Traditional Chinese Medicine Article Critique - Book Report/Review Example

Research Critique The article chosen for critique is called the “Treatment of patients with chronic headaches in a hospital for traditional Chinese medicine in Germany -A randomised, waiting list controlled trial” and is a joint effort by a few German and Swiss writers.1The Critique will adjoin to a TCM practitioner’s perspective (Traditional Chinese Medicine (TCM).2 At the outset it is worth beginning the article critique to begin with a very wise (and humorous) quote from the genius Lewis Carroll in his very famous work “Alice in the Wonderland” to illustrate the difficulty faced by authors of large pieces of work in keeping their work in context and relevant while at the same time being able to estimate their own direction and stance in relation to the research. Would you tell me, please? Which way I ought to go from here?" "That depends a good deal on where you want to get to," said the Cat. "I don't much care where -" said Alice. "Then it doesn't matter which way you go," said the Cat Struggling with the same issues of direction and context this article aims to review the “effectiveness of a clinical treatment program with traditional Chinese medicine for migraine and tension-type headache”3 and this research is stated at the outset to culminate into a finding that hospital treatment of TCM has caused “long lasting” improvements to the majority of patients.The aim of this critique thus becomes to explore the strength of this claim in terms of the given methodology and results.As a TCM practitioner it is possible to glean at the outset a certain sense of over-confidence amongst the researchers.Even though the methodology of randomised, waiting list controlled trials are very credible it is felt that there are a number of information gaps with in the content of the critique.This theme remains dominant with in the Discussion as when the weaknesses are discussed it seems “too little and too late” after the reader is lost in the labyrinth of tables and diagrams within the methodology. In the article at hand the writers try to cover the dynamics of TCM treatment for chronic headaches in Germany and whether it is effective through the methodology of randomised, waiting list controlled trials. This article was chosen for the critique over three others because of its comparative comprehensiveness with regard to successful TCM practices for the cure of headaches in German hospitals..When choosing this article I was impressed by its well-defined conceptual framework, detailed data collection and description of subjects, researcher subjectivity, and a thread of transparency that ties all of the sections of issues with each other.4 Yet my critique will expose areas where the study might not be as robust as it could be. The introduction and methodology provide a thorough history of the conception of TCM practices and their subsequently “proven success” in German hospitals.The methodology is precise in the sense that it is clarified at the outset that the patients who planned to start a new headache treatment prior to admission,or did not complain of headaches as a primary reason for admission or if their complaint was not “chronic headaches” and that they were not prepared to wait for the nine month waiting period were excluded from the scope of this study.One cause of concern here is however that it is clearly said that more than 70 % of the patients being treated were women and this shows that there may be a bias towards the male patient population here.Furthermore as a TCM practitioner the author felt that the summary/abstract was insufficient and did not address the competing points of view of other academics/professionals. For an article making such a magnanimous claim as this one and basing its findings mainly on its female patients such a short and biased introduction hardly seems appropriate.5 It can be argued that less is more but the unknowing/browsing reader is not being helped here particularly with the highly technical/ and abbreviated introduction. While assessing whether the hypothesis (or proposal) has been stated and is closely related to the topic of the research paper I felt that there was significant information gap as the author did not state the basis or methodology of study. My hypotheses evaluation found that the ordinary non-technical browser interested in the article would have little to interest in this regard. I have a similar opinion about the keywords which could have been more detailed. The methodology is sound but has not been explained along with the hazards of trusting a “randomised controlled listing”.The claim to success then with the Discussions section of this article lacks one or any references and secondly it does not do justice to the rest of the article. When the author does go on to state references they interrupt the flow and purpose of these sentences. In my opinion the paper is at times confusing and lacks a proper literature review .The structure and the beginning of the paper does little to help the non-technical