Nutritional and dietary supplements are often termed nutraceuticals as an amalgamation of the terms nutritional and pharmaceutical. Nutraceuticals still fall into a grey area from a regulatory point of view, yet in recent times have grown into a billion-dollar industry. These products have come a long way since entering companion animal medicine in the early 1990s. The enormous public interest in the relationship between diet supplements and OA often takes center stage when discussing OA and potential therapeutic plans with clients. Unfortunately, speculative information on nutritionally based therapies to treat OA has permeated every form of media. The paucity of well-designed scientific studies exploring these treatments leaves clinicians at a distinct disadvantage when discussing possible therapies with clients and colleagues alike. This discussion will focus on the use of evidence-based medicine (EBM) when evaluating nutraceuticals. Evidence is defined as "the data on which a judgment or conclusion may be based, or by which proof or probability may be established." The pragmatic use of EBM involves the integration of the best research evidence, clinical expertise and client/patient considerations. There are many ways by which to analyze and integrate evidence into the practice of veterinary medicine, and several schemes by which to rank the strength of evidence. This presentation will be based upon the Food and Drug Administration's (FDA) evidence-based ranking system for scientific data adapted and utilized for study rating and ranking.2" 4Additionally we will include data which is based upon a modification of this system. Briefly, three separate ratings are used for study evaluation: 1) a rating for study design, 2) a rating for study quality, and 3) a group agent rating for the strength of the entire body of evidence. A final rank of the scientific evidence is decided based upon the classifications from the three rating systems. This system does not use the terms rate and rank interchangeably. These notes will use data directly from two previous publications. Certainly everyone can use different criteria to assemble their data, and this is only one example of methodology and subsequent outcome. This presentation should be not considereda complete resource for all the data available to evaluate nutraceuticals. but instead an example of how to evaluate some of the products currently available.
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