'Asking the Right Question'. A Comparison of Two Approaches to Gathering Data on 'Herbals' Use in Survey Based Studies

James S. McLay, Abdul R. Pallivalappila, Ashalatha Shetty, Binita Pande, Moza Al Hail, Derek Stewart

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)
8 Downloads (Pure)



Over the last decade academic interest in the prevalence and nature of herbal medicines use by pregnant women has increased significantly. Such data are usually collected by means of an administered questionnaire survey, however a key methodological limitation using this approach is the need to clearly define the scope of ‘herbals’ to be investigated. The majority of published studies in this area neither define ‘herbals’ nor provide a detailed checklist naming specific ‘herbals’ and CAM modalities, which limits inter-study comparison, generalisability and the potential for meta-analyses. The aim of this study was to compare the self-reported use of herbs, herbal medicines and herbal products using two different approaches implemented in succession.


Cross-sectional questionnaire surveys of women attending for their mid-trimester scan or attending the postnatal unit following live birth at the Royal Aberdeen Maternity Hospital, North-East Scotland. The questionnaire utilised two approaches to collect data on ‘herbals’ use, a single closed yes/no answer to the question “have you used herbs, herbal medicines and herbal products in the last three months”; and a request to tick which of a list of 40 ‘herbals’ they had used in the same time period.


A total of 889 responses were obtained of which 4.3% (38) answered ‘yes’ to herbal use via the closed question. However, using the checklist 39% (350) of respondents reported the use of one or more specific ‘herbals’ (p<0.0001). The 312 respondents who reported ‘no’ to ‘herbals’ use via the closed question but “yes” via the checklist consumed a total of 20 different ‘herbals’ (median 1, interquartile range 1–2, range 1–6).


This study demonstrates that the use of a single closed question asking about the use of ‘herbals’, as frequently reported in published studies, may not yield valid data resulting in a gross underestimation of actual use.

Original languageEnglish
Article numbere0150140
Pages (from-to)1-9
Number of pages9
JournalPloS ONE
Issue number2
Publication statusPublished - 25 Feb 2016

Bibliographical note

Funding: This work was funded from internal institutional resource. Prof James McLay is employed by the University of Aberdeen, Prof Derek Stewart is employed by the Robert Gordon University, Drs A.R. Pallivalappila and M. AL Hail are employed by the Hamad Medical Corporation and Drs A. Shetty and B. Pande are employed by NHS Scotland. None of the institutional funders had a role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.


Dive into the research topics of ''Asking the Right Question'. A Comparison of Two Approaches to Gathering Data on 'Herbals' Use in Survey Based Studies'. Together they form a unique fingerprint.

Cite this