Evidence Mapping in Ayurvedic Clinical Trials

Abstract

Evidence mapping sits between the comprehensive narrative review and the synthesis-focused systematic review in the hierarchy of evidence-synthesis methods. It charts the distribution of clinical trial activity across conditions, interventions, geography, and methodological quality, and its main purpose is to identify where evidence exists, where it is thin, and where systematic review and meta-analysis are actually feasible. Applied to Ayurvedic clinical research, this kind of mapping has been overdue for at least a decade, because the field's perceived lack of evidence and its real lack of synthesisable evidence are genuinely different problems with different solutions. We catalogued 412 Ayurvedic clinical trials published or registered between January 2005 and December 2021, indexed from PubMed, the AYUSH Research Portal, ClinicalTrials.gov, the EU Clinical Trials Register, and the Cochrane Central Register of Controlled Trials. Trials were classified under five mapping frames: F1 (chronic disease management), F2 (acute conditions), F3 (wellness and preventive indications), F4 (Panchakarma procedures), and F5 (integrated multimodal protocols). Each frame was scored with the Ayurvedic Evidence Map Index (AEM), a weighted composite across trial volume, methodological quality, condition breadth, geographic diversity, and synthesis readiness. Chronic disease management (F1) had the largest trial volume and best synthesis readiness (AEM 0.858). Integrated multimodal protocols (F5) scored second (0.802), carried by recent methodological maturation. Acute conditions (F2) scored lowest (0.604), which is not a problem with Ayurveda per se but reflects that clinical practice in Ayurveda has historically concentrated on chronic presentations.