Featured Resource - 2008 No. 108

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About Natural Standard

Natural Standard provides high quality, evidence-based information on complementary and alternative therapies that can assist clinicians, patients, and healthcare institutions in making informed therapeutic decisions. Founded by clinicians at Harvard University and the University of California, Natural Standard has grown to an international research collaboration with more than 500 contributors from over 100 eminent academic institutions.

For each therapy covered by Natural Standard, a research team systematically gathers scientific data and opinions. A sophisticated grading system is utilized to evaluate the quality of available evidence, and findings are presented in order of strength of evidence. The information is summarized into several types of full-text reviews that vary in length and reading level, including comprehensive Professional Monographs, concise Bottom Line Monographs (many of which are available in Spanish), Flash-cards and Natural Standard/Harvard Medical School Monographs. 

Links to relevant news items are provided, as well as abundant references, often numbering into the hundreds, with links to the PubMed abstract. 

Natural Standard is impartial and is not supported by any interest group, professional organization, product, or manufacturer. Natural Standard is available to UVM and FAHC affiliates via institutional license through UVM's Dana Medical Library.

How to connect to Natural Standard

• Go to Dana Medical Library's homepage. 
• Click on Databases & E-Books>All Health Sciences Databases>Natural Standard.
• To access Natural Standard from off-campus, you must be a UVM or FAHC faculty, staff, or student. See the Connect from Off-Campus link on the Dana Medical Library homepage for details.
• Unaffiliated patrons may use Natural Standard on site at Dana Medical Library. 

The Natural Standard family of databases

Natural Standard consists of several inter-related databases on various topics relevant to complementary & alternative medicine. Search by keyword across all databases, or browse the alphabetical indexes of the individual databases

The Natural Standard Foods, Herbs, & Supplements database contains over 2000 entries covering the entire spectrum of foods, herbs and supplements. Search All Topics, or limit to Herbs & Supplements, Functional Foods, Vitamins & Minerals, or Brand Names. The content is variously provided in detailed Professional Monographs, concise Bottom Line Monographs, quick Flashcards, and Natural Standard/Harvard Medical School Monographs.

The most comprehensive of these, the Professional Monographs, are evidence-based systematic reviews of scientific literature, peer reviewed by Natural Standard editorial contributors. They provide in-depth coverage of efficacy, adverse effects, interactions, pregnancy/lactation, pharmacology/toxicology, dosing/standardization, and products tested by third-party laboratories. Also included are an evidence table, evidence discussion, statistical analysis, and quality rating of available clinical trials. The Professional Monographs are cross-referenced to other monographs by health condition.

The Professional Monographs for Herbs & Supplements open with the scientific name of the substance, and a list of synonyms and common names. For example, consider this impressive list of synonyms for the supermarket staple, Ginger: 

Next, the section entitled Clinical Bottom Line/Effectiveness provides a brief description of the most clinically relevant findings for that substance. This excerpt from the Aloe vera monograph, for example, states that aloe has been used for centuries to treat wounds, skin infections, and burns, and in addition may have properties that improve wound healing and reduce skin inflammation.

A key Natural Standard feature is the table of Scientific Evidence for Common/Studied Uses, complete with Evidence Grade. A cursory glance at the table for Glucosamine sulfate (below) indicates that there is good scientific evidence for its use in treating knee osteoarthritis, but the evidence of its efficacy in treating other conditions is considerably weaker.

The balance of the Herbs & Supplements Professional Monographs cover topics such as:

• Historic or Theoretic Uses that Lack Scientific Evidence
• Strength of Expert Opinion and Folkloric Precedent
• Safety Summary
• Dosing/Toxicology
• Precautions/Contraindications
• Interactions
• Mechanism of Action
• History
• Evidence Table
• Evidence Discussion
• Products Studied
• Author Information
• References

The Patient Handout page, accessed via the button at the top of the page, provides a link to the more concise Bottom Line Monograph.

The Show Methodology button describes the systematic aggregation, analysis, and review of the literature, including search terms used and databases searched.

Other Natural Standard Databases:

The Natural Standard Health & Wellness database contains information about:

• Therapeutic modalities, ranging from acupressure, Bach flower remedies, and chiropractic manipulation to Reiki, tai chi, and yoga. The reviews address clinical effectiveness, indications, adverse effects, precautions, safety, and history of usage.
• Diets of all types, including the Atkins, corn-free, Jenny Craig, DASH, low cholesterol, pH, South Beach, and Zone diets.
• Fitness-related topics such as abdominal exercises, ergonomics, high-impact dance, pedometer, and target heart rate.
• Beauty issues such as Botox, hair restoration, nail treatments, and tattoos.

The Natural Standard Comparative Effectiveness database provides charts listing specific therapies for various medical conditions, with the therapies ranked by levels of scientific evidence (strong, conflicting, negative, or lack of evidence.) Search the alphabetic list of all medical conditions, or search by medical specialty (e.g., dermatology, endocrinology, hematology, neurology & psychiatry). Links within the charts lead to monographs for the medical condition itself and for the specific therapies.

The Natural Standard Medical Conditions database contains monographs on a wide range of medical conditions. Encyclopedic in nature, they provide a description of the condition, signs & symptoms, diagnosis, risk factors, and standard and integrative therapeutic treatments. Search the list of therapies and their medical/therapeutic uses, sorted according to level of scientific evidence.

The Natural Standard Brand Names database provides the manufacturer and ingredient list for hundreds of brand-name products. Each of the ingredients is linked to Natural Standard monographs and news items.

The Natural Standard Interactive Tools include:

• Interaction checker, for finding allergy information, and food, drug, supplement, and laboratory interactions for a wide range of substances
• symptom checker, which correlates symptoms with associated conditions
• nutrition database, which provides the biochemical components of common foods. For example, did you know that 1 cup of seedless grapes contains over 15 mg of calcium?
• calculators, including asthma zone calculator, blood alcohol content, daily calorie needs, and more
• dictionary of unique CAM terminology
• training programs for integrative therapies, searchable by discipline and/or geographic location
• practitioners, searchable by discipline, last name, and/or geographic location
• continuing education, based on complementary and alternative medicine (CAM) evidence-based informational reviews, many of which are accredited Continuing Education (CE/CME).

For more information:

Natural Standard includes many more features and tools than can be described in this short summary. For help with searching Natural Standard or any of the other electronic resources available through Dana Medical Library, contact a reference librarian for personalized assistance:

• in person, at the reference desk, Mon-Friday 10:00 am -4:00 pm,
• by phone at 802-656-2201
• or send an email to danaref@uvm.edu.