Evidence-based medicine: group rates efficacy of herbs.

SAN DIEGO -- A group based at Massachusetts General Hospital has begun to rate efficacy of herbal medicines according to the published evidence, the way that conventional clinical guidelines now grade the strength of the evidence behind their recommendations.

"Our mission is to form a clearinghouse, central repository, or encyclopedia for these kind of data." said Catherine Ulbricht, Pharm.D., a pharmacist at the hospital and a chief editor of the Natural Standard Research Collaboration in Cambridge, Mass. Like their mentors at the Cochrane Collaboration, the group provides reviews of the data, but on different herbal medicines and alternative practices.

Currently, there is no other place to find such rigorously researched, quality evidence-based information, particularly on post-market surveillance, including safety and drug-herb interactions. Dr. Ulbricht said at a meeting on alternative medicine sponsored by the American Hospital Association.

"We weren't educated about these things at school, and I like to think of myself as a pretty young clinician," Dr. Ulbricht said.

The German Commission E report, which many in the naturopathic community often cite as an authority on herbs, contains information on specific herbs and what they are used for, but it has no detailed safety information and contains no systemic analysis of the data or comparative efficacy, she said.

The collaboration uses about 400 researchers and clinicians, and even has 45 translators, so that non-English publications can be incorporated.

At the meeting, Dr. Ulbricht discussed the evidence and safety for the 10 most popular herbs, with the grade that the Natural Standard analysis had given that herb for each condition: