Journal of Research in Ayurvedic Sciences

EDITORIAL
Year
: 2022  |  Volume : 6  |  Issue : 3  |  Page : 93--95

Pragmatic research approach - An ancillary requisite for amplifying the generalizability and reliability of Ayurveda clinical research


Rabinarayan Acharya 
 Editor-in-Chief, Journal of Research in Ayurvedic Sciences, Central Council for Research in Ayurvedic Sciences (CCRAS), Ministry of Ayush, Government of India, New Delhi, India

Correspondence Address:
Prof. Rabinarayan Acharya
Central Council for Research in Ayurvedic Sciences (CCRAS), Ministry of Ayush, Government of India, Janakpuri, New Delhi
India




How to cite this article:
Acharya R. Pragmatic research approach - An ancillary requisite for amplifying the generalizability and reliability of Ayurveda clinical research.J Res Ayurvedic Sci 2022;6:93-95


How to cite this URL:
Acharya R. Pragmatic research approach - An ancillary requisite for amplifying the generalizability and reliability of Ayurveda clinical research. J Res Ayurvedic Sci [serial online] 2022 [cited 2022 Dec 7 ];6:93-95
Available from: http://www.jrasccras.com/text.asp?2022/6/3/93/360158


Full Text



[INLINE:1]

Pragmatic research approaches (PRA) is an innovative and dynamic way that involves research focusing on what will work best in finding the solution for given research question.[1]In simple words, the PRA is centered on identifying a problem, viewing it with the broadest view, and finding the best solution that should be applicable in a real-world situation.[2] The emphasis in science on explanatory models and efficacy designs rather than more PRA is likely one of the causes of the slower and uncertain translation of findings into practice.[3] For example, a combination of several medicines is used in clinical practice, while ideally, a single medication is utilized in exploratory research. The drug-drug, food-drug, and drug-lifestyle interactions along with environmental, dietary, and lifestyle-related changes are responsible for limiting the research generalizability (GE) and reliability (RE).

The history and literature of Ayurveda is evidence presenting its origin and development based on the practical experience, keen analysis of observation, correlational interpretations; and deductive reasoning of the observation of nature, season, human body, lifestyle and the community. In other words, the therapeutic principles of Ayurveda are the results of community practice, and thus Ayurveda science should be viewed in terms of PRA. PRA can cater to address solutions for inferring the multifactorial and multi-dimensional approach of Ayurveda. Moreover, GE can be amplified by controlling the diet and lifestyle variables. Studies such as cost effectiveness of chlorofluorocarbon-free beclomethasone dipropionate in the treatment of chronic asthma: a cost model based on a 1-year pragmatic, randomised clinical study,[4] and A pragmatic randomised controlled clinical study to evaluate the use of silicone dressings for the treatment of skin tears,[5] are two examples which can help in understanding the PRA.

 Scope of PRA in amplifying GE and RE



The GE of the results depends on researcher’s ability to separate the “relevant” from the “irrelevant” and then the judgment about the relevance.[6] Most of Ayurveda research include individual assessments such as Prakriti (individual body constitutes), Agni (~digestive capacity), Koshtha (~metabolism capacity), and Dhatu Sarata (~predominant constitution body tissue). These parameters are related to the choice of interventions, the ADME of the drug (absorption, distribution, metabolism, and elimination), and the physiological response to treatment. These are “relevant” factors. Planning of research considering these factors and the scientific interpretation of the relevance will increase the GE. Based on the administration of multi-interventions, individual-based assessments, diet, and lifestyle-related measures, an overview of the Ayurveda clinical research indicates subconsciously adopting mixed methods approach of qualitative research. Still, there are certain limitations for adopting PRA. The insufficient consideration and understanding of PRA while planning, performing, and generalizing Ayurveda research is a significant hindrance. Another limitation is the bridging gaps between PRA and fundamental, experimental, exploratory, and applied research in Ayurveda.

 PRA, and population modeling



Population modeling is a strategy for determining and describing correlations between a subject’s physiological features and the observed drug exposure or reaction.[7] The Ayurveda principles, such as drug and its dose determination based on individual Prakrit, Agni, Koshtha, and extent of vitiated Dosha, indicate population modeling. Population modeling can play a vital role in drug development to predict individualized dose-exposure-response relationships. Such a predictive model can simulate the clinical trial design, decide on initial dosage regimens, and identify individual regimens. Indeed, such research will have a rigorous methodology, high impact, GE, and RE.

With changes in lifestyle and dietary regimens, the cycle of suffering from illness, medication, and new drug discoveries to deal with emerging diseases will be unending. The ancient seers of Ayurveda quoted that if Pathya (ideal dietary regimen and lifestyle) is followed, then there will be no need for medication, and if Pathya is not followed, then the medication will not have much effect. Because of this, Pathya is included in Ayurveda research along with other interventions. Due to the utilization of multi-intervention methodology, the exploratory research approach may highlight limitations/deficiencies in Ayurveda research rather than revealing the beneficial contributions. Therefore, the results obtained in those researches need to be viewed with PRA. Understanding, utilization and implementation a pragmatic philosophy and PRA in designing research methodology for qualitative, quantitative, pure Ayurveda and integrated research would be a better proposition to amplify the GE and RE of Ayurveda clinical research and explore the significant role of Ayurveda as a community medicine.

Financial support and sponsorship

Not applicable.

Conflicts of interest

There are no conflicts of interest.

References

1Anonymous. What is pragmatism? Available from: https://www.nottingham.ac.uk/helmopen/rlos/research-evidence-based-practice/designing-research/types-of-study/understanding-pragmatic-research/section03.html. [Last accessed on 23 Sep 2022] at 12.27 PM.
2Duram L Pragmatic study. In Salkind NJ, ed. Encyclopedia of Research Design. Thousand Oaks, CA: SAGE Publications, Inc.; 2010. p. 1073-5. https://dx.doi.org/10.4135/9781412961288.n326
3Glasgow RE What does it mean to be pragmatic? Pragmatic methods, measures, and models to facilitate research translation. Health Educ Behav 2013;40:257-65.
4Price D, Haughney J, Duerden M, Nicholls C, Moseley C The cost effectiveness of chlorofluorocarbon-free beclomethasone dipropionate in the treatment of chronic asthma: a cost model based on a 1-year pragmatic, randomised clinical study. Pharmacoeconomics 2002;20:653-64.
5LeBlanc K, Woo K A pragmatic randomised controlled clinical study to evaluate the use of silicone dressings for the treatment of skin tears. Int Wound J 2022;19:125-34.
6Kukull WA, Ganguli M Generalizability: the trees, the forest, and the low-hanging fruit. Neurology 2012;78:1886-91.
7Mould DR, Upton RN Basic concepts in population modeling, simulation, and model-based drug development. CPT Pharmacometrics Syst Pharmacol 2012;1:e6.