Following a
literature search and summary analysis of results,
the evidence for each recommendation was
assessed. The category of evidence and SOR was
assigned for each according to the method previ-
ously described (Shekelle
et al
. 1999). In addition,
each participant was asked to indicate how strongly
they rated each recommendation, based not just on
research evidence but also on all aspects relating
to their knowledge and clinical opinion. This was
recorded using a 10-cm visual analogue scale (VAS)
anchored with two descriptors labelled ‘not recom-
mended at all’ at the far left (0 cm) and ‘fully rec-
ommended’ at the far right (10 cm). The mean VAS
and standard deviation for each recommendation
18. were calculated. The recommendations were then
grouped according to their original SOR (A-D) and
the mean VAS and 95% confidence interval calcu-
lated for each group. A one-way
ANOVA
variance
analysis was performed to assess the difference
between the groups.
Results
The recommendations and the categories of evi-
dence, SOR and VAS for each, are shown in Table 2.
Figure 1 shows the mean VAS and 95% confidence
interval for recommendation groups A, C and D in
addition to one recommendation which was contra-
dicted by the research evidence and could not there-
fore be graded according to the traditional method
(‘not recommended’). No recommendations were
allocated a grade B SOR. The one-way
ANOVA
vari-
ance analysis identified a significant difference across
the groups (
19. P
<
0.001) and significant linearity
(
P
<
0.001).
Discussion
There was similarity between the SOR produced by
this method and the traditional methodology (Shek-
elle
et al
. 1999). The mean VAS for each recommen-
dation group (A, C, D) increased with the traditional
20. SOR, and therefore the category of evidence, and the
lowest mean was seen for the recommendation which
could not be recommended by the research evidence
ie was based solely on expert opinion.
This new system has the advantage of allowing the
SOR to be upgraded or downgraded based on ex-
pert opinion relating to global aspects of health
care delivery, such as generalizability, safety, cost-
effectiveness and patient preference, and common
sense. It therefore gives an additional dimension and
weighting to guideline recommendations other than
just the support from research evidence alone. In the
traditional system, the term ‘strength of recommen-
dation’ is almost a misnomer as it directly relates
to the category of evidence and provides little extra
information beyond that afforded by the ‘category of
evidence’. This is an important limitation of currently
practised evidence-based guideline methodology
that was overlooked in a recent critique of the meth-
odology of OA guidelines (Pencharz
et al
. 2002).
During the development of guidelines there are
many situations for which the existing SOR method-
ology (Shekelle
et al
21. . 1999) is not ideal. Interventions
for which placebo-controlled trials are impractical or
unethical (e.g. total joint replacement) cannot score
highly on the existing hierarchy and yet clearly may
Figure 1 Comparison of mean VAS (95% confidence
intervals) and traditional strength of recommendation.
VAS, visual analogue scale; NR, not recommended.
0
1
2
3
4
5
6
7
8
9
A C D NR
Strength of recommendation (Traditional method)
M
e
a
n
V
A
S
(
23. be very efficacious and warrant strong recommenda-
tion for clinical practice. The new method allows
the recommendation for such interventions to be
upgraded beyond that afforded by the category of
research evidence. Furthermore, when recommenda-
tions are not easily assessed in the setting of a clinical
trial yet have clear face validity, as with our third and
fourth recommendations (Table 2), the panel may
feel a much stronger recommendation is warranted
than that permitted by the current research-linked
method. For example, the mean VAS for both prop-
ositions 4 and 5B (Table 2) was 7.7, yet the SOR
according to the traditional methodology were D and
1B respectively. This reflects that although proposi-
tion 4 would be impractical to assess in the setting of
a RCT, it was highly supported by the expert panel
Table 2 Evidence-based recommendations for the role of
exercise in the management of osteoarthritis of the hip or
knee: category of evidence, strength of recommendation
(Shekelle
et al
. 1999) and visual analogue score (VAS)
Recommendation
Category of
24. Evidence (1–4)
Strength of
Recommendation (A-D)
Strength of
recommendation
(VAS) – Mean
(SD) cms
1. Both strengthening and aerobic exercise can
reduce pain and improve function and health
status in patients with knee and hip OA.
Knee 1B
Hip 4
A
C (extrapolated from knee OA)
8.9 (1.1)
6.3 (2.1)
2. There are few contra-indications to the
prescription of strengthening or aerobic
exercise to patients with hip or knee OA.
4 C (extrapolated from adverse
event data)
8.0 (1.5)
3. Prescription of both general (aerobic
fitness training) and local (strengthening)
25. exercises is an essential, core aspect of
management for every patient with hip or
knee OA.
4 D 7.1 (2.5)
4. Exercise therapy for OA of the hip or knee
should be individualized and patient-centred
taking into account factors such as age,
co-morbidity and overall mobility.
4 D 7.7 (1.9)
5. To be effective, exercise programmes
should include advice
and education to promote a positive lifestyle
change with an increase in physical activity.
4
1B
D
A
6.1 (2.6)
7.7 (1.4)
6. Group exercise and home exercise are equally
effective and patient preference should be
considered.
1A
4
26. A
D
8.0 (1.5)
7.6 (2.3)
7. Adherence is the principal predictor of
long-term outcome from exercise in patients
with knee or hip OA.
4 D 5.1 (2.4)
8. Strategies to improve and maintain
adherence should be adopted, e.g. long-term
monitoring/review and inclusion of
spouse/family in exercise.
1B A 7.6 (1.5)
9. The effectiveness of exercise is independent
of the presence or severity of radiographic
findings.
4 Not recommended 4.5 (2.8)
10. Improvements in muscle strength and
proprioception gained from exercise
programmes may reduce the progression of
knee and hip OA.
