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Logo of jmlaJournal informationSubscribeSubmissions on the Publisher web siteCurrent issue of JMLA in PMCAlso see BMLA journal in PMC
J Med Libr Assoc. Oct 2005; 93(4): 507–509.
PMCID: PMC1250333

Natural Standard

Reviewed by Nandita Mani, MLIS, Information Services Librarian

Natural Standard.
1 Broadway, 14th Floor, Cambridge, MA 02142. 617.758.4270; fax, 617.758.4274. moc.dradnatslarutan@ofni. http://www.naturalstandard.com; annual subscription $99.00 Web, $60.00 PDA; contact for institutional pricing; free trial available; PDA version including Handheldmed Reader requires 9MB.

The Natural Standard research collaboration, with a multidisciplinary editorial board, provides “access to alternative and complementary medicine information that is both peer-reviewed and evidence-based in nature” [1]. The Natural Standard collection of systematic reviews of alternative and complementary medicine is primarily geared toward clinicians who intend to provide information to help make informed therapeutic decisions. Natural Standard is available in both Web and personal digital assistant (PDA), for Palm and PocketPC, formats.

When examining the content of the Natural Standard collection, it is important to note that several types of monographs are available depending on the level of information an individual requires. Professional Monographs are comprehensive, peer-reviewed, evidence-based systematic reviews for health care professionals. Bottom Line Herb-Supplement and Modality Monographs, brief evidence-based reviews derived from the Professional Monographs, are appropriate for both patients and professionals. Bottom Line Herb-Supplement Monographs include information on effectiveness, side effects, interactions, dosing, pregnancy, and breastfeeding. Bottom Line Modality Monographs provide information relating to historic background, practitioner accreditation, and safety. Natural Standard/ Harvard Medical School Monographs are abbreviated reviews for patients or professionals focusing on evidence-based information about safety, harm, interactions, and dosing. All research is graded for evidence on a five-point scale (Figure 1). The primary difference between the types of monographs lies in the overall depth and type of information presented for specific audiences.

Figure 1
Natural Standard's grading system

When reviewing the various monographs available in Natural Standard, it appears that the information provided is clear, concise, and presented using a specific set of guidelines depending on the type of monograph. The scope of coverage seems to be quite generous. Natural Standard covers a great deal of information pertaining to complementary and alternative medicine. Search strategies are conducted in print resources in addition to the usual online databases (e.g., PubMed, CINAHL, the Cochrane Library, and EMBASE). Useful images of various herbs and supplements are included in both the Bottom Line Modality and Professional Monographs. The quality of the information can be verified using the descriptions of the selection criteria, data analyses, reviews, and update process. This information provides detailed knowledge of the methodology used to obtain, synthesize, and summarize information disseminated via Natural Standard.

The Patient Information Database, with links to the Bottom Line Modality Monographs, is the Natural Standard component that is primarily geared toward patients and consumers. Natural Standard/ Harvard Medical School Monographs are also included on selected topics. The Patient Information Database provides a wide variety of information on herbs and conditions, including background, scientific evidence (including the grading system mentioned above), traditional and theoretical usage, dosing, safety, interactions, and a bibliography. The patient information can be printed as a formatted text file. Patients and consumers can review the methodology used to conduct, analyze, and review the literature used to create the associated information in Natural Standard. Patient information files have been produced in an effective manner by focusing primarily on the type of information a patient would seek. Terminology has been geared toward the lay person without removing critical content, and the patient information files are easy to search using the sidebar menu for navigation. Standard disclaimers and date of last update are also provided on each patient information file. The Patient Information Database is a useful, thorough, and integral component of the Natural Standard Database.

Natural Standard also provides bibliographies on various topics with links to the National Library of Medicine's PubMed database. A “News” section provides conference information; Natural Standard–produced summaries of conference proceedings; and announcements of scientific publications, safety concerns, and product recalls. Accredited continuing medical education courses in complementary and alternative medicine are available and are based on evidence-based informational reviews. One can choose from several continuing education modules, and additional modules from multiple health care disciplines are being created. Natural Standard also provides customized research reports, clinical reviews, and clinical trial design protocols for an extra charge. Print reference books of evidence-based systematic reviews of herbs and supplements are also available.

The Natural Standard Website provides five databases: Herbs & Supplements, Condition Center, Alternative Modalities, Dictionary, and Patient Information. All databases can be searched individually or using the main search box, which spans the content of all five databases. The A–Z browsing list for each database helps make this Website user friendly.

It is important to note that the PDA version of Natural Standard, sold by Handheldmed, only includes the Bottom Line Herb-Supplement Monographs. A link to the PDA version is hidden on the Products page of the Natural Standard Website. The Handheldmed EZ Reader is required to use Natural Standard on a Palm or PocketPC PDA and is included in the purchase price. A seven-day trial version of Natural Standard is available for download on the Handheldmed Website.

Overall, information in both the Web and PDA formats is easily accessible. The information provided in Natural Standard is well written and therefore easy to comprehend for clinicians and other health care providers. The PDA version is easy to access (Figure 2), and drop-down menus are provided to allow users to quickly navigate to information they are interested in (Figure 3).

Figure 2
Personal digital assistant (PDA) version of Natural Standard
Figure 3
Drop-down menus in Natural Standard's PDA version

Some areas for improvement lie in developing an option to provide content in portable document format (PDF), providing an “email document” feature, providing links from the content in the main databases (Herbs & Supplements, Condition Center, Alternative Modalities) to the Natural Standard dictionary, producing and making content available in multiple languages, and developing a separate image database for herbs and associated conditions. Having a clear link to the PDA version on the Natural Standard home page would also be ideal to avoid confusion when searching for this particular component.

Natural Standard is a useful product relating to the field of complementary and alternative medicine and would be a valuable resource for clinical and academic libraries.


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