reader understand what is being studied, and the reason for choosing this topic and does little to indicate the direction of the research.. Also as a TCM practitioner reading a technical paper it was felt that the structure of the article does little to address where the introduction ends and where the main body of the article starts. Anyways if my assumption of where the introduction ends is correct, then it is an awfully short introduction and as scattered as the abstract itself and should have been longer and more comprehensive. Now coming to the Research methods applied here. It would be useful to assess whether the author has clearly described an appropriatejustification for their use provided? The aim of the Randomised controlled list is to proposition highlighted in the abstract to prove that there are long lasting improvements to headache patients.Before embarking upon an analysis culminating in a critique it would be useful to discuss the aims and intricacies of research based on academic opinion.Thus the aim here is to put forward a view point through sole primary research without addressing any secondary literature and thus it becomes a fact intensive methodology.(Dominowski, 1980). For Kerlinger (1970) this can be defined as a “ systematic, controlled, empirical and critical investigation of hypothetical propositions about presumed relations among natural phenomena.”It would be useful to assess the research philosophy being used in this article which is a main influence on the methodology of research. (Saunders 2000).Based on the above discussion it would be useful to assess the research philosophy dominant here (as it fundamentally depends on the research question Saunders 2000), the phenomenological philosophy has been chosen in this paper. It seems therefore that the author is developing a theory as he/she comments upon the analysis of the data. The research context is well stated on the other hand in relation to these three parameters behind decision making and the analysis and their role is discussed accordingly. However the writer(s)seems to ignore literature supporting the proposition that Chinese TCM practices may have become increasingly Westernized as this trial is based in Germany. Coming to the methodology involved here the writer(s)intends to draw up a framework of quantitative variables which will assist him in determining the truth in this statement.However as a critic I have my reservations to such an approach utilizing patients on a certain location especially the majority of whom are women. .However I did not find (based on the above and my personal observations) whether the description for gathering data too detailed but I do feel that the data is sufficient for a replication study.The writers seem to have done well with the tables and graphs representing the findings but there seems to be a lack of a review of the research done in the past. Next I will discuss whether the data analysis methodology has been accurately explained and whether the analysis is accurate. Being a novice TCM researcher although I am not in a position to comment fully upon the accuracy of the data analysis however the raw data that has been presented here lacks proper discussion and makes the scope of the findings limited. There is indeed a full discussion of the findings of the manner however I felt that the tables representing these findings did not exactly do justice to the text explaining them and the terminology within these tables was confusing. Surprisingly although the keywords list this article as a reference for “tension headaches”6 the discussion then goes on to exclude them without explaining whether tension headaches can actually be chronic.There is no discussion of why this study is “pragmatic” and why were certain types of patients with complex headaches excluded.This indicated bias.Also 9 months is a long waiting period and it is unlikely that all members of the population (like working men) could participate here.No wonder the majority of the patients were women.Again the lingual problems are obvious here.This was a case of German patients being treated by Chinese physicians.The language the diaries were filled in and whether transcripts of those in English are available is unlikely.7 The article then says that the “ results provide some preliminary evidence” that a “complex individualized treatment with traditional Chinese medicine might be beneficial in patients suffering from migraine and tension-type headache”.This is clearly in contradiction with the stated aims and objectives of the article at the outset. Finally the paradigm issues in regards to methods for gathering and indeed the ways of treating data were discussed earlier on in the methodology section of the article. This provides the reader with a feeling for the approach to which the researcher values and thinks about investigating the TCM patients and their day to day reactions. The pragmatic potential benefit of this study is mentioned in the introduction i.e. to be better able to identify the source of difficulties faced by TCM in