KMCRIC

Prof. Chris Zaslawski

University of Technology, Sydney (UTS), Australia

Title: Pattern Identification(Bian Zheng)-A viable concept for accupuncture research?

Chris Zaslawski is currently Director of the College of Traditional Chinese Medicine, a teaching and research unit in the University of Technology, Sydney (Australia). He has been practising acupuncture and herbal medicine for nearly 30 years and is an active researcher in the area. Chris has also been English editor for three acupuncture texts, which were published in conjunction with Chinese medicine colleagues from the Guangzhou University of Traditional Medicine, China. Chris has published 25 papers of which 19 were in peer reviewed journals as well as nine report and book reviews. He is currently Deputy Editor for the Australian Journal of Acupuncture and Chinese Medicine, and is also on the International Editorial Board for two other journals, Acupuncture Research, published in Beijing and the Journal of Acupuncture and Tuina Science, published in Germany.

Chris has been a temporary consultant for the World Health Organisation on four occasions and contributed to the development of two WHO documents concerning acupuncture clinical research and traditional medicine education. He also reviewed the WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region which was published in 2007. Recently he was head of a delegation from Standards Australia to Beijing to establish a technical committee for the international standards relating to Asian medicine.

Chris’ research has involved experimental pain and acupuncture, reliability of Chinese medicine diagnosis including tongue diagnosis and the influence of research ethics on the design of acupuncture and herbal medicine studies. He has been involved in several acupuncture clinical studies involving the efficacy of acupuncture on male sub-fertility, hepatitis C and stress. He is currently developing a clinical trial regarding the effect of acupuncture on lateral elbow pain and a Delphi study on a rating scale for assessing the adequacy of acupuncture in clinical trials.

http://cfsites1.uts.edu.au/science/staff/details.cfm?StaffId=540

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Q1.

Hello. Professor Christopher Zaslawski.

Good Afternoon.

Q2.

Good Afternoon. I am Taehyung Lee from AMSRC & KMCRIC at Kyung Hee University. Today, I’ll give you some questions based on your presentation today.

Sure.

Q3.

The first one is, the clinical studies, or acupuncture studies using pattern identification have made considerable improvement in standardization of Traditional Medicine. Please tell us the implications of your presentation today.

I think pattern identification is a very important component of Traditional East Asian Medicine. It’s necessary to improve the reliability. And I think the only way we can do that is through standardizing the patterns. At this point in time, there have been several groups that have tried to put forward particular standards, but it’s quite difficult to do so because we’re talking about something that is very subjective that in a sense can’t be measured. So, it can be quite difficult.

The area that has been shown to have some type of potential is to identify some bio-map as for particular patterns that might be a way of surrogate measure of a particular pattern. 

Q4.

Thank you. Here’s goes the second question. So, you have used pattern identification in your clinical researches and adjusting Traditional East Asian Medicine system to clinical studies seems quite challenging, could you tell us difficulty doing this attempt?

Yeah, I was involved in a study that, a very small study, pilot study to look at whether patterns can be used as an outcome measure. So, we actually measured the expression of a pattern or patterns of a particular individual, we gave them an intervention and then we assess those patterns again. In some cases we found that the patterns did change, but in some cases they may have stayed the same. So, I think it’s quite, it was quite an interesting way to think about patterns because if they are used as a diagnostic type of measure, maybe they can be used as an outcome approach as well.

Q5.

So, did you have any difficulty in reflecting real world clinical situation, when you apply pattern identification in your clinical studies? Could pattern identification further effect real world situation?

That’s a good question. I think it’s difficult. While we have tried to improve the validity of a model, model validity, of using oriental medicine, Traditional East Asian Medicine in a research study, it still isn’t exactly the same as what happens in clinic, there still is some gap. So, while it is an improvement by introducing these particular types of design approaches, which align more with the TEAM approach or Traditional East Asian Medicine approach, there still is something that’s not exactly like real life. And I don’t know whether we’ll be ever able to manage that gap.

So, definitely we’re decreasing the gap, but whether we can actually, clinical trials can mimic real life, I think that would be very difficult.

Q6.

And because today you mentioned about Traditional Chinese Medicine, in Korea there is some opinion that TCM is evolved in 1950’s, so, Chinese Medicine before 20th century could be quite different with Chinese medicine which is done today, these days, so...

That’s correct. We find that the type of education that is involved, primarily in China, what we call the TCM model, is a development from previous historical approaches. That’s not to say it’s not correct, because I think it is a movement towards, it’s a progression towards modernization, but we just have be aware of that.

You are right that historically there were many diverse approaches to doing diagnosis. But in the 1930s to 50s, they did systematize it to a certain extent. So, I think we have to keep on refining that model. And that’s part of the process that’s happening now, trying to fit biomarkers, looking at the reliability, improving the reliability, I think that’s part of a progression towards more standardized approach, and modernization of Traditional East Asian Medicines.

Q7.

Okay, because there is another question, there would be some differences between standardized pattern identification today and traditional pattern identification which is done before 20th century. So, with this gap, how could we deal with this problem, if there would be clinical significance in traditional pattern identification in ancient times? How could we modify this point?

I don’t know whether we could ever go back to the mindset that existed at that particular time. As individuals in the modern era, we automatically come with a lot of modern thinking, modern ways we think about things. I don’t know whether we can ever go back to that particular mode of thinking. Because we’re influenced too strongly by technology, by modern living, by different sciences moved on and shown us things. So, it’s very difficult to step back into that old framework. People do try to attempt to do that, but I think we have to see it as a progression forward. I hope it’s a good progression forward, but at this stage in point, we don’t know. But, I don’t think we’ve got much choice, we have to move forward. We have to modernize and to a certain extent we have to standardize.

Q8.

And most key concept is about the real world, is that right?

That is important. We’ve got to try and ensure that the type of research we use are lined itself with as close as possible with what happens in the clinic. But also has some scientific bases so that we can argue that, you know, that the research does reflect real life. But, it is very difficult. They’re complex therapies, both herbal medicine and acupuncture and they’re difficult to evaluate because they are complex. They are not like a pill you can take very quickly and you can blind… it’s not as easy as that.

Q9.

Thank you very much.

Okay.

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