4 D 4.2 (2.5)
28. Force (ACA/AHA 2004), the US Preventive Services
Task Force (2003), the National Institute for Clinical
Excellence (NICE) (NICE 2004) and the New
Zealand Guidelines Group (New Zealand Guide-
lines Group 2004), derive the SOR primarily from
the category of research evidence. The ACC/AHA
guidelines state that any combination of classification
of recommendation and level of evidence is possible
and that a recommendation can be strongly sup-
ported even if it is based entirely on expert opinion
and no research studies have ever been conducted on
the recommendation (ACA/AHA 2004). However,
this system does not provide for the incorporation of
factors such as cost-effectiveness and safety, and the
descriptive and quantitative criteria for assigning the
classification and evidence ratings weight research
evidence and clinical expertise equally, which may
not be appropriate for some modalities, e.g. total
joint replacement. The guideline development
methods of NICE state that when the evidence is
very strong, this should translate directly into a rec-
ommendation, yet when the literature search finds no
evidence to answer the clinical question, the guide-
line development group should consider using con-
sensus methods to identify current best practice,
suggesting that consensus methods are only needed
when there is no robust evidence (NICE 2004).
Furthermore, NICE produces guidance on the role of
individual treatments rather than disease-orientated
recommendations on global treatment strategies. The
recently published GRADE collaboration (Atkins
et al
29. . 2004), although highlighting the difficulties in
producing clinical guidelines and grading strength of
recommendation, has not produced a simple, practi-
cal solution. The VAS, on the other hand, has the
advantage of being simple to apply and allows all
facets to be incorporated, e.g. category of research
evidence, safety, cost-effectiveness, generalizability
and expert opinion.
A limitation of the VAS-SOR methodology is that
as the basis for the VAS is not based on explicit
criteria, it cannot be examined and assessed readily
by external groups. However, we recommend that
the VAS method should be used alongside the tra-
ditional method of determining the category of
research evidence supporting each recommendation.
Any discrepancy between the category of evidence
and SOR would therefore be highlighted and should
then be justified in the ensuing discussion. A further
limitation is that this method has only been used
in the setting of recommendations for exercise in
osteoarthritis by a single group of experts, so evi-
dence of its generalizability to other fields and other
groups is required.
Other possible methods for grading SOR include
the development of an ordinal scale. A numerical
scale, however, is commonly used to assess self-
reported pain and disability in clinical trials, and
applying this principle to SOR seemed preferable.
Although the numerical scale scores themselves do
not have intrinsic comparability between different
sets of guidelines, there is at least scope for grading
or even ranking of different recommendations within
each set of guidelines. Other groups that prefer
30. verbal scales may wish to develop an ordinal scale
with descriptors to help guide practice in a clinical
setting.
Our guideline development group concludes that,
in comparison to existing traditional methodology,
this new system of grading SOR is less constrained
and offers the advantage of allowing the SOR for
procedures which cannot be assessed in RCTs to be
upgraded according to expert opinion consistent with
the principles of evidence-based medicine (Sackett
et al
. 1996). We would encourage other groups that
develop management recommendations or guide-
lines to try this approach, so that its clinical applica-
bility and usefulness can be determined more widely.
Acknowledgements
We are grateful for an educational grant from
MOVE (http://www.move.uk.net) and are also
indebted to the Arthritis Research Campaign, UK
for financial support (ICAC grant D0593; WZ Senior
http://www.move.uk.net
E. Roddy
32. He has shares in Merck and Pfizer.
Marion McMurdo is a Director of D D Develop-
ments Limited, a University of Dundee company
whose mission is to provide exercise opportunities
for older people. Profits go to ageing research.
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Jamal Ad-Din Afghani: A Pioneer of Islamic Modernism
39. Malik Mohammad Tariq
∗
Abstract
The increasingly menacing encroachments by Western powers
against the peripheral Muslim states for a century and more,
the feeling of Islamic solidarity was certainly in the air during
the closing decades of nineteenth century.
1
The person who
accomplished and transformed into a dynamic force in the
world of the Islam was Sayyid Jamal ad-Din Afghani. Afghani
is considered to be the founding father and originator of
Islamic Modernism. He was one of the first important leaders
to try to reinterpret traditional Islamic ideas so as to meet the
agonizing problems brought by the increasing incursions by
the West into the Middle East. Rejecting either pure
traditionalism or uncritical imitation of the West, he began
what has become a continuing trend among Muslim
40. modernists emphasizing pragmatic values needed for life in
modern world. These included political activism, the freer use
of reason, and efforts to build up the political and military
power of Islamic states.
2
He was one of the early Muslim
political reformers during the latter half of the 19th century,
and has undoubtedly been one of the most influential Muslim
political thinkers.
3
He was a religious leader, philosopher,
reformist, writer, journalist and on top of all a politician and
liberator of Muslim world and the East.
Keywords: Jamal ad-Din Afghani, Islamic Modernism, Muslim
Ummah
Jamal al-Din Al-Afghani as-Sayyid Mohammad Ibn Safdar Al-
Husayn
(b. 1838, Asadabad, Persia (now Iran) – d. March 9, 1897,
Istanbul),
Muslim politician, political campaigner and journalist whose
41. belief in the
potency of revived Islamic civilization in the face of European
domination significantly influenced the development of the
Muslim
thought in the 19
th
and early 20
th
century.”
