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There is a general conception that, herbs are natural therefore, they are completely safe. In fact, herbs or herbal preparations can cause toxic adverse effects, serious allergic reactions and adverse drug /diet interactions. 

  The efficacy of a drug substance is its capacity to produce a   desired therapeutic effect, or the relative ability of a drug receptor complex to produce maximum functional response. Nowadays, in health care systems the term 'clinical effectiveness' or 'clinical governance' is preferred instead of efficacy, though both are having similar meanings. The term clinical effectiveness includes the sum total of the pharmacological and the non medical effects of bioactive compounds that may act synergistically, otherwise termed as placebo effect, or sometimes antagonistically or the nocebo effect. 

  Application of novel trial designs such as Point Of Care clinical trial (POC –CT) ,a newly derived  clinical trial approach developed by Dr.Philip Lavori of Stanford University, compares treatments that doctors are already using, and collects data on which treatments work best within the context of real-world, everyday practice.  

 The emergence of modern standardization tools like proteomics, bioinformatics and various chemical docking studies may improve the identification of the evidence based herbal constituents and products in the future.

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