More on Complexity

Sorry for the long gap without posting! I guess I'll blame it on the holidays and getting back to work, though that certainly can't account for such a long window. I'm reworking my website, and will be giving a presentationm though that kind of activity is always going on.
But I wanted to continue a bit with the article by Andrew Ahn, discussed here. I will highlight the pertinent part, because it reflects my thinking about Heart Rate Variability and what it can tell us about the overall health of the patient. He even says that it may reflect a person's "adaptability" which is the conclusion I've come to over the years. Though effective acupuncture treatment most likely is a function of the correct acupoints, the overall state of the subjects system is probably an important factor too. Then the question becomes, how best to nurture that adaptability that will allow for self healing.

Because heart rate is dynamically balanced through many elements, including the autonomic nervous system, respiration, hormones, and other physiologic systems, the heart theoretically should be responsive to, and exhibit increased complexity across, multiple time scales in concert with fluctuations in these elements. The temporal changes of a variable therefore may contain hidden information that is useful for describing the overall system. This capacity to capture the global state of a system or an individual suggests these complexity-based measures may act as surrogates for concepts that were traditionally difficult to measure but considered important for CAM research (e.g., “health” and “adaptability”). Does a homeopathy prescription or massage treatment affect complexity measures of HRV?...
means to understand CAM better, CAM therapies themselves can be thought of as exemplars for how complexity theory can be applied to clinical medicine. Historically, conventional medicine has evolved and developed under a reductionist Cartesian framework. Complex problems such as chronic diseases were typically divided into smaller, simpler, and thus tractable, units. This approach has affected the way practitioners diagnose, treat, and prevent illnesses. Importantly, it has also shaped the practitioner's worldview and heuristic approach to medicine. To incorporate a distinct philosophical framework such as complexity theory to medicine may therefore challenge pervasive entrenched beliefs and perspectives....
In this regard, CAM is uniquely poised to provide the needed perspective and experience. Many CAM therapies are rooted in a worldview most consistent with complexity and systems theory. The human body is viewed holistically and considered dynamic and complex; the mind, body, and spirit are inextricably linked; and the interactions among the organs and individuals are as important as the components themselves... fractal patterns within the body (e.g., reflexology, auricular acupuncture), and the use of minimal interventions to affect the larger system (e.g., acupuncture and homeopathy).

I didn't realize that the traditional medical model was a "reductionist Cartesian model." I've always thought that the limiting perpective of traditional medicine, was that it was mainly developed after the industrial revolution, and so the body is seen as a machine rather than a living, adapting, organism.

More on my practice here.

Complexity Science and CAM: More Mental Models

I will divide this topic into two posts since this article touches on more than one meaty subjects.
Applying Principles from Complex Systems to Studying the Efficacy of CAM Therapies
This article was published over a year ago, but I missed it. The lead author, Andrew Ahn, is a fellow I had met at the SAR (Society for Acupuncture Research) meeting in North Carolina in 2010, discussed briefly here. The article is available in its entirety. I will point out a few points that are of interest to me in particular. My research has involved HRV (Heart Rate Variability) analysis in conjunction with acupuncture. It makes sense to do this if you recognize that acupuncture cannot be explained in a linear, mechanistic fashion. I discussed some of these dilemmas here and here. So Dr. Ahn grapples with ways to study these nonlinear phenomena in this article, describing a workshop he had attended. He says,

"This discusses possible benefits and challenges associated with applying complexity science to CAM research...
Complexity theory provides a theoretical framework for evaluating and analyzing complex systems. These systems are “complex,” because they exhibit global properties not made obvious from the properties of the individual components, and they are “systems,” because they are composed of interconnected parts. Historically, complexity theory borrows concepts and tools from a range of disciplines, including chaos theory (physics), control theory (engineering), cybernetics (mathematics), and General Systems Theory (biology). More broadly, these disciplines share a common theme of nonlinearity—a concept maintaining that the size of an output is not proportional to the size of an input.
Terms such as adaptability, robustness, or health were previously considered qualitative terms and thus were quantitatively intractable. Yet, complexity science has identified analytical methods that can help assess these features... Finally, complexity science offers a conceptual framework that reflects reality better. In the real world, small inputs can have large effects, processes are dynamic, interactive effects can span across many temporal and spatial scales, and transformations from one state to another can happen gradually or precipitously...

There is a lot here. As I discussed previously in my "argument" with Dr. Longhurst over whether I was actually giving continuous stimulation with manual acupuncture, clinical outcomes attest that I get results without continuous stimulation. This requires that one sees acupuncture as setting a cascade in motion of self healing or self regulation in response to the tiny injury incurred, rather than a nerve stimulation directly to the spinal canal, brain that needs continuous input.
He also echoes one of my favorite ways of describing acupuncture's effect on the body, that it makes it sturdier, more robust, more resilient (spoke about it in this interview.) As he says "these were qualitative terms and thus were quantitatively intractable." The search for biomarkers of health, or healthy response can be seen in the testing for telomere length, HRV, galvanic skin response, or electrical impedance at acupoints. My own interest is in HRV as a measure of health and stress level or ability to respond. I will discuss this more in the next post using Dr. Ahn's article
More on the practice here.