4
Actually the political
activism made Jamal al-Din a great hero of the east and an
enemy of
colonialism, whose influence and effects spread outside the
borders of
his own country Afghanistan, and spread Bengal to the Atlantic
shores of
∗
Dr. Malik Mohammad Tariq, Chairman, Department of
Philosophy, University
of Balochistan, Quetta, Pakistan
42. Jamal Ad-Din Afghani as Founder of Islamic Modernism
Malik Mohammad Tariq
The Dialogue Volume VI Number 4 341
Africa. Afghani’s basic concern was revitalizing the Islamic
world.
Addressing the Indian Ulama, he says:
“Why do you not raise your eyes from those defective
books and why do you not cast your glance on this wide
world? Why do you not employ your reflection and
thought on events and their causes without the veils of
those works? Why do you always utilize those exalted
minds on trifling problems?. Yet you spend no thought
on this question of great importance, incumbent on every
intelligent man, which is: What is the cause of poverty,
indigence, helplessness, and distress of the Muslims, and
is there a cure for this important phenomenon and great
misfortune or not?...
5
In general, Afghani’s primary goal was to rebuild a strong
43. Islamic state
capable of withstanding Western encroachments. Undoubtedly,
Afghani
was an ideologist of pan-Islam and Islamic reform, and it was
his vision
and determination that Islamic history shall again be splendid.
Afghani
said at the opening ceremony of new University in Istanbul,
which
reveals him as a man, dedicated to Westernization for self-
strengthening
ends, he went on:
“My brothers: Open the eyes of perception, and look in
order to learn a lesson. Arise from sleep of neglect.
Know that the Islamic people (milla) were (once) the
strongest in rank, the most valuable in worth. They were
very high in intelligence, comprehension, and prudence.
They faced up to the most difficult things with respect to
work and endeavor. Later this people sank into ease and
laziness.”
6
44. My brothers, are we not going to take an example from
the civilized nations? Let us cast a glance at the
achievements of others. By efforts they have achieved the
final degree of knowledge and peak of elevation. For us
too all the means are ready, and there remains no
obstacle to our progress. Only laziness, stupidity, and
ignorance are obstacles to advance. Theses things I say
openly.
7
Jamal ad-Din Afghani was “the advocate of Muslim unity and
was less
interested in theology than in organizing a Muslim response of
Western
pressure.”
8
Afghani was one of the most noteworthy and outstanding
Jamal Ad-Din Afghani as Founder of Islamic Modernism
Malik Mohammad Tariq
45. The Dialogue Volume VI Number 4 342
personality in the Muslim world, he stirred the soul of Islam as
no one
else did, and the developments that had disturbed violently the
Islamic
world during the next four decades are unthinkable without him.
Jamal
ad-Din was the most dedicated and unselfish politician and the
leader of
the East- that while the whole Asia and the Muslim world were
in a deep
sleep of ignorance during the 19
th
century he was fighting with a power
of his pen and the strength of his spirit to emancipate his people
from the
European yoke. He continued his fight by every means, in every
city and
country, even in the heart of colonial centers such as London,
Paris,
Berlin, and Petersburg until he died.
Since Jamal ad-Din said that Islam should be based on the
Qur’an alone, and also said that the Qur’an could not be in
contradiction
46. with modern science, economics, and political theory, it seems
clear that
Jamal ad-Din’s famous and externally traditionalist principle of
a return
to the Qur’an and to the ways of the early Muslims meant in
fact
radically modernist interpretation of Islam. Essentially Jamal
ad-Din was
calling for an end to all traditional religious theories and
interpretations
that might stand in the way of Muslim unity and self-
strengthening and
for a modern interpretation of Islam that would inculcate the
virtues of
national cohesion, anti-imperialism, and modern science and
technology.
9
In the twentieth century, as the defensive and anti-imperialist
mood of the Muslim world grew and as more and more Muslim
intellectuals, particularly in the Arab world, began to build up
an Islamic
modernist system based on special interpretations of the Koran
47. and early
Islam, the words of Jamal ad-Din began to enjoy a new
popularity. His
anti-British and nationalist pronouncements and his reported
words to his
followers favoring popular or constitutional government also
met certain
twentieth-century needs. Thus it was that Jamal ad-Din, who
had few
political successes and only a sporadic influence in his own
lifetime
became, like many other men whose ideas are in some ways
ahead of
their times, the inspiration for many later movements.
10
Geographically, his activities encompassed the major portion of
the Muslim world – Afghanistan, Iran, India, the Arab world,
and Turkey
– as well as Western Europe and Russia. He founded the famous
Urwal-
ul-Wathq (1884),
11
and wrote in others to propagate his cause. Afghani
48. was primarily a religious reformer, deeply concerned with
setting the
house of Islam in order. In a word, he stood for a liberal Islam.
12
Afghani
taught the need of reconsidering the whole Islamic position and
called
for a reconciliation of the historic, theological and
philosophical
positions of Islam with the attainments of modern scientific
thought,
through interpretation and reformulation of Islamic doctrines.
“Religious
Jamal Ad-Din Afghani as Founder of Islamic Modernism
Malik Mohammad Tariq
The Dialogue Volume VI Number 4 343
reform, he thought, had been the key to subsequent European
progress
and power, and such a reformation was also needed for the
Islamic world
to achieve the same goals.”
13
49. He denounced taqlid bila kayf in
unmitigated terms, and advocated a revival of the spirit of
Islam. In
favour of Ijtihad, Jamal ad-Din said that the great legists and
scholars of
the past broadened their understanding of the Qur’an’s meaning,
but they
could not fully grasp all Qur’an’s secrets. With all their
brilliant
knowledge, scholarship, and effort what these scholars
understood of the
Qur’an was like a drop in the ocean compared with all the
wisdom in the
Qur’an. In one of his Persian article, Jamal ad-Din here adapted
the Sufi
idea of infinity of meanings in the Qur’an to the modern need
for a free
reinterpretation of the Qur’an in order to prove its consonance
with
modern values.
