Response to “A Novel Approach to Evaluate TCM Treatment Outcomes Using Pattern Identification”

Dear Editor:

I enjoyed reading the article on treatment outcomes using pattern identification. ¹ In the literature, there have been several articles attempting to define the symptom clusters associated with hepatitis C virus ² and studies demonstrating that Traditional Chinese Medicine (TCM) has helped decrease symptoms in people with hepatitis C virus. ³ Several problems exist in studying symptom management strategies in this population. The first problem is that severity of liver dysfunction can directly affect the symptoms that one may experience. In other words, depending on degree of liver fibrosis and hepatic inflammation, the symptoms experienced may not only be very different between individuals, but may also have a varying degree of response to relieving measures. Since liver fibrosis and inflammation factors were not captured in this study, this might help explain the lack of improvement that was found in primary symptoms in the treatment arm. The second problem is the presence of comorbidities such as diabetes mellitus, which might also display similar symptom clusters but have different TCM pattern expressions.

One hundred and thirty (130) participants expressed interest in the study; however, only 16 participants consented over a 19-month enrollment period. I am curious as to the reasons that such a large number of people chose not to participate in the study and why the reasons were not included in the article. Information of this type may help guide recruitment efforts for further research in this area.

I applaud the author in pursuing this novel study in hepatitis C using TCM pattern identification as an outcome measure. I look forward to reading further publications on this topic.