I was invited to comment on a #preprint
A Consensus driven statement for #Ayurvedic Nomenclature of Various #liver diseases (Yakrit roga) by Panda et al.
@CCRAS_MoAYUSH @moayush @AIIA_NDelhi
Please allow me to invite U to share my agony
#MedTwitter #livertwitter
1/

"A consensus statement is a comprehensive analysis by a panel of experts (i.e., consensus panel) of a scientific or medical issue"
What is issue here? - an #ayurveda group wants to give new names to liver diseases. They are not happy with 3000 yr old names. More on that below
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Why unhappy? It is becoz, currently, in Ayurveda, there is only one name for all liver diseases - Yakrddalyudara
Eg 1:
Male wit heavy drinking, new onset jaundice, ascites - Hepatology: its alcohol-related hepatitis with acute on chronic liver failure
Ayurveda: Yakrddalyudara
3/

Eg 2:
Middle aged woman, severe itching, skin color changes, severe fatigue,high cholesterol
Hepatology: Suspected primary biliary cholangitis
Ayurveda: Yakrddalyudara

Eg 3:
Cirrhosis with acute kidney injury
Hepatology: Possible hepatorenal syndrome
Ayurveda: Yakrddalyudara
4/

It is distressing & new nomenclature was essential.
So the consensus met and we have the following:

5 experts in #Ayurvedic #Hepatology discussed HEAVILY on the topic, which is quite evident as shown in the single line discussion in the paper.

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So afterwards, once they were all tired of the heavy discussion section, the results of the discussion was then compiled. Oh sorry about that - the discussion AND the results are actually in one single line. It is the same as above.
We have a conclusion now actually.
6/

The best part of it all? The WHOLE consensus is in ABSTRACT form ONLY. Yes. A whole consensus in abstract form. Sorry, I had to say it again. Here is the snapshot.

I have few genuine concerns about this consensus. They are as follows:

7/

1. This is not a consensus
2. I dont know what this is
3. 'Experts' should learn how consensus is made. There R set rules, regulations, protocols. Eg:
https://pubmed.ncbi.nlm.nih.gov/31328583/ 
https://pubmed.ncbi.nlm.nih.gov/31328583/ 
4. Dont use 'expert' in #pseudoscience consensus. It means - worst of the lot

8/

5. There are 15 references at the bottom of the abstract. You don't give references for an abstract. Rule number 1.
If U do, then quote them in text too

6. Reference number 8 is actually on #homeopathy. But consensus is on #ayurveda and #liver. My head is pounding. Im dizzy.

9/

As per new consensus, liver disease in Ayurveda may now be called Santarpana janya/Apatarpana janya. Again Yakritvridhi/Yakrit Kshyaya can be further classified as dosaja, amaja, krmija, visaja etc

7. We R back 2 square one, bcoz there is no consensus still "etc."

10/

8. I would like 2 rename,provide consensus on a new term that the authors hav used towards the end of their conclusions
See that term, "Ayurveda-Hepatology"?
I would like to propose a term for that, pending further consensus meeting

Toxicology

Advise: include real experts
11/11

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