14
Afghani called for the enthronement of the philosophic spirit
i.e., a
50. spirit of research and inquiry. “Whilst expounding the virtues
and
indispensability of science, Afghani was also at pains to stress
that
science needed another ‘science’ which is more comprehensive
which
would enable man to know how to apply each field in its proper
place.
This field of knowledge is falsifa (philosophy) or hikam
(wisdom) and
only it can show man the human prerequisites (values such as
what is
more important, fairer, more just etc.) He believed that the
decline of
Islamic civilization was caused by the death of philosophical
spirit and
the absence of knowledge in the Muslim community.”
15
He felt that the
study of philosophy should be made compulsory in the Muslim
societies
as it was the spirit behind all the empirical sciences. It was
likewise
51. necessary that Muslim societies should be re-established on the
foundations of constitutional democracy and rule of law.
16
He says:
“Philosophy is the escape from the narrow sensations of
animality into the wide arena of human feelings. It is the
removal of the darkness of bestial superstitions with the
light of natural intelligence; the transformation of
blindness and lack of insight into clear-sightedness and
insight. It is salvation from savagery and barbarism,
ignorance and foolishness, by entry into the virtuous city
of knowledge and skillfulness. In general, it is man’s
becoming man and living the life of sacred rationality.
Its aim is human perfection in reason, mind, soul, and
way of life. Perfection in one’s way of life and welfare in
livelihood are the chief preconditions for the perfection
of mind and soul. [Philosophy] is the first cause of
man’s intellectual activity and emergence from the
sphere of animals, and it is the greatest reason for the
52. Jamal Ad-Din Afghani as Founder of Islamic Modernism
Malik Mohammad Tariq
The Dialogue Volume VI Number 4 344
transfer of tribes and peoples from a state of nomadism
and savagery to culture and civilization. It is the
foremost cause of the production of knowledge, the
creation of sciences, the invention of industries, and
initiation of crafts.
17
According to Afghani it is philosophy that shows the man the
proper
road and makes man understandable to man. The highest crafts
are those
of the prophet, philosopher, caliph, doctor, and juriconsultant.
Not all
epochs have needed of a prophet, for a single religion and law
can
nourish many ages and peoples. But each age has need of an
especially
53. experienced and learned man, without whom human order and
survival
will be deranged. This learned man could dominate his period.
The
philosopher’s mission is equal to that of prophet,
18
such as follows:
“Firstly, whereas for the prophet, the truth of things is
attained by the paths of inspiration and revelation, for
the philosopher it is attained by means of arguments and
proofs. Secondly, whereas the prophet cannot commit
errors, the philosopher can. Thirdly, the teaching of
philosopher are universal and do not take into account
the particularities of a given epoch, whereas those of a
prophet are conditioned by latter. That is why the
prescriptions of prophets vary: they prescribe one order
for one time and establish another in a different
circumstance in conformity with what circumstances
permit, whereas the teachings promulgated by the
philosopher do not change in situations or of men,
54. because of passage of time”.
19
Afghani, unlike many of the revivalist thinkers of his
generation, was
well versed in traditional Islamic philosophy (hikmah), and
considered
philosophy essential for the revival of Islamic civilization. This
is clearly
reflected in his various lectures and particularly in The
Refutation of the
Materialists. In fact, Afghani’s philosophical arguments against
the
naturalists and materialists derive their force from his
philosophical
training. As we see in his lecture “The Benefits of Philosophy”,
Afghani’s vision of a ‘modern Islamic philosophy’ was closely
tied to his
confidence in the recent advancements made in the fields of
science and
technology. Unlike traditional theology (kalam), philosophy
should
articulate a cosmology based on the findings of modern science.
55. These
and similar ideas expressed by Afghani have been used by his
critics and
enemies to label him as a heretic. His role in the revival of the
study of
Jamal Ad-Din Afghani as Founder of Islamic Modernism
Malik Mohammad Tariq
The Dialogue Volume VI Number 4 345
Islamic philosophy in the Arab and Indian worlds, however,
remains
unmistakable.
How very strange is that the Muslims study those sciences that
are ascribed to Aristotle with the greatest delight, as if Aristotle
were one
of the pillars of the Muslims. However, if the discussion relates
to
Galileo, Newton, and Kepler, they consider them infidels. The
father and
mother of science is proof, and proof is neither Aristotle nor
Galileo. The
truth is where there is proof, and those who forbid science and
56. knowledge in the belief that they are safeguarding the Islamic
religion
are really the enemies of that religion. The Islamic religion is
the closest
of religions to science and knowledge, and there is no
incompatibility
between science and knowledge and foundation of the Islamic
faith.
20
Looking at Afghani’s activities and carrier as a thinker, there
had
a great impact on Muslim world and great source of inspiration,
however, some people disagree with him. Afghani’s plan for the
development of Islamic Modernism was based on the idea to
make an
arrangement or compromise between traditional culture and the
philosophical and scientific challenges of the modern Western
world.
The method and way opted by Afghani was not complete
rejection of
traditional Ulama nor to follow the West blindly. He took the
middle
path. He stresses the need of modern science and technology of
the West
57. which the Islamic world should acquire without unavoidably
accepting
the philosophical and theological consequences coming out
from their
use in the Western perspective. One should know Afghani’s
view on
science in his renewal and reform program. As he says:
“The Muslims must not turn to pure imitation of
Europeans, as this will open their countries to the
acceptance of Europeans rule. Instead, they should find
the inspiration for reform and science in their own
religious texts, especially the Koran. The latter, if
properly interpreted, will be found to be compatible with
modern values and even to predict them.”
