title: 'Asking the Right Question'. A Comparison of Two Approaches to Gathering Data on 'Herbals' Use in Survey Based Studies.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: The Division of Applied Health Sciences, The University of Aberdeen, Aberdeen, United Kingdom, AB25 2ZD.
authors.forename: James S
authors.initials: JS
authors.lastname: McLay
authors.affiliation: Pharmacy Department, Women's Hospital-HMC, Doha, Qatar.
authors.forename: Abdul R
authors.initials: AR
authors.lastname: Pallivalappila
authors.affiliation: The Department of Obstetrics and Gynaecology, The University of Aberdeen, Aberdeen, United Kingdom, AB25 2ZD.
authors.forename: Ashalatha
authors.initials: A
authors.lastname: Shetty
authors.affiliation: The Department of Obstetrics and Gynaecology, Ninewells Hospital and Medical School, NHS Tayside, Dundee, United Kingdom, DD1 9SY.
authors.forename: Binita
authors.initials: B
authors.lastname: Pande
authors.affiliation: Hamad Medical Corporation, Post Box - 3050, Doha, Qatar.
authors.forename: Moza
authors.initials: M
authors.lastname: Al Hail
authors.affiliation: School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, United Kingdom, AB10 7GJ.
authors.forename: Derek
authors.initials: D
authors.lastname: Stewart
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D029001:Herbal Medicine / Q000379:methods; D006771:Hospitals, Maternity; D006801:Humans; D008517:Phytotherapy / Q000706:statistics & numerical data*; D010946:Plants, Medicinal; D011247:Pregnancy; D012606:Scotland; D011795:Surveys and Questionnaires; D055815:Young Adult