Article Text

Original research
Cross-sectional survey and Bayesian network model analysis of traditional Chinese medicine in Austria: investigating public awareness, usage determinants and perception of scientific support
  1. Michael Eigenschink1,
  2. Luise Bellach1,
  3. Sebastian Leonard2,
  4. Tom Eric Dablander1,
  5. Julian Maier1,
  6. Fabian Dablander3,
  7. Harald H Sitte1
  1. 1 Center for Physiology and Pharmacology, Institute of Pharmacology, Medical University of Vienna, Wien, Austria
  2. 2 Institute of Microbiology and Infection, University of Birmingham School of Dentistry, Birmingham, UK
  3. 3 Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Dr Harald H Sitte; harald.sitte{at}


Objectives Despite the paucity of evidence verifying its efficacy and safety, traditional Chinese medicine (TCM) is expanding in popularity and political support. Decisions to include TCM diagnoses in the International Classification of Diseases 11th Revision and campaigns to integrate TCM into national healthcare systems have occurred while public perception and usage of TCM, especially in Europe, remains undetermined. Accordingly, this study investigates TCM’s popularity, usage and perceived scientific support, as well as its relationship to homeopathy and vaccinations.

Design/Setting We performed a cross-sectional survey of the Austrian population. Participants were either recruited on the street (in-person) or online (web-link) via a popular Austrian newspaper.

Participants 1382 individuals completed our survey. The sample was poststratified according to data derived from Austria’s Federal Statistical Office.

Outcome measures Associations between sociodemographic factors, opinion towards TCM and usage of complementary medicine (CAM) were investigated using a Bayesian graphical model.

Results Within our poststratified sample, TCM was broadly known (89.9% of women, 90.6% of men), with 58.9% of women and 39.5% of men using TCM between 2016 and 2019. Moreover, 66.4% of women and 49.7% of men agreed with TCM being supported by science. We found a positive relationship between perceived scientific support for TCM and trust in TCM-certified medical doctors (ρ=0.59, 95% CI 0.46 to 0.73). Moreover, perceived scientific support for TCM was negatively correlated with proclivity to get vaccinated (ρ=−0.26, 95% CI −0.43 to –0.08). Additionally, our network model yielded associations between TCM-related, homeopathy-related and vaccination-related variables.

Conclusions TCM is widely known within the Austrian general population and used by a substantial proportion. However, a disparity exists between the commonly held public perception that TCM is scientific and findings from evidence-based studies. Emphasis should be placed on supporting the distribution of unbiased, science-driven information.

  • complementary medicine
  • public health
  • health policy
  • quality in health care
  • health & safety
  • herbal medicine

Data availability statement

Data are available in a public, open access repository. The datasets used and/or analysed during the current study are readily available from our GitHub repository: DOI: 10.5281/zenodo.7313185.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data are available in a public, open access repository. The datasets used and/or analysed during the current study are readily available from our GitHub repository: DOI: 10.5281/zenodo.7313185.

View Full Text

Supplementary materials


  • Twitter @Meigenschink, @LBellach

  • Contributors Guarantor: ME; conceptualisation: ME, LB, TED, JM, HHS; methodology: ME and TED; survey: ME, LB, TED, JM, HHS; data analysis: FD and ME; data curation: FD and ME; writing—original draft preparation: ME, LB, FD and SL; writing—review and editing: JM, SL, FD and HHS; project supervision: HHS. All authors have read and agreed to the submitted version of the manuscript.

  • Funding The study was funded by the Medical University of Vienna.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.