21
These ideas obviously led him to propose liberal reforms in
politics since
he fervently believed that religious reforms could not be
affected in a
backward society. He stood for constitutional reforms, justice,
58. popular
rights, and for the supremacy of Law.
22
Afghani was not in favor of negative reaction against the West.
He was in favor of revival of Islam which could absorb the
modern
science. In his migrant life, Afghani, continuously struggled for
the
broad based tradition of Islamic intellectuals, which urged him
to move
from Iran to Afghanistan, India and to another places. When the
rulers
Jamal Ad-Din Afghani as Founder of Islamic Modernism
Malik Mohammad Tariq
The Dialogue Volume VI Number 4 346
failed to heed his advice, he became a revolutionary. To any
length he
would go to rid the Muslim countries of corruption and tyranny.
He said
that the evils of autocracy and tyranny, and the rest lying
corrupted by
59. the Western colonial powers corroded a part of the Muslim
world. He
tried to find constitutionalist movements in the former, and
liberationist
in the latter.
23
Through his tireless preaching, audacious propaganda and
dynamic activism, he first awakened the listless masses of the
Muslim
East to a new sense of their political weakness, and then
prepared them
for revolt and energetic reconstruction.
The idea that science and Islam are compatible is put forward in
one form or another in the construction of all Muslim
ideologues of the
nineteenth and twentieth centuries. Jamal ad-Din al-Afghani,
the pioneer
of pan-Islamism, was convinced that nothing but science and
technology
could eliminate economic and cultural backwardness. Afghani
objected
to dividing science into European and Muslim. He said modern
science is
60. universal, transcending nations, cultures and religion. He
argued that
modern science were not popular among the Muslims, because
in the
past centuries the Ulama had divided sciences into ‘Islamic’ and
‘non-
Islamic’. This false division had not only created a prejudice
among the
Muslims against modern sciences but had presented
“knowledge” as an
“adversary” of Islam in the Muslim societies.”
24
Afghani criticized the
Ulama. According to him:
“These days who have divided science into two parts.
One they call Muslim science, and one European
science. Because of this they forbid others to teach some
of the useful sciences. Afghani was indignant that
natural science was left out of the curriculum of Muslim
educational establishments. He said: ‘Those who
imagine that they are saving religion by imposing a ban
61. on some sciences and knowledge are enemies of
religion.’ In an article, ‘The Benefits of Study and
Education’, Afghani said that the misery in the Eastern
countries was due to their ignoring ‘the noble and
important role of the scientists’. Afghani himself set a
very high value on the public mission of the scientist. In
December 1870, speaking at a conference on the
progress of science and the crafts held in the New
Istanbul University, Dar ul-Funun, he described the
scientist's work as missionary. He compared the scientist
with a prophet, saying that prophecy is a craft (sanat)
like medicine, philosophy, mathematics, and so on. The
sole difference was that the prophet's verity was the fruit
Jamal Ad-Din Afghani as Founder of Islamic Modernism
Malik Mohammad Tariq
The Dialogue Volume VI Number 4 347
of inspiration, whereas scientific verity was the fruit of
reason.”
62. 25
Jamal ad-Din al-Afghani’s aim was the revitalization of Islamic
world.
He was keenly interested in (Western) science although he has
slight
knowledge of it. He knows that it was science which made the
West
superior in knowledge and power and dominating the world. He
argues
for science and says:
“If Afghani says nothing of the industrial and technical
revolution, that does not mean he was not aware of it.
He knew that the successes of Europe were due to
knowledge and its proper application, and the weakness
of the Muslim states to ignorance, and he knew also that
the orient must learn the useful arts of Europe. But for
him the urgent question was, how could they be learnt?
They could not be acquired by imitation; behind them
lay a whole way of thought and –more important still –a
63. system of social morality.”
26
Afghani argues that originally science came from the Islamic
world and
it is the cause of Western development and supremacy. He urges
the
Muslim to reclaim it and become powerful and progressive.
According to
Afghani:
“One might say that in all this period the sciences made
astonishing progress among the Arabs and in all the
countries under their domination. Rome and Byzantium
were then the seats of theological and philosophical
sciences as well as the shining center and burning heart
of all human knowledge. Having followed for several
centuries the path of civilization, the Greeks and Romans
walked with assurance over vast field of science and
philosophy. There came, however, a time when their
researches were abandoned and their studies
64. interpreted. The monuments they had built to science
collapsed and their most precious books were relegated
to oblivion. The Arabs, ignorant and barbaric as they
were in origin, took up what had been abandoned by the
civilized nations, rekindled the extinguished sciences,
developed them, and gave them brilliance they had never
had. Is not this the index and proof of their natural love
for sciences?”
27
Jamal Ad-Din Afghani as Founder of Islamic Modernism
Malik Mohammad Tariq
The Dialogue Volume VI Number 4 348
Afghani was fully committed to modernity and human reason.
Renan
(1883) in exchange with Afghani criticized early Arabs and
Islam for
being unreceptive and hostile to philosophical and scientific
inquiry.
28
65. Afghani criticized Renan as racially prejudiced, because, he
said, by nature, Arabs are hostile to science. Afghani argued
that all
peoples and nation are unable to distinguish good from evil in
the early
stage. They need prophet, and teachers to guide them.
29
And, since humanity, at its origin, did not know the causes of
events that passed under its eyes and the secrets of things, it
was perforce
led to follow the advice of its teachers and the orders they gave.
