Whole Systems Research - Themes

Themes

Understanding of WSR is best acquired by reading key articles (see below), but here is a simplified synopsis of several themes that have emerged:

1. Focus should be on treatment of individual patients (clinical medicine) rather than on treatment of groups of patients (administrative medicine).
2. There should be consideration of inter-relationships among patients and important others in their lives, especially CAM practitioners and conventional physicians.
3. Emphasis should be on matching the patient to the therapy, implying individualistic treatment approaches, rather than “first-line�?, “second-line�? … sequentialization of treatments that ignore important whole system aspects of the patient.
4. There should be willingness to consider a wide variety of outcome dimensions, including physiological, psychological, spiritual, social, and personal preference/utility, and to recognize that various dimensions will hold different salience for different patients.
5. Clinical research should inform clinical practice, with basic science studies generally following rather than preceding them.
6. Medical whole systems are complex, meaning that there are barriers to conventional analysis and synthesis (and not meaning just that they are “complicated�?), and this is particularly important in CAM.
7. Recognize that the dynamic nature of biomedical systems must be properly included in research design.
8. Qualitative analysis is generally required in order to map out complex and often unanticipated relationships among a system’s components.
9. Question conventional notions of the role of “placebo�? or “sham treatment�? in clinical research, especially for CAM therapies.
10. Value exploratory studies on an equal footing with confirmatory trials.

In general, WSR is an eclectic set of ideas that represents an attempt to make clinical research more relevant to the actual practice of both conventional medicine and CAM. As such, WSR draws on a variety of experiences from other areas of research, while also developing novel study designs.