Research Methods

Question 1

What is the definition of “Research”?

Answer 1

The systematic study of a subject in order to establish facts and reach new conclusions.

Question 2

What is the definition of “Isolated Research”?

Answer 2

Isolated Research looks only at an isolated part of the whole picture and thereby draws false conclusions from it.

Question 3

What is the definition of “Science”?

Answer 3

the systematic study of the structure and behaviour of the physical and natural world through observation and experiment.

Question 4

Medical approach to disease:

Answer 4

• The symptom is the disease and cause at the same time (high blood pressure, eczema, arthritis). If no measurable or observed symptoms are found, the patient is pronounced ‘healthy’, even though they feel sick.
• Little attempt is made to establish the real cause - poor diet, stress, drug adverse effects, environment, poor function of an organ, etc.
• When symptoms have become chronic over decades, and measurable tissue changes have taken place, a patient can be declared as “sick”, often too late to be successfully treated❗️

Question 5

Medical approach to disease- Examples:

Answer 5

• Type II Diabetes ➡️ (Metformin) to increase insulin sensitivity
• Stomach ulcer ➡️ (Proton Pump Inhibitors) to inhibit stomach acid production.
• High cholesterol ➡️ (Statins) to lower cholesterol

Instead of establishing connections such as: Diabetes – poor diet; stomach ulcer - chronic anger; dizziness – drug adverse effect; medical researchers take the symptom (the “output”) as the disease

Not addressing the cause means the disease continues. The patient gets worse over time and additionally must deal with adverse effects resulting from the ‘orthodox’ treatment given.

Question 6

What is “suppression”?

Answer 6

• Symptoms in medicine are considered as causes

* Treatment of symptoms as causes is suppression and it makes a symptom “disappear” without treating the true cause.

Question 7

Examples of suppression:

Answer 7

– Fever: anti-inflammatories: weaken the immune system.
– Pain: painkillers incl. opiates: cause tolerance, i.e. patient requires more and more drugs for the same effect.
– Allergy: anti-histamines to suppress the body’s response.

Suppression always drives the disease deeper into the body❗️

Question 8

An example of “Isolated Research”: Alzheimer’s disease:

Answer 8

• Medicine believes that Alzheimer’s is ‘caused’ by the accumulation of plaques in the brain made of a protein called amyloid-beta (Aβ or Abeta). Alzheimer’s is considered a single disease, but no explanation is given for the presence of amyloid-beta protein.
• Amyloid is a potent pathogen fighter and part of a protective response of the brain to invading pathogens and suboptimal levels of nutrients.
• Getting rid of amyloid-beta is, therefore, not a successful treatment for Alzheimer’s and can be damaging. Natural medicine instead looks at why the beta amyloid has formed.

Question 9

Medical Research:

Answer 9

• Not searching for the true causes of disease (lifestyle, diet, environment, organ disfunction, stress, etc.).
• Isolates specific aspects of the problem without reference to the whole picture.
• Is almost exclusively funded to fulfill a purpose – sets out to ‘prove’ what the industry wants to sell.
• In general looks at isolated situations or symptoms (in vitro research, research on tissues, controlled clinical trials).
• Is subject to distortion due to the focus of removing the symptom/s, rather than finding and treating the cause.
• Is, therefore, very naïve – remove the symptom (e.g. pain) and you have cured the disease.

Question 10

Μedical Research on animals:

Answer 10

Laboratory animals are under stress; results are, therefore, false:

– Stress hormones increase; metabolism changes; functions of cells and organs are thereby distorted.
– Animal studies are inhumane and brutal. Animals have feelings, too.
– Animal physiology is different from human.

Question 11

Competing Paradigms:

Answer 11

• Louis Pasteur (French biologist): developed ‘Germ Theory’: Disease comes from outside of the body, bacteria, viruses, fungi are responsible for diseases.
• Antoine Béchamp (French scientist, rival of Pasteur) developed ‘Terrain Theory’: Disease occurs from within the body (negative changes in terrain responsible for disease).
• Bacteria / viruses are the ‘after-effects’ not the cause of disease. Diseases are the result of an acidic, low oxygenated terrain where the diseased tissue supports the growth of micro-organisms which can develop into different forms (pleomorphism = “many forms”).

Question 12

Medical Research: the ‘Gold Standard’ Clinical Trial (RCT):

Answer 12

RCT = Randomised (double-blinded) placebo- Controlled Trial:

• Research that has limitations, conducted on humans, involving a specific intervention (often a drug), to be tested against a placebo.
• Has to ensure that each participant has an identical pathology and no other complicating factors.
• Often conducted in a ‘clinical’environment i.e. a space where nothing ‘normal’ happens.
• Is subject to strict ‘scientific’ rules, including that neither the patients nor the physicians
administering the trial know who is getting the real drug, and who is getting the placebo (double-blinding).

Question 13

Medical Resęarch: Weaknesses of RCTs:

Answer 13

• Real people don’t come as ‘standard’ – they have different lifestyles, diets, constitutions, and medical preferences.
• RCTs are not concerned with causes, just whether the drug works to suppress the symptom or not.
• Clinical situations do not reflect real life: abnormal environments will create abnormal responses.
• Drugs tested are single molecules and no attempt is made to test alongside co-medications which the patient may be taking.
• Data can easily be ‘cherry-picked’ – results that support the hypothesis are adopted; all other results discarded.