This
obedience was imposed in the name of the Supreme Being to
whom the
educators attributed all events, without permitting men to
discuss its
utility or its disadvantages. This is no doubt for men one of the
heaviest
and most humiliating yokes, as I recognizes; but one can not
deny that it
is by this religious education, whether it be Muslim, Christian
or pagan,
66. that all nations have emerged from barbarism and marched
toward a
more advanced civilization.
30
Jamal al-Din Afghani refuting the European thinkers with great
vigour, argued that Islam promoted knowledge and favoured the
study of
sciences. It never supported static attitude. Abu Rayyah
narrated that
Jamal al-Din was known for his extreme hatred for taqlid and
stagnation:
31
“Once someone narrated Qadi ‘Iyad’s statement as an
authority during discussion and insisted so much on his
authority as if it was a revealed text. Jamal al-Din
Afghani said, “Glory be to God. Whatever Qadi ‘Iyad
said was based on his limited wisdom and its relevance
was confined to his time. Had no one other than Qadi
‘Iyad the right to convey the clearer and more correct
opinion which was closer to truth than his opinion or
67. that of the other jurist? Why was it necessary to confine
to the statements of humans and to fall into a static
attitude whereas these people never felt restricted by the
statements of their ancestors? They used their own
intellect; they drew inferences from the original sources
and made statements on that authority. They dived deep
into the ocean of knowledge and brought forth pearls
befitting the needs of their time, familiar to the intellects
of their generation. The rules did change with the
change of time.”
32
Jamal Ad-Din Afghani as Founder of Islamic Modernism
Malik Mohammad Tariq
The Dialogue Volume VI Number 4 349
Afghani used to say:
“The gate of ijtehad is not closed at all – It is not only a
68. duty but also a right to implement the principles of the
Qur’an on the problems of our time continuously. Its
refutation is tantamount to taqlid and stagnation. Both
these attitudes are as inimical to true Islam as
materialism is to it.”
33
Defining taqlid as stagnation, Afghani developed the concept of
ijtihad
as a principle of dynamism. However, his involvement with
contemporary politics led him to think in the European
framework in
such a way that in his thought, ijtihad becomes equivalent to the
European notion of the “reformation of religion”. In the early
period of
the reformation of religion in Europe two fundamental trends
had
emerged, viz. those of regionalism and rationalism. According
to Aziz
Ahmed, Afghani recommended that “Ulama’ should establish
regional
69. centres in various countries where Ijtihad could be exercised for
the
guidance of the common man. These regional centres should
then be
connected with the global centre which may be established in
any one of
the holy places. The representatives of various centres may
gather to
exercise Ijtihad for the whole of Ummah. This will reinvigorate
the
Ummah and will prepare it to withstand foreign challenges.
34
To Afghani, the only remedy lay in the unity and consolidation
of the existing Muslim states and in improving the means of
their
national defense. Thus was conceived the pan-Islamic ideology
that has
since been associated with his name. It was at best a defensive
strategy;
in fact, a last-ditch attempt to roll back the tide of Western
encroachments.
35
To support this approach, Islam itself had ordained
70. such attitude. However, he did not believe that all Muslims
ought to
unify under one ruler, or Caliph. Rather, cooperation amongst
Muslims
world was his answer to the weakness that had allowed Muslims
to be
colonized by the Europeans (namely Britain and France). He
believed
that, in fact, Islam (and its revealed law) was compatible with
rationality
and, thus, Muslims could become politically unified whilst still
maintaining their faith based on a religious social morality.
These beliefs
had a profound effect on Muhammad Abduh who went on to
expand on
the notion of using rationality in the human relations aspect of
Islam
(mu'amalat).
36
“The appeal for unity is indeed the theme, which runs all
through al-Afghani’s work. Both the common danger,
and the values which all Muslims shared, should
71. outweigh differences of doctrine and traditions of
Jamal Ad-Din Afghani as Founder of Islamic Modernism
Malik Mohammad Tariq
The Dialogue Volume VI Number 4 350
enmity. Differences of sect need not be a political
barrier, and the Muslims should profit from the example
of Germany, which lost its national unity through giving
too much importance to differences of religion. Even the
deepest gulfs, between Sunnis and Shi’is, could be
bridged.”
37
The most distinguished idea of Afghani was his vow and
dedication for
pan-Islamic civilization. He was of the view that Muslim world
could
make progress and regain the vanished glory of the past. That
can be
achieved by going back to the fundamental teaching, that is, to
unite. His
72. political plan of pan-Islamism was to assemble Muslim nations
to
struggle and fight against Western domination and acquire the
military
supremacy and power through modern science and technology.
Afghani’s mission for Islamic nationalism was the independence
of
individual Muslim nations. His aim of pan-Islamism was not a
religious
one but a political one. Afghani believes that the Islamic world
could
regain its glory by unity instead of division in groups.
“When he talked of Muslims unity, he did not mean only
co-operation of religious or political leaders; he meant
the solidarity of the umma, the sense of responsibility
which each member of it should have towards the others
and the whole, the desire to live together in the
community and work together for its welfare. Solidarity
(ta’assub) was the force, which held society together,
and without it would dissolve. Like all human attributes,
73. it could be perverted; it was not a law unto itself, it is
subject to the principle of moderation or justice, the
organizing principle of human societies. Solidarity,
which did not recognize this principle and was not
willing to do justice turned into fanaticism.”
