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BackgroundThe habitual "any other comments" general open question at the end of structured questionnaires has the potential to increase response rates, elaborate responses to closed questions, and allow respondents to identify new issues not captured in the closed questions. However, we believe that many researchers have collected such data and failed to analyse or present it.DiscussionGeneral open questions at the end of structured questionnaires can present a problem because of their uncomfortable status of being strictly neither qualitative nor quantitative data, the consequent lack of clarity around how to analyse and report them, and the time and expertise needed to do so. We suggest that the value of these questions can be optimised if researchers start with a clear understanding of the type of data they wish to generate from such a question, and employ an appropriate strategy when designing the study. The intention can be to generate depth data or 'stories' from purposively defined groups of respondents for qualitative analysis, or to produce quantifiable data, representative of the population sampled, as a 'safety net' to identify issues which might complement the closed questions.SummaryWe encourage researchers to consider developing a more strategic use of general open questions at the end of structured questionnaires. This may optimise the quality of the data and the analysis, reduce dilemmas regarding whether and how to analyse such data, and result in a more ethical approach to making best use of the data which respondents kindly provide.

Summary Objectives:  To update previous systematic reviews of 12‐month prevalence of complementary and alternative medicine (CAM) use by general populations; to explore trends in CAM use by national populations; to develop and apply a brief tool for assessing methodological quality of published CAM‐use prevalence surveys. Design:  Nine databases were searched for published studies from 1998 onwards. Studies prior to 1998 were identified from two previous systematic reviews. A six‐item literature‐based tool was devised to assess robustness and interpretability of CAM‐use estimates. Results:  Fifty‐one reports from 49 surveys conducted in 15 countries met the inclusion criteria. We extracted 32 estimates of 12‐month prevalence of use of any CAM (range 9.8–76%) and 33 estimates of 12‐month prevalence of visits to CAM practitioners (range 1.8–48.7%). Quality of methodological reporting was variable; 30/51 survey reports (59%) met four or more of six quality criteria. Estimates of 12‐month prevalence of any CAM use (excluding prayer) from surveys using consistent measurement methods showed remarkable stability in Australia (49%, 52%, 52%; 1993, 2000, 2004) and USA (36%, 38%; 2002, 2007). Conclusions:  There was evidence of substantial CAM use in the 15 countries surveyed. Where national trends were discernable because of consistent measurement, there was no evidence to suggest a change in 12‐month prevalence of CAM use since the previous systematic reviews were published in 2000. Periodic surveys are important to monitor population‐level CAM use. Use of government‐sponsored health surveys may enhance robustness of population‐based prevalence estimates. Comparisons across countries could be improved by standardising approaches to data collection.

ObjectiveTo develop an empirically based framework of the aspects of randomised controlled trials addressed by qualitative research.DesignSystematic mapping review of qualitative research undertaken with randomised controlled trials and published in peer-reviewed journals.Data sourcesMEDLINE, PreMEDLINE, EMBASE, the Cochrane Library, Health Technology Assessment, PsycINFO, CINAHL, British Nursing Index, Social Sciences Citation Index and ASSIA.Eligibility criteriaArticles reporting qualitative research undertaken with trials published between 2008 and September 2010; health research, reported in English.Results296 articles met the inclusion criteria. Articles focused on 22 aspects of the trial within five broad categories. Some articles focused on more than one aspect of the trial, totalling 356 examples. The qualitative research focused on the intervention being trialled (71%, 254/356); the design, process and conduct of the trial (15%, 54/356); the outcomes of the trial (1%, 5/356); the measures used in the trial (3%, 10/356); and the target condition for the trial (9%, 33/356). A minority of the qualitative research was undertaken at the pretrial stage (28%, 82/296). The value of the qualitative research to the trial itself was not always made explicit within the articles. The potential value included optimising the intervention and trial conduct, facilitating interpretation of the trial findings, helping trialists to be sensitive to the human beings involved in trials, and saving money by steering researchers towards interventions more likely to be effective in future trials.ConclusionsA large amount of qualitative research undertaken with specific trials has been published, addressing a wide range of aspects of trials, with the potential to improve the endeavour of generating evidence of effectiveness of health interventions. Researchers can increase the impact of this work on trials by undertaking more of it at the pretrial stage and being explicit within their articles about the learning for trials and evidence-based practice.

Feasibility studies are increasingly undertaken in preparation for randomised controlled trials in order to explore uncertainties and enable trialists to optimise the intervention or the conduct of the trial. Qualitative research can be used to examine and address key uncertainties prior to a full trial. We present guidance that researchers, research funders and reviewers may wish to consider when assessing or undertaking qualitative research within feasibility studies for randomised controlled trials. The guidance consists of 16 items within five domains: research questions, data collection, analysis, teamwork and reporting. Appropriate and well conducted qualitative research can make an important contribution to feasibility studies for randomised controlled trials. This guidance may help researchers to consider the full range of contributions that qualitative research can make in relation to their particular trial. The guidance may also help researchers and others to reflect on the utility of such qualitative research in practice, so that trial teams can decide when and how best to use these approaches in future studies.

significant. These event rates are per consultation, and they do not give the risk per individual patient.Demographic data suggest that the acupuncturist volunteers were reasonably representative of the members of the two societies, but over-reporting and underreporting are inherently possible in such studies. High individual rates may be due to a low personal threshold for reporting, or they may indicate the need for further training of the acupuncturist. Some avoidable adverse events occurred, and acupuncturists might consider modifying their practice to reduce the incidence of such events.We thank members of the British Medical Acupuncture Society and the Acupuncture Association of Chartered Physiotherapists for collecting data, Mike Fitter and Hugh MacPherson for advice in designing the questionnaire, and Val Hopwood for help in recruiting volunteers.Contributors: EE, SH, and AW planned the study, which was supervised by AW. The data were collected by members of the British Medical Acupuncture Society and the Acupuncture Association of Chartered Physiotherapists. The results were collated by AW, and AH performed the statistical analysis. The final report was written by AW, SH, AH, and EE. AW and EE will act as guarantors.Funding: The posts of AW and EE are funded by the Maurice Laing Foundation.Competing interests: AW has received fees for lecturing at scientific and educational meetings arranged by the British Medical Acupuncture Society and the Acupuncture Association of Chartered Physiotherapists. SH has received fees for lecturing and for acting as editor of the professional journal of the British Medical Acupuncture Society, Acupuncture in Medicine.

Objective: To provide the first valid and reliable estimate of the health status of Gypsies and Travellers in England by using standardised instruments to compare their health with that of a UK resident non-Traveller sample, drawn from different socioeconomic and ethnic groups, matched for age and sex. Design: Epidemiological survey, by structured interview, of quota sample and concurrent age-sex-matched comparators. Setting: The homes or alternative community settings of the participants at five study locations in England. Participants: Gypsies and Travellers of UK or Irish origin (n = 293) and an age-sex-matched comparison sample (n = 260); non-Gypsies or Travellers from rural communities, deprived inner-city White residents and ethnic minority populations. Results: Gypsies and Travellers reported poorer health status for the last year, were significantly more likely to have a long-term illness, health problem or disability, which limits daily activities or work, had more problems with mobility, self-care, usual activities, pain or discomfort and anxiety or depression as assessed using the EuroQol-5D health utility measure, and a higher overall prevalence of reported chest pain, respiratory problems, arthritis, miscarriage and premature death of offspring. No inequality was reported in diabetes, stroke and cancer. Conclusions: Significant health inequalities exist between the Gypsy and Traveller population in England and their non-Gypsy counterparts, even when compared with other socially deprived or excluded groups, and with other ethnic minorities.