the treatment of Chronic headaches. This article is also significant for further future research in terms of its methodology; which albeit briefly mentioned in the abstract, is an attempt by the authors to validate the methods used and if the reader can find the analysis of the data agreeable to his own views this would form a good sort of guidance for their conceptualization of the problem and understanding of any solutions therefore. I would not say based on my reading that the introduction was well organized and clear because its layout combined the findings with the introduction. In conclusion although I was impressed by the well referenced lay out of the review amply supported by tables and diagrams I felt that the there was a lack of an element of surprise as there was a marked predictability of the results and as well as the approach to be adopted for the data analysis.I found the conceptual framework for the study clear, but a lack of a convincing stance in the literature review or the lack thereof to make this study necessary. References 1. Berger, P.G. & Ofek, E. (1995). Diversification's Effect On Firm Value. Journal Of Financial Economics, 37, 39-65. 2. Cohen, L. Manion, L. & Morrison, K.(2000). Research Methods In Education. 5 Th Edn. London: Routledge. 3. Dominowski, R, L, 1980. Research Methods. Prentice-Hall 4. Lewis Carroll , Alice in the Wonderland 5. Nasir LS. Acupuncture. Prim Care Clin Office Pract 2002; 29: 393– 405. 6. Fisher P, Ward A. Complementary medicine in Europe. BMJ 1994; 309: 107– 11. 7. Kaptchuk TJ. Acupuncture: theory, efficacy and practice. Ann Intern Med 2002; 136: 374– 83. 8. Rajput M. Attitudes about acupuncture and homeopathy among doctors in research positions: a survey. J Altern Complement Med 2005; 11: 229– 31. 9. lungenhausen M, Endres EG, Kukuk P, Schaub C, Maier C, Zenz M. Überschätzen Ärzte die Effekte der Akupunkturbehandlung? Der Schmerz 2005; 9 [ Online publication: 10.1007/s00482-005-0392-0]. 10. Ramey D, Buell PD. A true history of acupuncture. Focus Altern Complement Ther 2004; 9: 269– 273. 11. White A, Ernst E. A brief history of acupuncture. Rheumatol 2004; 43: 662– 63. 12. Frühauf H. Chinesische Medizin in der Krise: wissenschaftliche und politische Hintergründe der Entstehung der ‘‘TCM’’ (Teil II: 1990 bis heute). Chin Med 2005; 20: 71– 80. 13. Dimond EG. Acupuncture anesthesia. Western medicine and Chinese traditional medicine. JAMA 1971; 218: 1558– 63. 14. Ramey DW. Acupuncture points do not exist. Sci Rev Altern Med 2001; 5: 140– 5. 15. Heine H. Periphere Schmerzverarbeitung an Gelenken durch Akupunktur – Bedeutung des Parasympathikus. Dtsch Z Akup 2004; 47: 15– 23. 16. Vickers A, Goyal N, Harland R, Rees R. Do certain countries produce only positive results – a systematic review of controlled trials. Control Clin Trials 1998; 19: 159– 66. 17. Hussey R., Collis J., Business Research, 2nd Ed. 2003, Palgrave Macmillan 18. Kerlinger, F, N, 1970. Foundations Of Behavioural Research. New York: Holt, Rinehart And Winston. 19. Ter Riet G, Kleijnen J, Knipschild P. A meta-analysis of studies into the effect of acupuncture on addiction. Br J Gen Pract 1990; 40: 379– 82. 20. White AR, Ernst E. A systematic review of randomized controlled trials of acupuncture for neck pain. Rheumatology 1999; 38: 143– 7. 21. Mukaino Y, Park J, White A, Ernst E. Effectiveness of acupuncture for depression: a systematic review of randomised clinical trials. Acupunct Med 2005; 23: 70– 6. 22. Stener-Victorin E. The pain-relieving effect of electro-acupuncture and conventional medical analgesic methods during oocyte retrieval: a systematic review of randomized controlled trials. Hum Reprod 2005; 20: 339– 49. 23. Lee H, Ernst E. Acupuncture analgesia during surgery: a systematic review. Pain 2005; 114: 511– 7. 24. Ernst E. Clinical effectiveness of acupuncture: an overview of systematic reviews. In: White A, Ernst E, eds. Acupuncture: a Scientific Appraisal.Oxford : Butterworth Heineman, 1999; 107– 27. 25. Birch S, Hesselink JK, Jonkman FAM, Hekker TAM, Bos AAT. Clinical research on acupuncture: Part 1. What have reviews of the efficacy and safety of acupuncture told us so far? J Altern Complement Med 2004; 10: 468– 80. 26. Linde K, Ter Riet G, Hondras M, Melchart D, Willich SN. Characteristics and quality of systematic reviews of acupuncture, herbal medicines, and homeopathy. Forsch Komplementarmed Klass Naturheilkd 2003; 10: 88– 94. 27. Cherkin DC, Sherman KJ, Deyo RA, Shekelle PG. A review of the evidence for the effectiveness, safety, and cost of acupuncture, massage therapy, and spinal manipulation for back pain. Ann Intern Med 2003; 138: 898– 906. 28. Birch S. Clinical research on acupuncture: Part 2. Controlled clinical trials, an overview of their methods. J Altern Complement Med 2004; 10: 481– 98. 29. Tang JL, Zhan SY, Ernst E. Review of randomised controlled trials of traditional Chinese medicine. BMJ 1999; 319: 160– 1. 30. Zhang HW, Tong J, Tang JL. An RCT trial to evaluate the credibility of a sham acupuncture design. Focus Altern Complement Ther 2004; 9: ( Suppl 1): 61– 2. Read More