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Evidence-Based Complementary and Alternative Medicine
Volume 2013, Article ID 163412, 7 pages
Review Article

Best Available Evidence in Cochrane Reviews on Herbal Medicine?

1Pain Relief Unit, Department of Anesthesia, Hadassah Hebrew University Hospital, Jerusalem, Israel
2Institut für Rechtsmedizin, Universität Freiburg, Albertstrasse 9, 79104 Freiburg, Germany
3School of Health and Sport Sciences, Cluster for Health Improvement, University of the Sunshine Coast, Maroochydore DC, QLD 4558, Australia

Received 3 December 2012; Revised 19 February 2013; Accepted 23 April 2013

Academic Editor: Alexandra Deters

Copyright © 2013 Elyad Davidson et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Cochrane reviews are considered by many to be the “gold standard” or the final word in medical conversation on a topic. We explored the eleven most relevant Cochrane reviews on herbal medicine and identified that frequently herbal medicines in the included studies had not been sufficiently well characterised. If data on the effects of the plant parts are unavailable, effects of co-active ingredients need to be considered and the plausibility of the study medications for the specific indications discussed. Effect sizes calculated from exploratory studies would be best used to determine the sample sizes required for future confirmatory studies, rather than as definitive reports of intervention effects. Reviews should be comprehensive, including discussion of putative adverse events and possible drug interactions. We suggest that the guidelines for preparing Cochrane reviews be revised and offer assistance in this task.