Science Based Evidence-Based
Dr.Remya Krishnan MD ( Ayu) PhD,
Faculty, Applied Pharmacology –
• Do you often evaluate the patient outcome in your clinical
• Do you attempt to revise your medical decision based on
“Science based evidence” ?
• Have you ever thought that the results which you make in
the patient are many times serendipity results ?
• Do you feel depressed if your patients report worsening of
status for some reasons unknown to you ?
• Do you often wish for a standardised right approach to
make your practice” scientific “ ?
But why do this happen ?!
• This happens because of the wide gaps
between “what we know “ and “what we
• This could happen also because we do not
know exactly what we know and what we do
not know .
• We also do not know what we must know .
Why we are like that ?
• Too much of misled training in our Science .
• Too much of wrong information to handle
• Too much of preference to “cookbook
approach” in practice
• Too much of business interests vested in our
You provide poor quality of healthcare
If you belong to this category :
a. Feel aversion towards samhithas ?
b. Feel restless or irritable if you happen to be in the midst
of a case disussion in Ayurvedic perspective ?
c. Work more like an officer and less like a doctor ?
Would you like to fix the gap ?
• The gap between “what we know” and
“what we practice “.
• Interactive training workshops on SBEBP
( Science Based Evidence Based Practice )
will help for that.
• Interactive workshops are stronger than
“one way lectures “
The practice of doing the
RIGHT TREATMENT in the
RIGHT TIME in the RIGHT
SITUATION in RIGHT
• Science Based Evidence Based Practice – Best
Science Based Evidence is translated into
• Treatment- Standardised guidelines to
monitor and evaluate the quality and
appropriateness of your treatment protocols.
• Research- Standardised methodology to
develop, uncover or add new science based
evidences into practice
Possible suspicions on SBEBP
• Is it a new term for Ayurveda ?
• We know that Ayurveda is scientific , then
why coin the term Science Based Evidence
• As we think that Patient care is based on
diverse logic of doctors , how to
• What is “scientific “ without RCT or meta
analysis etc ?
Benefits of the training
At the end of training sessions,
You will be able to :
A. Define and describe what is accurate
scientific practice of Ayurveda – SBEBA.
B. Identify the reasons for promoting the
practice of SBEBA.
C.Know and appraise the best “Science
based evidence” to integrate in your clinical
Best evidence in Ayurveda is NOT
The results published
in academic journals
or systemic reviews
published in data
Not RCT reviews.
Not case control
Not the study reports
of expert committees.
Best evidence in Ayurveda is NOT
Not gathered from
Not every stuff which
displays statistical data .
Not cook book practice
Not cost mounting
(When best evidence is
applied, treatment cost falls
, not rise.)
• That which pertinently guides you from the
Basic Science to manage the particular
clinical situation in your particular patient.
• Basic Science led evidence is the best
• Clinical decisions should be ideally led by
inbuilt science led evidence.
Is to be applied in :
a. Confirmation of Diagnosis
b. Estimation of prognosis.
c.Formulation of scientifically pertinent
treatment protocol .
Why do I need “Best evidence “?
• For scientific Rogi pareeksha (examination of patient)
• For scientific Roga pareeksha ( examination of disease )
• For scientific estimation of prognosis of clinical situation
with respect to the patient.
• To select the pertinent scientific Treatment Principle for the
• To individualise the Treatment Principle.
• To produce the “intended effects “ in the patient.
• To evaluate the scientific response of treatment .
• To scientifically ensure that we are doing “right”
and not that which is “probably right”.
What is Science based Evidence-
Based Ayurveda ?
Science Based Evidence Based Medicine is the
conscientious, explicit, andjudicious
integration of Ayurvedic science based
evidence in making decisions aboutthe care of
individual patients in their own unique
What is “SBEBA” NOT?
• SBEBA is not EBM
• “Cookbook medicine”
• Risk-benefit analysis
• Randomized Control
WRONG WAYS OF DECISION
How do I make decisions?
• Dogma: Superstitious “belief “in a medicinal
• Tradition: “We’ve always done it that way”
• Convention: “Everyone does it this way”
• Replication : Professor does this way .
How do I decide what to do?
• Depend on SBEBA
• Develop appraisal skill .
• Decide the pertinent
STAGES OF EVIDENCE TRANSMISSION
Evidence based observation
Evidence based assumption
Evidence based analysis
Evidence based reasoning
Evidence based confirmation
Science based evidence based Observation
Science based evidence based Assumption
Science based evidence based Analysis
Science based evidence based Reasoning
Science based evidence based Confirmation
OAARC ► BEST evidence
What are the intended effects ?
• Cure of the disease depending on the
prognostic standards – all subjective as well
as objective parameters .
• Attainment of health – Clear manifestation of
Arogya lakshanas .
• When we treat for the “intended effects”,
there is 0 risk for the patient .
A novel technique for standardised health care in Ayurveda
named “Evidence Triad Approach” is developed by Dr.
Remya Krishnan in her reformed health care practice
system in Ayurveda called Science Based Evidence Based
Evidence Triad Approach
Barriers of SBEBP
• Lack of support from Government and policy
makers of Ayurveda.
• Lack of knowledge and unfamiliarity with the
guidelines in Basic science and methodologies of
appraisal by the policy making superior authorities
• Peer pressure to continue the practices that are
steeped ina tradition – “We have always done this
way and do not want to change “.
• Medical Faculties unenthusiastic in modifying the
way they practice and teach .
Excellent optimised Practice of Medicine
requires practice of science
If you are interested to know,
learn and practice the utmost
scientific SBEBA (Science Based
Evidence Based Ayurveda)
Let us initiate
Let us initiate the best scientific trend in
Ayurvedic practice – Science Based Evidence
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