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Small projects
Most practitioners who use ARRC do so not as a resource for their own research, but to summarise or investigate other people's. Hence they can arm themselves with information for talks and meetings (especially when dealing with conventional medical people/bodies) aiming at gaining referrals, employment, funding and generally promoting themselves and their practices.
One way of taking this a stage further is to do some research of your own. Here are some examples of the possibilities.
- Analyse all your old records for demographic details, medical conditions, numbers of treatments, outcomes of treatments etc. Impress your audience with your conscientious record-keeping , rigorous analysis, variety of patients and wonderful results. That this can pay dividends is not in doubt (there was an example given by a practitioner at this year's Research Symposium), but take care: if you put your practice forward in this way you must ensure that your methods can withstand critical scrutiny.
- Many of us would probably own up to our old files being as leaky as sieves, especially if it comes to assessing treatment outcomes. Also, the prospect of spending hours of your time poring over months and years of old records is not usually one to quicken the pulse, except in exasperation. Why not start afresh then? Ensure that you collect all the information you will need by having a checklist or form to fill in, and do this with all your new patients over the next year/two years/five years/evermore. But how exactly would you go about assessing the outcomes of your treatments? It's not just a case of scoring 'patient got better: yes or no'. Designing your own measure is possible, but again, you should get advice from an expert if you are intending to publicise the results in any way.
- In respect of treatment outcomes most people use pre-existing (and externally validated) measures like MYMOP (http://www.pms.ac.uk/mymop/). For several years a group of acupuncturists in the South West of England used MYMOP with all new patients. They had backup in terms of central administration and data collation/analysis, group meetings and technical assistance if needed. It may be possible to duplicate this scheme, and indeed individuals elsewhere have used MYMOP on their own, but I would encourage you to look closely at what support you could get in your own district: the formation of local research support groups may be a vital factor in the success of ventures like this.
- Many of you will not see any need to prove that acupuncture works, whether by your own or anyone else's research. What is of far more interest perhaps is to develop your own skills so as to become better practitioners, or to brighten up your business, work more efficiently, attract more patients. In this you would have the support of the experts: at the practitioner level research should aim to improve things rather than prove them. There are various possible aspects to this, and a range of techniques to draw upon, such as case study analysis, reflective practice and audit. Whether or not these are defined as 'real research' is rather irrelevant here: they can or can not be depending how you use them. Also, use of outcomes measures such as MYMOP can be as much (or more) focussed on improving practice as on showing that it works.
If you wish to focus on a particular type of condition rather than general practice then it may be that a specific measure is more appropriate. It is always a good idea to read about what other researchers have used in recent studies in the same area. Get in touch and discuss it with them (the email address of the lead author is often given in the article or even with the abstract). There is a comprehensive guide to outcomes measures in two books by Bowling (see references below).
Some Ideas for Topics
Ask yourself:
- What are you passionate about with regard to your practice?
- Are you curious about any aspects of it?
Research is simply taking those curiosities and working systematically with them to try to shed some new light.
You might be interested in:
- How many treatments you did in the last year, how many new patients, the average number of treatments given, how many patients only came for 1 or 2 treatments etc.
- What are the 10 or 20 most common medical conditions you've treated, what percentage of patients fall into different medical condition categories.
- What are the most common acupuncture patterns you've diagnosed and treated, what proportion of patients fall into these different categories.
- What proportion of your patients have reported that they've improved/are completely better/no change/worse/better in some things but not others/symptoms no better but they're better able to cope with them/changed their medication, etc.
- As above, but compared for different medical conditions.
- As above but for different acupuncture patterns.
- What characteristics of patients seem to be associated with better treatment outcomes.
- Ditto for practitioners.
- What are your experiences of deqi and how important do you think it is.
- What sort of needle manipulation and retention do you use - and how important does that seem to be.
- What point location procedures do you use and how accurate are they.
- What tongue and pulse characteristics do you commonly identify, what emphasis do you put on them, how reliable are they.
- What 'miraculous', unusual, unexpected experiences have you had - and how to share that information with each other
- How often are you late for patients & by how much; how often are they late for you
- What are the expectations of your patients - and can you meet them?
When you have your ideas for a possible subject to research, you can then decide on a suitable research methodology for exploring the question.
References
Lao L, Sherman K & Bovey M. "The role of acupuncture schools and individual practitioners in acupuncture research". Clinical Acupuncture and Oriental Medicine (2002); 3(1): 32-38
Sherman K. "A research agenda for the acupuncture community". Acupuncture and Oriental Medicine (2003); 4(4): 114-120
Bowling A. "Measuring Health: A Review of Quality of Life Measurement Scales", 3rd Edition. Open University Press / McGraw Hill, 2004
Bowling A. "Measuring disease : a review of disease-specific quality of life measurement scales", 2nd Edition. Open University Press, 2001
Measure Yourself Medical Outcome Profile http://www.pms.ac.uk/mymop/
White A. "Conducting and reporting case series and audits - author guidelines for acupuncture in medicine". 2005; 23(4):181-187 [Free access at http://www.acupunctureinmedicine.org.uk/]
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