Selection of Ayurvedic Formulations for the Management of Amlapitta (Functional Dyspepsia) Using the RAND/UCLA Appropriateness Method: A Modified RAND/UCLA Consensus Study

Background: Functional dyspepsia is a highly prevalent functional gastrointestinal disorder characterized by heterogeneous symptom presentation; there is limited consensus on the optimal approach for long-term management. Classical Ayurveda describes such a condition as Amlapitta and recommends multiple formulations for management based on the predominant dosha. Lack of standardized, transparent criteria in order to select specific formulations for clinical research is a major lacuna in this context. RAND/UCLA Appropriateness Method provides a structured framework for integrating available evidence with expert clinical judgment in such scenarios. Objective: To identify classical Ayurveda formulations considered appropriate for management of Amlapitta based on dosha specific presentations using a modified RAND/UCLA Appropriateness Method to inform future clinical research. Methods: A structured Modified RAND/UCLA Appropriateness Consensus was conducted. Evidence was synthesized from classical Ayurvedic texts and biomedical literature. A multidisciplinary expert panel of 9 experts independently rated the appropriateness of shortlisted formulations for dosha-based presentations of Amlapitta on a 9-point scale. Ratings were carried out over 2 rounds with discussion intervening between the rounds. Agreement, disagreement, and final appropriateness classifications were arrived at by standard RAND criteria, including median scores, inter-percentile ranges, and disagreement parameters. Results: 6 Ayurvedic formulations were evaluated across 3 dosha specific types of Amlapitta: Vataja, Kaphaja and Vatakaphaja. After 2 rounds of consensus, 3 combinations were classified as appropriate, 7 as uncertain while none as inappropriate. Kamadugha Rasa, Leelavilasa Rasa and Shankha Vati were rated appropriate for Vataja, Kaphaja and Vatakaphaja Amlapitta respectively, each signifying strong agreement among panelists (DI <1). Conclusion: RAND/UCLA Appropriateness Method application in the selection of formulations for Amlapitta in the current study signifies how structured expert judgement can bridge classical Ayurvedic knowledge and contemporary research standards. Implications of this approach can strengthen methodological rigor, improve standardization, and enhance the credibility of future Ayurvedic clinical trials.