38
Afghani believed that to live in the modern world demanded
changes in
Muslim ways of organizing society, and that it must try to make
those
changes while remaining true to it. Islam, Afghani believed,
was not only
compatible with reason, progress and social solidarity, the bases
of
modern civilization, but if properly interpreted it positively
enjoined
them. However, he felt that this would be possible only if Islam
was
interpreted to make it compatible with survival, strength and
progress in
the world. Afghani felt that a united Islamic civilization was
one answer
74. to this problem. He felt that if all Islamic sects were united,
they could
balance the threat from the West better than they could in their
current
Jamal Ad-Din Afghani as Founder of Islamic Modernism
Malik Mohammad Tariq
The Dialogue Volume VI Number 4 351
divided state. He desired to unite all branches of the Islamic
community
in a program of self-strengthening that required theological
distinctions
to be played down -- including the Sunni/ Shii split -- in favor
of a vague
belief in the superiority of Islam that could appeal to everyone.
Keddie
argues that pan-Islam and the reform of Islam could seem to
him two
sides of a program for strengthening the Muslim world and
defeating
imperialism.
39
75. “O, sons of the East, don’t you know that the power of
the Westerners and their domination over you came
about through their advance in learning and education,
and your decline in these domains?....Are you satisfied
after your past achievements, after you had reached the
acme of honor through learning and education, to
remain in that wretched state into which you were
plunged by ignorance and error. …Make the effort to
obtain knowledge and become enlightened with the light
of truth so as to recoup glory and obtain true
independence.”
40
The pan-Islam, however, did not gain popularity till it first
appeared in a
French periodical in 1881. Afghani called the society he had
founded in
Makkah with the object of creating one Caliph over the entire
Muslim
world, the Unum-ul-Quran.
41
76. This society was, however, suppressed by
Sultan Abdul Hamid (1876-1909) within a year of its founding.
Afghani
developed highly pragmatic and political views regarding the
possible
panaceas to the predicament confronting the Muslim world. He
opposed
outright importation of ideas or values from the West, and
instead sought
to reconcile what he saw as the fundamental precepts of the
Islamic faith
with the intellectual and social values, which have made sudden
upheaval progress possible in the West.
42
Like other Islamic modernists, his general line for defending
Islam, nationalism, and modernism at the same time was to try
to show
that modern virtues originated with Islam, and that the Muslims
who
rejected them were acting against the principles of their
religion. Like the
early modernists of many cultures, Afghani apparently hoped
77. that the
rational attitudes and scientific innovations necessary to self-
strengthening could be adopted without the foreigners’ cultural
and
linguistic baggage, whose acquisition could disrupt national and
religious
unity and encourage passive admiration for foreign conquerors.
43
It can be concluded that viewing the strength of the West as
imbedded in the superior knowledge of science and technology,
al-
Afghani nevertheless argued that Islam, despite its outward
decadence
Jamal Ad-Din Afghani as Founder of Islamic Modernism
Malik Mohammad Tariq
The Dialogue Volume VI Number 4 352
and decline, still possessed strong spiritual and moral values,
such values
if combined with Western scientific and technological power
could raise
the Muslim world out of its state of decadence.
44
78. Al-Afghani’s ideas,
however, are faced with serious limitations. In the first place as
a
politician and activist, he was able to satisfactorily address the
philosophical issues, which came to the fore as a consequence
of the
encounter of cultures and religions. What he advocated was not
assimilation, but mixture and amalgamation. Secondly, he never
structured his ideas in a distinct formula for action, with the aid
of which
the Muslims could encounter the West. Al-Afghani’s
importance,
instead, lay in the precedent, which he set and the students
whom he
trained, mainly through his attempts to bridge the gap, which
existed
between the traditional Muslims and the Westernizing
modernists.
45
The
task of formulating a modernist body of Islamic thought was
then left to
79. al-Afghani’s disciples. The most noteworthy of whom were
Mohammad
Abduh, Rasid Rida and Qasim Amin. Expanding upon the trend
of
thought first initiated by al-Afghani, these disciples addressed
an array of
issues such as, concepts of liberty, reform, political
participation and
even women rights in the context of Islam. The most prolific
and
therefore, famous propagator of modernism in Egypt during this
period
was Mohammad Abduh. Unlike his mentor, al-Afghani, Abduh
was not
concerned with imperialism or political action, but rather with
religious
reform.
Jamal Ad-Din Afghani as Founder of Islamic Modernism
Malik Mohammad Tariq
The Dialogue Volume VI Number 4 353
Notes & References
80. 1
Ali Rehnuma (ed.) Pioneers of Islamic Revival, Trans. by M.
Yahya Khan,
(Lahore 1999) 39.
2
Nikki Keddie, Sayyid Jamal al-Din Afghani: A Political
Biography, (Berkeley:
University of California Press, 1972) 1.
3
Ali Rehnuma (ed.) Pioneers of Islamic Revival, op.cit. 29.
4
The New Encyclopedia Britannica, Vol. 6, Robert Metteny Ed.
in Chief,
(Chicago, 1993) 479.
5
Nikki Keddie, An Islamic Response to Imperialism: Political
and Religious
Writings of Sayyid Jamal al-Din “al-Afghani”, (Berkeley:
University of
California Press, 1983) 120-122
6
Nikki Keddie, Sayyid Jamal al-Din Afghani: A Political
Biography (Berkeley:
University of California Press, 1972) 63
7
Ibid., 64
81. 8
Nasr, Vali, The Shia Revival, (W.W. Norton & Company,
2006) 103.
9
Nikki Keddie, Sayyid Jamal ad-Din Afghani: A Political
Biography, op.cit.,
395-396
10
Ibid., 422-423.
11
Encyclopedia Britannica, 480
12
M.M. Sharif, A History of Muslim Philosophy, Vol-II, (Royal
Book Company
Karachi, 1981) 1487.
13
Nikki Keddie, Sayyid Jamal al-Din Afghani: A Political
Biography, op.cit.,
141.