Question 14

Research in Food/Pharma Industry: Research Funding:

Answer 14

Who funds the research, as this generally dictates the results of the research:

• Drug / food research funded by the pharma and food industry is an integral part of licensing and selling products.
• Food research funded by the food industry is an integral part of getting food products on the shelves and promoting them to the public.
• ‘Natural Medicine’ research is often funded by universities and conducted by ‘scientists’ who do not know anything about Natural Medicine; the purpose is often to debase and disprove it.
• Medical research is uniquely designed for the testing of isolated pharmaceutical drugs.

• The pharmaceutical and food industries finance most of the clinical trials into their own products.
• They finance / influence universities and the continuing education of medical doctors and dieticians, build new hospitals and wards.
• Clinical trials are often conducted on small groups of unrepresentative subjects.
• Negative data is routinely withheld, and researchers fired if their findings are negative.
• Supposedly independent academic papers may be commissioned and even ghost-written
by pharmaceutical companies or their contractors, without disclosure.

Question 15

Biomedical Research 🆚 Natural Medicine Research (assumptions):

Answer 15

• Aims to demonstrate the effectiveness of a single treatment intervention e.g. a drug 🆚 Aims to demonstrate the effectiveness of a treatment strategy in any particular case.
• Is funded by vested interests for profit: major expense for pharmaceutical companies 🆚 Natural products and treatments cannot be patented, therefore, few if any profits to be made.
• Cuts out complexity and variability as far as possible: tests simplistic hypotheses 🆚 Embraces complexity and variability as part of life, and, therefore, patient experience.
• Only useful for what can be precisely measured 🆚 Precise measurements not important in the context of overall outcome.
• Assumes that patients (people) are all the same and will respond similarly to drugs / treatments 🆚 Assumes that patients are different and works to develop greater individualisation in treatments.

Question 16

The Conventional Hierarchy of Evidence:

Answer 16

• puts ‘scientific research’ at the top of the pyramid:

Question 17

The INVERTED pyramid:

Answer 17

Question 18

Natural Medicine Research:

Answer 18

• Doesn’t equate the symptom with the disease
• Asks why is the symptom there, what led up to it, what is the underlying cause?
• Considers that each person is an individual and, therefore, needs an individual approach.
• Examples of natural medicine are: Herbal Medicine, Nutrition, Homeopathy, Acupuncture, Naturopathy, Bach Flowers, etc.
• Natural therapists recognise the fact that diet and treatment approaches differ from individual to individual (not everybody gets the same treatment for headaches, asthma, diarrhoea, etc.)
• Qualitative research rather than Quantitative research.
• Case studies and research based on the experience of practitioners.
• Patient questionnaires such as MYMOP (see later) – ‘Measure Your Own Medical Outcome Profile’.
• Clinical audits conducted within practices to identify strengths and weaknesses.
• Outcome studies to test whether patient needs are being met.

Question 19

Quantitative 🆚 Qualitative:

Answer 19

• Quantitative research: refers to any research based on something that can be accurately and precisely measured, such as blood pressure, blood chemistry, etc. Most medical research is quantitative.

• Qualitative research: refers to any research based on something that is impossible to accurately
and precisely measure, such as the way people feel about something, or why they prefer one thing over another.
• Qualitative research has been identified as being more appropriate for complex investigations; i.e. it can align with real practice in the field of natural medicine, with social, as well as clinical applications, e.g. patient differences.

Question 20

Case Studies:

Answer 20

➡️ the notes that practitioners take in consultations with patients are a valuable source of information about what works in treatment:

• Sharing case studies is a valuable way for practitioners to compare notes and share their experience of what works in practical application.
• They deal with real people in all their complexity and can, therefore, be useful in identifying individual responses to treatment.
• They are plentiful and are readily accessed and anonymised to provide a rich source of data.

Question 21

MYMOP ➡️ Measure Your own Medical Outcome Profile:

Answer 21

• Patient fills in the questionnaire.
• Patient reports from visit to visit whether their symptoms are improving.
• Simple to fill in and analyse.
• Completed questionnaires are kept with the patient notes - fully confidential and secure.
• Questionnaires can then be used in a clinical audit to produce data about clinical effectiveness of the treatment.

Question 22

Clinical Audit:

Answer 22

1. To determine whether best practice is being carried out in clinic; covers health, safety and hygiene, and the provision of positive patient experience.
2. To draw out data regarding the effectiveness of treatments delivered in clinic. For example,
   extract the MYMOP forms of all patients receiving treatment for IBS and assess whether treatment outcomes are conclusively positive for that pathology.

Question 23

Outcomes Research (very similar to Clinical Audit):

Answer 23

Examples:
• Questionnaire to all patients in a clinic to get their impressions, levels of satisfaction, success of their treatment.
• May also assess convenience, geographical accessibility and patient preferences, as well as actual treatments.
• Enables service providers to ensure the best use of resources.
• Patients also have a stake in Outcomes Research because it facilitates their decision-making: what treatment is best for them, given they are ultimately paying for the service.

