Although we believed a review has a greater chance of considering the characteristics of TCM if at least one author works in TCM department, university or hospital, or it stated that it had got suggestion from TCM practitioners, it is quite possible that some reviewers had consulted TCM experts while designing and doing the review, but did not report it in articles. As cases of this kind could not be ruled out, we therefore might have underestimated the proportion of reviews getting support from TCM practitioners. In addition, we restricted our search to Cochrane reviews because they are generally less prone to bias than systematic reviews published in paper-based journals [9, 75, 76] . However, this might cause the results of this study to be only applicable to review articles in the Cochrane database. Further evaluation is needed in order to know whether the systematic reviews of CHM published in English paper-based journals even in the leading journals have the same problem.