14
Ibid., 396
15
Dr. Javid Iqbal, Islam and Pakistan Identity, (Iqbal Academy
Pakistan,
82. Lahore, 2003) 211.
16
Ibid. 211.
17
Nikki Keddie, Sayyid Jamal ad-Din “al-Afghani” A Political
Biography,
op.cit., 163-164.
18
Ibid., 69
19
Ibid., 69
20
Ibid. 162-163
21
Ibid., 392
22
Ali Rehnuma ed. Pioneers of Islamic Revival, op.cit., 44-46.
23
Ibid., 30
24
Dr Javid Iqbal, Islam and Pakistan Identity, op.cit. 211
25
The New Encyclopedia Britannica, Vol. 6, Robert Metteny Ed.
in Chief,
83. (Chicago, 1993) 479.
26
Hourani, Albert, Arabic thought in the Liberal Age 1798 –
1939, (Cambridge
University Press, Cambridge, 1983) 114.
27
“Religion Versus Science, S. Jamal al-Din al-Afghani”,
Mansoor Moaddel &
Kamran Talatt (Ed) Modernist and Fundamentalist Debates in
Islam, (Palgrave
Macmillan, New York, 1999) 25-26
Jamal Ad-Din Afghani as Founder of Islamic Modernism
Malik Mohammad Tariq
The Dialogue Volume VI Number 4 354
28
Nikki Keddie, Sayyid Jamal ad-Din “al-Afghani” A Political
Biography,
op.cit., 85.
29
Mansoor Moaddel & Kamran Talatt (Ed) Modernist and
Fundamentalist
84. Debates in Islam, op.cit.,13
30
Nikki Keddie, Sayyid Jamal ad-Din Afghani: A Political
Biography, op.cit.,
191.
31
Mas’ud, M. Khalid, Iqbal Reconstruction of Ijtihad, (Iqbal
Academy Pakistan,
Islamic Research Institute, Islamabad, 1995) 68.
32
Ibid., 68-69
33
Ibid., 69
34
Ibid., 69
35
M.M Sharif, A History of Muslim Philosophy, Vol.-II, op.cit.,
1486.
36
Albert Hourani, Arabic Thought in the Liberal Age 1798-1939,
op.cit., 104-
125.
37
Ibid., 115
38
85. Ibid., 117
39
Nikki Keddie, An Islamic Response to Imperialism
40
Nikki Keddie, Sayyid Jamal al-Din Afghani: A Political
Biography, op.cit.
107.
41
Ibid., 1487
42
Nasr, S. Vali Reza, “Reflections on Myth and Reality of
Islamic Modernism”,
Hamdard Islamicus, Vol. XIII/ No.1, (Spring 1990) 73.
43
Nikki Keddie, Sayyid Jamal ad-Din Afghani: A Political
Biography, op.cit.
165-166.
44
Nasr, S. Vali Reza, “Reflections on Myth and Reality of
Islamic Modernism”,
op.cit., 73
45
Ibid.
86. Instructor; Dr. Benaouda Bensaid
Contemporary Islamic Thought
Activity I: Scoring Rubric for Article Review
(Journal article/Chapter Book Review)
Assignment Objective:
· Investigate and evaluate recent scholarly literature pertaining
to Contemporary Islamic Thought
Assignment Guidelines:
· Understand the purpose of a chapter book review:
· Cheating and Plagiarism are not tolerated under any
circumstance. Reviews containing clear plagiarism will result
in a 0 grade.
· Review requirements:
· Select 1 article from the given resources in the Blackboard
Article folder
· No more than 750 words (2-3 pages, not including title page
and references page)
· 12 font size, Times New Roman font
· Review should be done in a group of no more than 3 students
Rubric/ Article Review
Criteria
Points Earned
Cover Page
· Article Title
· Names of group members with Student numbers
· Section number
1
87. Article Review
· Review is well-summarized and clear
3
Explanation & Critique
· Review explains and critiques the methods, sources, findings,
conclusions and/or analysis present in the article
3
Evaluation and Conclusion
· Critique is well-supported by facts and accepted theory rather
than opinion alongside suggestions to the authors.
3
Total
10
Roddy Analysis Worksheet
Using the worksheet below, complete an assessment of the
following article.
Roddy, E., Zhang, W., Doherty, M., Arden, N. K., Barlow, J.,
Birrell, F., et al. (2006). Evidence-based clinical guidelines: A
new system to better determine true strength of
recommendation. Journal of Evaluation in Clinical Practice,
12(3), 347-352. Retrieved from
http://library.gcu.edu:2048/login?url=http://search.ebscohost.co
m/login.aspx?direct=true&db=a9h&AN=20870724&site=ehost-
live&scope=site
What was the research question?
What were the independent variables?
What was the dependent variable?
88. What was the sample size and how was it chosen?
What was the experimental design and use of control group?
Were the instruments of measurement shown to be reliable and
valid?
What data types were included?
Describe the statistics used, what they were used for, and the
results.
What were the researchers’ conclusions? How did they answer
the research question(s)?
How was error controlled?
Did you see any concerns with the research study? If so, what?
Ganz Analysis Worksheet
Using the worksheet below, complete an assessment of the
following article.
Ganz, F., Fink, N., Raanan, O., Asher, M., Bruttin, M., Nun, M.,
et al. (2009). ICU nurses' oral-care practices and the current
best evidence. Journal of Nursing Scholarship, 41(2), 132-138.
Retrieved from
http://library.gcu.edu:2048/login?url=http://proquest.umi.com.li
brary.gcu.edu:2048/pqdweb?did=1780947491&sid=1&Fmt=3&c
lientId=48377&RQT=309&VName=PQD
What was the research question?