Question 24

Examples for Natural Medicine:

Answer 24

Examples of individuals and traditions that used observation and experience to come to their conclusions about health and healing:

– Ayurvedic Medicine
– Traditional Chinese Medicine
– Hippocratic Medicine
– Samuel Hahnemann (Founder of Homeopathy) – Ignatz von Peczely (Iridology)
– Edward Bach (Bach Flower Remedies)
– Bernard Jensen (Naturopathy and Iridology)

Question 25

Ayurveda (India):

Answer 25

➡️ Translates as “The Science of Life”.

There’re 3 basic types or energies in Ayurveda:
• Vata: tend to be thin, dry, cold, mentally agile, can be anxious.
• Pitta: medium-bodied, physically active, warm, can be bad-tempered.
• Kapha: strong build, can go to excess weight, solid, dependable, can get depressed.

Example - Diagnosis of Arthritis:
• Vata out of balance: joints will be cold, dry, cracking, require warming and lubricating - herbs with warming and moistening properties, soups and broths.
• Pitta out of balance: hot, inflamed, swollen, require cooling and calming – relaxing, sedative, anti-inflammatory herbs and foods.
• Kapha out of balance: cold, damp and stuck, require warming and moving – spicy herbs and
foods, detoxification, alternating hot and cold-water cures.

Question 26

Traditional Chinese Medicine (TCM):

Answer 26

• TCM includes Acupuncture, Chinese herbs, Nutrition, Massage, Movement (Tui Na and Qi Gong).
• based on observation of the natural world.
• Ying & Yang

Examples:
• A headache may be related to the Gallbladder. One can access the source of the tension by stimulating specific points along the gall bladder “meridian” – not necessarily on the head itself but along the whole meridian which runs through the length of the body

Question 27

Acupuncture:

Answer 27

➡️ developed via observations and clinical experiences on clients.

• 12 main channels, the meridians, have been discovered which move energy throughout the body to create balance and health.
• Meridians represent organs and functions of the body.

Acupuncture point ➡️ area on the skin where a meridian comes to the surface.
• Acupuncture points can be needled or pressed to balance energy.

Question 28

New Natural Therapies:

Answer 28

New natural therapies and diagnostic methods continue to be developed out of experience, observation, understanding of the body, and practice - here are a few examples:

• Tooth reflex chart (energetic relationships between teeth and organs).
• Lymphatic drainage (manual stimulation of lymph to detoxify).
• Foot Reflex Zones (relationship of foot zones to organs – diagnosis and treatment).
• Kinesiology (muscle testing to diagnose and treat).
• Thermography (heat distribution showing potential problems)

Question 29

Face Reading:

Answer 29

Question 30

Reflexology:

Answer 30

Question 31

Kinesiology:

Answer 31

Question 32

Thermography:

Answer 32

Question 33

Thermography:

Answer 33

Question 34

Quantitative Biomedical Research:

Answer 34

Seeks to provide statistics in answer to specific questions and includes:
• In Vitro (Latin = “in glass”) - done in laboratories.
• Animal trials
• Human clinical trials, including RCTs
• Systematic Review
• Literature Review
• Meta-Analyses
• Epidemiological studies
• Retrospective studies
• Prospective studies

Question 35

Other types of Biomedical Research:

Answer 35

• Systematic Review – A review of all available literature (i.e. clinical studies) on a drug, in order to analyse the evidence for or against its effectiveness: e.g. Review of all herbal medicines used for anxiety.
• Literature Review – like above, but may take in other kinds of literature as evidence, such as theory or pharmacology. Broader scope than the Systematic Review: e.g. Review of the pharmacology and biological activity of Devil’s Claw.
• Meta-analysis – statistical procedure for combining data from multiple studies. The reality is that it often distorts evidence by including research that is flawed.
• Epidemiological – the ‘how and why’ of disease in a particular population: e.g.“Why does Scotland have high rates of Multiple Sclerosis?”(But often does not look at the whole picture).
• Retrospective study – a historical investigation of a particular issue or factor in health; usually involves comparison with a non-affected group.
• Prospective study – follows a group of subjects over a period of time to find out what happens to them. Relies on the continuing availability and willingness of research participants.
• Descriptive Study – describes the current situation, e.g. “How many cancer patients have also tried homeopathic remedies?”

Question 36

Methods in Qualitative Research:

Answer 36

Interview:
• People’s opinions, attitudes, beliefs, behaviour.
• Good for complex or sensitive issues.
• Disadvantage: time consuming if many subjects are involved.

Questionnaires:
• Gathering straightforward information from a large number of people.
• Disadvantage: cannot handle individualised information

Observation:
• Anthropology, ethnographic, study of cultures, narrative, e.g. Narrative Medicine, currently being explored by the World Health Organisation.

Emic v. Etic perspectives:
• Used in Anthropology: Emic approach looks into the thoughts and beliefs of local people “from the inside”; Etic approach studies them ‘scientifically’ “from the outside”. Although seemingly opposite, these approaches are frequently combined for best results.