Latin binomial name, family name, common name o Proprietary name (brand name) or extract name, manufacturer Whether the product is authorized and its characteristics Part of the plant used Type of product used (raw, extract) Type and concentration of extraction solvent used (herbal drug: extract ratio) Method of authentication of raw material Lot number Voucher specimen o Placebo : it may be difficult to develop a placebo for a herbal product due to things such as distinct smells and tastes or lack of blinding may influence response rate o Meta-analyses with herbal products: often results from when very different formulations are combined in a meta-analysis. For example, they may be different species, extracts o How to select a herbal product for treatment: Choose a product that is the same as (or closely resembles) the product found to be effective in clinical trials Ideal = some name brand
Otherwise choose = same species, same part of the plant, same preparation, same standardization Must be approved by Health Canada Must have NPN, DIM-HM, EN (exemption number) Product finding can be assisted by Licenced Natural Health Product Database Natural medicines o It is a review committee that provides monographs of CAMs and it is updated every 18 months o Committee consists of multiple different types of health care professionals o Scoring system: Natural Medicines Brand Evidence-based Rating (NMBER ) From 1-10 Ratings based on scientific evidence Ratings based on safety, effectiveness, and product quality o Effectiveness rating: Effective : Product very high level of reliable clinical evidence that supports use for specific indication To achieve this rating all of the following is required: o Evidence must be able to pass FDA, health Canada, or other approval processes o Level of evidence = A 2+ RCTs or meta-analysis with several hundred to several thousand patients o Quality rating = A studies have a low risk of bias and a high level of validity by meeting stringent assessment criteria o Evidence shows POSITIVE outcomes consistently w/o any valid contrary evidence Likely effective: Product very high level of reliable clinical evidence supporting its use for a specific indication To achieve this rating all of the following is required: o Level of evidence = A 2+ RCTs or meta-analysis with several hundred patients o Quality rating = A studies have a low risk of bias and a high level of validity by meeting stringent assessment criteria o Evidence shows POSITIVE outcomes consistently w/o significant valid contrary evidence Possibly effective:
Product some clinical evidence supporting its use for a specific indication but evidence is limited by quantity, quality, or contradictory findings To achieve this rating all of the following is required: o Level of evidence = A or B 1+ RCT of meta-analysis or level of evidence = B 2 population based or epidemiological studies o Quality rating = A or B low to moderate risk of bias and
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